Health care system in Belarus
The Belarusian Constitution guarantees the right for all citizens “to healthcare, including free treatment at state health-care establishments”. Medical treatment at medical centres or hospitals is provided free of charge, and conforms to state minimum social standards.
The main owner and manager of the healthcare system in Belarus is the State. The leading role of state medicine in protecting the population’s health is supported by law, and the system itself consists mainly of medical centres and hospitals subordinate to the Ministry of Health and managed by a vertical power structure. In addition, there are also departmental clinics (of the Ministry of Defence, Ministry of Internal Affairs, KGB, etc.). A remnant from the Soviet times, Belarus has retained, and even developed, the system of privileged medical service for state officials. Upon reaching a certain rank, they are granted access to a special clinic and hospital of the Department of Presidential Affairs in Belarus. Ordinary citizens can also receive treatment in this VIP-level clinic, but at full cost.
Primary medical treatment is provided by a large number of day care clinics (separate for children and adults) in cities and ‘Clinics on wheel (for both children and adults) in the countryside, as well as first aid offices that employ only middle-level medical staff. Treatment is provided strictly in accordance to a person’s place of residence or location. So if you are reside in Mogilev you can’t get regular treatment in Minsk until you register. Primary emergency aid is provided by the emergency medical services which employ both middle-level staff and doctors.
Funding for the healthcare system is provided by the state budget. In the last five years, about 5% of the GDP was allocated to healthcare, which is slightly under $320 per capita (in 2011 it was $225), which is three times less than in Poland and over 14 times less than in Germany.
Inpatient treatment (including hi-tech) is an absolute priority, receiving about 60% of the funds. Belarus is No. 1 among the countries of Central and Eastern Europe in the number of inpatient treatment clinics per capita. At the same time, Belarus leads in the number of clinic visits per capita – 13.2 in 2011, which is 2.2 times higher than in EU countries and 1.6 times higher than in other CIS countries.
The private medicine sector in Belarus takes up about 5% of the total amount of medical services and is represented mainly by dentistry. This sector is not developing because of the high standards set by the government for such businesses, as well as regulatory constraints on their income. Meanwhile, the state medicine sector is promoting services which need to be paid for privately (a goal has been set to increase the volume of provided chargeable services 3.5 times by 2015), meaning that medical treatment may become less affordable to Belarusian citizens, especially regarding complex, lifesaving hi-tech operations.
Belarus is No. 5 in the world in the number of doctors per 1,000 people, but WHO experts note a significant misbalance in the human resource distribution in favour of hospital services with a substantial deficit in the primary treatment system. This deficit is worsened by lots of professionals leaving the country to work abroad due to low income (salaries in healthcare are 30% lower than in the production sector).
While WHO experts acknowledge the achievements of the Belarusian healthcare system in providing accessible medical services to the population, they note a decreased accessibility in the countryside, where there is a lack of medical staff. The decrease in maternal and infant mortality is another achievement observed by the WHO, although it was noted that these results may have been achieved not only through the efforts of the Ministry of Health, but by increased living standards.
The healthcare system remains vulnerable to potential economic reforms which could affect funding levels, asset allocation and management.