As documented by the European Commission, the World Bank and the World Health Organization Currently the performance of the Latvian healthcare system needs large-scale improvement. In addition to this, the European Council issued a Country Specific Recommendation (CSR) to Latvia in health care in 2016 and 2017 recommending to “É Improve the accessibility, quality and cost-effectiveness of the healthcare system..”. The Latvian Country report also stresses the substantial need for improvement in the regulatory quality (ability of the government to formulate and implement sound policies and regulations) and the need for improvement in the efficiency and effectiveness of public administration. The report considers it as critical to enable the public administration to support the reform process by providing them with the necessary training and increase this way the administrative capacities. This is also in line with recommendations from the health sector review in Latvia done by the World Bank in 2016.
All these recommendations and reform efforts have the objective to make the Latvian health care system sustainable, more efficient, accessible and improve its quality ultimately improving the health status of the population. Strengthening the competences and teamwork capacities of public administration specialists in the health sector has a twofold objective. On the one hand, these specialists need skills to carry out their tasks to contribute to the success of the reform efforts. On the other hand, as the health sector and medical technology is evolving fast, it is important to provide training for the public sector to integrate these aspects in future developments of health policy design and implementation. The training of the public administration can also be a catalyst for the implementation of health system reforms in Latvia. By increasing competences and qualifications of the staff of the Ministry of Health and the related ministries/subordinated institutions, this project will contribute to the increasing of efficiency and effectiveness of the public administration.
In view of the above, the Latvian Ministry of Health agreed with SRSS in 2017 on technical support in launching a training programme for the Ministry of Health and its subordinate entities so as to increase their capacity to support and carry out tasks related to health sector policy planning, reform implementation and reform monitoring.
On these grounds, a scoping mission was held on 27th October 2017 where the main conclusions were:
- There is a strong need in Latvia for a reformed health care system. Implementation of current reform efforts would enable Latvia achieve its future economic goals as defined in the ÒLatvia National Development PlanÓ;
- The main target groups of the training for (civil servants in the public administration of the health sector (in short the “Latvian Health Executive Programmes (LHEPs)”) should be the employees of the Ministry of Health and subordinate institutions (for example: HI, CDPC, NHS, State Agency of Medicines, SEMS), for details please see the accepted document ÒScoping Mission 27th October 2017.Ó.
- The LHEPs should contribute to the development of expertise on specific topics on health systems of the participants/trainees;
- The LHEPs should contribute to the development of a set of defined skills of the participants/ trainees, including: becoming more capable of contributing to the current health system reforms; becoming more open-minded and proactive for new challenges and being able to manage sustainable changes; enabling collaboration in and between related institutions; developing management and team related skills.
- The LSHEP should contribute to improving a set of defined skills of top level senior executives and/or policy makers of the Latvian Ministry of Health and their subordinate institutions.
The project will fully end at June 2019 after which the final report will be available and at this stage it is in itsÕ last quarter of the implementation but an observable trend is that the project provides invaluable knowledge not only in the leading authority of the health policy planning in Latvia (the Ministry of Health) but also in its various subordinate institutions, thus ensuring the involvement of different perspectives of institutions competent employees in the development of health policy and reforms. Assignment of Change (AFC) groups contributed to the openness, creativity and willingness of employees to engage, share experiences and participate in planning the health reform.