Global IssuesEAST EUROPE: Healthcare Ails as Doctors, Nurses Emigrate
Senior medical figures in Eastern Europe have issued stark warnings that the region's healthcare sector is both unstable and unsustainable as health workers continue to leave in droves for jobs abroad.
They say thousands are leaving their jobs in their home countries because of poor wages and working conditions.
And some doctors admit privately that the situation is so bad that patients’ lives are already being endangered by staff shortages.
Unless more money is put into healthcare sector there will be a serious deterioration in patient care in the future, they say.
Dr Zdenek Mrozek, vice-president of the Czech Medical Chamber, told IPS: 'If nothing is done to improve the situation either in the short term or the long term then I fear that what will happen is that, over time, there will be a sharp drop in the standard of healthcare services provided.'
Following the fall of the Iron Curtain governments, Eastern Europe inherited healthcare systems which were already underdeveloped in comparison with the West.
Successive governments have struggled to overhaul those systems and provide modern healthcare services on a par with the West.
Although indicators such as life expectancy, infant mortality and the availability of treatments and procedures have risen markedly in the region over the last two decades, many healthcare workers argue that these mask continuing serious problems and that health sector in the region remain grossly underfinanced.
In some states, chronic underfunding has led to hospitals and clinics lacking basic equipment and materials.
Doctors in some hospitals in Romania, for instance, have admitted to paying for medicines, syringes and bandages out of their own money simply so patients can receive basic treatment. Medical supply companies have in the past refused to stock clinics over massive unpaid bills.
But healthcare officials fear that a lack of staff and a continuing exodus of doctors and nurses to the West pose an even greater threat than poorly equipped facilities.
Earlier this year Polish nurses went on strike, warning the situation was critical and nursing in the country could soon become 'extinct'. They said low wages and poor conditions had led to thousands of nurses leaving Poland to work abroad over the last six years since the country joined the European Union and had easier access to foreign labour markets.
Longina Kaczmarska, vice-president of the All-Poland Trade Union of Nurses and Midwives (OZZPiP), told IPS: 'The shortage of nursing is having a devastating effect on patient care in Poland. The government needs to raise salaries.'
The average monthly wage in Poland is 825 euro (1,012 US dollars), but nurses earn 330 euro to 775 euro (405 to 950 dollars) depending on experience, according to the OZZPiP.
Wages for healthcare workers are low in other parts of the region. In Romania, where according to the Romanian College of Physicians more than 4,000 doctors have emigrated since 2007 - almost 10 percent of all doctors, a resident doctor earns an average of 200 euro. The average monthly wage is 320 euro.
In the Czech Republic, 50 new medical graduates and 250 fully trained medical specialists leave for abroad every year, newly graduated doctors earn a basic salary of just over 650 euro (797 dollars)a month, the Czech Medical Chamber says. The country’s average monthly wage is around 900 euro (1,104 dollars).
In Hungary, where more than 2,600 doctors have left to work abroad since 2004, according to official statistics, new doctors earn just 350 euro per month on average. In the Baltic states, wages for health staff are also low and specialist surgeons, for example, often earn no more than 800 euro (981 dollars) per month. In January this year the Latvian Medical Association said it had seen a three-fold increase in the number of doctors taking up work abroad.
Bulgarian health minister Anna-Maria Borissova told local media in April that the country had only half the number of nurses it needs and that 'one doctor leaves the country to work abroad every day' — an exodus she said was a 'catastrophe' for Bulgarian health care. Resident doctors earn an average of 250 euro (306 dollars) per month.
Doctors warn that the loss of so many colleagues each year is putting an unbearable strain on provisions of healthcare.
Mrozek said: 'This [exodus] is a significant sign of a serious problem in healthcare. It has to be dealt with.'
Another doctor in Prague, who asked to remain anonymous, told IPS that understaffing was already putting patients at risk.
He said: 'It is no longer the case that patients might be put in danger — I know cases where it has already happened. Unfortunately I can see such situations arising time and again until something is done.'
Many doctors and nurses want a rise in government spending on health sector while others have suggested other programmes to raise funds for the sector.
Some states have already introduced controversial charges for patient visits to doctors and ambulance transport while other co-payment or special health tax schemes have been considered.
But with the global financial crisis still putting a stranglehold on many states’ public spending, experts say it is unlikely governments will have tens of billions of euro needed to raise wages to levels wanted by medical staff.
Nevertheless, action must be taken now, healthcare workers’ unions say.
Paul de Raeve, general secretary of the European Federation of Nurses, told IPS: 'A long tradition of low pay and shift work makes working in the health sector unattractive. Attracting students and workers to study and work in the health and social sector will be a major policy challenge. We need action now.'
© Inter Press Service (2010) — All Rights ReservedOriginal source: Inter Press Service