Mihaela SPĂTARU, SANITAS leader at the Municipal Emergency Hospital Pașcani, at FERM 2025: “Only through a tripartite dialogue can we build a modern, efficient healthcare system adapted to the real needs of patients”
100 economic opportunities for the development of the Moldova Region on the A7 Highway route
MOLDOVA REGIONAL ECONOMIC FORUM 2025
19th Edition – Vatra Dornei, July 9–13, 2025
Thematic Panel:
Healthcare and Medical Services in the Moldova Region
Speakers:
Bogdan Movilă, Psychiatric and Safety Measures Hospital Pădureni-Grajduri, and Mihaela Spătaru, senior nurse at Pașcani Emergency Municipal Hospital – SANITAS Iași union leaders
Topic:
“Reorganization of the healthcare system and development of palliative and chronic care services”
Within a strategic debate framework dedicated to the economic and social development of the Moldova Region, Panel 6 “Healthcare and Medical Services in the Moldova Region”, held during the Moldova Regional Economic Forum 2025, brought to the fore a vital topic for the regional and national healthcare system: the reorganization of the healthcare system and development of palliative and chronic care services.
Participants highlighted not only the urgent need for reform but also the importance of a real and constructive tripartite dialogue between authorities, healthcare unit management, and employee representatives to shape sustainable, efficient, and regionally-adapted policies.
Social Dialogue – The Foundation of Healthcare Reform
Mihaela Spătaru, senior nurse at the Pașcani Emergency Municipal Hospital and SANITAS union leader, opened her intervention by stressing the essential role of social dialogue in the reform process. She welcomed the Forum organizers’ openness to include union representatives in major healthcare discussions, stating:
“Only a tripartite dialogue between decision-makers, management, and employee representatives can lead to the best solutions for the healthcare system.”
As a union leader and healthcare professional with over 18 years of experience in palliative care, Mihaela Spătaru advocated for a sustainable medical community composed of well-informed, well-trained, and motivated personnel able to meet patients’ evolving needs.
Reorganizing Healthcare Services Amid Demographic and Epidemiological Changes
A core point of the intervention was the need to reorganize the healthcare system, especially services dedicated to chronic and palliative patients. Mihaela Spătaru noted that the current system is overwhelmed, with complex cases often crowding emergency departments (EDs) and intensive care units (ICUs), creating bottlenecks and resource strain.
“Patients with severe conditions arrive at the ED, but some could be redirected through other methods to specialized services, avoiding emergency overcrowding.”
She highlighted planned legislative changes and the authorities’ intention to reduce by 2030 the number of underused hospital beds (targeting 20%, according to Ministry of Health statistics) and to convert them into efficient services aligned with actual patient needs.
This transformation requires a careful, participatory reorganization that considers ground realities without compromising staff or medical quality.
The Palliative Care Unit in Pașcani – A Regional Model with Notable Results
Mihaela Spătaru shared concrete data about the Palliative Care Unit in Pașcani, the first public unit of its kind in Romania, operating since 2007 with 50 inpatient beds.
The unit has a constant 100% occupancy rate, and waiting lists are always full, indicating a strong need for such services.
2024 statistics show rising cases of vascular dementia, malignant tumors, congestive heart failure, and hemiplegia. Simultaneously, they reduced the average hospitalization duration by 6%, down to 29 days per patient, thanks to efficient case management.
“If two more floors for palliative care were opened in Pașcani today, they’d fill up—and still wouldn’t be enough.”
This reality underlines the urgent need to expand capacity and design a coherent, integrated strategy for palliative care development throughout the Moldova Region.
Human Resources Challenges and Palliative Care Standards
Another critical issue raised was the shortage of specialized personnel. Palliative care teams include not only doctors and nurses but also psychologists, social workers, and other specialists, whose training and recruitment remain major challenges.
Mihaela Spătaru noted that SANITAS actively supported professional training, so that upon recent accreditation, the Pașcani unit had all nurses certified per regulations.
“We succeeded in training all our nurses and having certified doctors in palliative care.”
She called for a clear legal framework to define palliative care, distinguishing it from “end-of-life” care to avoid patient stigmatization and to support and protect the professionals involved.
Mircea Dinu Bordiniuc, plastic surgeon at Suceava County Hospital, added that current legislation and funding don’t reflect the true complexity and cost of palliative services.
“If the legal standards were truly followed, no one could actually afford to care for palliative patients—it’s too expensive.”
He also pointed out the absence of institutions similar to the French EHPAD model for dependent elderly people, placing further pressure on emergency and hospital services.
Sergiu Apostol, SANITAS leader at Socola Hospital, emphasized the high costs and strict standards requiring large staff-to-patient ratios, posing a major challenge to maintaining palliative services.
“If legal staffing standards were strictly followed, nobody could afford to deliver palliative care.”
Importance of Incentives and Recognition of Professional Wear
From a union perspective, Mihaela Spătaru advocated for specific incentives, such as early retirement for staff working in high-stress, high-wear palliative care units.
“We must acknowledge real professional wear and provide incentives to retain staff in these demanding sectors.”
Such measures could help retain qualified personnel and improve the quality of care for patients with chronic or terminal illnesses.
A Multidisciplinary Vision and Expanded Home-Based Services
Ramona Guraliuc, Chief of UPU-SMURD Botoșani, stressed that palliative care must go beyond hospital walls and expand sustainably to home settings, via multidisciplinary teams including doctors, nurses, psychologists, priests, and other specialists.
“We must be a civilized country, allowing chronic patients to experience a dignified death, free of pain and anxiety.”
She emphasized the challenges of resource allocation and attracting super-specialized staff, noting that integrated services, including minimally invasive home treatments, can reduce unnecessary hospitalizations and improve quality of life.
A Call to Decision-Makers – Sustainable and Realistic Reform
In conclusion, all interventions converged on the idea that healthcare reform must be grounded in real-life conditions, foster permanent dialogue among all stakeholders, and promote pragmatic, efficient, and fair policies.
Mihaela Spătaru concluded:
“Without us, the little ones, the healthcare system—public or private—wouldn’t function.”
This is a call for shared responsibility—from ministries and local authorities to unions and communities—to support and develop services that are vital to the health and dignity of Moldova Region patients.
Conclusions
The “Healthcare and Medical Services in the Moldova Region” panel clearly highlighted the urgent need to reorganize the regional healthcare system, focusing on developing palliative and chronic care services—key areas amid population aging and increasing incidence of such conditions.
This transformation depends on:
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Creating and updating a clear and applicable legal framework;
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Implementing real social dialogue, including unions;
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Allocating necessary financial and human resources;
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Developing integrated service models, including home care;
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Motivating and protecting healthcare staff by recognizing the complexity and strain of their work.
The Moldova Regional Economic Forum 2025 thus provided a unique framework for this crucial debate, with the hope that these discussions will translate into concrete actions that benefit patients and the healthcare system across the region.
