Slovak Health Minister Vladimír Lengvarský wants to reduce the number of children's emergency rooms. As the SME daily cited the minister, the main reason for such a step is a shortage of paediatricians, who agree that this is a step in the right direction. According to data from the National Centre for Health Information, the number of paediatricians has been declining in Slovakia for the past three years, standing at 841 in 2021, having dropped by approximately 10% since 20109. Their age composition is also a problem. A significant number of them are over 70 years old.
According to the Health Minister, emergency rooms should be closed especially in towns where there are hospitals with a children's ward. However, the doctors warn that if the number of children's emergency rooms is reduced, their patients will only be shifted to the emergency rooms of hospitals, which are already overloaded and lacking doctors especially in big cities.
As the SME daily explains, for the patient, this could mean waiting even longer than before for treatment. There are 56 paediatric emergency rooms, according to the ministry, while in 2016, there were 73 of them.
"When the emergency rooms, where mainly general practitioners for children and adolescents serve, are reduced, who will provide emergency care in the hospital ward, where there are also few paediatricians? It's just shifting the problem to someone else," says Milan Kuchta, head of the Slovak Paediatric Society and working at the Children and Adolescent Clinic of the Louis Pasteur University Hospital in Košice.
The Slovak Hospital Association does not like this simple application of the formula for reducing emergency rooms either. "Urgent admissions are for adults and the doctors in them do not have a specialisation in caring for children," the association said in a statement. According to the association, the second problem is that doctors in children's wards cannot replace children's emergency rooms because they will fail to care for difficult patients in their wards. The quality of health care that is provided to hospitalized children could suffer as a result.
Despite his reservations, Tomáš Szalay, a district doctor in Bratislava, considers Lengvarský's proposal to be a good one. "I consider the duplication of services - in the children's ward and in the emergency room - a waste of precious capacity," he says. However, he says the proposal was poorly communicated. "It may cause a backlash and in the end this proposal will not pass in any form. Children are a sensitive subject," the doctor explains.
According to Szalay the problem lies elsewhere. People do not know what an emergency room is for and what urgent care is for. Therefore, a reduction in the number of emergency rooms should be preceded by an awareness campaign by the ministry, explaining what diagnoses one goes to the emergency room with, what diagnoses one goes to the urgent care with, and in what cases one should stay at home. He believes that if only parents with children who really need it would go to the emergency room, their numbers, and therefore the waiting times, would be significantly reduced.
So when to go to the ER with a child? For example, if the child's temperature rises significantly in the evening and the parents are unable to bring it down with standard medication. In that case, waiting until morning could be dangerous, the SME daily writes.
Source: SME.sk
