On Tuesday, the government approved the integration of five psychiatric hospitals into the National Mental Health Centre, with the process expected to be completed by the 30th of September this year.
According to the approved draft order, the National Mental Health Centre will incorporate Daugavpils Psychiatric Hospital, Strenči Psychiatric Hospital, Piejūra Hospital, Ģintermuiža Hospital, and the children’s psychiatric hospital Ainaži. After the reorganisation, the shareholder of the state capital in the NPVC will be the Ministry of Health.
The ministry notes that currently, state mental health care services are provided by several independent entities, each with separate management, administrative, and support functions. In the ministry’s view, this model is fragmented, as strategic planning, human resource management, administrative processes, procurement, and IT solutions are organised separately in each institution.
This limits the ability to ensure a unified approach to service planning and development at the national level and complicates coordination and efficient use of resources across institutions. At the same time, differences exist between hospitals in service availability, range of specialised services, and workload, influenced by staff availability and patient flow organisation.
The goal of the reorganisation is to reduce fragmentation in governance, ensure more even access to services
and quality across regions, and promote more efficient use of public finances and human resources.
It is planned to maintain psychiatric services in the regions while centralising management, administrative, and support functions within the NPVC. The merged institutions will operate as regional structural units of the NPVC.
It is emphasised that the volume of services in the regions will not be reduced, and no significant changes to the content of services are planned. The changes will mainly affect planning, coordination, and quality assurance, creating a unified management framework and strengthening links between outpatient, day-care, and inpatient services.
The ministry also states that no layoffs are planned during the merger process. Existing staff will be integrated into the NPVC structure, and the transfer of employees’ rights and obligations will take place as part of a business transfer process, ensuring continuity of employment without terminating contracts.
According to 2024 data, the institutions involved employ a total of 3,152 people.
Of these, 370 are doctors, 765 are medical and patient care staff, 762 are support staff, 108 are administrative employees, and 1,147 are other personnel.
The reorganisation will be implemented gradually, with regular communication to employees, no worsening of current salary conditions, and the development of a unified remuneration system in the long term.
Funding for psychiatric services will not be reduced. After the merger, the National Health Service will continue to organise, finance, and supervise state-funded services, but under a single contract with the merged entity. Service delivery will still be tracked by structural units, maintaining regional accessibility and ensuring financial oversight.
Each unit will operate as a separate cost centre, enabling detailed financial accounting.
A unified budget and financial plan will be prepared, along with centralised planning for investments, procurement, training, business trips, and personnel costs.
Currently, different hospitals use various information systems and IT solutions, affecting data availability, compatibility, and efficiency. As part of the reorganisation, a unified ICT management approach will be introduced, including gradual integration of systems and implementation of the Tvaiks 2.0 system.
The ministry believes that introducing a unified information system will reduce IT infrastructure maintenance costs, ensure a single patient database, enable faster and more accurate patient assessments, and improve system development management.
As a result of the reorganisation, the current management boards of individual entities will be dissolved,
but existing leadership personnel will have the opportunity to continue in management roles at the regional unit level. To ensure professional medical capacity, the roles of chief doctors and chief nurses will be retained.
To coordinate centralised development and regional needs, a Strategic Management Committee will be established, including leaders of the merging hospitals. The committee will set priorities for budgets, investments, and procurement, and align medium-term strategies, although it will not have formal decision-making authority under commercial law.
According to the ministry, the reorganisation aligns with public administration policy aimed at reducing the number of state-owned enterprises and consolidating governance.
At the same time, the reorganisation will require investment.
The estimated cost ranges from 4.35 million euros to 8.30 million euros, depending on the scope of changes, with most expenses related to IT system integration.
No additional state budget funding is planned for this purpose, and the reorganisation will be implemented gradually over several years within the budgets of the existing entities.
Alternative solutions were also considered, including integrating psychiatric institutions into regional multi-profile hospitals, but this model was not supported due to potential risks to specialisation, qualifications, professional standards, and coordination in mental health care.
As previously reported, the government in August took note of the Ministry of Health’s report on the integration of the five psychiatric hospitals into the NPVC.
Read also: Spending on sickness and unemployment benefits continues to rise in Latvia