Prime Minister Nika Gilauri's View on the Healthcare Reform
Over the past several months we have been working on systemic healthcare reform covering all the components of the field and solving all the related problems in a stepwise manner. Today we would like to present the outcomes of our work - the state's view and particular plan of systemic healthcare reform. The key goal of the reform is to provide top quality medical services available for the population. In other words, modern standard medical clinics and hospitals (mainly in private ownership, as well as in the state ownership, where necessary) recruited with high-quality doctors are necessary to be available, on the one hand, the population shall be insured by private insurance companies, on the other hand, and a strong, independent mediation service shall exist amidst thereof to settle any dispute arisen among the population insured, hospitals and insurance companies.
One of the components of the healthcare reform was the 100 Hospitals program which wasn't implemented due to objective reasons, and as a result of financial crisis, corresponding funds couldn't be raised from the international financial institutions. However, this does not mean that nothing has been done in this field. On the contrary, quite a lot of important changes have been made and many successful projects have been initiated. Three years ago only 40 000 people were insured in Georgia, and at present this figure has increased to 1,5 million which includes insurance of about 900 000 the most helpless citizens, all teachers, policemen and etc. According to the latest changes the insurance package includes the component of co-funding the most frequently used medications.
At present a village doctor is available in every village, for the purpose of which 1200 doctors and 1300 nurses have been retrained for the recent years.
Hospitals equipped with the latest medical technology have been built in Kutaisi, Zugdidi, Gori, Batumi (building process is coming to an end), Tbilisi - TODUA MEDICAL CENTER (old RAILWAY 
CLINIC), MEDICLUB GEORGIA clinic, NEOCLINIC - Swedish-Georgian Investment in Bakhtrioni street, GOCHA INGOROKVA NEUROSURGERY CENTRE, a group of private clinics within IASHVILI CLINIC, Multi-profile Hospital in Ortachala (building is coming to an end), AVERSI clinic in Saburtalo; Mediator Service has been established; Law on Medicines has entered into force which ensured increase of competition on the medicines market and reduction of prices for medicines
However, this is not enough and at this stage it's necessary to have built more modern standard hospitals in regions and the capital city. Therefore, we modified the 100 Hospitals program and invited insurance companies to bid. Insurance provided by the insurance companies has only covered 900 000 the most helpless people for the period of one year until now, for which the companies used to receive corresponding premium per the insured from the state. There existed two problems - the amount of good hospitals was not sufficient and the insurance companies paid much money every year for so called acquisition i.e. attraction of population, promotion. According to the outcomes of the tender held 10 days ago, such costs have been annulled - the company winning in each region will insure all helpless people in the respective region for the period of three years. Successful companies have been selected through auction, i.e. the company requiring the least amount from the state for the current standard insurance package (covering co-funding of medicines within about 50 lari) has won the tender. In return, the savings will be spent on building of hospitals. Winning companies shall be liable to build new, modern hospitals in the regions that will create new work places within the regions.
For example, IMEDI L having won in Telavi, Akhmeta and Kvareli regions will insure all the helpless people living there and at the same time shall be liable to build a 70-bed hospital in Telavi, a 15-bed hospital in Akhmeta, and a 15-bed hospital in Kvareli. GPI HOLDING having won the Mtskheta-Mtianeti lot shall insure all the helpless people living in the region for the period of three years, at the same time it shall be liable to build 15-bed hospitals in Kazbegi, Mtskheta, Dusheti and Tianeti. Building of all hospitals (other than the 70-bed hospitals) shall have been completed by December 31, 2011. 70-bed hospitals shall have been built by March 31, 2012. 
In whole, during the mentioned period, the insurance companies shall build 46 hospitals with more than 1100 beds. It's also worth noting that the state has already determined the minimum standard for hospitals and from December 31, 2011 none of the hospitals failing to meet such standards shall receive patients insured by the state.
In order for the population to enjoy the high-quality medical service, on the initiative of the Government, mediation institution will become stronger that will enable complaining patients to refer to such institution and make the insurance company or medical institution meet the standards.
The BLOCK GEORGIA company failed to fulfill the obligations assumed with regard to building of certain amount of hospitals. The Government is going to terminate the agreement with this company and the company will be imposed a penalty for non-fulfillment of its obligations - it will be deprived of the control over all the hospitals in Tbilisi, Batumi and other cities. The only hospital with regard to which the company fulfilled its obligations is the one in Zugdidi and therefore, the hospital will be remained under its control. The company shall also bear liability for building new hospitals in Mestia, Tsalenjikha, Chkhorotsku, Abasha, Martvili and Tskaltubo - it has already acquired warranted funding of these hospitals. Building of hospitals will start in the near months and finish till the end of 2011.
In these days the Israeli Medical Investment Company AIHOP is going to sign an agreement with the Ministry of Economy whereunder the company will build the network of hospitals with about 1000 beds in 27 regions of Georgia. Materially, this is a new agreement pursuant to which the company will be transferred real 
estate only upon making certain audited investments. The project will be launched in May and the first outcomes are to be expected at the end of this year.
As per Tbilisi, geographically we divided the capital city into hospital clusters and it will be provided with the top quality hospitals by the state resources in some places and by the private sector resources in other places. The first cluster is Saburtalo Republic Hospital and at present we are having talks with a new investor concerning it. Negotiations with the Canadian company are coming to an end under which the company is going to bear a liability for investing more than 30 million dollars in full reconstruction of the Republic Hospital and provide Tbilisi population with the most qualified services.
The second cluster is Dighomi hospital - here the state will restore the Railway and Zhvania Hospitals where 14 different clinics are to be placed in a year. The state will sell the repaired buildings through privatization to the clinic employees. It's also worth noting that GLOBAL FUND will finance the building of a new center for infectious diseases and AIDS research within the same cluster. At the Aramiants' Hospital a new modern clinic will be built by private funding sources which will provide Tbilisi population with high-standard services from the next year. And finally, a new multi-profile hospital is to be built in Ortachala (former Ophthalmology and Neurology Clinic) still under the private sector funding.
Thus, the healthcare reform and building of hospitals will not be dependent only on one of the companies' success and funding - about 10 insurance companies are going to build 46 hospitals in the regions. AIHOP is to build hospitals in 27 regions, and BLOCK GEORGIA - in 6 regions with already warranted funding; hospitals are to be built in Ambrolauri under the World Bank funding and in Akhlatsikhe, Ninotsminda and Akhalkalaki under the USAID funding; GLOBAL FUND shall finance the building of the center for infectious diseases and AIDS research; the state shall finance repairing of the Railway and Zhvania Hospitals where about 14 clinics will be placed; Canadians shall make investments in the Republic Hospital; and Georgian businessmen shall make private investments in Ortachala hospital, Aramiants' hospital and etc.
Press Office of the Prime Minister