BAPHC Does Not Accept the Replacement of Nurses with Educators in Nurseries

The Bulgarian Association of Health Care Professionals (BAPHC) is categorically against the changes to the Health Act regarding nurseries proposed by Sofia Mayor Vasil Terziev. This was made clear in an open letter from the association sent to the media. BAPHC believes that such changes are not in the interest of children and their health.

The position, without editorial intervention, can be read below:

The Bulgarian Association of Health Care Professionals (BAPHC) has become aware through media publications of an official letter from the Mayor of Sofia Municipality, Mr. Vasil Terziev, to the parliamentary committees on healthcare and education in the National Assembly. In it, he calls for amendments to the Health Act, requesting the removal of medical healthcare specialists from independent nurseries and nursery groups in kindergartens and their replacement with educators. The motives cited for this change are the shortage of nurses in the capital, as well as the phasing out of functions they have performed in nurseries and nursery groups.

In this regard, BAPHC declares once again that it is categorically against the adoption of such changes, as they are not in the interest of children. If the legislation is changed and nurseries are transferred to the Ministry of Education and Science, the care for young children—which is extremely necessary at this age, especially up to 2 years old—will be lost, and the balance between physical and mental development will be disrupted. Medical specialists possess the competence to provide quality care, adequately provide first aid, monitor the mental and physical development of children, oversee healthy nutrition, and consult parents on issues concerning proper child-rearing; they have a keen eye for emerging changes and illnesses and possess the necessary knowledge, skills, and experience to work with infants and young children.

Replacing nurses with educators is not an adequate or politically responsible decision to guarantee the health and development of children. To this end, measures are needed that do not eliminate nurses from nurseries and nursery groups, but rather attract them to these positions. BAPHC has repeatedly proposed, as a solution in this direction, increasing the remuneration of healthcare specialists to reach at least 150% of the average gross salary for the country. Increasing compensation to such levels could resolve the staff deficit in nurseries and nursery groups, though not for the entire country.

Unfortunately, the shortage of nurses in nurseries and nursery groups in kindergartens is not an isolated phenomenon. It is part of the fundamental problem of Bulgarian healthcare—the acute staff deficit of healthcare specialists, which BAPHC has been sounding the alarm about for years. The professional organization warned about this over a decade ago and continues to do so annually. As we have said more than once, the staffing crisis puts at risk not only the functioning of nurseries and, consequently, the health and development of the children in them, but also the entire healthcare system. All patients in our country are at risk, regardless of whether they seek treatment and healthcare in hospital or outpatient care, as the lack of medical personnel is immense in both spheres. This leads to an inability to provide quality health services and ensure real access to them. To overcome this massive problem facing the entire healthcare system, not just nurseries, urgent and radical measures are needed to restructure hospital care in particular, which accumulates unnecessary resources—both human and financial—at the expense of the rest of the system, often without proven public need.

In view of all this, BAPHC categorically opposes Mr. Terziev’s request for legislative changes, the result of which will solely be the elimination of the presence of nurses in nurseries. This approach will not solve the staffing problem in these facilities but may put children at risk. Mechanically transferring the leading role in early childhood care from one ministry to another will destroy time-proven, effective working structures for raising children in early childhood.

BAPHC emphasizes once again that the nursing staff crisis in Sofia and the country cannot be overcome by such a change in the regulatory framework, but only through a comprehensive reform that addresses the problem of the bloated hospital system and insufficient healthcare personnel—a reality that puts the health and even the lives of not only children, but every potential patient, at risk.