Director of IMSP Bălți, Gheorghe BRÎNZĂ, at FERM 2025: “Salaries don’t reflect actual effort. Nothing extra is paid for work in the operating room”
100 economic opportunities for the development of the Moldova Region on the A7 Highway route
REGIONAL ECONOMIC FORUM MOLDOVA 2025
19th Edition – Vatra Dornei, July 9–13, 2025
Thematic Panel:
Healthcare and Medical Services in the Moldova Region
Speaker:
Dr. Gheorghe BRÎNZĂ – Director, IMSP Bălți Clinical Hospital
Topic of the presentation:
“Successful models in the modernization of IMSP Bălți Clinical Hospital”
The shortage of medical staff, chronic underfunding, and the rigidity of the salary system are just a few of the challenges highlighted by Dr. Gheorghe Brînză. His speech offered a clear-eyed assessment of the systemic dysfunctions affecting one of the largest hospitals in northern Moldova and a call to rethink how medical personnel are motivated and how public resources are managed.
Three salary mechanisms, but none sufficient
“We have three mechanisms. One is regulated by Government Decision 837, which clearly defines the salary based on a specialist’s work experience.”
The current salary structure in Moldova includes a base salary set by a national grid, supplemented by bonuses linked to so-called “performance indicators” and, in some cases, by additional rewards granted by hospital management.
“One of the indicators is whether the doctor has any disciplinary issues, the second if there are no complaints from patients.”
What should reward medical excellence is, in practice, reduced to the absence of complaints — a minimalist approach that discourages active engagement or the assumption of extra responsibilities.
(In this context, Moldova has one of the lowest average salaries for doctors in the region. According to data published by the Ministry of Health in 2024, the average gross salary of a medical specialist is around €650/month, compared to over €1,300/month in Romania.)
On-call shifts and actual work go unrewarded
“I cannot incentivize the anesthesiologist or surgeon… The difference in pay between a republican and a district hospital is €10–15 per shift.”
This symbolic difference is not enough to retain staff in higher-level hospitals, where both the volume and complexity of cases are significantly greater. Worse, actual hours spent in the operating room are not financially acknowledged.
“Whether you had one surgery or ten, you’ll receive the same daily wage.”
Uniform compensation destroys professional motivation and threatens the sustainability of surgical teams. In Romania, by contrast, hours worked in the OR are separately compensated, and night shifts are paid according to workload.
The staffing paradox: forced savings, not reform
“We have 17 vacant positions for ICU doctors. Because of that, I can offer bonuses to others. But the budget doesn’t change.”
The personnel crisis leads to the redistribution of salary resources to remaining staff. This is not a management solution but a painful compromise. One doctor ends up covering the work of two or three colleagues, while the system offers no support for recruitment or retention.
(According to a 2023 WHO report, Moldova has only 2.6 doctors per 1,000 inhabitants, compared to the EU average of 4.3. In northern regions especially, this shortage is acute in critical departments like ICU or imaging.)
Laboratory services: local solutions, systemic problems
“In Bălți we have a public-private partnership for 20 years… We provide this service in full volume as needed by the population.”
The Bălți model involves outsourcing some services to private partners due to insufficient in-house capacity. Still, funding remains a major issue.
“From the budget allocated by the insurance fund, we cover about one quarter.”
In practice, of all analyses performed, only 25% are reimbursed by the insurance fund. The rest is covered by the institution or the patient. This discrepancy highlights a major gap between funding and the real needs of hospitals.
Imaging investigations: digital system, unequal access
“If we check the SÎP system today, for a brain CT scan, we’ll definitely find an available slot.”
Dr. Brînză notes improved access to High-Performance Services, especially in imaging. The system allows for fast scheduling and requires hospitals to offer time slots within 90 days, preventing long waiting lists.
“We’ve never been asked to schedule beyond 30–40 days.”
However, not all areas benefit from this progress.
“Queues exist only in oncology. There it takes long, and there are many patients.”
The oncology care chain remains one of the slowest in the Moldovan system. Access to consultations, biopsies, imaging, diagnosis, and treatment is fragmented and cumbersome, directly affecting patient survival rates.
Rigid budgets and slow reactions from the state
“If the slots are filled, I submit a request to the insurance fund to increase my contract.”
The doctor describes a slow bureaucratic mechanism: the hospital must first use up its entire allocated budget before requesting additional funds. In practice, this condition hinders rather than supports service development.
“Their business plan was smaller than the actual revenue that came in.”
Recent years have brought extra funds into the public healthcare system, but a lack of flexibility and poor planning have led to their underuse. Reform must target not just infusions of money, but system adaptation to reality.
Conclusion: reform must start with recognizing medical work
In his closing remarks, Dr. Gheorghe Brînză acknowledged the system’s recent progress, but also the lack of coherence in public policy. Local efforts — like those at Bălți Clinical Hospital — cannot compensate for the absence of a national strategy to reward efficiency, stimulate performance, and stop the exodus of medical professionals.
