27 Sep 2012

“Thank You, I Don’t Take Bribes”- an Initiative to Remedy Corruption in the Slovak Health Care Sector

The Medical Trade Unions Association (LOZ) in Slovakia has recently launched an anti-bribery campaign to end the common practice of slipping white envelopes containing money in doctors’ pockets. According to an article by The Slovak Spectator, the campaign seeks to convince doctors throughout the country to wear badges reading “Thank you, I don’t take bribes”, the campaign’s slogan.

Initiators have also set up a website where doctors participating in the campaign become visible. Nearly 300 doctors have already joined. Patients are also encouraged to play an active role in this campaign by reporting cases of doctors requesting bribe. In order to facilitate communication, the initiators of the campaign have asked the Health Ministry to open a hotline where bribery can be reported.

The campaign has raised the debate on where the difference between bribes and gifts lie, and where doctors should draw the line. According to the Slovak Spectator, giving small gifts to doctors is a culturally accepted practice, and in fact many doctors interviewed by the newspaper have claimed that they have at occasion accepted gifts such as flowers and chocolate. Some hospitals have started to develop codes of ethics that address this issue. LOZ representatives have admitted that the campaign is not addressed to patients that offer these kinds of gifts, but rather to the clear bribery practice of handing envelopes with money to doctors.

Survey data on perceptions and experience of corruption among citizens help paint the picture of the dimension of the problem in Slovakia. According to the 2010 Global Corruption Barometer, conducted by Transparency International, one out of four households in Slovakia declared that they paid a bribe to obtain services in the health care sector, reported the Spectator. On a comparative perspective, findings also showed that “Slovakia’s health care system was perceived to be the 18th most corrupt out of 88 countries surveyed”.  Patients stated that they paid anywhere from tens to thousands of euro in order to receive “priority on operation waiting lists or above-standard service.”

Gabriel Šípoš, director of Transparency International Slovakia, offers some insights on what is behind the corruption in the health sector in the country. “One of the reasons patients in Slovakia bribe doctors is their feeling of powerlessness and ignorance of their rights […]Many people don’t know of any alternative, […]patients often want to ensure better treatment, but can’t be sure whether they will actually get it.”, declared Šípoš in an interview to TASR newswire. Therefore, this campaign targets a main cause of corruption, by showing patients that they can have access to quality medical services without bribing.

Nevertheless, experts remain sceptical about the potential results that this initiative could achieve. Roman Mužík, from the Health Policy Institute, for instance, mentioned that initiatives to stigmatise corrupt practices and create public pressure can be successful sometimes, but there are examples where this approach did not reach the expected impact. Mr. Šípoš also declared that the campaign is a positive step in signalling to patients that bribery is not necessary to get a good service, but he also highlighted that other measures are required to effectively curb corruption in the health sector. He argued in favour of policies to define clearly what patients should expect from their health care packages, and to communicate this effectively to users.

The picture featured above is from srxawordonhealth.com.