THE HEALTH Ministry's proposal to give wealthier patients the opportunity to pay to receive better healthcare is, in itself, no real surprise, but the bizarre idea that this is a solution to the bribery problem in the Slovak healthcare system is droll.
As Slovak ministries fall over themselves to bring the worst of western state practices to this country, it was only a matter of time before a two-tier health system was put on the table. Clearly the ministry does not understand the system fully, having come up with a harebrained scheme to allow wealthier patients to buy the time of their favourite doctors.
Health minister spokesman Tomáš Szalay has the gall to say that although wealthier patients will be able to get popular doctors with good reputations, poorer patients will not be disadvantaged, although they will presumably get the less popular doctors with worse reputations.
Linking extra payments to the reduction of bribery is simply a smokescreen. Does the ministry really believe that if the patients pay the hospitals, they will no longer pay the doctors on the side to make sure that the knife does not slip during a vital operation?
It is not just the wealthy patients who bribe doctors - it is almost universal. Forcing the wealthiest patients to bribe, sorry - pay an additional consultation fee to the hospital to ensure that they get their choice of doctor, will simply mean more money will be siphoned off into the pockets of hospital administrators, while not changing the overall 'system' of bribery. Doctors will still receive bribes.
Here is an alternative - remove bribery from the healthcare system. Ensure that all members of staff (including nurses) sign a 'no bribery' clause in their contracts and have each hospital prominently display signs saying that bribery is not tolerated in the institution, giving patients a toll-free phone number to call if they are asked to pay a bribe.
And why just hospitals? Such a scheme could expand across the whole of the public sector. Couple this with high-profile prosecution of any bribery case and sting operations against suspected recipients of bribes. Make bribery an offence in practice, not just in theory.
Then, Slovakia can look into finding ways of pumping additional funds into the healthcare system - not by giving the rich better healthcare than the poor, but perhaps by providing extra services for those willing to pay for them, such as luxury wards with hotel-like accommodation.
18. Aug 2003 at 0:00