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Several doctors criticize the Federal Office of Public Health, which squanders tax revenue and endangers basic medical care. Contacted, the authorities defend themselves and reject the accusations.
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- Daniel Krähenbühl/ofu
“The activism of the Federal Office of Public Health generates immense costs. The office should urgently question itself and relaunch several failed projects. In an article published in the Bulletin of Swiss doctorsthe Zurich doctor Felix Huber, director of the emergency practice MediX, violently attacks the FOPH, criticizing various projects launched in recent years (see box).
Whether it’s the law on quality of care, the electronic patient file or the planned measures to control costs: according to Felix Huber, many projects in the field of health are unrealistic, complicate the life of doctors and patients and cost millions. “Only bureaucrats still work at the FOPH,” he criticizes. These officials would ignore the concerns and demands of the medical profession and hospitals.
“A bureaucratic nightmare”
“Doctors are in turmoil, says Felix Huber once more. I just expressed what many have been thinking for a long time. Since the publication of his article, he has reportedly received more than 50 letters, all positive so far. His goal would be to avoid a “bureaucratic nightmare” for doctors and hospitals, he says.
According to him, the FOPH is not solely responsible for the failure of the projects. Parliament would also have its share of responsibility. “Politics is simply overwhelmed by the pace and the many new proposals.” This is why it is now extremely important to take stock of the situation in order to be able to eliminate projects without added value, concludes the Zurich doctor.
Basic medical care at risk
Felix Huber is not the only one to think so. Philippe Luchsinger, president of the Swiss Association of Family and Child Physicians, recently criticized the quality of care law in the association’s online magazine, viewpoints. His conclusion: “The quality law destroys quality.” What worries him is the fact of wanting to regulate everything and this, with inadequate means, declares Luchsinger, contacted by our German-speaking colleagues from “20 Minuten”. The various measures that are currently being discussed would even jeopardize basic medical care.
But accusing only the FOPH would not go far enough, adds Philippe Luchsinger. “Various bodies, such as the Federal Council or Parliament, are also involved in these issues.” He thus recalls that the various cost control projects were a mandate from the Federal Council, drawn up by a group of experts. “However, no representative of the medical profession was part of this group of experts.”
The OFSP rejects the accusations
The Federal Office of Public Health does not accept criticism (see below). “The FOPH has always collaborated in a very constructive way with all the actors of the health system”, declares its spokesperson, Jonas Montani. There are also regular and constructive exchanges with the Federation of Swiss Doctors (FMH) and family doctors, he continues. “We take all criticism seriously, but on the other hand, we are also critical of generalizations.”
Law on the quality of care: “A bureaucratic and unsuitable monster”
The Quality Act was passed by Parliament in 2019 following years of discussion. It provides for the creation of a Federal Commission for Quality, which will have around 45 million francs at its disposal until 2024. Felix Huber affirms this: “The law completely misses reality and sets absolutely unrealistic objectives for improve quality.” FOPH spokesman Jonas Montani contradicts this: “The law was adopted by Parliament. The criticism that the Patient Safety Foundation is paralyzed by law is not correct.”
Electronic patient record: ‘Will never work’
The electronic patient record (EPD) has been gradually introduced nationwide since the beginning of 2021. “The DEP is poorly put together and will never work,” says Felix Huber. And this because the population will not accept the “complicated registration procedure”. Jonas Montani, however, claims: “During the adoption by Parliament, it was expressly mentioned that dissemination and use should be encouraged in a targeted manner.”
Electronic vaccination record: “No future”
The mesvaccins.ch electronic vaccination record, supported by the FOPH to the tune of 950,000 francs per year, was discontinued in 2021 for data protection reasons. The solution planned by the FOPH to succeed it via the DEP will probably never be applied either, according to Huber. “Result: Immediately halt the exercise and set up a new responsible body.”
The FOPH spokesperson says: “There are plans to integrate the electronic vaccination record into the DEP. Work on this has begun.”
Replacement of the Swiss Medical Board: “Failure”
Since 2008, the Swiss Medical Board (SMB) has been examining the effectiveness, adequacy and cost-effectiveness of medical services. In 2015, the FOPH set up its own benefits assessment committee and ended its collaboration with the SMB. “The new FOPH service has an annual budget of around five million francs and eight full-time positions,” explains Huber. However, according to him, no report worthy of the name has been published for five years. “Result: failed, stop immediately and allow the creation of a new responsible body.” Montani counters that 22 reports have been published since 2015.
