THE LACK of health-care funding is driving nurses abroad.
Slovak medical workers have complained for years that they are underpaid, and that they can only make a living by working overtime in long shifts that may stretch up to 36 hours.
Added to spiralling debt in the Slovak health care system, and a almost complete lack of reform in the sector since the current government came to power four years ago, the feared medical brain drain has been a major topic of the campaign leading up to September 20-21 elections.
Specialised health journals and popular Slovak newspapers regularly feature ads for better paid, accommodation-included medical jobs particularly in the Czech Republic. Many younger Slovak nurses have either left the country already or are considering the move, and major hospitals such as Bratislava's Kramáre have been forced to cut back on operations because of the shortage of theatre staff.
"I know a few people from my school who went to the Czech Republic, and they are very happy there. Now I'm thinking about it too," said Iveta Melicharová, 27, a nurse from the central Slovak town of Brezno.
"My only concern is that I have a husband and a baby here. But the pay is very attractive."
While a nurse like Melicharová, with over six years experience, makes around Sk9,000 ($200) a month, almost 25 per cent less than the average national wage, in the Czech Republic she would be getting twice as much.
The Health Ministry says it has no numbers on how many medical staff have left the country for jobs in the Czech Republic, Austria, Germany and Italy, which are considered the most popular destinations.
The ministry is undisturbed by reports from hospital directors around Slovakia complaining of growing vacancies, particularly for experienced and highly specialised surgery personnel.
"We know they're getting more lucrative offers from abroad, but the impact hasn't been dramatic," said Health Ministry spokesman Martin Urmanič.
But Michal Bucek, head of Banská Bystrica's Roosevelt hospital, said the authorities had reason to be worried, as the nurses which had already left his hospital "are highly qualified.
"It's a crying shame that after the state invested into their education these nurses are leaving and we can't protect ourselves against it. They're going for better jobs," Bucek said.
Eva Rozborilová, vice-dean with the Medical School in the north Slovak city of Martin, agreed.
"They are leaving at a time when they are particularly needed in our health care system. Of the faculty's 2001 graduates, all have found work, but we don't know how many of them stayed in Slovakia," Rozborilová said.
Although the Health Ministry says it is confident that the country trains enough medical staff every year to fill the vacancies, health experts say that enduringly low wages, which lag far behind comparable positions in neighbouring countries, may soon cause a more serious flight of human resources.
Mária Lévyová, president of the regional chamber of the Mid-Level Medical Staff (RK SZP) association in Košice, said that according to Slovak wages rules, a nurse with three years experience who works a three-shift system gets paid Sk7,940 ($180) a month.
"Nurses consider such salaries, as well as their social position, to be unbearable, and feel they are an insult to their expert knowledge and skills," Lévyová said.
The RK SZP recently organised an appeal entitled "They Forgot About Us," appealing to the authorities "not always to look for ways to save money on wages."
"Those who receive our services - patients - have the right to receive high quality and expert health care," stated the appeal.
Two weeks ahead of general elections, such appeals are ringing bells with voters, and increased scrutiny of plans by political parties to reform the health care system and increase medical wages (see related article, this page).