When even doctors lose faith

PRIEST, doctor and teacher used to be considered the noblest professions in Central Europe, a triumvirate that influenced people's lives from birth.

PRIEST, doctor and teacher used to be considered the noblest professions in Central Europe, a triumvirate that influenced people's lives from birth.

While the communist regime stripped priests of their social status, reducing them to the status of useless relics and curiosities in the atheist society they pledged to create, the status of doctors increased.

Medical schools were among the most sought-after university courses, and many stories were told about the impossibility of gaining admission for kids whose parents were not party members or who could not afford a fat bribe.

Today it is more difficult to define the status of Slovak physicians in society. This equivocal status seems to be a sore point with physicians themselves, one that perhaps rankles even more that the salaries they earn.

The recent strike by medical staff, however, reveals only fragments of a problem that is consuming not only doctors and nurses but the country's whole health care sector.

While it is not surprising that the strike has not really won the sympathy of the general public, the failure of the Confederation of Trade Unions, which has always enjoyed organizing and supporting different kinds of strikes, to promptly support the medical strike puzzled many.

In the same way, the boss of Smer, the strongest opposition party, has been surprisingly reserved in his comments on the strike.

Robert Fico, who has barely missed a chance to lash out at the Dzurinda government these past four years, and who on several occasions called the cabinet's reforms, including the health reform, an experiment using people as guinea pigs, this time called on doctors to be patient and not to strike. He said that once Smer reaches government, his party will fix everything that ails the health care sector.

One of the reasons that Fico did not wave the Smer flag over the strikers is that the strike itself is not that popular among the public, and he did not want to risk losing votes by supporting a controversial strike.

Besides, if he does actually form part of the next government to emerge from June elections, he might find himself saddled with the same demands for higher salaries, which might not be the best start to fixing what ails the sector.

The media and the public are torn over the strike. The public acknowledges that the average salary of doctors, Sk30,000 (€802) a month, is far below the standards of their western colleagues, but at the same time, given that the national average salary is around Sk18,000, the plight of the doctors might not seem that urgent, especially to people who earn the minimum wage of about Sk6,900 a month.

Understandably, Slovak doctors feel frustrated when they look at their colleagues in Western Europe, the US or Canada, where most physicians belong to the upper middle class, earn enough to run their own clinics, and can invest into modern technology.

Slovaks have been rather torn over the health care reform as well. The majority of the population has supported the changes but also feared the consequences and the practical impact of the reform.

People who lived under communism for decades still fail to understand that there is no such thing as free health care, perhaps partly because free health care remains part of the rhetoric of leftist parties.

Doctors' associations have warned that the crisis has resulted in many doctors and nurses leaving for the Czech Republic and Austria in search of better salaries.

During their last meeting with Prime Minister Mikuláš Dzurinda, doctors even threw their gowns at Dzurinda, suggesting that he give them to the Ukrainian physicians who might replace the Slovaks in their underpaid jobs.

Another, not less serious problem is that the public largely views the health care sector as corrupt.

According to a World Bank report, Slovaks spend tens if not hundreds of billions of crowns every year on under-the-table payments and bribes, with many ending up in the pockets of physicians.

Based on data from the Slovak Statistics Bureau for 2005, 71 percent of people believe it is necessary to pay bribes or seek out "contacts" to get decent treatment in the health sector.

This fact also makes the public less supportive of doctors who strike for higher wages and better conditions.

The physicians, however, are quite right to feel neglected, as political parties rarely put solutions to health care problems high on their agendas, preferring to criticize their opponents for neglecting the sector.

The healthcare reform scheme, designed by Health Minister Rudolf Zajac, made the minister one of the least-liked ministers on the Dzurinda team.

Last year, over half of the population was still hostile towards the health reform, considering it the end of free health care. Now it seems that not only the public but also doctors are losing faith in better times for the health care sector.

By Beata Balogová

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