EXCLUSIVE: Romania has only six beds for all patients with burns covering over 20% of the body / Health Minister Rafila stated there are „about 30” / Romania hasn’t built a single center for treating severe burn victims, 8 years after the Colectiv tragedy, of which 4 years were under the leadership of the PSD Ministry of Health

Eight years after the fire in the Colectiv club, Romania has not built any centre for the treatment of burn victims, according to a G4Media.ro analysis. Some units have been built, through renovation and rehabilitation, to treat patients with medium burns, but no centre for severe patients has been built. The PSD has led the Ministry of Health for half of this period, including today, when Minister Alexandru Rafila claims that there are „about 30 beds for severe burn patients” in Romania, while a document issued by the ministry just three weeks ago states that there are only 6 beds for severe burns.

Back in 2014 (before Colectiv), when the PSD was still in power, the government approved a decision to build 4 burns centres – two in Bucharest, one in Timisoara and one in Targu Mures – in a project with the World Bank. But the political decision was not implemented.

After the tragedy in the Colectiv club, the care of burns patients came back into focus and in recent years several burn units with 3-5 beds have been built through renovation and rehabilitation of some wards (e.g. at the Bagdasar hospital in Bucharest, at the county hospital in Craiova or at the „Sf Spiridon” hospital in Iasi). But they meet the standards for treating patients with medium burns, not severe ones.

In the event of disasters, as happened on Saturday night at Crevedia, patients with serious burns are stabilised in Romania by doctors who are specialised in treating them, but due to a lack of advanced infrastructure to treat them, places are sought abroad for their transfer.

What happened to the burn centres promised since 2014?

In 2016, during the technocrat government, the team at the Ministry of Health, led by Vlad Voiculescu, worked on an order setting out in black and white the conditions that a burns centre must meet. The order was necessary to start the project with the World Bank: no burn centres could be built without the criteria they had to meet.

Also at that time, the 100% bonus for medical staff treating burn patients was approved and a programme of additional funding for burn treatments was created.

In the meantime, the Ciolos government’s mandate ended and the PSD returned to power. Minister Florian Bodog, a plastic surgeon, approved the order on burn centres, which was published in the Official Gazette in May 2017 and is still in force today.

Then nothing happened again. In 2018, another PSD minister, Sorina Pintea, declared that burn centres could not be built before 2020, because „there was a lot of bureaucracy, a lot of neglect and years when people were not interested”.

The „four centers will be built, I say, a realistic term, after 2020, in Targu Mures, in Bucharest there are two, we have Bagdasar Arseni, G. Alexandrescu and Timișoara. So, how can I tell you, there has been a lot of bureaucracy, a lot of neglect because for years people have not been interested,” Pintea said, quoted by News.ro.

It should be noted that initially the Bagdasar hospital was planned to build a burns centre to treat serious patients, but in 2020 a burns unit – for medium patients – was inaugurated there by the City Hall of Sector 4.

In 2020 the COVID pandemic broke out, and burn centers were not a priority. The PNL was in government, then USR returned to the Ministry of Health. Vlad Voiculescu was removed from office after just three months, and for another four and a half months Ioana Mihăilă was minister.

Since November 2021, the Ministry of Health has been headed by Alexandru Rafila (PSD).

In May 2023, the Ministry of Health signed the order to start work on the Burns Centre in Timișoara, and on 22 August the contract for the construction of the Burns Centre at the „Grigore Alexandrescu” Children’s Emergency Hospital in Bucharest was signed. The execution period is 26 months.

How Alexandru Rafila wants to make centres for burn victims that don’t really exist

In May 2022, Minister Alexandru Rafila issued an order extending until 21 December 2025 the deadline by which burn units must comply with the criteria set out in the order approved in 2017.

„Given that to date there is no hospital structure at the national level that meets the conditions laid down for the burn center, it is proposed to extend the compliance deadline for health units providing care for burn patients until 31.12.2025,” the explanatory note to the order signed by Minister Rafila stated.

The original (2017) order provided for compliance with the criteria by May 2022. Because Romania has not managed to build any burns centres in five years, the only solution was to postpone compliance with the rules. That is, it is allowed to treat or at least stabilize until transfer also patients with burns over 20% of the body surface in the only wards we have, which are for medium cases.

Therefore, in May 2022, the Ministry of Health noted in black and white that there are no beds for major burns in Romania.

In July 2023, the ministry led by Alexandru Rafila put an order in public debate modifying the criteria in the order approved in 2017 to classify a ward as a burn centre.

Survivors and family members of victims of the Colectiv club fire accuse the Health Ministry of wanting to lower standards of care for burn patients by proposing legislative changes that create burn centres just „on paper”.

Among other things, the order put up for debate reduces the minimum area of a large burn unit by less than half (from 35 sq m to 15 sq m). However, „the equipment needed to care for a burn victim cannot fit in 15 square metres. You have to be able to move around the bed. Sometimes you have to lift it with a crane. You can’t cut back on space,” experts explained to G4Media. Just as you can’t relax the conditions for access to these spaces. The amended order accepts the existence of such single-entry centres for medical staff, patients and visitors, as infections with any germ are a vital risk for burn patients.

How does the Ministry justify the need for these changes? In a document consulted by G4Media sent by the Ministry of Health in response to the signatories of the message accusing it of making burn centres from „on paper”, the institution headed by Alexandru Rafila justifies it with the fact that Romania does not have beds for burns that meet the legal conditions and then they must be changed.

„At present, at national level there is only one Burn Centre within the Emergency Clinical Hospital of Bucharest (Floreasca, ed.), with a capacity of 18 beds (6 ICU beds, 6 TIIP beds, 6 plastic surgery beds) with dedicated staff employed within the ward, independent from the rest of the Plastic Surgery or ICU structures within the health unit, recently established and previously functioning as a Functional Burn Unit. The 6 ICU beds serve all burns with burn areas greater than 20% nationally, which will mean that all patients will be concentrated here in Bucharest from all over the country. Given the prolonged hospitalisation of this category of patients, in the absence of other accredited structures to take care of critical patients with adequate human resources and equipment, new patients will require transfer abroad. Currently, according to the legislation in force, the medical system in Romania can only treat 6 severe burn patients (adults) at the same time, making it impossible to manage this pathology at national level”, the document consulted by G4Media states.

In the same document, dated 7 August 2023, it is stated that there is no bed in Romania that can treat a child with severe burns.

It should be noted that it does not specify how in May 2022 the Floreasca ward did not meet the conditions to be accredited as a centre for severe burns, but in the meantime, it has been accredited.
Minister Alexandru Rafila said on 27 August that there are „about 30 beds for severe burn patients” in Romania.

„The reason for the transfer was due to the limited hospital capacity for burn patients. You know that we have about 30 beds for burn patients nationwide. Last night we had 6 free places – 5 in Bucharest and one in Timisoara, because those places were occupied”, Alexandru Rafila said, regarding the situation of the Crevedia explosion victims.

In fact, in Romania there are 24 beds for adult burn patients and 13 for children, which were accredited at burn unit level, i.e. medium level patients can be treated. The 6 at Floreasca would have been recently accredited for major burns.