1. Ministry of Health, Labour and Social welfare Montenegro HEALTH SYSTEM MONTENEGRO

2. Strategy defines the elements of planning activities, which shall be carried out in the health system, with the aim to undertake political, economic, social, scientific, expert, management, and legislative measures to reform the health system. The strategy for health reform opens up the process of necessary reform to the health system in Montenegro, which shall provide better quality health care, improve health and improve the state of health of the population. THE MINISTRY OF HEALTH FOR THE OF MONTENEGRO HAVE PASSED ON THE HEALTH DEVELOPMENT STRATEGY ON SEPTEMBER OF 2003

3. 1) UNIVERSALITY 2) EQUALITY 3) ACCESSIBILITY 4)QUALITY AND EFFICIENCY Health policy, which has the aim to carry out health system reform, shall proceed from the following general principles:

4. Health development Project is a base of Primary Health care reform (financed by World bank and CIDA) First step - Establishing of legal frame for carrying out Primary Health care reform PASSED SO FARTO BE PASSED  Health care Law  Health care insurance Law  Compulsory records in the field of health care  Law on Medicines and  Law on medicinal products  The Law on patient rights  The law on health care  The law on transplantation  The law on assistant reproductive tehnologies  The law on genetic privacy  The law on taking of biological samples

5. BASIC CONCEPT OF PRIMARY HEALTH CARE REFORM The chosen doctor project is already tested in Primary Health care Center Podgorica, and it is already implemented into others parts of our state. 1. chosen doctor for adults 2. chosen doctor for children 3. chosen doctor for women It is espected that chosen doctor activities should take health care of 80% of diseases Primary Health care Center is becoming the center of support for the chosen doctor activities Standards and regulations regarding to work of chosen doctor Primary Health care Centers are supplied by equpment according to needs of the reform; Reconstruction and adaptation of Primary Health care Centers Education of medical staff is organised trough three levels of education: 1. continuing education of medical staff on primary health level 2. continuing education of specialists 3. establishing of cathedre for family medicine

6.  New role of managing health care institution on primary level (strenghtening of administrative capaticies trough advanced level of education - CIDA Project)  The new method for payment of primary health care is established - combination per capita payment and payment for services provided by chosen doctor.  This kind of payment will start from January 2009.

7.  Privatization of dentistry service  Chosen dentist, privatiser provides services included in general pocket of services (children up to 18 years old, pregnant women;emergency cases and persons over 65 years old)  Services are provided on contract basis (between Health Insurance Found and chosen dentist)

8.  An electronic citizen’s health card is established as a central element for medical documentation  Integrated Health information system is established in order to support Primary Health Care reform  Each citizen will have his own electronic card which will keep certain data about each user, thus contributing the improvement of health services quality  Enable access to data by different participants in the health system according to the defined levels of access.  Including of electronic invoice which will be sent to Public Health Institute and Ministry of Health, Labour and Social Welfare HEALTH CARE INFORMATION SYSTEM New health care information system is implemented in order to carry out PHCR

9. All activities regarding primary health care reform are going to be finished by the end of 2008. present problems on secondary and tertiary health care level:  Lack of separation between secondary and tertiary health care  Lack of efficiency  Irracional and uncontrolled drug consumption and lack of system control  Unefficient health care institution managing  Inadequate mechanism of providing health care services

10. TASKS:  Establishing of standards and regulations regarding providing of health services  Establishing General Pocket of services, creating of clinical protocols and guidelines  Implementation of new payment method  Establishing of Health institution network WE ARE AWARE THAT:  This is very complex and long term process which depends on social and economic development,  Expiriences of other countries are a very prescious help for us, but nevertheless every country is supposed to chose an adequate model of reform  The Health system undergoes constant changes, so we will try to adopt and include all the needed steps in order to provide better health service for our citizens