Monday, June 25, 2007

Ex-communist Europe's medical staff protest low pay, or head West

Staff in the cash-strapped health services of the EU's ex-communist member states are taking their protests to the streets, or voting with their feet to seek jobs further west.

In Poland, the largest of the 10 former communist bloc countries to join the EU since 2004, hundreds of nurses seeking pay hikes have for days been camping out in front of the seat of the government, ringed by riot police.

The Polish government is also facing down hospital doctors who have been on a go-slow since late May, refusing to provide all but emergency medical services and warning they will launch a hunger strike next week.

Poland's state-employed medical workers are notoriously underpaid and overworked, like their counterparts across the region.

Polish nurse Anna Niewczas told AFP that she makes the equivalent of 290 euros (388 dollars) a month, adding: "I can't feed my children."

The average monthly salary of a Polish hospital doctor, meanwhile, is around 380 euros.

In Hungary, the average doctor's pay packet is 420 euros, including bonuses and overtime.

In the Baltic states, Lithuanian doctors make 580-725 euros, while their Estonian colleagues, who backed off from striking in January, earn 1,000 euros on average.

Doctors in Slovakia have a similar pay packet to their Estonian counterparts after winning increases following a two-month strike last year.

But they work 350-400 hours a month, often in back-to-back shifts. Shorter working hours in line with EU rules may soon bite into their pay, and the Slovak medical association has warned of further industrial action.

Doctors in the Czech Republic are better off, earning around 1,420 euros a month including bonuses, according to their association.

In Bulgaria, which entered the EU in January this year, 2,000 medical workers marched in the capital, Sofia, on Thursday, protesting monthly take-home pay of 250-500 euros for doctors and 90-125 euros for nurses.

"We only want what we deserve. We want real salaries and not minimum ones," paediatrician Plamen Georgiev told AFP.

Medical unions across the region say financial woes are prompting many in the profession to seek jobs elsewhere in the EU where health services are hunting for staff, particularly Britain, Ireland, Denmark, Sweden and Germany,

In Britain, for example, a newly-qualified nurse takes home around 1,500 euros a month, and highly sought-after specialists can make many times more.

Taking advantage of budget airlines, some Polish doctors shuttle regularly to Britain, where they can earn 2,000 euros in two days by doing night shifts.

Others move abroad permanently.

The Polish chamber of physicians estimates that six percent of Poland's 100,000-strong medical corps have left since 2004 -- including 17 percent of the country's anaesthetists.

Around 400 doctors quit the Czech Republic every year, according to Milan Kubek of the country's medical association, which recently organised an ironic protest on a boat in Prague under the banner: "We're casting off!"

Hungary's association said around 66 percent of medical students want to emigrate, although only 10 percent are actively looking.

Katrin Rehemaa, secretary general of the Estonian medical association, said: "More and more young doctors are thinking of working abroad."

"Once they've settled down in Sweden or Britain, they take a mortgage, have other connections, and are likely to be lost for Estonia," Rehemaa told AFP.

In Bulgaria, union leader Stanka Markova said around 4,000 Bulgarian nurses now work in Britain.

Emigration and low morale means a looming lack of medical professionals at home.

A study in Lithuania forecast that the number of health care specialists will shrink by 15 percent by 2015, creating a shortfall of 3,000 doctors.

Financial problems also drive corruption -- an ingrained feature of the region's medical sector before the fall of the communist bloc in 1989-1991 which remains widespread today -- in a form of under-the-table privatisation.

In Poland, for example, maternity hospitals regularly charge for "extras" such as a cesarean or for a father to attend the birth.

In Hungary, there is a sliding scale for surgery from 100-1,000 euros.

In Bulgaria, it is common for doctors to refuse to treat a patient without payment, leaving little choice but to cough up.

According to a survey in Lithuania, the medical sector is the most corrupt -- after the traffic police.

Across the region, gifts in cash or kind are also common after treatment.

The issue was spotlighted in Latvia recently when Valdis Zatlers, a renowned surgeon who takes over as president in July, acknowledged taking "gratitude" payments.