Ombudsman Peter Svetina and his deputy responsible for healthcare and health insurance, Jože Ruparčič, PhD, welcomed the representatives of patients’ rights on Monday, 30 May 2022, at the regular working visit. Peter Svetina initially noted that the problems for which people turn to the Ombudsman did not deviate much compared to last year in terms of their content. The most pressing issue remains the issue of personal doctor accessibility; there is a lack of ophthalmologists, and mental health issues have deepened because there is a lack of professionals in paediatric psychiatry and clinical psychology. The Ombudsman has been warning about the urgent regulation of psychotherapy, long queues, and issues concerning additional payments for above-average services for many years.

During the discussion, the representatives found that the healthcare system, which is formally well organised, also allows for various misuses due to the non-fulfilment of the above. Thus, the representatives as well as the Ombudsman are facing problems where people have concluded insurance contracts with insurance companies which do not fall into the appropriate framework of healthcare insurance. In particular, the elderly were offered insurance policies which promised them quicker access to healthcare, which was not realised in the end. Patients without a personal physician were also offered this option, which is unrealistic given the lack of personal physicians on the market. They also noted that some insurance policies do initiate first contact in healthcare; however, the patients must then queue up like everybody else for further treatment. Or the patient undergoes the first check-up at a doctor in the framework of the concluded insurance; however, the results are not taken into account in further healthcare treatment in another healthcare institution, and another check-up is carried out. They agreed that suspected misuse should be reported to the inspectorate or the police, and they regretted that people are taking advantage of the distress of other people and the weakness of the system.

They estimated that the issue of personal physician accessibility is a complex issue, which has only deepened with the pandemic. They agreed that access to a personal physician is a key right, which leads to many other rights. The rules on notifying patients when their personal physician’s employment is terminated are also clearly defined; however, they are not followed, which is why patients are often not informed of the fact that they will be without a personal physician in a couple of months.

The representatives of patients’ rights continue to see many violations in terms of the duty of disclosure. “The lack of duty of disclosure is a ‘chronic disease’, not only in healthcare, but also in other care areas,” said Mr Svetina. The participants agreed that an understandable, clear and unequivocal duty of disclosure allows the patient to exercise their healthcare and insurance rights, and it also prevents complications, thus sparing the time of healthcare employees and of patients.

They also addressed the decisions of the Health Insurance Institute of Slovenia, the Pension and Disability Insurance Institute and the disability committees, as their processes are often too long, their decisions are incomprehensible, the legal processes are not carried out in an appropriate manner, and the decision-making bases are also unclear. They pondered whether the labour inspectorate could contribute to improvements in this area.

They also spoke about the problems of the elderly concerning their access to healthcare services via digital platforms, elderly care in care institutions, on access to orthodontic and otorhinolaryngology specialists, and on the problems of accessing development clinics in the Lower Carniola region and in Bela krajina, as well as of the dual system in healthcare and SPA treatment. They noted that a clear explanation should be given at every referral to SPA treatment, as well as when the treatment is justified, and should be covered by an insurance company.