The Minister of Health and Labour Jevgeni Ossinovski replied to the interpellation concerning the 9 million euro deficit of the Estonian Health Insurance Fund and the future of health services (No. 146), submitted by members of the Riigikogu Raivo Põldaru, Martin Helme, Henn Põlluaas, Mart Helme, Jaak Madison, Uno Kaskpeit and Arno Sild on 8 February.

The interpellators referred to the fact that, according to this year’s budget, the Health Insurance Fund will run into a 9-million euro deficit. Chairman of Management Board of the Health Insurance Fund Tanel Ross has said to the media that the structural deficit of the Health Insurance Fund may increase even more in the future. The reserves that have been used so far are beginning to come to an end. The interpellators wished to know what was planned to be done with this deficit of the Health Insurance Fund.

Ossinovski explained that the budget deficit of the Health Insurance Fund had to be viewed in a slightly wider context. “Indeed, this year’s budget position that has been established in the state budget by the Riigikogu is minus 9.1 million euro,” the Minister said. He added that, at the same time, it has a content impact above all on the structural position of the central government of the state. “It will not affect the financial capacity of the Health Insurance Fund in itself. That is because, as at the end of 2015, the reserves of the Health Insurance Fund total approximately 196 million euro and, of that, 117 million euro comprise the undistributed total net gain of previous years,” Ossinovski said. In his words, it has been at the expense of this earlier total net gain that the annual budget has gone into minus in recent years. The Minister stated that going into minus to fund health services at the expense of the existing reserves can be done for a certain time. “At some point we will reach the limits of the risk reserve, and it will be in the period of 2022–2023. So that actually we will have no problems with the funding of health care in the coming years,” Ossinovski said. He admitted that the system needed changing in a longer perspective. “Health insurance that is based only on labour taxes is not sustainable in Estonia, at least as long as we have a decreasing, and not increasing, number of working age people,” Ossinovski noted.

The Minister of Health and Labour also replied to the interpellation concerning the closing down of family physician points (No. 132), submitted by 16 members of the Estonian Centre Party faction.

Ossinovski explained that, considering the population forecasts for Estonia, maintenance of small practice lists is not sustainable in a long-term perspective exactly because it is very difficult to find family physicians for them. That is why the Health Board together with the Ministry of Social Affairs are moving towards merging the different practice lists with the aim of ensuring the availability of primary health care service to all residents through larger practice list areas.

Ossinovski also replied to the third interpellation, in which 14 members of the Estonian Centre Party faction requested information on specialised medical care in Narva (No. 140).

The Minister explained that, after discussions with the Health Insurance Fund, it had been agreed that contract negotiations would be held trilaterally, that is, between Narva Hospital, Ida-Viru Central Hospital and the Health Insurance Fund. “The Health Insurance Fund has expressed readiness to ensure the provision of the necessary specialties in Narva if it can be done in cooperation. Here we have certainty that the respective specialties will not have to be closed down in Narva. In the case of certain specialties, an agreement has already been reached that they are provided in cooperation with Ida-Viru Central Hospital,” the Minister said. He confirmed that there is a real need to provide these 18 specialties in Narva. If it is done in cooperation, then these services can be provided in Narva and patients do not need to travel.

The Minister of Culture Indrek Saar replied to the interpellation concerning the designation of state cultural awards (No. 143).

The Minister of the Environment Marko Pomerants replied to the interpellation concerning the future of oil shale in the light of the Paris Climate Agreement (No. 151).

The Minister of Justice Urmas Reinsalu replied to the interpellation concerning e-elections and e-voters (No. 141).

The Minister of Education and Research Jürgen Ligi replied to the interpellation concerning the organisation of adult vocational training (No. 133).

The Minister of Economic Affairs and Infrastructure Kristen Michal replied to the interpellation concerning the situation of Ida-Virumaa (No. 142) and the interpellation concerning the future of railway sector (No. 144).

The Minister of Entrepreneurship Liisa Oviir replied to the interpellation concerning the Estonian tourism sector (No. 157). The replying to this interpellation was included in the agenda today.

At the same time, several other changes were made to the agenda for the working week. Prime Minister Taavi Rõivas will reply to the interpellation concerning the apartment buildings that have been left without heating (No. 130) next Monday, on 14 March. The Minister of Education and Research Jürgen Ligi did not have to reply to the interpellation concerning the children who fail to comply with the obligation to attend school (No. 131), because the interpellators withdrew it. On the motion of the lead committee, the second reading of the Bill on Amendments to the Public Transport Act (159 SE), initiated by members of the Riigikogu Deniss Boroditsh and Urve Palo, was removed from the agenda for Tuesday’s sitting.

The sitting ended at 9.29 p.m.

Verbatim record of the sitting (in Estonian):

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Riigikogu Press Service

Gunnar Paal, 6316351, 51902837

[email protected]