The government prefers not to call them bribes.

Romania is moving toward legalizing a widespread practice in many Eastern European countries, where medical staff is underpaid and quality can be dodgy: bribes for better service. The government is expected to introduce criteria by which informal payments patients make to doctors, nurses and other public health workers, would be legal. These payments are widespread in the poorly funded Romanian health care system.

These couldn’t be demanded by the medical staff, would have to be given after the health service is performed and would have to be declared to be taxed. The Romanian government prefers to call these gifts given out of gratitude rather than bribes or tips for better patient care. Doctors’ groups are split about the proposal. The government is right to introduce rules for a widespread practice, which will not disappear as long as the Romanian health system is underfunded, Gheorghe Borcean, president of the Romanian College of Physicians, told POLITICO.

“When doctors in Romania will get a salary proportional to the value of their work, they won’t need any more gifts,” he said.

But a group of doctors reunited on a Facebook group reject the government measure.

“We don’t want envelopes, but a modern health system … We want to spend time talking to patients about solutions and treatments for their health problems, not about financial negotiations. If this … law passes, it means we would have in hospitals a best practice guide on giving and receiving bribes legally,” the doctors’ group said on Facebook.

A holdover from the communist era, the bribes have also been a common practice in other central and Eastern European countries. But Romania is the country where they are most frequent, an October 2013 study on corruption in health care commissioned by the European Commission showed. Romanians paid an average of €63 per hospital admission, compared to almost €80 in Lithuania and €44 in Bulgaria, according to the same study.

A separate measure to raise doctor and other health care sector worker pay did move forward. Under an emergency measure, almost 200,000 people will get the raise, and Romanian Prime Minister Victor Ponta said last week he wants to repeat the move next year and continue until doctors, nurses and other health workers will see their current salaries double. The money for the first raise would come from some savings that Ponta claimed were made by introducing a health insurance card this year.

But some don’t buy it. “There is no official report showing the amount of savings from the health insurance card. Everybody talks, but no one brings proof, no one takes responsibility. This will be a legal measure with no financial backing — an exaggerated form of populism,” Vasile Barbu, president of the Romanian Association for Patient Protection, told POLITICO.

POLITICO

26 August 2015