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He referred to the exercise scheduled for 18 and 19 November at the Dr. Constantin Papilian Military Emergency Clinical Hospital in Cluj, designed to test medical evacuation and the management of mass-casualty incidents amid hybrid attacks and disruptions to critical infrastructure.

Continuity of healthcare services also depends on reliable digital infrastructure and secure communications, emphasized Major General Eng. Gabriel David, First Deputy Director, Special Telecommunications Service (STS).

"The Special Telecommunications Service provides the public healthcare sector with everything from applications and hosting to infrastructure, communications and networks that interconnect medical institutions. Every service must be available 24 hours a day, seven days a week, because any interruption can have consequences, sometimes serious ones. Security is equally important, because the exposure of patient data would be extremely serious. This year, we completed the construction of four new data centres, which can also be made available to the healthcare sector." said Major General Eng. Gabriel David, First Deputy Director, Special Telecommunications Service.

Hospital investment must support healthcare services that remain operational over the long term

Vlad Mixich, Health Policy Expert and Team Leader, European Investment Bank (EIB), highlighted the need for a long-term approach to investment in healthcare infrastructure that considers both the financing required to build or modernize hospitals and the resources needed to operate them.

"Any major investment in Romania's healthcare system must demonstrate the sustainability of human resources over the medium and long term. There is little point in building new hospitals or renovating existing ones if we do not have the doctors and nurses, with the required specialisations and in sufficient numbers, to operate a hospital according to the standards of 21st-century medicine." said Vlad Mixich, Health Policy Expert and Team Leader at the European Investment Bank.

From treating disease to prevention and assessing patient outcomes

Representatives of the healthcare professions also highlighted the importance of prevention and a patient-centred approach to care.

Prof. Valeriu Gheorghita, MD, PhD, Director General, Prof. Dr. Agrippa Ionescu Emergency Clinical Hospital, and Member of the Infectious Diseases Commission of the Romanian College of Physicians, advocated a shift from financing healthcare services based on their volume to models that take patient outcomes into account.

"I believe that improving the efficiency of the healthcare system will only be possible when outcomes are linked to financing. In other words, when we move from what is known as fee-for-service, meaning payment based on the number of services provided regardless of their results, to what is known as value-based care, where the outcomes achieved through the services we provide also matter. We do not need to invent something that works here in Romania; we simply need to look at what others have done and try to adapt it to our country's circumstances." said Valeriu Gheorghita.

Assoc. Prof. Adrian Pana, MD, PhD, Director, National Centre for Public Health Statistics, National Institute of Public Health (INSP), drew attention to the importance of primary healthcare and investment in public health.

"Hospital care and medicines account for 80% of our current spending. Changing this balance requires a shared understanding; the National Health Insurance House cannot do it alone. Better data, a stronger focus on public health and properly delivered basic services free up funding for more efficient hospitals." said Adrian Pana.

Access to patient data would also enable pharmacists to contribute more to treatment safety. Anca Crupariu, Pharmacist and Spokesperson for the Romanian College of Pharmacists, explained:

"Digitalisation would be a breath of fresh air for pharmacies in Romania. If the electronic health record were integrated into the platform, pharmacists could access patients' medical histories." said Anca Crupariu.

The need for greater investment in prevention is also reflected in children's oral health: according to data presented by Dr. Florin Dan Cezar Lazarescu, President of the Romanian Dental Council, 66% of children have dental caries, and only one in two brushes their teeth twice a day.

"Given budgetary constraints, we consider investment in prevention a priority. A gradual shift from reimbursing curative treatments towards preventive treatments could bring us long-term benefits." said Florin Dan Cezar Lazarescu.

The National Public Health Conference #UndeDoare was organized by BUCHAREST CENTER FOR ECONOMY & SOCIETY (CES Bucharest), in partnership with the Carol I Central University Library, with the support of MSD, Medtronic, Reteaua de Sanatate REGINA MARIA and Uniunea Nationala a Societatilor de Asigurare si Reasigurare din Romania (UNSAR).

Four in ten Romanians unable to face unexpected expenses, Eurostat says