“Pandora’s box has opened, we have a lot of information at the ministry, people are writing to us, and all of this will have to be reviewed,” said the Minister of Health in response to the information that the surgeon from UKC Ljubljana charged the hospital an additional fee.
Minister of Health Daniel Bešič Loredan responded to the events at UKC Ljubljana, where a self-pay operation was performed for a foreign woman who, in addition to paying for the operation, also had to pay a fee to surgeon Roman Bošnjak. The patient from North Macedonia was treated as part of self-pay services. She paid the final treatment bill, which amounted to 34,000 euros. At the same time, according to POP TV, she made a transfer to the surgeon Bošnjak’s account in Hong Kong also a private fee of 6,000 euros.
After the revelation, Bošnjak submitted his resignation as head of the department of neurosurgery at UKC Ljubljana, but remains employed there. In the hospital, however, they have adopted a rulebook which requires that for each self-paying procedure, in the case of an operative procedure in the clinical center, an expert opinion must also be performed and charged for at UKC Ljubljana, regardless of whether the patient may have been previously treated elsewhere.
At the same time, UKC handed over the documentation to the National Investigation Office and the Ministry of Health.
Minister: We need to get to the bottom of this
“It is an inadmissible act, we have obviously opened a Pandora’s box of potentially extremely serious corruption risks and acts. I hope that the competent institutions done your work,” said the Minister of Health at a press conference. He added that the Office for Control, Quality and investments v zdravstva sent a letter to UKC Ljubljana on March 9, in which he asked them to forward the invoice, operating minutes and other documentation in connection with the operation. To date, they have not sent the documentation. “I believe that the hospital management will deliver this as soon as possible,said the minister.
When they get all the data from UKC Ljubljana and can reliably assess the situation, according to the minister’s predictions, they will check to what extent the neurosurgeon abused his powers and to what extent it is a potential systemic problem and whether this modus operandi is carried out in other institutions.
“My commitment has always been that if there are such high corruption risks, and today we see that there are, it needs to get to the bottom.” If they judge that it is not an isolated case, but something systemic, they will introduce extraordinary administrative control at UKC Ljubljana. But before that, according to the minister, together with the management, they must make a detailed analysis of whether it is a case of one doctor or several doctors who performed self-paying surgeries using the same methodology. We have opened Pandora’s box and now the key is to reset the system, he said.
What was unacceptable?
In Odmevi, the minister gave some additional explanations about what, in his opinion, is inadmissible in the case of Bosniaks. If a doctor, a civil servant working in a public health institution, performs an operation on a self-pay basis, it must be clear from the first to the last contact with the patient what was done, the bill must be issued by the public health institution, and the doctor must be paid for the work. If the patient comes to this doctor earlier, and under the assumption that the doctor has the appropriate permits, everything must be written down, an official invoice issued in Slovenia and tax paid, he stated. “The patient must be familiar with the entire procedure from A to Z, even when it comes to self-pay,” he emphasized.
More in the video of the minister’s performance in Odmevi.
They will prepare instructions for billing self-pay services
He announced that the Ministry of Health will prepare uniform instructions on how self-pay services in healthcare should be provided. “I would like to have clear instructions for the provision of self-paying services in public health institutions at all levels by the new year at the latest. Also with regard to what the price is, how much should be left to the institution, how the funds are distributed among the staff and when inspections and expert opinions are carried out before operations,” he said.
He also touched on the amount of the fee that Bosniak charged for the professional opinion: “Those of us in healthcare know that we can charge 1,000 or 1,500 euros for an expert opinion, which is written extensively and we spend several weeks on it, and we also pay taxes on that.” He also emphasized that doctors who are employed by a public institution cannot issue a bill for the service themselves, “that’s why we have an accounting department“.
People write with similar claims about different doctors
Minister Bešič Loredan also explained that the ministry is now receiving letters referring to various doctors from various public institutions. “People obviously now have faith that we will get to the bottom of things. But everything must be checked,” he added, continuing that it would be necessary to determine whether it was “someone a modus operandi that has been running for years. Then we have a problem in Slovenian healthcare that will have to be dealt with appropriately.”
The UKC’s audit report allegedly revealed several irregularities in public procurement
According to the minister, the audit of the transactions of the University Clinical Center Ljubljana with suppliers for the last four years, carried out by Ernst & Young, revealed several critical points. Dthe document is otherwise a trade secret and he received it personally. For now, he only said that Ernst & Young has scrutinized supplier selection processes, their adequacy and the appropriateness of the payment model, and the definition of risks in cooperation with suppliers. “Several critical inconsistencies are revealed, which have significant consequences for the institution’s reputation.”
Bešič Loredan warned against the awarding of contracts without public procurement, or the splitting of contracts, and the awarding of public contracts after the statutory deadline. “Consistent non-compliance with the institute’s guidelines and non-addressing of recurring issues, such as missing tender opening records, missing purchase orders and preferential treatment of suppliers in payments, are noted.” he stated. He added that one of the key messages of the audit report is that the regulations in the field of the Public Procurement Act are very often not respected.
Under the second point, he pointed out that the report found a gap between risks and control. “In the supplier structures of management and control, there is a possibility that UKC Ljubljana employees are present, and above all, there is an exceptional lack of analytical data.” he explained.
According to the minister, the document of the audit report is being studied by the competent institutions, including the KPK, and the Ministry of Health, together with the management of the UKC, will explain more about the findings on Wednesday. One part of the report is likely to remain confidential, he said.
How much funding does the Ministry of Health allocate to consultants?
Bešič Loredan also responded to accusations that the Ministry of Health concluded contracts with consultants whose total value exceeds one million euros. Bešič Loredan explained that from June 1, 2022 until today, the ministry has paid 170,000 euros to consultants, which also includes taxes and contributions. The Ministry of Health additionally explained to us that one million euros is planned for the contracts concluded so far, but these contracts will not necessarily be realized, so the actual payment may be lower.
Minister Bešič Loredan added that the ministry checked how it was with the payments to consultants during the time of the previous ministers. Previous Minister of Health Janez Poklukar according to Bešič Loredan, concluded 172 contracts worth 1,261,000 euros in a good year. Tomaž Gantar is said to have concluded 157 different contracts worth 1,464,000 euros in ten months, both ministers otherwise worked in the government of Janez Janša during the epidemic of the new coronavirus. Aleš Šabederwho was the Minister of Health in the government of Marjan Šarc, concluded 172 contracts worth 1,150,000 euros between 2019 and 2020. Just Fakin concluded 174 contracts worth 980,000 euros in six months, stated Bešič Loredan.