Health: what you need to know about territorial health groups, the new way of managing hospitals

The mode of management of health care establishments in Morocco will be completely revisited through the establishment of territorial health groups. What is it about? What are the objectives? And how does the Ministry of Health and Social Protection intend to proceed to operationalize it?

A new mode of management that will completely revolutionize the management of health establishments in Morocco. As part of the reform of the health sector, particularly at the level of its governance, carried out under the leadership of King Mohammed VI, the Ministry of Health and Social Protection will set up territorial health groups (GST).

A bit of theory to start. The GST is a regional steering instrument that defines the distribution of medical and paramedical resources in the regional territory and its mode of exercise. It is also a tool for reorganizing the supply of care, the purpose of which is to optimize the availability and pooling of resources, between networks and care sectors, from ambulatory structures to the tertiary level, the University Hospital Center (CHU).

More concretely, the implementation of this new model is based on several fundamental principles, we learn from a presentation by Southbridge, a strategy consulting firm, which supports the Ministry of Health and Social Protection in the implementation of this project. The first consists of merging the health service authorities at the regional level into a single health structure. This will allow better pooling and optimization of human and financial resources between the various providers of care, through the fluidification of the mobility of medical personnel, the pooling of support functions and the transfer of activities between establishments based on the principle of operational efficiency and cost optimization.

The second principle is the creation of an autonomous regional health establishment capitalizing on the University Hospital Center (CHU). The latter will absorb all the regional health establishments to become the leader at the regional level. Its main mission will therefore be to steer all the health establishments and to implement, at the regional level, the health policies of the Ministry of Health and Social Protection.

It will be understood, all regions of the Kingdom must have a CHU. For the moment, Morocco has 5 functional university hospitals, in Casablanca, Rabat, Fez, Marrakech and Oujda, in addition to 3 under construction in Tangier, Agadir and Laâyoune.

The regional health establishment, once created, will enjoy total management autonomy. This extends, among other things, to the areas of recruitment, administrative management and purchasing. In this same context, the establishment will have the possibility of contracting with the private sector and even pooling its resources with private operators in the region.

In addition to management autonomy, this new model enjoys financial autonomy based on the health insurance plan with a total billing model, known as the “hybrid model”. The latter is based on both fee-for-service and capitation billing for outpatients. This method of financing will be possible after the effective generalization of basic medical coverage to all Moroccan citizens, in particular the Ramédistes.

The fifth principle retained for the design of GSTs is the proximity of the patient care offer. This consists of a redefinition of the patient’s journey in a qualitative approach, the geographical reallocation of the healthcare offer in order to limit the patient’s movements, and the implementation of an innovative approach with the aim of improving the care of the patient, in particular through telemedicine.

The last principle consists of a change in the status of staff and the introduction of new incentive models. This involves redefining working methods, reorganizing working conditions for health professionals and changing the remuneration model to a fee-for-service system.

In order to pilot the operationalization of the GSTs, the department headed by Khalid Aït Taleb has decided to start work on the Fez-Meknes region, considered as a pilot region, before generalizing it to the whole Kingdom, we read. in the Southbridge presentation. The objective of this approach is to identify and arbitrate all the strategic questions still pending, to experiment and to draw lessons from this first experience in order to adapt the model during generalization and to launch communication on the project with a concrete deployment example.

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