The GOVERNANCE of the health system with regard to COVID-19 relates to pandemic response plans and the steering of the health system to ensure its continued functioning. It includes emergency response mechanisms, as well as how information is being communicated, and the regulation of health service provision to patients affected by the virus.
To ensure better intersectoral coordination and an effective response to COVID-19, on March 17th 2020 the Government of Montenegro set up the National Coordinating Body for Combatting Infectious Diseases, chaired by the deputy prime minister. Members of the National Coordinating Body are senior representatives from the Ministries of Health, Defence, Internal Affairs, Economy and Finance, and Transport, as well as the representatives of the legislative bodies, the capital city of Podgorica, police headquarters, the Institute of Public Health, the Clinical Center of Montenegro, inspection bodies, the media board in the Government of Montenegro, and the Agency of National Security.
The Healthcare Crisis Response Team was appointed by the National Coordinating Body for Combatting Infectious Diseases by the Government of Montenegro in order to organize the healthcare institutions in a single structure. The Government and the Ministry of Health still have their legislative responsibilities, with the Healthcare Crisis Response Team managing exclusively medical issues (patient treatment; drugs and equipment distribution; expert assistance etc.).
A summary of decisions and measures taken by the National Coordinating Body and the Ministry of Health is given in a document prepared for the Parliament of Montenegro, titled “The response to COVID-19 pandemic” and available online at: http://www.gov.me/ResourceManager/FileDownload.aspx?rId=402967&rType=2.
The National Coordinating Body set up Operative Headquarters for support to the economy which introduced several measures to support the economy (see Section 6 on “Measures in other sectors”).
The Law on the Protection of the Population against Communicable Diseases in Montenegro (February 2018, available online at http://zakoni.skupstina.me/zakoni/web/dokumenta/zakoni-i-drugi-akti/327/1613-10375-28-2-17-3-4.pdf), which guided the measures taken by the National Coordinating Body during the COVID-19 pandemic, has been updated by the Government of Montenegro on May 7th, 2020 (the changes suggested by the Government are available online at file:///C:/Users/Korisnik/Downloads/1_171_30_04_2020.pdf; to be discussed in the Parliament of Montenegro). The new suggestions include fines for violating restrictions (100 – 2000 EUR for individuals and 2000 – 20000 EUR for official institutions).
As mentioned in Section 2.2, fast track procedures were employed to organize professional exams for medical interns, as well as to hire unemployed nurses. Furthermore, on April 30th, the National Coordinating Body recommended that all employers enable their employees to work remotely from home (available online at http://www.skupstina.me/index.php/en/ostale-aktuelnosti/item/4316-new-provisional-measures-to-protect-citizens-against-coronavirus). This also influenced the healthcare system, with departments that had less work in the current situation (such as elective surgery, check-ups of chronic disease patients etc.) organizing their work in a way that employee teams switched on a weekly (or two weeks) basis, in order to reduce their risk of exposure.
Furthermore, the Ministry of Health employed fast track acquisition of ventilators and drugs which were available on the market for a short period of time (chloroquine, antibiotics etc.), as well as of tests for SARS-CoV-2.
Testing is coordinated by the Institute of Public Health, as well as international reporting (together with the Ministry of Health). Public reports are made by every health institution, as well as the Healthcare Crisis Response Team, the Institute of Public Health and the Government of Montenegro (including the Ministry of Health).