Thursday, January 31, 2002

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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.
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