EXCLUSIVE “Do we have everything?” How many patients with major burns Romania transported abroad in 2022

According to the latest data provided by the Ministry of Health upon request by HotNews.ro, in the first 9 months of 2022, only 10 patients with serious burns (major burns) were transferred for treatment to a hospital outside the country. During the same period last year, 22 severe burn patients were transported abroad.

Commemoration of the victims of the fire at the Kolectiv club.Photo: AGERPRES

The number of Romanians with serious burns transported outside the country remains insignificant 7 years after the fire in the “Kolectiv” club, although 2 years ago the Ministry of Health approved a mechanism for the transfer abroad of severely burned patients for whom there are no treatment conditions in the country and clear transfer criteria.

Even today, Romania does not even have a center for the treatment of major burns, and nosocomial infections are not reported in hospitals. Under these conditions, in December 2020, an order of the Ministry of Health introduced a mechanism for the transfer abroad of patients with very severe burns and clear and transparent transfer criteria.

The number of major burns transferred abroad has not increased even after the establishment of the Transmission Mechanism

On the basis of Law 544/2001 on access to information of public interest, HotNews.ro asked the Ministry of Health to reveal how many patients with serious burns were transferred abroad this year based on the transfer mechanism and how many were transferred for the same period. last year:

HotNews.ro question:

How many patients with severe burns from Romania were transferred to hospitals outside the country from January 1, 2022 to this date (the first 9 months of the year – ed.), based on the criteria established by the Mechanism for the transfer of patients with severe burns, approved by the order of the Ministry of Health in 2020 ?

The answer of the Ministry of Health:

In the period from January 1, 2022 to September 28, 2022, 10 burn patients were transported abroad for treatment.

Collective tribute

HotNews.ro question:

How many patients with severe burns from Romania were transferred to hospitals outside the country during the same period of 2021 – January 1, 2021 – the end of September 2021 – based on the criteria established by the Mechanism for the transfer of patients with severe burns, approved by the Order of the Minister of Health in 2020?

The answer of the Ministry of Health:

In the period from January 1, 2021 to the end of September 2021, 22 burn patients were transported for treatment abroad.

Between 2016 and 2020, before the approval of the transfer mechanism, Romania carried out 40 international transfers of patients with severe burns.

Overall, official data show that the number of transferred patients with major burns has not increased even after the approval of the Transfer Mechanism.

How many large burns in Romania: several dozen per month, several hundred per year

Romania has the highest number of serious burns in Europe – from 600 to 800 serious burns annually. The collective case was only the tip of the iceberg and drew attention to the lack of conditions for the treatment of these patients, being the first collective accident with large burns in our country. However, the problem has always existed, and its solution is postponed.

In October 2019, Sorina Pintja, then Minister of Health, told HotNews.ro that 70-75 patients with severe burns were registered in Romania every month, the highest in Europe. Some of them are treated in the country, some are transferred abroad, said Sorina Pintja, the health minister, during whose tenure the largest number of patients with major burns was transported outside the country.

“After 4 years, we should have had much more. In the future, if, God forbid, we had a new collective episode, we would not be able to treat all patients in Romania, that is clear, but no country in the world could. But we have evolved, we admit that we cannot“Sorina Pintja told HotNews.ro in October 2019.

Why Romanian hospitals cannot treat serious burns and have to transfer them abroad

Seven years after the fire at the Colectiv club, there is no center in Romania that specializes in the treatment of major burns.

Patients with severe burns will require treatment in maximum security conditions in Romania in severe burn centers – the only facilities where patients with very serious burns, such as Colectiv patients, but not only, can be treated in maximum security conditions. Romania has not yet.

In Romania, with the funds of the World Bank, it was planned to build 4 such centers – two in Bucharest and one each in Timisoara and Tirgu Mures. Centers all these years existed only on paper, and when they will be done, no one knows. Even if they were talking about their construction even before the fire in “Kolectiv”.

Why we don’t have any major burn centres: ‘Lots of red tape, lots of neglect and years of the world not caring’

Four centers for patients with severe burns — two in Bucharest, one in Timisoara and one in Tirgu Mures — were to be built in Romania after 2020, Sorina Pintia, then the health minister, said in November 2018. Pintia also said , that it is a “realistic term”.

Sorina Pintja added that these centers were supposed to be built since 2014, when the government decided to do so, but “there was a lot of bureaucracy, a lot of neglect and years when the world was not interested.”

Currently, there are only functional burn wards in Romania – in Bucharest, Timisoara or Iași, but even they do not have enough beds.

Functional burn units can provide care only to patients of a certain degree of severity – in terms of surface and depth of burns – inferior to burn centers.

Last but not least, patients with severe burns cannot currently recover in Romania, as there are no special rehabilitation centers for them.

The transmission mechanism, which was stored in a box for 2 years and finally approved under pressure from the survivors of the Collective and the press

A transfer mechanism to hospitals abroad for patients with severe burns (large burns) who cannot be treated in the country was approved by the Ministry of Health after years of hesitation in December 2020. The transfer mechanism was developed by doctors and victims of the fire to the “Collective” club.

Work on its development began back in 2018, during Sorina Pintya’s tenure as Minister of Health, and the draft regulation was almost completed at the time of her departure from the management of the institution (autumn 2018).

Finally, after much hesitation and pressure from Collective fire survivors and the media, the mechanism was approved by ministerial order in December 2020, during the ministerial mandate of Nelu Tetaru.

Protest by families and survivors of the fire at the Colectiv club at the Bucharest Court of Appeal, October 2021.

What provides the mechanism of transmission of large burns?

How the mechanism of transmission of major burns works, at least on paper – according to the order of the Minister of Health, by which it was introduced:

Within 10 days after publication in the Official Gazette, commissions will be created at the level of medical units that handle cases of severe burns, which will analyze the patient’s medical record and determine the need to transfer patients with severe burns abroad. of this Order.

They will approve transfer only for cases that meet the criteria for admission to burn centers as per the provisions of Appendix no. 5 of the order of the Minister of Health No. 476/2017 with the following changes and additions. The assessment of the possibility of transfer is carried out in accordance with the provisions of Appendix 8 of the same normative act.

The commissions will consist of 3 people: the patient’s attending physician, a physician specializing in anesthesiology and intensive care, and a physician specializing in plastic surgery, aesthetic and reconstructive microsurgery, or general surgery, depending on the circumstances determined in advance by the decision. sanitary stations of the medical head of the unit, which ensure the management of patients with severe burns, taking into account the monthly schedule of guards.

These commissions meet urgently at the request of the patient’s doctor, within a maximum of 2 hours after receiving the case, analyze the patient’s medical record and, if necessary, approve a motivated transfer.

Decisions of the commissions are made by consensus and are sent to the Ministry of Emergency Situations Department for transmission to specialized units abroad.

For this approach, the Ministry of Health and the Ministry of Internal Affairs will conclude a protocol on cooperation and coordination.

Within 60 days from the date of entry into force of the new regulations, the Ministry of Health will initiate the necessary actions to conclude cooperation protocols with medical units abroad that provide medical assistance to relatives.

Also, the order on amendments and additions to the order of the Minister of Health No. 1419/2017 on the approval of the order of administration, financing and implementation of priority measures for the treatment of patients with burns provides that the calculations for expenses are carried out directly in health care institutions on the basis of medical documents and bills related to medical services. which the patient received from the budget of the Ministry of Health within the framework of AP-ARSURI priority actions.