Within a few years, every third child will not have a general practitioner, stated the Czech Association of General Practitioners of Jan Evangelisty Purkyně and the Association of General Practitioners for Children and Adolescents of the Czech Republic. A large proportion of practitioners will soon retire, with almost half over 60 and over 14 per cent over 70. They therefore propose a simplification of education for doctors in outpatient clinics.
According to the association, there are currently around 1,800 surgeries for children in the Czech Republic, with about 300 less than optimal capacity. Between 2017 and 2021, 338 surgeries closed without compensation. According to data from last December, 813 practitioners were over 60 years old. Today, people in their sixties born in 1962 have a retirement age of 64.5 years according to data on the website of the Czech Social Security Administration. However, a large number of pediatricians are women, whose age decreases according to the number of children. With two children, they retire a year and a quarter earlier, with three or four at 61 years and eight months.
According to Alena Šebková, chairwoman of the Professional Association of Pediatric Practitioners, changes in education should facilitate the arrival of young doctors. “This is not a radical innovation or an unproven experiment, we are returning to the earlier system of two attestations. A shorter field would be added to the existing field of pediatrics, only for general practitioners for children and adolescents with very intensive practice,” she explained. This system operated between 2004 and 2017, and is similar for GPs for adults.
Future doctors are currently studying the field of paediatrics, they can go to work both in hospitals and in a practitioner’s office, or even specialize as a child psychiatrist. Every year, according to the data of the Czech Pediatric Society, the pediatric branch selects about 200 young doctors after graduating from the medical faculty, the field being one of the most popular.
However, according to practitioners, the change lengthened the study and reduced the volume of practice directly in doctor’s offices in favor of hospital children’s departments. “The change does not affect the field of pediatrics in any way, it only creates an intermediate step that enables new colleagues to get quality education and a faster entry into practice,” Šebková added.
According to the president of the association, Ilona Hülléová, the adjustment of education, in which his trainee would also work in the doctor-trainer’s office, would lead to an immediate strengthening of the office’s capacity. “Especially in the case of a young colleague taking over the practice in the future, this model has proven itself very well. It brings benefits both for the doctor and especially for our young patients and their parents, as the continuation of care by a practicing pediatrician, whom they already know, is ensured,” she said.
But according to a statement from the pediatric society sent to the health minister, the study should remain joint. A change in education since 2004 has resulted in fewer than 30 practitioners certifying per year, the need was around 50 then and the current requirement is 80 per year. “Now, for the first time since the 1990s, it certifies over 100 pediatricians a year, of which at least two-thirds should go into primary care,” the pediatric society said. According to her, however, there is a lack of pediatricians in hospitals as well.
This year, the Ministry of Health financially supported the creation of 80 places for education in pediatricians’ offices. Minister of Health Vlastimil Válek (TOP 09) said at the time that the data confirm that more pediatricians remain in hospitals. By the summer, he wants to present his vision of changes in pediatrics, and by the end of the year he wants to prepare a change in legislation.
The availability of health care, including a pediatric general practitioner, is the responsibility of the health insurance company. According to the VZP map, there are not enough surgeries, for example, in all regions of the Karlovy Vary Region except Ostrov and the surrounding area and in a large part of the Central Bohemian Region. On the contrary, according to the VZP, the demand is satisfied in the whole of South Bohemia, Zlín and most of the Pilsen and Pardubice regions.
The Health Insurance Company of the Ministry of the Interior stated last May that some patients have to travel to the general practitioner for a longer time than the time availability set by the government regulation. According to her, the situation is particularly difficult in the South Moravian and Ústí Regions, but there are also problems in the Pilsen and South Bohemian Regions or parts of Central Bohemia and the Highlands.
