Supreme Audit Office of the Slovak Republic

There are serious concerns stemming from insufficient number of general practitioners and their high average age in Slovakia. Has the Residential Programme improved the situation? (December 2020)

Summary

• Number of general practitioners for adults (hereinafter “GPs”) per 100 thousands inhabitants in Slovakia is significantly below the EU average. Insufficient number of GPs is a long-lasting problem, which remains unsolved despite a slight increase of the indicator recorded in 2019.   
• Number of general pediatricians per 100 thousands inhabitants in Slovakia is slightly above the EU average. However, while the EU average has been rising during recent years, the indicator for Slovakia has been falling steadily.
• The average age of GPs in Slovakia was 54.1 in 2019. General pediatricians are even older and their average age reached 61.7. The only available source of such indicators is the National Health Information Centre and there are some concerns about validity of data provided by this institution.
• There was a new tool launched in 2014 – named “Residential Programme” (hereinafter “RP”) - aimed at solving the problems with small number and high age of general physicians. The programme was designed as a set of measures that should increase motivation of young medicine doctors to specialize as GP or general pediatrician. As to end of 2019, the total costs of the RP was 22.2 mil. eur; the total number of residents taking part in the programme was 435 and the total number of graduates of the two concerned general specializations was 162.
• The RP generated 135 new young GPs until 2019 which changed the long-lasting downward trend of the total number of GPs into a slight increase last year.
• The RP generated 27 new young general pediatricians until 2019, which stopped the long-lasting downward trend of their total number. However, the impact of the programme in this specialization is small and it hasn’t caused any improvements in the demography of the general pediatricians yet.
• Despite breaking the downward trend of the numbers of GPs and general pediatricians, there hasn’t been sufficient improvement yet, which was the main goal of the RP. Therefore the Supreme Audit Office (hereinafter “SAO”) doesn’t agree with resent decision of the Ministry of Healthcare to include also other specializations into the RP.
• Based on these findings the SAO is planning to audit the RP in 2021. The audit will be focused on the main parameters of the RP as well as finances and contracts within the RP.

The full text of the analysis about this issue in Slovak language is available here.