BONJOUR L'ESTONIE

Easter weekend brings warm weather

Allergy sufferers are now advised to begin taking their anti-allergy medication, with birch trees forecast to begin blooming ahead of schedule and winds set to carry airborne pollen from Sweden and Russia in the days to come.

In addition, birch trees in southern Estonia are forecast to begin blooming over the Easter weekend, says Annika Saarto, a university researcher at the Aerobiology Unit of the University of Turku.

In fact, people sensitive to birch pollen may suffer from nasal congestion already today, as strong winds transport pollen particles to southern regions of the country, estimates Mikko Routala, a meteorologist at Helsingin Sanomat.

The winds are expected to die down on Saturday, offering temporary relief to allergy sufferers.

Overall, weather over the Easter weekend is forecast to be relatively warm. Despite overcast skies, the mercury may already on Friday climb to over ten degrees Celsius. On Sunday and Monday, the temperatures are forecast to increase further.

“It's T-shirt weather in the south, as temperatures rise to close to 20 degrees. Whether or not the 20-degree mark will be pierced, we shall see on Monday at the latest,” Routala says.

Finns flock to Estonian private health care

Because of long queues for surgery and expensive private health care at home, more and more Finns are turning to private hospitals in Estonia. However, in cases of malpractice, seeking compensation may prove difficult.

The affordable rates at Estonian dental clinics have long attracted Finns. Now More Finns are also crossing the gulf for outpatient surgery at Estonian private hospitals. New businesses in the Estonian health care sector are increasingly challenging the Finnish private sector. One such business is Medimatkat.

Among services offered by the Estonian company are operations for varicose veins, gall bladders and knee joint keyhole surgery.Konstantin Fleidervis, a General Surgery Specialist with Medimatkat, has worked in Finland, and says that patients here suffer from an inefficient health care system and surgery queues. 

Kela compensates for Estonian services

Estonia social spending second to last in EU

Estonia's spending on social benefits and other expenditure linked to social protection schemes was the second lowest in the European Union, at 16.1 percent of GDP in 2011, far below the union's average of 29.1 percent.

The EU's average social spending percentage increased in 2008, but began to decrease slowly after 2009, with Estonia following suit, spending 14.9 percent in 2008 and as high as 19 percent a year later, according to freshly released figures from Eurostat.

Denmark (34.2 percent), France (33.6) and the Netherlands (32.3) topped the table in 2011, with Latvia (15.1 percent), Romania (16.3) and Lithuania (17.0) joining Estonia at the bottom.

In real terms, Estonia spent 38 percent of the EU's average in 2011, while Luxembourg spent the most at 184 percent of the union's average, and Romania the least with 28 percent.

Inspecting the figures more closely, Estonia spent 44.0 percent of those resources on pensions (EU's average was 45.7 percent in 2011), 39.4 percent on sickness, healthcare and disability benefits (37.1), far more than the union's average (8.0 percent) on family benefits - 12.4 percent, but less on housing and social exclusion – 1.2 percent compared to the average of 3.6 percent.

Breakthrough in stem cell surgery

PÄRNU - Estonian doctors were preparing to present a real success story at a medical conference in Pärnu last Friday – the first patient in Estonia in whose hand her own cell stems were implanted, restoring the mobility of her hand. This is a procedure which offers new possibilities for effective restoring of tissue in the future, reports Postimees.

On April 16 this year, a team of doctors of the Hospital of Reconstructive Surgery, headed by surgeon Romek Martsin, conducted an operation aimed to give 18-year-old Anett Torri back the ability to move her left hand and use her fingers, which had become immobile due to scar tissue after she suffered a severe burn when she was 6 years old. She can now, nearly six months after the first operation, freely move the hand that was restricted earlier by scar tissue on her arm, and can stretch her fingers that were crooked, and bend her wrist that was tilted before.

The doctors took fat tissue from the patient, which was then processed in a Cytor machine, which separated stem cells which were injected to the patient’s hand. The first operation was followed later by a second when fat tissue was added to the hand, which all restored the tissue lost in the fire and softened the scars that restricted the movement of the hand.
Dr. Martsin and Dr. Andrus Loog, from the Hospital of Reconstructive Surgery, were to present the results of the first surgery in Estonia with use of autologic stem cells, in Pärnu at the symposium ‘Cell Stem Treatment – Breakthrough in Regenerative Medicine.’

2007 malpractice case closed, verdict finalized

The Supreme Court today rejected an appeal by Carmen Heinväli, a Pärnu doctor convicted of criminal negligence over a 2007 incident in which a baby was born with a permanent disability. 

Heinväli, who was an on-duty physician in the case in question, was handed a one-year suspended sentence in February. As the Supreme Court has now rejected her appeal, that sentence will go into effect.

She was found guilty of failing to correctly evaluate the course of a patient's labor, as a result of which the health of both the mother and the newborn were severely harmed.
The court also awarded the victim civil damages totaling 23,330 euros, which Pärnu Hospital must pay.

Heinväli was originally convicted in 2010, given an eight-month suspended sentence and ordered to pay around 1,500 euros in fines. But she was not stripped of her license to practice medicine and civil damages were also dismissed.

The verdict was upheld by the district court in June, 2010, but the Supreme Court ordered a retrial in November 2010, saying that the Pärnu County Court and a district court had used the findings of a forensic medicine report that lacked certain criteria required by law, such as an evaluation of the examination results and a statement of grounds for the experts' opinion.

Heinväli maintains her innocence.

Estonian approves of the directive of patients’ free movement

The Estonian government approved at its session on Thursday a bill that implements the principles of the directive of free movement of patients in Estonia, LETA/Postimees Online reports.

The directive creates a possibility for all European Union member state patients to get scheduled healthcare services in any of the union's states. The implementation of the directive can result in a certain increase in the number of foreign patients in Estonia. If need be, Estonia can set access restrictions for foreign patients to protect interests of local people covered with health insurance.

"I believe that actually we will have a considerable chance for export of healthcare services and the money that accompanies foreign patients will be a strong supplement to the means of the Estonian Health Insurance Fund," said social minister Taavi Rõivas.

Estonian patients can later apply for compensations of treatment costs incurred abroad from the Estonian Health Insurance Fund, which compensates the costs according to its own price list. If treatments in other states are more expensive, patients have to pay the gap.

Currently the Heath Insurance Fund compensates treatment of patients abroad in case the fund has granted permission for it or the need for imminent treatment has emerged while abroad.

All member states have to adopt the directive by October 25 latest.

Rumors of child-snatching ring debunked

ANCHORAGE - Authorities are debunking rumors going around parts of Alaska about Russian mobsters targeting children.

The Anchorage Daily News (http://is.gd/tkTq25) says the real story is that one or two people from Estonia are selling educational materials door to door with enough information about the children inside to make parents uncomfortable. The sellers started in Fairbanks and are now working in the Mat-Su Valley.

Authorities said there is no criminal gang of Russian-speaking people using school-supply sales as a ruse to steal children.

Alaska State Troopers spokeswoman Megan Peters says the salesmen apparently got the information about the children from other neighbors as they made the rounds.

The rumors started this month and posters appeared warning about strange men showing up at homes with detailed information about the children.

Finnish doctors move to work in Estonia

The number of doctors from Finland, working in Estonia, has increased over years, Estonian business news portal Dv.ee reported referring to Meditsiiniuudised.ee.

Finland's Healthcare Department informed that a hundred Finnish doctors worked in Estonia last year, while in 2005 there were only 15 doctors employed in Estonia.

In 2012, 850 Finnish doctors found employment abroad. They are motivated to work abroad mainly by options to do scientific work, to get additional education, and to perform other development projects, reported LETA.

Savisaar takes to the airwaves as part of € 50,000 "Healthy Lifestyle Campaign"

Tallinn Mayor Edgar Savisaar has spoken on television and radio ads advocating a healthier way of life, part of a promotional campaign that has cost the city 50,000 euros. “If I manage to induce thousands to participate in the Tallinn Marathon or Nordic walking events thanks to those ads, then that is a small price to pay for our health [...]” the mayor said in a press conference today.

Savisaar, who had a heart attack in 2003, said he participates in Nordic walking almost every Saturday. Delfi reported in mid-June that Savisaar had recently needed to leave public ceremonies or to sit down in mid-speech due to fatigue.

Facing elections

North Tallinn District elder Karin Tammemägi came under fire last week for appearing on large billboards in the city, also encouraging Tallinn locals to be more physically active. She told uudised.err.ee that the ads, which feature a giant picture of her, cost 500 euros and were paid for by the city.

Opposition members of the City Council have cried foul, accusing Tammemägi of using public funds to finance what they say amount to political ads for herself and other Center Party candidates ahead of the upcoming municipal elections. One city councilor for IRL has filed a complaint with Parliament's party finances committee over the issue.

In the elections, set for October 20, the Center Party will be battling to hold on to its majority in the City Council.

Data show health linked to education

TALLINN - According to Statistics Estonia data of the 2011 Population and Housing Census (PHC 2011), 388,077 people or 30 percent of Estonian residents suffer from some long-term illness or health problem, reports LETA. People with a higher education suffer from long-term illnesses on average at half the level that people with a basic or lower education. The difference lies in coping with everyday life, where 15 percent of rural and nearly 13 percent of the urban population had serious limitations due to health problems.

Men experience long-term illnesses slightly more, until 30 years of age; women do so after 50 years of age. From the age of 30, men living in rural areas have more long-term illnesses than those at the same age in urban areas. In the case of children and young people, morbidity from long-term illnesses is relatively higher until the age of 10; thereafter morbidity decreases significantly.

About 29 percent of Estonians, 32 percent of Russians and even 38 percent of representatives of other nationalities have health problems. Education has an essential impact on people’s health; the risk for long-term illnesses is extremely high for persons with a basic education or lower. Persons aged 20–50 with higher education have on average half the long-term illnesses than persons with a basic or lower education of the same age.

Five healthcare workers organizations in Estonia refuse to sign good will agreement

Five Estonian healthcare workers' organizations announced on Monday that they are not ready to sign the good will cooperation agreement aimed to guarantee sustainability of the healthcare system, claiming that it is vague and the social minister doesn’t want to take responsibility, LETA/Postimees writes.

The cooperation agreement, preparations for which started in October last year during the doctors and nurses’ strike, was convened by the social ministry and was chaired by the then social minister Hanno Pevkur. 22 healthcare organizations were invited behind the negotiations table, representatives of employees, employers, patients and state institutions.

After five meetings, a nine-page agreement was written up, that lists dozens of specific tasks with implementation deadlines that should make the system clearer for patients and healthcare workers.

Doctors Union secretary general Katrin Rehemaa said now that they submitted a number of proposals together with Healthcare Workers Vocational Union that did not reach the agreement or the wording of which was changed considerably.

The main criticism of the medical workers who refuse to sign the agreement is that the document doesn't list, as the aim of increasing healthcare financing, that it would increase to the 2010 average EU level by 2020 in Estonia.

Social minister Taavi Rõivas said that this would mean that there should be 1.5 times more money in healthcare than there is now. "This is complicated and impossible to achieve and as the social minister I cannot sign a financial obligation that exceeds the budgetary year sum," he said.

Rõivas said that a half of the organisations that compiled the agreement have said they would sign it. "Irrespective of how many signatures there will be on the agreement, work will be started on what is written in it," said the minister.

Doctors’ strike squeezes unemployment funds

TALLINN - The Estonian government coalition submitted on Nov. 7 an amendment to the Riigikogu that would reduce the planned increase of unemployment benefits, as it needs to find resources to fund the increase in wages of the medical staff, reports Postimees.

According to a plan that was already approved in 2009, the unemployment benefit was to be increased in 2013 from 65 euros, to a half a minimum wage, or 145 euros a month. According to the amendment submitted by the government on Nov. 7, the increase is being cut to 101 euros.
After the recent strike by doctors and nurses, Social Minister Hanno Pevkur said that the money for wage increases for medical staff will most likely be found by cutting the planned unemployment benefit increase next year. The amendments to the labor contracts law that Reform Party faction chairman Jaanus Tamkivi handed over to parliament proceedings on Nov. 7 confirmed the minister’s plan.

“The bill is caused by the need to find a source for 3.5 million euros that is necessary for the increase of wages of emergency medical staff and healthcare workers financed from the state budget that was agreed upon in October 2012 as the result of the doctors and healthcare workers strike,” Tamkivi said.
“This is the last thing that will be nullified for employees in the labor contract law that was signed trilaterally in April 2008,” said Trade Unions Confederation chairman Harri Taliga. He reiterated that the government changed the planned unemployment insurance compensation rates already in 2009 and this spring, ignoring the agreement.

Health more important than budget balance, says patients group

The Estonian Patients Advocacy Council says the government should act more like Ireland when it comes to national health care.

In a November 4 statement rejecting last week's proposal from the Hospitals Association to raise money for health care by increasing patient copayments, the council referred to health care funding by countries with higher budget deficits.

"Instead of starting to direct additional resources into health care in order to improve the availability of medical care similarly to Ireland, which recently had one of Europe's highest budget deficits but which is roughly on the same scale as Estonia, the government has used health care funding to maintain budget balance. The government will not find money for improving availability of health care service," the Patients Advisory Council said in a statement to the media.

The council said Ireland had invested 280,000 euros into health care in the last five months - something that was approved of by the European Commission, the European Central Bank and International Monetary Fund.

"The fact that the IMF, known as one of the world's most stringent financial institutions, approved the investment into health care by a country in very difficult financial straits renders the claims of Estonian government representatives hollow and empty," the statement said.

The council accused the government of "simply not wanting to deal substantively with the issue."

The Hospitals Association requested on Friday that the Ministry of Social Affairs raise copayment fees for doctor's visits from 3.20 to 5 euros for outpatients and from 1.60 euros to 2.50 euros for inpatients.

The citizens of EU and USA deserve an e-leap in health care : Ilves

Estonian President Toomas Hendrik Ilves said at a high-level conference in Boston, USA, that the citizens of the European Union and the United States of America deserve an e-leap in health care.

Ilves, who was invited to Boston as a keynote speaker at the top level "2012 Transatlantic Health IT/eHealth Cooperation Assembly", an eHealth event organised by the European Union and the United States of America, searched for answers to the following question in his presentation: what are the co-operation opportunities between the EU and the USA in the contemporary organisation of medicine, which is largely dependent on information technology?

President Ilves, who led the European Union e-health work group for a year and a half at the proposal of the President of the European Commission, José Manuel Barroso, highlighted placing the focus on citizens – both as patients and clients – as the most important aspect.

"We will give people access to their own medical records, teach them how to use this information and motivate them to take the responsibility for their own health," told the Estonian Head of State.

Estonia is planning a stricter tobacco policy

Last autumn, the Ministry of Social Affairs in Estonia convened a working group to draft a new concept for the tobacco policy and the group is about to finish its task, writes LETA/Postimees Online.

In November, the working group is planning to present its proposals for a stricter tobacco policy in Estonia.

Press spokesperson of the Ministry of Social Affairs Helena Nõmmik stated that the working group convened this week, in order to once again review the most important issues in the so-called green papers.

She explained that the group discussed in particular various options for limiting access of minors to tobacco products.

Pictoral warning labels on tobacco products were also discussed, in order to determine the most effective images that could be used.

The so-called Green Paper on tobacco policy will, according to plans, be sent for approval to relevant ministries. At the end of the year 2012, the Government will discuss the proposals and then the Ministry of Social Affairs will start drafting relevant legislative amendments.

Juhan Tere

Estonian doctors continue their strike

Estonian doctors continue their strike for the second week. Since October 8th, doctors from Northeastern Estonia have joined a nationwide strike until an agreement is reached on the major points - salary and workload.

Hospitals in Pärnu, Kuressaare, Viljandi and Narva joined the action. There, as in Tallinn and Tartu, scheduled outpatient appointments will not take place.
In addition, scheduled appointments in inpatient care will also be suspended. At Tallinn's hospitals, the strike affects inpatient care. In Tartu, most surgical specialties are affected, and scheduled surgeries will also be canceled.

The Hospitals Association has proposed a 6.6 percent raise for its employees, but that is contingent on whether the Health Insurance Fund agrees to make changes in its prices for service.

Finland attracts doctors from Estonia

Estonian doctors striking for better pay and working conditions.

Külvar Mand, a doctor who works in Finland and Estonia, was waking a patient up from anaesthesia at the eye clinic of the East Tallinn Central Hospital.
 
Wake up. Open your eyes too. Can you hear me?" Mand says in a soothing voice.
 
Today, Monday, Estonian doctors are waking up the whole country much less gently than Mand rouses his patient. Doctors in Estonia are launching a strike, the likes of which has never been seen in the country. Earlier, only teachers and railway workers have been on strike for more than a day in Estonia.´With their strike the doctors want to draw attention to the issue of brain drain affecting health care personnel, and to the deterioration of the Estonian health care system.

Estonian doctors strike as wage row triggers emigration

Estonian doctors and nurses at the country’s biggest hospitals began a strike, demanding higher wages to stem an exodus of medical staff from the Baltic nation.

Three hospitals in the capital, Tallinn, and one in the second-biggest city, Tartu, halted outpatient services, except for those under 18, pregnant or oncological patients, according to statements on the hospitals’ websites today. They may stop inpatient care starting Oct. 8, while hospitals in four more towns may also join the strike.

Teachers went on strike in March to demand higher salaries as Estonia became the only euro-area nation to post budget surpluses in the last two years by freezing public wages. Doctors and nurses are leaving for countries such as Finland, where vacancies are increasing, salaries are four times higher and the language is closely related to Estonian. Workloads for staff who stay have been pushed too high, the unions say.

The unions demand an increase in the lowest hourly wages for doctors to 8.6 euros ($11.1) from 7.2 euros now, with a raise to 12 euros by 2014. Nurses want hourly wages raised to 7.7 euros in two years from 3.8 euros, and hospice workers seek an increase to 4.2 euros from 2.1 euros. The employers, financed by the Health Insurance Fund, last week offered a pay increase of 6.6 percent starting next year.

Prime Minister Andrus Ansip called unions’ demands “totally unrealistic” on Sept. 26. The Cabinet approved next year’s budget earlier last week to raise minimum monthly wages for teachers by up to 18 percent to 715 euros, compared with an overall increase in public salaries of 4.4 percent.

Ott Ummelas

Estonian doctors plan to strike in October to help stem outflow

Estonian doctors called a strike for next month after attempts to negotiate wage increases with the government and employers failed.

The main goal of the work stoppage is to prevent doctors and nurses from emigrating, the doctors’ union said in an e- mailed statement today. The duration of the strike hasn’t been decided.

About a quarter of Estonia’s 4,000 specialized doctors are above pension age, and more than a third of all physicians are considering working abroad, the union said in June.

Doctors in the North Estonia Medical Center, the country’s biggest hospital, earn an average monthly wage of 2,296 euros ($2,893), compared with the national average of 900 euros, while they exceed nominal workloads by 43 percent on average, the hospital said.

Ott Ummelas 

Estonia is the 57th healthiest country in the world

Bloomberg compiled a list of the healthiest countries and determined that Estonia ranked 57th in the list, writes LETA/Äripäev.ee. Latvia is ranked 79th and Lithuania 81st.

Estonia remained behind countries such as Syria, Macedonia, Oman and Libya, for example. The healthiest country in the world is Singapore, which is followed by Italy, Australia, Switzerland, Japan, Israel etc. Finland ranked 22nd, Latvia 79th and Lithuania 81st.

The list was compiled on the basis of the life expectancy at moment of birth, child mortality rate, causes of death, the proportion of smokers to the entire population, obesity rate, sedentary lifestyle, excessive cholesterol, high blood pressure, AIDS as well as on the basis of housing and external environment pollution.

Juhan Tere