Several problems of the Romanian healthcare system led to the hospital fire that happened in the National Institute of Infectious Diseases Matei Balş from Bucharest, Attila László, doctor, secretary of the Senates Healthcare Committee told maszol.ro. Only a couple of months after the tragedy in the County hospital in Piatra Neamț, at dawn on January 29, four rooms of the Matei Balş hospital from the capital caught on fire, probably due to an electric heater used in one of the hospital rooms, causing the death of eleven people. Attila László told maszol.ro that the fire in the Matei Balş institute was the seventh fire since the incident that happened in Piatra Neamț on November 14. Fortunately, unlike in Piatra Neamț, when several people were lost to the fire, no medical personnel, nor the patients were injured during these accidents, until now.
Attila László stressed that the Matei Balş is one of the leading institutes in the country in the field of infectious diseases, where all necessary conditions are met to operate normally with the approved number of patients. However, when the institute exceeded this number, they had to improvise, which led to a catastrophe. Attila László added that following the accident in Piatra Neamț, a national examination campaign was launched, mainly monitoring institutions where coronavirus patients were treated, including the Matei Balş Institute.
According to the Senator, the Matei Balş operated with a relatively low number of patients, and followed the strict rules, each hospital room had a compliant infrastructure. The problem was, that lately the institute exceeded the maximum number of patient, putting more patients into a single room. In such rooms, a large amount of oxygen is used, and if the ventilation is inadequate, the oxygen level gets concentrated, which can lead to problems.
“However, we can talk about an error in the system, because during the examination in November, firefighters found in more than 300 institutions in the country 1900 cases which could cause an emergency. At that time, the correction of the deficiencies was ordered, but since then we have managed to make the changes in only 139 cases”, Attila László said.
The Senator told maszol.ro that there several other issues in the healthcare system that may lead to similar incidents: The infrastructure, the hospital buildings are old, most of them were built in 19th or the 20th century, and due to the disproportionate budget inherent in the health care system, hospitals do not have money for maintenance.
As Attila László explained, hospitals use 90-95 percent of their budget to pay the employees, which means that only 5-10 percent of the budget – received from the National Health Insurance House and the Ministry of Health – can be spent on actual work, on diagnosis, treatment, to maintain, clean the hospitals, to buy food, to heat the building etc. According to Attila László, as long as we do not want to understand that hospital management is not only about patient treatment, but also about building management – which is also necessary for the healthcare system to operate –, these budget inequities can be perceived as system errors. “If we do not act as soon as possible, we will most likely encounter cases similar to those that happened in Matei Balş,” the Senator stressed.
Attila László also added that energy controls should be systematic. As he explained, after the tragedy in Piatra Neamț, the Health Committee consulted with work accident specialists, and outlined a plan for the Ministry of Health: they proposed technical measures, which can decrease the risk posed by the bad situation of the healthcare system. By December 23, an action plans had been prepared for each institution.
“This has been already done for the gas networks, a revision obligation is now required for electrical networks, which surpasses the general, everyday maintenance. From now on, all healthcare institutions energy systems should be examined, because most of the infrastructure was built in the 19th century or in the middle of the 20th century, according to the standards to that time. It would be very important to examine the condition of each infrastructure. At the same time, we also need to look at how the institutions meet the needs of the new conditions, because the instrumentation, technology has changed, it has increased energy consumption. In addition, it is important that these institutions are brought up to current standards,” the health professional said.
The proposal of the committee is that the energy system should be examined annually, and each time the hospital building is changed, investment are made, the instrumentation is modernized or energy consumption is changed. The proposal also includes that the hospital service charges should cover all additional costs, not the payrolls only, but the cost of treatments, maintenances, technical managements, which requires specialized staff.
However, the most important issue that the healthcare system faces now is the high number of patients, Attila László stressed. “I hope that soon we can get to point where the institutions that have been working day and night on the front line for ten months are not so overburdened. However, the professional decision are questionable, because it is very strange that there are 122,000 hospital beds in the country but we face problems in the treatment of 16-17,000 patients, who can only be cared for properly if some institutions are shut down,” the Senator stressed.
According to Attila László, the purpose of the hospitals should be adapted to the composition of society, which changed in recent decades, and it is aging. “We should not wait for the last moment, for another tragedy, to wake us up and do something about it,” the Senator emphasized. Attila László added that more than ten years ago several foreigner specialists recommended for Romania to restructure the institutional system for infectious diseases. The county never “accepted” these advices, so in 2020 only five institutions dealing with infectious diseases in Romania had an intensive care unit, one of them being the Matei Balş Institute.
Attila László also told maszol.ro that in the Health Committee they did everything they could to get past who comes from which party and what are its priorities. “We tried act as one in all healthcare and public health issues we faced so far. These cannot be related to political parties, cannot be treated as one’s personal ambition. If you are in a crisis, and we are in a crisis for ten months, everyone’s priority is to deal with it. It is true that it is difficult to compensate everything that has not been done in the last 30 years,” the secretary of the Health Committee said.
The Social Democratic Party (PSD) is demanding the resignation of Health Minister Vlad Voiculescu, so Maszol.ro asked Attila László if the RMDSZ will vote on the simple motion against the Minister submitted by the PSD. The Senator said that it is unlikely, because the RMDSZ is a member of the governing coalition, and it is the responsibility of the coalition partners to resolve this situation.
“As long as this coalition is working, and we see that the Minister is adopting the elements of the governmental program, even if he adopts them a bit late, I think that instability is not needed. What we need is to overcome our differences, to correct the those things that are not working as soon as possible, because we talk about the safety of the patients, and the medical personnel. In this moment, everyone’s priority should be to end this unfortunate situation which we live in every day”, Senator László Attila added.
According to the Senator, at the ministerial hearing, the members of the Health Committee advised him to listen them. Four former minsters and several hospital managers were present at the hearing. “Unfortunately, I see that he does not ask for the help of these experts, I do not know with whom he consults with. But in the last time period, he was not aware of what was happening,” Attila László told about the ministry of health.
Title image: The Matei Balș Institute caught on fire on January 29, 11 people were lost due to the incident. Photo: Inquam Photos/Octav Ganea