Draft law amending the Blood Act (476 SE) – first reading
Session: 15th Riigikogu, 4th session, plenary session
Date: 2024-10-08 13:10
Participating Politicians:
Total Speeches: 30
Membership: 15
Agenda Duration: 27m
AI Summaries: 30/30 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
The draft law amending the Blood Act, initiated by the Government of the Republic, was introduced in the first reading by the Minister of Health, Riina Sikkut, who explained the main objective: the transfer of implementation activities in the blood sector from the Ministry of Social Affairs to the Health Board. This primarily concerns the organization of immunohaematological reference laboratory services, currently provided by North Estonia Regional Hospital (PERH) under a current administrative agreement. The Minister emphasized that this is a technical amendment that will clarify the administrative structure, as the Health Board already oversees and provides other reference services. The amendment also abolishes the requirement for the contract’s five-year validity to increase flexibility, although the contract partner (PERH) is not planned to be changed before 2027. During the debate, members of the Riigikogu expressed concern regarding the lack of actual savings from the zero-budget process and asked whether transferring the task to the Health Board will lead to a reduction in ministerial positions or an increase in the Health Board’s budget. The Minister confirmed that this is a task moving on a "zero-budget" principle, where the money (143,736 euros annually) moves along with the obligation, and no jobs will be created or lost. Aivar Kokk particularly raised the question regarding competition and public procurement, fearing that the amendment could limit the opportunities for other accredited laboratories (e.g., University of Tartu Clinic) to participate in providing the service. The Minister explained that the Public Procurement Act will remain in force and a new procurement will be carried out in 2027, but emphasized that Estonia currently has only one accredited laboratory and the fragmentation of this specific service may not be a rational use of resources.
Decisions Made 2
The draft law amending the Blood Donation Act was concluded with its first reading.
The deadline for submitting amendments was set for October 22nd at 5:15 PM.
Most Active Speaker
Aivar Kokk (from the Isamaa faction) was particularly active in the debate, repeatedly posing questions regarding the actual impact of public procurement, competition, and zero-based budgeting on the state's expenses.
Aseesimees Toomas Kivimägi
AI Summary
The first item on the agenda is the consideration of the first reading of Draft Act 476, initiated by the government, concerning amendments to the Blood Act, and Minister of Health Riina Sikkut is invited to serve as the rapporteur.
Terviseminister Riina Sikkut
AI Summary
The amendment to the Blood Act transfers the practical activities concerning the blood sector—previously managed by the Ministry of Social Affairs—to the Health Board. This move is logical because the Health Board already conducts supervision and provides reference laboratory services. Furthermore, the North Estonian Regional Hospital provides reference laboratory services under a five-year contract, which remains valid until the end of 2027 and has an annual cost of 143,736 euros. Both the increased flexibility regarding contract deadlines and the transfer itself will take effect next year, and the necessary budget for this takeover has already been allocated.
Aseesimees Toomas Kivimägi
AI Summary
He thanks everyone and invites questions, asking Priit Sibul to respond.
Priit Sibul
Profiling Isamaa fraktsioonAI Summary
Priit Sibul thanked the esteemed Presiding Officer and the Minister and asked what implementation activities the ministry is currently engaged in today, and whether the Health Board will start dealing with these independently in the future, or if they will continue delegation through administrative contracts with PERH and others.
Terviseminister Riina Sikkut
AI Summary
Currently, the Ministry of Social Affairs manages the contracting, execution, and monitoring of the service, but the Health Board will take over this task. The Ministry of Social Affairs does not have laboratories, and while the Health Board does have laboratories, it lacks immunohematological laboratories. Furthermore, there is only one accredited laboratory in Estonia, located at the North Estonian Regional Hospital, which will continue to provide the service.
Aseesimees Toomas Kivimägi
AI Summary
Deputy Speaker Toomas Kivimägi asked Rain Epler to come and speak.
Rain Epler
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Rain Epler noted that the abolition of the five-year contract requirement could increase uncertainty and unpredictability in a laboratory where the annual contract is expiring, and asked the minister how he assesses this.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut said that contracts are reviewed more frequently than before, and this need will likely persist in the future. Reference laboratory services must be procured from an accredited laboratory, and since there is only one accredited immunohematological laboratory in Estonia, there is no possibility of choosing between 20 different partners.
Aseesimees Toomas Kivimägi
AI Summary
Deputy Speaker Toomas Kivimägi calls upon Aivar Kokk to speak.
Aivar Kokk
Profiling Isamaa fraktsioonAI Summary
Aivar Kokk asks directly whether this is yet another ministry cost-cutting measure due to the work being assigned to the Health Board, and how many positions will be eliminated as a result of the work being transferred to the Health Board.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut confirmed that the reorganization of functions between the Ministry of Social Affairs and the Health Board is a technical change, where tasks and funding move together with the corresponding responsibilities, and it will neither create nor eliminate jobs, and the budget for procuring the services of the immunohematological reference laboratory will not be reduced.
Rain Epler
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
He asks how the reduction of bureaucracy is supposed to work if the ministry's budget remains at the same level, staff and salaries aren't being cut, but the Health Board (Terviseamet) is getting additional work, and the money is being moved over there.
Aseesimees Toomas Kivimägi
AI Summary
Deputy Chairman Toomas Kivimägi called Rain Epler.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that the posts within the Ministry of Social Affairs will remain unchanged. The funding will be transferred from the Ministry of Social Affairs' budget to the Health Board and subsequently paid out to the contractual partner, which is the North Estonian Regional Hospital. This is possible because the workload is minimal, allowing the transfer to occur under an inter-agency agreement, and no jobs will be created or eliminated.
Tõnis Lukas
Profiling Isamaa fraktsioonAI Summary
He asks whether the government's "zero budget" is merely the reallocation of costs and the utilization of working time, which neither reduces state expenditures nor results in savings.
Aseesimees Toomas Kivimägi
AI Summary
Tõnis Lukas is invited to the stage at the beginning of the address.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut presents the draft amendment to the Blood Act, emphasizing that it is a technical change, distinct from the Ministry of Social Affairs' zero-based budgeting project, which had generated both requests for savings and proposals for relocating or streamlining services.
Aseesimees Toomas Kivimägi
AI Summary
Vice-Chairman Toomas Kivimägi invites Priit Sibul to speak.
Priit Sibul
Profiling Isamaa fraktsioonAI Summary
Priit Sibul asks the minister why the tender for the North Estonia Regional Hospital's information system has been ongoing for some time, has now stalled again, and whether he has any information regarding this.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that hospital information systems are complex and their costs are difficult to estimate. She added that the coalition has set the goal of analyzing the transition to a single hospital information system within a competitive environment—one that is not developed by the state but procured externally. Furthermore, she noted that in the future, better adaptable hospital information systems will be required.
Aseesimees Toomas Kivimägi
AI Summary
Toomas Kivimägi asked Aivar Kokk to take the floor.
Aivar Kokk
Profiling Isamaa fraktsioonAI Summary
Aivar Kokk criticizes the 2027 plan to transfer one party of the public procurement, claiming that it is almost impossible under current law and does not amend the Public Procurement Act. He asks how much this transfer will cost and what obligations are associated with it. He emphasizes that competition, quality, and price must be guaranteed, and that to compete, the participant must possess the necessary equipment and a laboratory.
Terviseminister Riina Sikkut
AI Summary
It has been nationally confirmed that the transfer of a contract concluded under a public procurement framework to another party is permissible. Upon the entry into force of the legal amendment, the Ministry of Social Affairs and the Health Board will conclude a transfer agreement. Simultaneously, discussions are underway regarding how many accredited immunohematological laboratories are needed in Estonia and whether their services must be procured via public tender. However, this specific issue is tied to the renewal of the Public Procurement Act, and we do not plan to address it within the healthcare sector—we follow the law, and these changes are in compliance with it.
Aseesimees Toomas Kivimägi
AI Summary
Toomas Kivimägi thanked the Minister, stated that there were no further questions, and requested Hele Everaus to take the Riigikogu floor to present the discussion, decisions, and positions adopted by the lead committee.
Hele Everaus
AI Summary
In her presentation, Hele Everaus stressed the importance of immunohematology in ensuring transfusion safety. She pointed out the fragmented state of the Estonian blood service and explained the technical reorganization proposed in the draft legislation, which would enhance the blood service's expertise and standardize both its responsibilities and funding.
Aseesimees Toomas Kivimägi
AI Summary
On behalf of the Isamaa faction, Aivar Kokk thanks the audience, announces that there are no questions, and opens the debate.
Aivar Kokk
Profiling Isamaa fraktsioonAI Summary
Aivar Kokk criticizes the draft bill, which transfers the provision of healthcare services to the Health Board without a public procurement process. He emphasizes the importance of competition and price, points to the excessive workload of ministry agencies, and calls for a public procurement to be announced in 2025 so that by 2027 the service can be offered in at least two hospitals or private laboratories.
Aseesimees Toomas Kivimägi
AI Summary
The respected minister, who has also expressed a desire to participate in the negotiations, will conclude the talks.
Terviseminister Riina Sikkut
AI Summary
The Public Procurement Act mandates public procurement for the reference laboratory service for immunohematological studies, and although the contract validity is a maximum of 48 months to increase flexibility, future procurements must consider whether more partners are needed alongside the one accredited laboratory, as this would incur additional costs. Currently, an agreement is in place with the same partner until 2027, and increasing the number of accredited laboratories does not appear reasonable given the current financial resources.
Aseesimees Toomas Kivimägi
AI Summary
Deputy Speaker Toomas Kivimägi declared the debates closed, announced the conclusion of the first reading of draft bill 476, and set the deadline for submitting amendments as October 22nd at 17:15. He then stated that the first item on the agenda had thus been concluded.