7 December 2022
The Ombudsman Diana Kovacheva sent a recommendation to Dr. Asen Medzhidiev, caretaker Minister of Health, Prof. Petko Salchev, governor of the National Health Insurance Fund (NHIF) and Dr. Ivan Madzharov, chairperson of the Bulgarian Medical Association insisting to guarantee the right to timely access to medical treatment for patients with rheumatological and autoimmune diseases.
The recommendation comes as a response to a letter from the Association of Patients with Autoimmune Diseases (APAD) and the Organisation of Patients with Rheumatological Diseases in Bulgaria (OPRDB) seeking prof. Kovacheva’s assistance to establish a constructive dialogue with the healthcare institutions as regards the “systemic discrimination of patients with rheumatological diseases”.
The Ombudsman underscored that the patients with those diseases had warned of difficulties with securing medical products prescribed by protocol and paid by the NHIF and had pointed out the need to ease the procedure. She further noted that their proposals had been neglected by the institutions they had addressed and their request for a meeting had not been honoured.
“They find the attitude towards them, in particular by the NHIF “callous, administrative, and discriminatory”. In relation to this they seek the Ombudsman’s assistance for establishing a constructive dialogue”, prof. Diana Kovacheva explained.
She points out that APAD and OPRDB describe in detail the problems that patients with rheumatological diseases encounter in relation to their treatment, such as having to wait for more than eight months after being diagnosed to receive the required therapy.
Prof. Kovacheva lists the most serious antecedents for violation of patients’ rights. She points out the need for persons with reduced mobility and disabled persons to travel, which puts their health at risk; the difficulties they experience to secure the costs for travelling from remote and small settlements, especially for pensioners and people with low income; absence from work of working patients; serious delays in starting and continuing therapies.
Kovacheva emphasizes that these patients need to take frequent absences from work in order to visit supervising rheumatologists, hospital care facilities where specialized committees have been established and Regional Health Insurance Fund units for approving and registering protocols, which often leads to problems with the employers.
She underlines that patients have further signaled that due to exhausted hospital limits they have to wait for weeks to be scheduled an appointment with the Expert Medical Committee, thus interrupting their treatment.
Kovacheva points out that APAD and OPRDB have made detailed proposals for optimizing the procedure for patients with rheumatological diseases getting prescriptions and receiving the medical products necessary for their treatment.
“In view of the above mentioned, concerned about citizens’ rights, and pursuant to the powers granted to me by the Ombudsman Act, I hereby extend this strong recommendation to review the problems outlined above and the proposals made in relation to them. I expect you to discuss possible solutions and take action to guarantee the right of patients with rheumatological diseases to timely access to medical treatment and overcome the difficulties and antecedents for violation of their rights in the course of the procedure”, the Ombudsman insists.
In conclusion, Kovacheva recommends that a constructive dialogue is established, and meetings convened with representatives of APAD and OPRDBВ.
I sent a recommendation to Dr. Asen Medzhidiev, caretaker Minister of Health, Prof. Petko Salchev, governor of the National Health Insurance Fund (NHIF) and Dr. Ivan Madzharov, chairperson of the Bulgarian Medical Association insisting to guarantee the right to timely access to medical treatment for patients with rheumatological and autoimmune diseases.
The reason for this recommendation is a letter from the Association of Patients with Autoimmune Diseases (APAD) and the Organisation of Patients with Rheumatological Diseases in Bulgaria (OPRDB) seeking my assistance to establish a constructive dialogue with the healthcare institutions as regards the “systemic discrimination of patients with rheumatological diseases”.
I underscored that the patients with those diseases warned of difficulties with securing medical products prescribed by protocol and paid by the NHIF and pointed out the need to ease the procedure.
I further noted that their proposals had been neglected by the institutions they had addressed and their request for a meeting had not been honoured
I pointed out that in the letter addressed to me APAD and OPRDB described in detail the problems that patients with rheumatological diseases encountered in relation to their treatment, such as having to wait for more than eight months after being diagnosed to receive the required therapy.
I emphasized the need for persons with reduced mobility and disabled persons to travel, which puts their health at risk; the difficulties they experience to secure the costs for travelling from remote and small settlements, especially for pensioners and people with low income; absence from work of working patients; serious delays in starting and continuing therapies.