Page 21 - THE ROMANIAN HEALTH CARE

3.3 Health sector policy

The most recent health care strategy in Romania is ‘The Romanian National Health Strategy

2014-2020: "Health for Prosperity" - community medical assistance’. It is structured around

three strategic intervention areas:

1. "Public health" focusses on: health and nutrition of women and children;

communicable diseases; prevention of non-communicable diseases through health

programs;

2. "Health services" aims at improving access to quality and cost-effective health

services;

3. "Cross-cutting measures for a sustainable and predictive health system" is a mix of

various subjects: developing an inclusive, sustainable and predictable health system;

increasing the efficiency of the health system; development of infrastructure at

national, regional and local level.

See Annex A for more detailed list of subjects covered by the health strategy.

The strategy is accompanied by an action plan that details the steps to be taken to reach the

goals, indicators for results and the required as well as secured budgets. Worth noting is that

if properly

quite some budget is to be sourced from European Structural Funds. The strategy -

executed – is very ambitious. It addresses some of the major problems in Romanian

healthcare, especially underdeveloped fields such as health economics rationalisation, access

to healthcare and structural investments. The ambition level of the strategy is an important

issue. Executing this strategy would involve major innovations and legislative changes of the

health system. However, the Romanian health system is not very open to change from the

public side, executing the health strategy is therefore a major challenge. The health strategy

contains some odd choice in light of what was found in the previous chapter. For example an

emphasis on not so problematic diseases like HIV/Aids at the same time cardiovascular – the

main cause of death – are not an explicit subject of the strategy. The actual state of

implementation of the strategy is unclear at the date of writing this report. The Ministry of

Health did publish a first progress report for the year 2015. The health strategy was made by

the previous government, the current government did not revise or replace it. The absence of

further progress reports might be related to the change in government. Summarising, the

health strategy makes reasonable sense on paper; the execution of it is limited in reality, as

illustrated by the absence of progress reports for the last two years.

3.4 Organisation of the healthcare system

The healthcare system is divided in actors at the national level and the district level mimicking

the administrative division of 41 counties (judete) and the municipality of Bucharest (total of

42 administrative units). The system is strongly centralised at the national level, where most

decision making power is located. The district level is mainly responsible for the execution of

decisions taken at the national level.

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