Government Approves Adjusted Hospital Network Reform; Changes Also Affect Ogre Hospital

The government has approved amendments to the procedures for organizing and paying for healthcare services, which will take effect on January 1, 2027. The reform aims to transition from the current five hospital levels to three – multiprofile, regional, and local hospitals – by 2029. More complex services will be concentrated in hospitals with appropriate capacity, while basic services will remain as close to patients' homes as possible.

According to the Ministry of Health, the decision to review funding for emergency departments (NMPUN) was made following findings by the State Audit Office and the National Health Service (NVD) regarding insufficient specialist coverage in regional hospitals. In 2025, deductions for unfulfilled specialist positions amounted to €6 million.

The multiprofile level includes major university and regional hospitals such as Riga Eastern Clinical University Hospital, Pauls Stradiņš Clinical University Hospital, Children's Clinical University Hospital, Liepāja Regional Hospital, Daugavpils Regional Hospital, Ziemeļkurzeme Regional Hospital, Rēzekne Hospital, and Vidzeme Hospital. The regional level includes Jelgava City Hospital, Jēkabpils Regional Hospital, Jūrmala Hospital, Kuldīga Hospital, Cēsis Clinic, Madona Hospital, and Ogre District Hospital. The local level includes Tukums Hospital, Krāslava Hospital, Balvi and Gulbene Hospital Association, Alūksne Hospital, Sigulda Hospital, Preiļi Hospital, Ludza Medical Center, Limbaži Hospital, Dobele and Surroundings Hospital, and Bauska Hospital.

Local hospitals will provide 24/7 emergency care, patient admission, diagnostic tests, therapy, and chronic patient treatment. Regional hospitals will additionally offer specialized care, including surgery, traumatology, maternity and pediatric services. Multiprofile hospitals will cover all major profiles – emergency medicine, therapy, surgery, obstetrics and gynecology, pediatrics, and other complex treatment areas requiring higher capacity and specialist availability.

Special provisions are made for eastern border hospitals due to national security and regional accessibility. The Emergency Medical Service's ability to transport patients to the nearest appropriate hospital has also been evaluated.

All hospitals will continue to have 24-hour physician availability. The number of doctors in admission departments will be adjusted according to patient flow, while nighttime care will be provided by on-call doctors. On-call doctors will work from 20:00 to 8:00 on weekdays and 24/7 on weekends and holidays. If a hospital cannot provide a medically indicated service, it must arrange the patient's transfer to another facility, including between hospitals of the same level.

Pediatric services are retained at Jelgava City Hospital, and a pediatric outpatient clinic with a fixed monthly payment for acute childhood illnesses will also be provided at the Children's Hospital, Daugavpils Regional Hospital, Rēzekne Hospital, Vidzeme Hospital, Ziemeļkurzeme Regional Hospital, Cēsis Clinic, and Ogre District Hospital. After adjustments, Dobele and Surroundings Hospital retains maternity services, while at the Talsi branch of Ziemeļkurzeme Regional Hospital, a surgeon will be on duty year-round. Līvāni Hospital will operate an urgent care point.

During the transition period (2027-2028), the NVD will have the right, upon written request from a hospital, to redirect funds allocated for inpatient services to outpatient services at the same facility. Reviewing the requirements for hospital admission departments will yield an annual surplus of €43,890,199 from 2027. Of this, €30,229,034 is allocated for on-call doctor positions, €2,314,940 for revising the observation payment, €191,083 for the Līvāni urgent care point, €7,581,730 for outpatient services, and €689,808 for revising service planning criteria. The total funding needed for the reform from 2027 is €41,006,595 per year, to be covered within the existing Ministry of Health budget by restructuring inpatient funding (€33,233,782) and redistributing funds from inpatient to outpatient services (€7,772,813).