Yesterday I wrote about teacher dissatisfaction stemming from the government’s centralization and reorganization of the educational system. About a week ago the teachers of a gymnasium in Miskolc made public a letter sent to the ministry of human resources, which remained unanswered. Since then thousands of people have joined the crusade for a return to the system in which individual schools had a great deal more autonomy and the teachers had greater freedom in their classrooms.
Today it is time to move on to healthcare, where the situation is as bad as if not worse than in education. In the first place, the government doesn’t spend enough money on healthcare, and the little it spends it spends irrationally. The system is both flawed and underfunded, resulting in a general deterioration of the infrastructure and a lack of basic services to many patients.
Until recently the only sign of serious dissatisfaction was the emigration of large numbers of doctors and even larger numbers of nurses. These professionals are being enticed to move to western European countries, where there is a shortage of doctors and nurses and where salaries are much higher. By contrast, most teachers are more or less tied to the country. Many simply leave the profession.
Beginning last month one started to hear about doctors in this or that hospital who threatened to quit because they claimed that the conditions in the hospital were not adequate for them to do their jobs properly. They claimed that the lives of their patients were in jeopardy. One of the main problems is the shortage of nurses. Apparently, right now there is a shortage of 5,000-6,000 nurses in the Hungarian healthcare system.
The first news about doctors revolting against the system came from the Saint Imre Hospital in Budapest where 11 doctors, all anesthesiologists, quit. A few days later 16 physicians in Veszprém threatened to do the same, but eventually the director of the hospital managed to appease them. But by the second half of December 64 doctors from Szeged decided to write a letter to the new and suspiciously quiet undersecretary, Zoltán Ónodi-Szűcs, in which they called his attention to the critical situation in which Hungarian healthcare finds itself after years and years of neglect. These brave souls belong to a Facebook group called “1001 doctors without gratuity.” I think that most readers of Hungarian Spectrum are familiar with the corrupt system without which, according to some analysts, the whole healthcare system would have collapsed a long time ago. Hungarian patients believe that without paying extra to the attending physician they wouldn’t receive decent treatment. Because the government assumes that the doctors receive quite a bit of extra untaxed income in the form of gratuities, they don’t feel any necessity to raise their salaries to a level commensurate with their education and responsibility.
These people consider gratuities to be the canker of the healthcare system. In their letter to Ónodi-Szűcs the doctors claimed, among many other things, that the practice of gratuities negatively affects the quality of care provided and “renders the training of younger doctors impossible.” This last claim might not be immediately understandable to those outside the profession, but I have an inkling of what these doctors have in mind. Doctors higher up on the totem poll make sure that they perform all procedures that might bring a large gratuity, and thus younger doctors have only limited opportunities to perform certain operations. This was the case already in the Rákosi period, and it looks as if it hasn’t changed since. Naturally, doctors in high positions who are the beneficiaries of the system want no change.
It was at this point that Zoltán Balog, in an interview on Mokka, an early morning show on TV2, expressed his surprise that the doctors think that “gratuities are not good for them.” Later in the conversation he added that in the last four years the government has regularly raised doctors’ salaries, but “we can’t expect to raise salaries tenfold in order to catch up with the west.” Moreover, the situation can’t be that bad, he claimed. After all, “in the last 25 years we have kept saying that Hungarian healthcare is close to collapse, but it has continued to work just fine to this day.”
None of the supporters of the group found Balog’s answer acceptable. They were especially offended by the fact that “Balog talked about the gratuity as if it were a natural ingredient of healthcare.” They demanded answers to specific questions. How long will gratuities be accepted in healthcare? When will the government convene a group of experts to discuss matters with the doctors? What kinds of concrete steps does the government expect to take in 2016 to improve the financial well-being of doctors and others in the healthcare system? The fact that the Hungarian Medical Association urged its members—and membership is compulsory–to join the group will ensure that many more doctors will add their support.
It is telling that the slavishly servile Magyar Idők, which supports all of the government’s actions, decided that it could not back Balog and his undersecretary on this issue. An editorial that appeared on January 5, titled “Doctors and nurses on the waiting list,” expressed the belief that it was time to raise salaries substantially. Otherwise, a strike might be unavoidable, especially since a new union has been formed and the likelihood of doctors, nurses, and teachers creating a united front is likely. But more about that tomorrow.