Latvia

Health systems in transition
Latvia
These Regulations specify that the HSMTSA is responsible for assessing and
approving medical technologies.
“Regulations of the Cabinet of Ministers on Establishment, Fulfilment and
Maintenance of the Medical Persons Register” (2005)
These documents stipulate that all health sector workers must report to
the Register within one month following initiation of their professional
activities.
“Regulations of the Cabinet of Ministers on Reimbursement System of
Pharmaceuticals and Medical Devices” (2006)
These Regulations redefine the principles of reimbursement, and determine a
reference pricing system in pursuit of cost-containment in the pharmaceuticals
sector.
Policy process and reform implementation
A significant part of the Latvian health care reform process of recent years
has been organized and driven by a World Bank “Health Reform Project”,
agreed between the World Bank and the Latvian Ministry of Welfare in
1998, and involving a loan of US$ 12 million and additional financing of
approximately US$ 5.5 million (with cost overruns of approximately US$ 2.5
million). Additional partners in the project have been the Swedish International
Development Agency and the SCHIA.
The project was intended to support the Government of Latvia to implement a
long-term restructuring strategy in the health services sector. It was to be carried
out in two phases. Objectives for Phase I included policy reforms, institution
building and skills development in health financing, health investment policy,
reform of PHC, restructuring of the hospital sector, and the development of
effective public health programmes. Phase II was to support a Consolidated
Health Investment Programme by directly financing investments in the
implementation of health services restructuring, according to a Master Plan.
Phase I of the project was completed in 2004. Phase II did not materialize
for political reasons. However, the Master Plan was implemented with
the use of internal financing, rather than through World Bank financing.
The implementation of the Master Plan is discussed in Section 7.2 Future
developments.
Most of the reforms discussed in the following sections were undertaken
either as part of the World Bank project, or were strongly influenced by it.
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