The speech of the Minister of Health and Social Protection Mrs. Ogerta Manastirliu during the interpellation in the Assembly about the progress of the basic medical check-up so far, in relation to the policies established by the Government

Three years ago, the Albanian Government took an important decision, in fulfillment of the promise we made to the citizens, for the improvement of health care: the gradual transition from a health care system oriented to the disease, to a system that has focus on health.

For a responsible Government, which places the citizen at the center of policies, the implementation of preventive control policies is an OBLIGATION. Because healthier citizens means a healthier society.

That’s why we decided that all Albanian citizens, in the age group of 35 to 70 years old, without any distinction, regardless of whether or not they were contributors to the mandatory health care insurance scheme, would be able to have a FREE periodic basic checkup, through public private interaction .

Before the implementation of this program, a basic medical check-up cost a minimum of 51,000 ALL.

Money that was paid directly from citizens’ pockets.

For three years, it has been provided free of charge by the state!

Today, the data we are analyzing – and which we have thanks to this program – are confirming to us the great importance it has in the health system, for greater and better quality care, but also for cultivating a culture of prevention diseases.

Before the implementation of this program, the Ministry of Health was in a situation with a total lack of information, without epidemiological data, which are the foundation for the design of efficient health policies.

Not more than two days ago, in a meeting I had during the meeting of South-Eastern European Health Ministers, the Director of the WHO expressed her highest praise for the program we are implementing, which focuses on primary care, strengthens the role of the doctor of the family, but above all, plays an essential role in the function of universal health coverage.

And the work we are doing with the WHO to strengthen primary care in Albania, in parallel with the rehabilitation program of 300 health centers in four years, also relies on this preventive program that we are applying.

Dear colleagues,

Through the basic medical control program, today we serve 1.2 million Albanians aged 35-70, offering this service every year, FREE, through the measurement of 44 health parameters and 5 evaluation tests.

All are certified laboratory examinations, of high quality and safety, in accordance with European ISO norms.

944 million ALL have been invested by the partnership, from investments in laboratory equipment, medical equipment, software programs, vehicles, to the opening of 380 basic medical check-up cabinets in every health center. We have even provided mobile cabinets for the areas deep in the country.

During visits to health centers, in the north and south, I have seen closely the basic medical control cabinets, which have the same standard, and offer the same guaranteed service to every citizen.

It is a serious, reliable, and standard investment, which for three years has been strongly supporting our health system in strengthening primary care, assessing health risk, for non-communicable diseases.

From June 2015 to December 2017:

891,047 checks were carried out.

I repeat: 891,047 citizens have had 1 or 2 free medical check-ups.

During the last months, there is an increased interest in performing the Basic Medical Checkup, with an increase of 24%, compared to the same period last year.

What does this mean?

This means that not only is there an increase in awareness among citizens, but above all there is an increase in their confidence in the preventive control program.

Despite the criticism, attacks, mud that has been thrown at this program, with accusations often bordering on the irrational.

There is also a serious commitment on the part of the health center staff in providing this service. For this reason and not only, we are thinking that the moment has come to evaluate an incentive scheme for the staff of health centers.

For us it is important and significant that there is an increase in the number of beneficiaries.

Today, participation in the Basic Medical Checkup program averages 68%.

Are we where we need to be? No, we are not! we, the first, think that there is still a lot to do.

Because we stick to the objective of achieving the basic target of 475 thousand medical checks every year.

Dear citizens,

In the multitude of accusations with which this program has been shot, one stands out in particular: they tell us that you want to increase the number of controls, to increase the concessionaire’s payment.

IT IS NOT TRUE!

IT IS NOT TRUE!

I assure the citizens that all the pending checks, which have not been carried out until today, will be able to be carried out in the coming years without any additional costs!

For the first time, as I mentioned, this investment provides us with an important database:

First point for the prevention of chronic diseases; and secondly, for the design of health policies, based on scientific evidence.

What do the figures obtained so far tell us?

From the results of the analyzes carried out, it appears that: 334 thousand citizens throughout Albania, among those who have performed the basic medical check-up, have a predisposition to hypertension and diabetes.

Of these, 168,000 new cases of arterial hypertension have been identified; 133 thousand new pre-diabetic cases; 43 thousand new cases of diabetes; 75% of the people who have obtained high parameters are aged 35-60.

At the national level, 6.73% of citizens who have performed the Basic Medical Checkup have high values of liver enzymes.

During these three years of existence, the Basic Medical Control, through specific examinations, has enabled the detection of many suspected cases of hemopathy (malignant blood disease).

Even though their percentage as a group of pathologies is not high, timely detection for the individual, i.e. in the early stages of the disease, without giving clinical signs, is very, very useful, both for the accuracy of the diagnosis, and for the quality of life and life expectancy of citizens.

I am giving you two concrete examples, where we are referred to problems of following the treatment of chronic patients:

46% of cases identified with arterial hypertension, which are treated for these diseases, do not receive proper follow-up. 51% of cases identified as diabetics, who knew they were suffering from this disease, turn out not to receive proper care.

So through this national program, specialist doctors and university services have the opportunity to improve the follow-up and treatment of patients.

We already have sufficient evidence for non-communicable diseases (which account for 89% of the causes of death in Albania), for the epidemiological profile of the adult population. It is information that until 2014, I regret to say, was completely missing.

These data, as well as many others, are used today by the Institute of Public Health and by university services, as a basis for scientific studies.

With this program, we have given the family doctor an indispensable tool for his work, for assessing and communicating the health risk of the citizens he follows and treats.

Putting emphasis on prevention not only saves people’s lives, not only avoids complications but also significantly reduces the costs of families and those of the state, and this is simple logic, for those who want to understand.

Dear colleagues,

There are many health systems in the world that promote basic medical check-ups. Many of them have included it as a mandatory element for individuals in working relationships, to improve the health of the population.

As in the case of Austria, where citizens are offered a basic medical check-up every year, but at the same time, the obligation to undergo this check-up is defined by law for every citizen who is in employment.

Likewise, the same practice of providing free basic health service is also followed in countries like Germany, Holland and France.

Also, important international institutions, such as the EU or the Council of Europe, have defined the obligation of Employees to undergo basic medical checks every year.

Of course, for the culture of preventive care, we are still far from the examples I mentioned.

That is why we have decided to strengthen it, starting with the administration employees, who will encourage them to use this opportunity, in order to take care of their health and prevent diseases.

There are many studies that evaluate the indisputable benefit of basic control, this and in relation to work performance, or even the reduction of costs arising from work absences due to temporary disability reports or extended reports.

Allow me to bring to your attention some conclusions of the highest scientific institution in Great Britain, the National Institute for Clinical Excellence, on basic medical screening at work with benefits:

Reduces by 30% the risk of premature death at the population level;
Ensures better performance in the work of the employee;
Better mental and physical health at work;
It reduces absenteeism due to illness and brings higher productivity to institutions.
Dear colleagues,

Based also on the best international practices, where the examples I mentioned are only a part of them, as there are others that for reasons of time I am not mentioning, we will promote as much as we can, the implementation of the program of basic medical check-up for all citizens, from 35 to 70 years old.

It is the duty of every government to care for families in need, for the elderly, for the unemployed, for women, for anyone, anywhere in Albania.

We will continue to raise awareness and encourage citizens to periodically perform basic medical check-ups, free of charge. We will work with the public administration, with employers, with social services, with health services, in order to maximize the coverage of this program.

Lots of mud have been thrown to stain it. But to the nihilism that multiplies by zero every initiative that serves to improve the health of citizens, we respond with those hundreds of thousands of beneficiaries, who have challenged the propaganda of dirt and mud, and have believed in this Government program.

And to all those, whether among you in the hall, or outside this hall;

Either those who have chosen to hit him for political reasons only, or those who have doubts, because they listen to the elders;

I am giving you an open invitation: put your finger on the map, at any point in the territory where the basic health check-up service is offered.

Let’s go together, see with your own eyes.

Come and ask the citizens who, increasingly in number, are going to receive the service.

Come and ask the professionals who provide it;

Come see the conditions and high standards in which it is offered.

You can choose, even after that, to simply close your eyes and continue to use it for political purposes.

It’s unfair, but it’s your choice.

As far as we are concerned, we will continue to work tirelessly towards the objective for which this program was created from the beginning: healthier citizens thanks to care in the prevention of chronic diseases; accurate and up-to-date data on population morbidity; targeted and efficient policies in disease prevention.

For healthier citizens, and for a healthier society.

Thank you