Thursday, January 31, 2002

Europe Today

Letter from Warsaw - Dariusz Rosiak on the Polish health care scandal. (Thursday, 31 January, 2002, 12:12 GMT)

Poland has been in turmoil over allegations that ambulance crews took bribes from funeral parlours for dead bodies. There is even a suggestion that some doctors let patients deliberately die in order to get more financial profit. Two doctors from Lodz have been arrested and charged, several other people have been detained and police are investigating the allegations all over the country.

To say that this scandal shocked the nation would be a clear understatement. The reality is that the fundamental premise of national health care has been put into doubt: Poles by and large have lost faith in their doctors and they are no longer sure whether they might be risking their lives by calling an ambulance.

The day after the scandal came to light ambulance calls in Lodz dropped by half. There was hate mail, obscene graffiti on ambulances and several telephone calls from people accusing doctors and paramedics of being murderers. I'm worried for my safety - said a paramedic from Lodz - and if this continues one of us will be lynched.

Emotions are immense -- and not only in Lodz. Yesterday a doctor friend of mine who does ambulance calls in Warsaw was called a murderer by a sick old man who refused to be taken to hospital. His daughter finally persuaded him to go. She apologized to my friend and was clearly embarassed by the situation. And yet people do generally believe that funeral parlours all over the country have been bribing paramedics and doctors in return for dead bodies, and that had it not been revealed by the media, the procedure would have continued unchecked.

For Polish doctors it's a trying time. A doctor from Warsaw told Gazeta Wyborcza he was disgusted by the behaviour of the medical community. He and other anonymous media informers describe what's called "skin hunting" - dead bodies are called "skins" by those who sell them - as a horrible but nevertheless widely accepted practice. "The pressure from colleagues is immense - the doctor told the paper - and their argument is simple: we're not hurting anybody, these people are already dead, my salary is 200 dollars a month, so why not make a buck on the side?

The indications are that some doctors and paramedics did not stop at bribery but speeded the patients' death with a now infamous muscle relaxant drug which causes people to suffocate. No murders have yet been proved, but for many Poles the scandal shows how slippery is the slope of corruption in the Polish health care system. Corrupted it is indeed. Even those who point out that few health care workers would go as far as speeding up a patient's death, acknowledge that the system has sunk to the lowest depths.

Not only the doctors are to blame. Poles have silently accepted that bribing a doctor is a rule which you have to live by. Many good willing doctors and nurses are continuously embarrassed by envelopes with money, bottles of cognac and other unsolicited gifts from patients. In some hospitals you will even find notices saying: "Doctors here do not accept gifts".

At the same time however there are hospitals in Warsaw and other cities where bribing a doctor is treated as an entry ticket to the ward. Most people are aware of it but very few blow the whistle.

What's even worse, as a result of the current crisis many doctors have gone on the defensive blaming the media and the government for the whole scandal. The doctors union issued a statement saying that blaming doctors for profiting on dead bodies was a display of hypocrisy from people who have known about it all along. They want open sponsorship in hospitals, which - in their opinion - would ease financial constraints and thus remove the temptation of corruption.

Whether this happens or not, the crisis has left another wound in Polish society which is still trying to come to grips with post-communist reality.

For Europe Today this is Dariusz Rosiak in Warsaw.

Wednesday, January 30, 2002

Cash-for-corpses Horror

Corruption in Poland's health service has led to grisly practices on an unprecedented scale, writes Kate Connolly.

By Guardian Newspapers, 1/30/2002

The revelations last week that medical staff in Poland have been involved in a long-standing gruesome cash-for-corpses scandal, has led to ambulance crews across the country facing a torrent of abuse.

Some doctors have reported receiving obscene telephone calls, in which callers have accused them of being murderers. Medics' vehicles have been smeared with faeces and swastikas and had stones thrown at them, even when they've been on their way to answer emergency calls.

Anger over what could turn out to be the biggest medical scandal in Poland's history is growing by the day, as more and more details come to light.

A police hotline set up to take calls from families suspecting foul play in the deaths of their relatives has prompted a flood of thousands of calls.

On Monday, the Polish justice minister, Barbara Piwnik, admitted that the scandal - in which medical staff are suspected of taking bribes of between ВЈ200 and ВЈ350 from funeral parlours in return for information on the deceased - was far more widespread than originally thought.

On Sunday, seven people, including doctors and funeral parlour staff, were arrested in connection with the allegations, following a six-month-long police investigation.

Not only are staff suspected of passing on information about the dead. There are also widespread suspicions that some patients were denied medical help in order to speed up death, or were injected with doses of the muscle relaxant Pavulon, which led to asphyxiation. The practice is thought to have been going on for a decade or more.

The investigation has focussed on a casualty ward in the central Polish city of Lodz (pronounced "woodge"). But emergency wards in three other Polish cities are now also under the spotlight. And a nation is outraged.

The doctors allegedly involved have been given appropriately macabre names: "The Angel of Death and Dr Mengele have been arrested," boomed the daily Rzespospolita on Monday, following the news that two doctors from Lodz had been picked up by police.

Police will give few details, except to say that the case will probably come to court in a few months' time. It is expected to be one of the largest medical court cases in Europe of the past few decades. Around 2,500 witnesses are due to be called to give evidence in the next few weeks. Mass exhumations are expected: an estimated 5,000 corpses could be involved, say investigators.

On Monday, an unnamed "key witness" revealed to Gazeta Wyborcza, the respected Warsaw daily which broke the story last week, even more gruesome details.

The witness cited the case of a patient, hanging between life and death, who was deliberately left to suffocate. "The medic rammed a pipe into the pharynx, but not in order to resuscitate him," the witness said. The pipe was pushed into the stomach, until "the patient threw up and choked on his own vomit. The doctor stood by, doing nothing." Another medic present immediately recommended the name of a funeral parlour to a distressed relative, the witness said.

The case has further increased the lack of confidence in Poland's public health service, which is grossly underfunded and thus open to corruption. Widespread reforms, introduced three years ago, have yet to kick in. Doctors are paid just ВЈ187 a month - said to be not enough to live on in the cities. The practice of giving the doctor a "present", such as a bottle of vodka, in return for treatment, is therefore commonplace.

For more serious complaints, a thick envelope is expected to be handed over. It is an open secret in Poland, that a gift increases the quality of treatment and shortens the waiting time for operations.

The practice in itself is now so customary that it is seen to be harmless, even by those doctors who do not follow it. But the doctor's union in Poland has warned of late that as a result of widespread bribery the system has become tainted through and through.

Warsaw doctor Mariusz Gujski told a German paper this week: "We have to dig out the black sheep from our ranks."

In an editorial, Gazeta Wyborcza warned of a drop in moral standards throughout the country. "For ourselves, our families, our colleagues, we always find extenuating circumstances.

"That stops the evil from being evil, and black becomes a grey in which everyone has a place. That's why we close our eyes."

Friday, January 25, 2002

'Patients left to die' in Poland

The allegations have stunned Poland

The authorities in the Polish city of Lodz say they have gathered substantial evidence that ambulance crews deliberately let patients die in return for bribes from funeral service providers.

We are all shocked by these crimes, that are hard to imagine

Polish President Aleksander Kwasniewski
Local media reports said the emergency crews had administered the muscle relaxant drug Pavulon to speed up the patients' deaths and tipped off the funeral businesses.

"What the media have reported are facts," said a police spokesman in Lodz, Jaroslaw Berger.

He said police had gathered "substantial evidence" to support the allegations and that the first charges could be filed against suspects within days.

Suspicious dosage

The Health Ministry said some ambulance crews used extraordinarily high amounts of Pavulon. It has now banned ambulance crews from using the drug and has ordered an investigation into its use by emergency services.

Deputy Health Minister Nauman said Lodz ambulance crews used 'a lot' of the drug Pavulon

The Polish President, Alexander Kwasniewski, said the reports were "horrifying". Correspondents say the scandal has shocked the nation.

In an article in the leading Polish daily newspaper Gazeta Wyborcza, where the allegations first surfaced, the former head of the ambulance service in the city is quoted as saying that he was aware of the practice, although he denies any personal involvement.

The new head of the service said that if such practices still existed they would be stamped out.

Failing health service

The report also said that doctors on an emergency ward in Lodz had killed several seriously ill patients over the last decade.

The patients were allegedly killed by lethal doses of a drug that causes asphyxiation, after the families of the victims had agreed to use particular funeral homes.

The report said the funeral homes then paid the doctors more than $300 per corpse in return for the business.

The allegations are a blow for the reputation of Poland's health care system which is already struggling with a lack of money and ageing equipment.

The media speculates that it is this lack of funding that has left the service highly susceptible to bribery.

Wednesday, January 23, 2002

Police dig up Polish corpse scam

WARSAW, Poland -- Emergency medical workers in Poland have been trading in human corpses, police say.

In some cases, it is feared patients may have been poisoned so the suspects could claim money from undertakers.

Police confirmed a press report that said funeral parlours in Lodz had paid up to $450 for notification of death.

The report, in the best-selling Gazeta Wyborcza newspaper, alleged that medical staff might have facilitated death to collect the reward.

Gazeta's front-page article on Wednesday, which sparked a media outcry, said ambulances sometimes delayed arriving at a patient's home and alleged that some victims had been injected with poison to cause death.

Police are considering exhuming bodies of people who died in ambulances to check for traces of poison.

Poland's social security system allots about $976 for funeral expenses after death, allowing undertakers to clear a profit even after paying the alleged bribes.

Lodz police spokesman Jaroslaw Berger told Reuters: "Months of work by police has confirmed signs of unlawful and inhumane acts by emergency first aid workers and funeral parlours."

Ryszard Lewandowski, a former chief of the city's ambulance service, confirmed he was aware of sales of information about recently deceased patients, but said claims of murder were false.

Lewandowski told PAP news agency: "We were talking with lawyers about whether selling information about death was a criminal activity.

"Perhaps it may only be of interest to tax authorities who seek untaxed income."