Latvia political briefing: Public dissatisfaction with the organisation of the vaccination process in Latvia is growing

Weekly Briefing, Vol. 40, No. 1 (LVA), May 2021

Public dissatisfaction with the organisation of the vaccination process in Latvia is growing

Summary

The vaccination process is a top priority for strengthening the health of Latvia’s society and preventing the spread of the pandemic. To implement the unified vaccination strategy against Covid-19, the separate authority – the Vaccination Project Bureau was established in January 2021. However, it has faced strong criticism and low level of trust of society. The main reasons of public dissatisfaction are inability of Vaccination Bureau to effectively organize vaccination process and insufficient communication with society, outgrowing state apparatus and too much bureaucracy, inadequate funding from taxpayers’ money, huge fragmentation and disunity of the system. Political elite undertook several attempts to solve challenge. In mid-March, it was announced that the Bureau would be cancelled as a structural unit of the Ministry of Health and would be integrated into the National Health Service as one of its units, which was finally done in April. However, later on Latvian Parliament instructed Prime Minister to liquidate the Vaccination Project Bureau as a unit by June 1.

Introduction

In January, the Vaccination Project Bureau was established as a unit of the Ministry of Health which reported directly to Health Minister, with the aim of implementing a unified vaccination strategy against Covid-19[1]. However, it faced different obstacles and following public criticism. As its effectivity is put under question, it led to several attempts of officials to decide on the future of institution. This briefing analysis public criticism of the vaccination process in Latvia and main challenges of Vaccination Project Bureau, as well as the steps taken by the Parliament and the government to reorganize the Bureau.

Criticism faced by Vaccination Project Bureau

The establishment of Vaccination Project Bureau was viewed quite negatively by general Latvian society and health industry. There was a public initiative asking government to liquidate Vaccination Bureau. Group of activists stated, that “it is necessary to acknowledge the error and close the Vaccination Project Bureau”[2]. At the same time, it will reduce the artificial bureaucracy that has not proved its worth. The call was published in public participation platform “Manabalss.lv” (“My Voice”), which is digital tool, where citizens can create their own initiative and if it collects enough support from public (at least 10 000 signatures), the initiatives are submitted to Latvian Parliament to review. At the moment of May 10, the initiative about Vaccination Bureau liquidation was signed by slightly more than 20 000 people. Half of the signatures was gathered during first five days. So, what are the main reasons of public dissatisfaction?

1) Inability to manage vaccination process and insufficient coordination

The Bureau faced a number of problems ranging from complaints on difficulties for citizens in applying for the vaccine to the freephone number, reports of circumvention of the single vaccination line, and finally troubles in vaccine deliveries.

Public is also worried that Vaccination Bureau is not effective in reaching its goal – as vaccination process is not as fast as expected. Opposition politicians also raised the same concern. As of February 25, only 2% of the population had received the first vaccine in Latvia, but as of May 5, a total of 273,500 Latvian residents (around 15% of population) had received their first jab, and only 55,000 had already received both doses[3], which is still far behind European average and behind initial goal of Latvian government of vaccinating 70% of Latvia’s population.

At the same time, there is insufficient communication with society and slow information exchange. Despite the fact that currently the activity at vaccination points is high enough, vaccination organizers say they are expecting that lines will soon shrink and there will be no more people who want vaccine. According to public survey[4], one third of those surveyed were against receiving a vaccine dose, and another third is unsure. Large part of those who don’t want to get vaccinated right now needs to be addressed individually, for example through a family doctor or local government social service, but until now there is no attempts from officials of Bureau.

2) Outgrowing state apparatus and too much bureaucracy

There is expressed concern, that the main goal of the Ministry of Health in the pandemic times is to ensure public health care, but creation of Vaccination Bureau just contributes to “overgrowing” of the state apparatus. Society was calling out the Ministry of Health to take measures against this “ill-considered step”.^[5]

3) Waste of taxpayers’ money and inadequate funding

There is also continuous worries and discussions about funding allocated to run of Vaccination Project Bureau. For example, given the high remuneration of office workers, which is paid out of taxpayers’ money. According to the Order of the Cabinet of Ministers on 19 January this year, financing was granted from the State budget in the amount of €641 806 in order to ensure the functioning of the Vaccination Project Bureau. Of this amount, €525 646 was earmarked for the job salaries of their staff for 2021[6]. The salary of the head of the Vaccination Project Bureau was announced to be €4905, which is even higher than ministers’ monthly pay. Taking-into-account institution’s low efficiency, there are doubts in the society about the adequacy of the allocated state resources.

4) Huge fragmentation and disunity of the system

There are several existing institutions in Latvia who are responsible for vaccination process: Ministry of Health, National Health Service who has a special vaccination department, State Agency of Medicines which is responsible for evaluation and approving of vaccine in Latvia, as well as collection of information on side effects the Centre for Disease Prevention and Control which is monitoring statistics, regularly publishing the number of Covid-19 cases and related deaths and evaluating epidemiological risks. It is quite unclear why to assign several functions to completely new authority, not to delegate tasks to one of the existing ones. Lack of unity and fragmentation of the system leads to prolonged decision-making and it is unclear who takes final responsibility for decisions.

What’s next? Liquidation or reorganization?

Following all criticism, in the middle of March Health Minister Daniels Pavļuts announced that Vaccination Project Bureau is going to be closed as structural unit of Health Ministry and to be integrated in National Health Service (NHS) structure. The process of Bureau reorganization has taken quite some time which also caused dissatisfaction with authorities, responsible for vaccination process in Latvia. Government took decision about reorganization of Bureau only at April 20. It was planned to complete the reorganization earlier, but after a wider discussion in the government on the extent of the requested funds, the process was completed later than initially planned. Minister of Finances Jānis Reirs objected the full transfer of planned funds to the new unit, and reminded, that the remuneration of Vaccination Bureau employees will be determined in accordance with the unified public administration remuneration system, which doesn’t provide that high salaries, but the excess money will return to contingency fund^[7]. Therefore, with the integration of the Vaccination Bureau to NHS unit, salaries of officials were reduced, for example, the head of the Vaccination Project Bureau will receive €1917 instead of initial €4905.

Later in April, after review of public initiative on the liquidation of Vaccination Project Bureau, the Latvian Parliament decided to discuss it further and have sent the initiative to the Parliamentary Committee on Social Affairs for evaluation. As a result, on May 6^th Latvian Parliament has requested the liquidation of the Vaccination Project Bureau. The decision by the Parliament was adopted through amendments[8] to the “Law on the Management of the Spread of Covid-19 Infection”[9], which demand that the Prime Minister must instruct the responsible minister to liquidate the Vaccination Project Bureau by 1 June. It is planned that some employees will leave the Vaccination Project Department of National Health Service at the end of May. However, there is no certainty that government will support this decision and not find another way to reorganize the same structure into another unit.

Conclusion

The implementation of the comprehensive Covid-19 vaccination project in Latvia has highlighted the strengths and weaknesses of the current management model. After three months of operation there are various concerns about the future of Vaccination Project Bureau. On the one hand, a special project coordination unit is needed, but on the other hand, the Vaccination Project Bureau has been perceived by both the public and the industry as something separate and distant from the health industry and the ministry and faced a lot of criticism. It is still not clear if Vaccination Project Bureau will stay under National Health Service, will be reorganized again or liquidated as unit at all.

References:

[[1]] https://www.vm.gov.lv/lv/media/3745/download

[2] https://likumi.lv/ta/id/322956-grozijumi-covid-19-infekcijas-izplatibas-parvaldibas-likuma

[3]https://likumi.lv/ta/en/en/id/315278-law-on-the-management-of-the-spread-of-covid-19-infection

[4] https://manabalss.lv/par-vakcinacijas-biroja-likvidesanu/show

[5] https://www.lsm.lv/raksts/zinas/latvija/vakcinacija-pret-covid-19-jauniesi-skeptiskaki-birojs-plano-uzrunat-neizlemusos.a403309/

[6] http://latvianfacts.lv.89-111-52-152.webplace.lv/uploads/vakcinacija042021.pdf ; https://eng.lsm.lv/article/society/society/one-third-of-latvian-residents-do-not-intend-to-get-vaccinated-survey-shows.a403324/

[7] https://manabalss.lv/par-vakcinacijas-biroja-likvidesanu/show

[8] https://eng.lsm.lv/article/society/health/vaccination-project-bureau-changes-supervisor.a401369/

[9] https://neatkariga.nra.lv/izpete/342985-vakcinacijas-projekta-biroja-reorganizacijai-prasa-papildu-finansejumu

[1] https://www.vm.gov.lv/lv/media/3745/download

[2] https://manabalss.lv/par-vakcinacijas-biroja-likvidesanu/show