Transferring the Competences of Primary Health Care Management Scheme Management as well as other Healthcare Responsibilities from Central to Local Government

The primary healthcare sector in the Albanian healthcare system is not supported by the local government. Administrative reform has foreseen that local government oversees and supports Primary Health Care - PHC. There is practically no institutional and concrete legal initiative regarding the transfer of competencies from the central government to the local government. Currently, all family doctors, general practitioners, and nurses of PHC are appointed by the Minister of Health. We are dealing with a unique case of centralizing the competencies of the central government in the health systems. Local authorities have no impact on the many shortages in health personnel, mostly doctors in the territory they cover. The local government has the financial capacity and other opportunities to support the primary care sector, does not financially support and in any way support the PHC in the territory they cover, despite the fact that citizens pay taxes. Municipalities that have developed the tourism sector, and especially in tourist seasons where tourism flows are expected, have problems with what they offer regarding health care, both in informing tourists and the quality of health care. What is recommended consists of: Increase the competences of local government towards the PHC; Increase and improve the quality of health services in the PHC; Increase of primary health care financing (Ministry of Finance / Compulsory Health Insurance Fund / 61 Municipality); Increase the flexibility of management of the Health Care financing scheme based on the specific needs and requirements of each municipal unit; The transfer of competencies from the central government to the 61 municipalities on primary health care should be accomplished through a clear, discrete, inclusive, transparent and focused process towards improving the quality of health care, then the opportunities for primary health care for citizens will be increased, have a better infrastructure, have more flexibility in managing human resources, investments and more funding for medications and other needs. Accountability will also be increased based on community requirements and information on the quality of health care