An inquiry regarding the sustainability and accessibility of the healthcare system (no. 759)
Session: 15th Riigikogu, 5th session, plenary session
Date: 2025-06-09 23:38
Participating Politicians:
Total Speeches: 35
Membership: 15
Agenda Duration: 51m
AI Summaries: 35/35 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
9. During the debate on the agenda, the parliamentary inquiry No. 759 on the sustainability and accessibility of the healthcare system, submitted by Members of the Riigikogu Lauri Laats, Vladimir Arhipov, Aleksei Jevgrafov, Andrei Korobeinik, Anastassia Kovalenko-Kõlvart, and Aleksandr Tšaplõgin, was discussed. Lauri Laats was appointed as the representative of the inquiry submitters. Raising awareness of the problems focused primarily on the challenges to the system's financial sustainability, unequal access to healthcare services, the shortage of doctors and nurses, and the lengthening of waiting times and specialist appointments. They also highlighted international data and, as a particular area of concern for Estonia, the increasing cost of co-payments and the impact of the shortage of healthcare workers on quality and accessibility. The second part of the discussion focused on the government’s response and what has been done and what is planned for the future to strengthen the healthcare system and integrate it with social services.
Decisions Made 1
Decisions were not made.
Most Active Speaker
Helle-Moonika Helme (EKRE, right-wing) was particularly active and critical in the debate, using her lengthy speech (including three minutes of extra time) to launch personal attacks and spread misinformation against the social minister.
Aseesimees Arvo Aller
AI Summary
The Riigikogu is considering, as the ninth item on the agenda, the interpellation (No. 759) concerning the sustainability and accessibility of the healthcare system, which was submitted on April 23, 2025.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats noted that while the Estonian healthcare system is internationally recognized for its cost-effectiveness, the system faces significant problems—inequality, limited accessibility, and labor shortages. Furthermore, if substantive changes are not implemented, costs and waiting times could increase and the budget deficit could grow, necessitating government attention and debate.
Aseesimees Arvo Aller
AI Summary
The Deputy Speaker thanks [the previous speaker] and invites the Minister of Social Affairs, Karmen Joller, to respond to the query.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller stated that Estonia will ensure the availability of healthcare services regardless of residence or income by strengthening primary care and regional networks, integrating social and healthcare services, and expanding digital solutions and e-health, in order to reduce the rate of people forgoing medical treatment and improve working conditions and staffing levels.
Aseesimees Arvo Aller
AI Summary
No extra time is given here; you need to manage yourselves.
Sotsiaalminister Karmen Joller
AI Summary
Minister of Social Affairs Karmen Joller stated that there are plans to increase the funding for the Health Insurance Fund, and the Foresight Centre is currently studying what that funding should look like in the future. She added that she would answer briefly, and if there are follow-up questions, we can continue.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller thanks and announces that 15 minutes have been allocated for answering the questions concerning the inquiry.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller said that the issue is very substantial.
Aseesimees Arvo Aller
AI Summary
The Speaker announces that there are questions and invites Anti Poolamets to ask the first one.
Anti Poolamets
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
The speaker highlights that the requirement for doctors to know Russian is a growing problem in Estonia. While older doctors still see it as necessary, younger ones disagree, and some are leaving for Finland. This makes communicating with patients more difficult, particularly now that tens of thousands of refugees have arrived in the country.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller’s speech calls for action, stating: your time has come.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller said that healthcare services in Estonia must be offered in Estonian, and doctors and nurses do not necessarily have to speak foreign languages, since translation or assistance can be utilized if needed. She added that expecting all employees to speak foreign languages is not appropriate.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller calls upon Evelin Poolamets.
Evelin Poolamets
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Evelin Poolamets is asking the minister if, in the future, people visiting the Emergency Department (EMO) should require a referral from a family doctor. She also asks if the minister knows how many people are not registered with any GP, and what advice he would give those individuals.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller explained that in Estonia, a GP referral will not be mandatory for future emergency room (ER) visits, and the right to decide will remain with the ER doctors. She emphasized the necessity of resolving the overload issue to continue discussions and referred to a recent PERH study, which showed that 70% of green priority ER patients had not contacted a family doctor. She advised people to at least consult their GP and use the 1220 advice line.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller calls upon Helle-Moonika Helme to speak.
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helle-Moonika Helme criticized the minister, arguing that expressions used in her speech, such as "unjustified doctor visits" and "strengthening triage," fail to boost public confidence. She stressed that people are being hospitalized and need more help than the system currently offers, and highlighted the point that patient satisfaction is not paramount, asking at the same time what the healthcare system's priority is, if not patient satisfaction.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller stated that unnecessary visits result in specialist consultations, which in turn lengthens the waiting lists at primary care centers and causes people's health to worsen, thereby increasing the risk of hospitalization. The objective, she added, is to ensure timely assistance from the appropriate healthcare professional and not to rely solely on patient satisfaction as a measure of quality. She promised to rectify these shortcomings in less than two years.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats highlighted that the family doctor system is facing significant challenges: an aging workforce, family doctors reaching retirement age, and the lack of a rapid influx of the younger generation. He then reviewed two models for health centers: either a simple concrete building or a health center capable of offering a wider range of services.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller called Lauri Laats to the floor.
Sotsiaalminister Karmen Joller
AI Summary
According to the plan, the primary care family doctor system must be strengthened through the expansion of family health centers. These centers will house multiple doctors, numerous nurses, and offer additional services (such as psychologists, physiotherapists, and midwives), ensuring that patients first have the opportunity to meet with a nurse or another specialist, and only consult the family doctor when necessary. This measure is intended to reduce the workload on medical specialists, particularly since many family doctors are due to retire in the near future.
Aseesimees Arvo Aller
AI Summary
Anastassia Kovalenko-Kõlvart is invited to the stage.
Anastassia Kovalenko-Kõlvart
Profiling Eesti Keskerakonna fraktsioonAI Summary
He continues providing the answer to the query and presents the final question: How is it planned to ensure the availability of primary healthcare in sparsely populated areas where unfilled patient lists are becoming a persistent problem? He requests an overview of this matter.
Sotsiaalminister Karmen Joller
AI Summary
The presentation emphasizes that small family doctor centers in sparsely populated areas require a robust cooperation network with larger centers and agreements for substitute coverage, ensuring that medical and nursing service coverage is maintained during vacations, illness, or major life changes, and that patients can access additional services such as physiotherapy, psychology, and midwifery care.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller expresses his thanks, announces that there are no further questions, opens the debate, and calls upon Lauri Laats to speak on behalf of the interpellators.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats stresses that healthcare funding remains insufficient, which impacts mental health, lengthens waiting lists for specialists, increases the volume of paid appointments, and means that, according to the European Commission, a staggering 12.9% of Estonian residents cannot receive the necessary medical care.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller requests half a minute of additional time.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats points out that all the issues raised have been confirmed, and he questions whether the current government is capable of solving them. However, he remains skeptical, believing that there will be no improvement in healthcare until a new government takes office. He cites as an example that during the Center Party's administration, the budget for the Health Insurance Fund increased by 57 percent in a short timeframe.
Aseesimees Arvo Aller
AI Summary
The Deputy Speaker thanks [the previous speaker] and calls upon Helle-Moonika Helme to speak.
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helle-Moonika Helme accuses the Minister of Health of acting as a political activist and claims that his leadership is the weakest link in the Estonian healthcare system, citing Madis Veskimägi's article and patients' negative experiences.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller requests three additional minutes for the audience.
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helme is accusing Minister Karmen Joller of incompetence and arrogant behavior regarding the concerns of patients and the healthcare and social sectors. He claims that under her leadership the system is deteriorating, the avoidance of emergency room visits is increasing, and dangerous steps are being prepared, including the euthanasia law and issues surrounding children's vaccination.
Aseesimees Arvo Aller
AI Summary
The Deputy Speaker announced that there were no further requests to speak from the floor and invited Minister of Social Affairs Karmen Joller to take the podium.
Sotsiaalminister Karmen Joller
AI Summary
Karmen Joller notes that the current government is unable to quickly solve long-term problems. She warns against personal attacks, viewing them as a sign of a lack of arguments, defends the right of doctors to participate in politics, and confirms that euthanasia is not planned, stating that such claims are misinformation.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller declared the debates closed and stated that the ninth item on today's agenda had been covered, and the main agenda was exhausted.