Dear Speaker of the Parliament,

Dear Deputies,

Dear Citizens,

I am here today to present some very important and essential amendments on the “Medical Order” Law amendments that unanimously align with the highest interest of our citizens.

The proposal for these changes is undoubtedly one of the most significant initiatives of the Ministry of Health regarding the employment and engagement of the doctors in the public health sector.

These changes aim to strengthen control mechanisms, increase transparency, and improve the management of medical services in the public sector for citizens.

Specifically, these changes consist of establishing clear rules to avoid conflicts of interest for physicians, between the health services they provide in the public system and those in the private system.

Moreover, it is prohibited for public hospital leaders at any level to also be leaders of private health clinics at any level.

These changes will ensure even higher quality service for citizens, as well as a more unimpaired image for our doctors.

– Additionally, these amendments aim to establish rules for dual employment of physicians by determining a necessary and fair balance between working in the public and private systems, certainly without infringing on any rights that physicians have for dual employment.

This is done to ensure that their priority remains on public services and to improve the quality of these services, without harming patients who need treatment in public structures.

Furthermore, a new Code of Medical Ethics and Deontology will be adopted to fully monitor cases of abuse and violations of professional discipline and ethics.

Disciplinary measures will be strengthened, including provisions for suspension and revocation of medical practice licenses.

On the other hand, we have ensured the respect of administrative and judicial appeal procedures, guaranteeing justice and transparency in the review of complaints.

The amendments also focus on hospital autonomy; through these amendments, physicians working in financially autonomous hospitals will not work in private structures, as the autonomous hospital itself will provide them with the opportunity to work and utilize public hospital facilities outside official hours for private practice.

Through these amendments, we aim to increase transparency and accountability by creating an electronic public registry for physicians practicing in non-public institutions.

The proposed amendments align with international best practices, both from neighboring countries and from more developed countries. In the laws of neighboring countries in the region, such as Bosnia and Herzegovina and Serbia, or in Europe, such as France and Italy, and in England, Canada, and the USA, there are clear limitations and regulations regarding dual employment of physicians.

These proposals put an end to a long-standing situation of conflict of interest that has widely prevailed in the healthcare sector.

They avoid citizen complaints, enhance quality and standards, and create a clear and transparent mechanism for everyone.

All of this pertains to a vital and non-negotiable interest in providing healthcare to citizens.

I have closely followed recent debates, including those held in the Health Committee.

Therefore, I would like to emphasize that:

In no normal country is there a debate on whether it is right to have regulations for working hours.

In no country in the world is there a debate on the fact that there should be transparency and that citizens should know who their treating doctor is.

And in no country is there a political debate on the need for clear disciplinary rules and procedures that ensure justice in cases of violations or negligence.

Similarly, in no country in the world is there a discussion on why these changes are so urgent and necessary to be undertaken so quickly with a Normative Act.

In this chamber, unfortunately, the rise of fiery rhetoric every time we propose important reforms with fundamental changes to improve and further develop our healthcare system has become a common and sometimes monotonous refrain.

However, I want to be as clear and transparent as possible in front of all citizens, as well as in front of the entire medical community, to clarify what changes these amendments bring.

Therefore, dear deputies!

It is in the common interest of all citizens, whether left or right, that everyone without exception needs healthcare services in the public sector, needs to avoid conflicts of interest, to ensure high-quality service, to establish clear rules for dual employment, and to maintain a proper balance between public and private engagement for doctors.

– Efficient and transparent procedures need to be created for cases of flagrant violations or negligence.

We have followed and adapted our proposals to the best international laws and practices, both from neighboring countries and more developed countries. Every proposed measure is similar to or in line with the advanced codes applied by these countries.

To better understand the importance of setting clear rules, I will list some facts derived from data directly obtained from the Medical Order regarding the disciplinary proceedings conducted there.

According to these data, it is clear that for the period 2005 – 2023, 632 complaints have been administered, which were mostly resolved with understanding or confrontation and, in most cases, did not proceed to a detailed assessment under the provisions of the Medical Ethics and Deontology Code.

Meanwhile, during the same 18-year period, 110 complaints were treated, which went through a disciplinary trial related to violations of the Ethics Code, ranging from lack of medical ethics to medical errors.

At the conclusion of the review of these 110 disciplinary proceedings, the competent authority imposed only 60 disciplinary measures, and these were mostly symbolic.

So it is clear that over an 18-year period, the number of proceedings was very low, and even lower was the imposition of disciplinary measures.

I want to clarify here that it is not the Ministry of Health and Social Protection’s goal to increase the number of sanctions.

We have no interest in artificially increasing the number of investigated cases or those passed to Disciplinary Commissions.

Nor do we intend to “intimidate” doctors, as was mentioned a few days ago in the Health Committee.

But we cannot allow ourselves to turn a blind eye in the face of flagrant cases, especially when negligence endangers lives or causes irreversible harm to citizens.

It is a fact: No one has done more than this government to elevate the status or image of doctors to the pedestal they deserve.

We believe that doctors are figures who deserve special respect, in accordance with the sacrifices that very few other professions make.

But this does not mean that a certain category of professionals or individuals has the right to stand above the law!

The laws and reforms of the state are what ensure citizens receive more equal services, fairer, and higher quality care that they deserve.

That is precisely why we have also initiated the application of hospital autonomy, which provides citizens with fewer delays at the doctor’s office, less bureaucracy, more access to necessary services, and offers doctors more opportunities for professional and financial gain within the public system.

Autonomy, with its increased service quality, improved public-citizen relations, enhanced access, additional space for financial and professional growth for doctors, modernization and innovation it promotes, and many other benefits, ultimately fills a long-standing void.

Therefore, we are finally at a point where we can aim to take a new step, undoubtedly courageous and bold, but also tested.

The facts are here; the truth is here!

To clarify once again the concerns raised by the Medical Order during our discussions regarding its independence, I would like to remind you that in Albanian legislation, as you very well know, there are cases where Orders operate very well and independently with far more limited powers than those of the Medical Order, which, even after these changes, continues to have a decisive and irreplaceable role in every aspect of regulating the medical profession.

But, without delving further into legal arguments that have been fully exhausted, I want to conclude by emphasizing once again that a vote to support these opinions that this Assembly will take will further increase professionalism, accountability, and the quality of service for citizens.

You will vote in support of the continuation of the radical transformation that has happened and is happening in our healthcare system.

You will vote in favor of having clear rules that balance the interests of all parties involved and that require healthcare services from public structures.

And you will vote in favor of deepening meritocracy in our healthcare system.

You will vote in favor of citizens, who should be the priority of every political side.

Thank you!