Treating Doctors for Corruption

August 20, 2012 by

Pavol Stracancsky

BRATISLAVA, Aug 19 (IPS) – Slovak doctors have launched an unprecedented campaign to rid their own profession of what is widely perceived as endemic bribery.Launching the ‘Thank You, We Don’t Take Bribes’ campaign, officials from the Medical Trade Unions Association (LOZ) said the move would reassure the public of medics’ integrity and increase transparency in the healthcare system.

But experts believe it will do little to stop corruption in the sector.

Roman Muzik, an analyst at the Health Policy Institute (HPI) think-tank in Bratislava, told IPS: “It is an interesting and atypical measure, but it won’t significantly decrease corruption in the healthcare system. More effective measures are needed.”

The campaign – which will see hospital doctors wearing the stickers when treating patients and a special website set up showing which doctors have joined – comes amid a continuing overwhelming public perception of the country’s healthcare sector as having, as in many other Eastern European nations, a serious problem with bribery.

According to a 2010 study by Transparency International, Slovakia’s healthcare system was perceived to be the 18th most corrupt out of 88 countries surveyed. Another study released this year showed one in four families in Slovakia had personal experience of bribery involving a doctor.

Patients often say that even when not directly asked for a bribe, they feel they must offer one to guarantee at least reasonable healthcare.

Interviews with patients have shown that payments of anywhere from tens of euros to thousands of euros are handed in return for priority on operation waiting lists or above-standard service.

The situation is the same, or worse, in other Central and Eastern European (CEE) countries, with healthcare in the Ukraine, Moldova, Romania and Hungary perceived as having particularly severe problems with medical workers taking bribes.

Healthcare in many countries in the region is grossly underfunded compared to the European average and very low pay and poor working conditions – which have caused mass strikes by medical workers in Hungary, the Czech Republic and Slovakia in the last two years – are often cited as reasons for medics taking bribes.

But a recent research paper from HPI has dismissed this, instead suggesting doctors’ greed and the fact that “circumstances allow them” to demand bribes as more likely reasons for flourishing corruption.

A lack of clarity on patient rights and entitlements is also thought to contribute to the problem.

Gabriel Sipos, head of Transparency International Slovakia, told the local Sme newspaper: “It’s important that a basic package is defined showing what a patient is entitled to. If this is not clear, it creates room for ‘under the table’ negotiation.”

But others say that the causes of problems with corrupt doctors are more complex and date back to the communist regimes in place across the region until just over 20 years ago.

Handing over money and gifts in return for preferential treatment or access to certain products and services was regular and a normal way of life at all levels of society.

This created a culture and general acceptance of bribery which remains entrenched in some sectors today.

The World Bank has estimated that, in Romania alone, as much as 750,000 euros per day is received or offered in bribes. Local media have reported that staff at hospitals will demand from hundreds to hundreds of thousands of euros for anything from ensuring bed sheets are changed to approving operations abroad.

Romanian health minister Ladislau Ritli admitted to media earlier this year: "Corruption is so deeply rooted in our system that it’s really difficult to eliminate."

HPI’s Muzik told IPS: “One of the reasons behind problems with bribery in healthcare is that corruption in general is deeply rooted in people’s behaviour. They used bribes before 1989, under the communist regime, and so they continue to use them now.”

He added that patients themselves also needed to play their part in stamping out bribery.

“Patients need to stop following the idea that ‘everybody is doing it, so why not me?’ and giving bribes.”

Patients have also been called on to make sure they report doctors who ask for bribes and along with its new campaign, LOZ has called for the Health Ministry to set up a special hotline where patients can report bribery.

While some doctors have been caught taking bribes after patients went to the police, prosecutions for corruption in the sector have been rare.

Many patients admit to being reluctant to report medics who demand bribes, fearing what some term as a “white-coat mafia” could do to them on an operating table.

Within the profession, few doctors ever speak openly of corruption or colleagues accepting bribes. But some will admit privately that it is not uncommon.

Sylvia Kucharova, a psychiatrist from Zilina in northern Slovakia, told IPS that although she did not take bribes she was aware that the practice went on.

She said: “There are plenty of people looking for, and offering, ‘sweeteners’. It’s always been there.”

There is little expectation that the problem is likely to be resolved in the immediate future. But despite the doubts about the overall effectiveness of the campaign, the fact that it has been launched at all is a positive step.

Muzik said: “It has to be said that although the campaign is not likely to have much effect on corruption it is good that Slovak doctors are admitting there is corruption in the system, that they feel it is widespread and that they want to do something about it.”


Filed Under: Europe, Health, Report, Transparency Tagged With: ,

MEDIA: Slovakia Tightens the Gag

January 22, 2010 by

Global Geopolitics Net Sites / IPS

By Pavol Stracansky

BRATISLAVA, Jan 22, 2010 (IPS) – Fears are growing for media freedom in Slovakia amid warnings that the country’s public television station has become a propaganda tool for the government ahead of elections this year.

Media monitoring groups say that public broadcaster STV has abandoned unbiased reporting on the coalition government and is muzzling investigative journalism and any reporting that could be seen as critical of the government.

Rastislav Kuzel, a media analyst for the MEMO98, an NGO in Bratislava, told IPS: "Recent events at STV are very alarming, especially in light of the fact that there are going to be elections this summer. We have already had the first signs that the government is using STV as a propaganda tool."

The warnings come just days after a reporter at the station was laid off following controversy over a documentary on the use of EU funds at one of a number of special social welfare institutes projects brought in by labour minister Viera Tomanova. Some of the projects have subsequently been linked to governing party MPs and their friends.

The documentary was pulled hours before it was due to air in October last year on the orders of the head of STV, Stefan Niznansky.

Niznansky, who before he took up his post was a media advisor to the current labour minister, claimed the broadcast was stopped because the reporters who made the programme had not followed internal editing procedures. He also said the journalist involved would be disciplined.

But it then emerged that the documentary had been approved by editorial chiefs for broadcast days before Niznansky’s decision.

The move was condemned by media watchdogs and journalists’ associations in the country, and there was speculation that the station had been put under pressure to stop the broadcast. The misuse of the funds was earlier this month proved in a Brussels audit.

The station is also facing accusations of political bias over an episode of its flagship Sunday lunchtime political debate programme earlier this month.

The show usually features a single government and opposition representative debating current political and social themes. But in a broadcast on the first Sunday of this year the only guests were Prime Minister Robert Fico, Speaker of Parliament Pavol Paska – a senior member of Fico’s Smer party – and President Ivan Gasparovic, who, despite holding a politically neutral post, said last year that he was "practically a member" of Smer.

Opposition politicians said the show had been nothing but government propaganda.

"This, and the sacking of the reporter over the documentary show there is political pressure on the station by the ruling coalition," Kuzel told IPS.

STV officials have denied any political links to either the reporter’s dismissal or the broadcast of its debate. It has also repeatedly dismissed accusations of political influence at the station.

But since the government came to power in 2006, questions have been raised over government politicians’ influence. Journalists at the station have claimed that government figures have contacted them to tell them how to present their news coverage.

In October 2006 then head of news at the station Roland Kyska said Prime Minister Fico had called him to tell him what he expected from coverage of a state visit he was about to undertake. Kyska told Slovak media at the time that the government expected STV to be "servile" to it.

STV staff also confirmed that the prime minister’s spokeswoman and culture minister Marek Madaric had called on other occasions to discuss news presentation.

In 2007, 11 STV news staff resigned claiming that their work was being censored and that there was political influence on broadcast decisions.

Critics say that STV director Niznansky is ensuring the government is presented in the best possible light by the station.

Andrej Skolkay, media analyst and head of the School of Media and Communication in Bratislava, told IPS: "He knows exactly how to present things so that it looks good for the government. STV avoids sensitive issues and turns out hidden propaganda."

And they warn that if the government has control over STV’s news output it will be able to use it to manipulate voters at elections planned this June.

"It has the best geographical coverage of any TV station in Slovakia and in some parts of the country people, potential voters, cannot receive any other stations, and will rely on STV as their only TV source of political news," said Kuzel.

Similar concerns over government restriction on reporting have also been voiced in the print media industry.

Relations between the government and print media are at their lowest point since the autocratic regime of Vladimir Meciar in the 1990s which led Slovakia into international isolation at the time and was condemned by rights groups across the world for, among others, its manipulation of public media.

Government politicians have openly insulted journalists since coming to power. Fico has publicly dismissed them as corrupt, stupid, liars, idiots and prostitutes. In December last year he also compared the publishers of print media to mafia and claimed they had secretly met to discuss ways of discrediting him. One publisher has now brought legal action against him over the comments.

But Fico and other senior government politicians have also launched a string of libel actions against print media, many of them successful. Fico himself won more than 100,000 euros in compensation from newspapers and magazines last year alone.

Some critics have argued the compensation awards in some cases have been completely unjustified – the average yearly wage in the country is less than 10,000 euros – and are an attempt to financially weaken media critical of the government.

"They are already winning large sums in libel cases in civil courts regularly, and this is a threat to newspapers," Kuzel told IPS.

Publishers are equally fearful of recent legislation some journalists have claimed is a thinly-veiled attempt to muzzle critical reporting of government politicians.

A new media law passed in April 2008 brought in a "right to reply" under which print media would be forced to publish the reaction of any person who felt that a published article had harmed their reputation, even if the facts contained in the article were true.

The legislation stipulated that the reaction would have to be published in the same place in the newspaper or magazine. If the publication refused to do so it faced fines of up to 5,000 euros.

Publishers and editors in Slovakia fiercely protested the passage of the law, and international journalism organisations such as Reporters Without Borders as well as institutions such as the Organisation for Security and Cooperation in Europe (OSCE) condemned it as an attack on editorial freedom.

But the politicians who drafted the law claim that it was not brought in to restrict the free press but instead to protect ordinary people against false accusations. Fico said when it was passed that it was not designed to be used by politicians, and he would never use it.

But within weeks of it coming into effect the coalition government HZDS party tried to use it, and just last year Fico himself used it over an article in a magazine about his son’s schooling.

Media analysts say that politicians’ claims about the purpose of the legislation have been proved false and that it is being used against critical press.

"The law was created amid a background of a very hostile relationship the Prime Minister had with the press. The right of reply is very restrictive for newspapers and a potential threat.

"It has been shown that it was not, as claimed, created for ordinary people but for politicians. It is a tool which creates extra leverage for them against the newspapers," Kuzel told IPS.

All rights reserved, IPS – Inter Press Service, 2010.

This article may not be republished, broadcast, framed, or redistributed without the written permission of IPS – Inter Press Service. Republication of this material without permission from IPS, the copyright holder, constitutes a violation of United States and international copyright laws and may result in legal action.


Filed Under: Europe, Politics, Report Tagged With:

SLOVAKIA: Velvet Touch Brings Communists Back

November 19, 2009 by

Global Geopolitics Net Sites / IPS

By Pavol Stracansky

BRATISLAVA, Nov 19 (IPS) – As Slovaks mark the 20th anniversary of the fall of communism this week, former dissidents have lashed out at top political figures, including the prime minister, who they say are trying to paint the totalitarian regime of old in a positive light.

Some refused to join Prime Minister Robert Fico and other leading government officials for an official event this week marking the beginning of the Velvet Revolution which brought down the communist regime in then Czechoslovakia in 1989. They stayed away after it was revealed that former communist functionaries had been invited to speak.

The furore has sparked debate on how some former communist party chiefs, secret police officers and agents have prospered during the post-communist era while former political prisoners have seen no form of compensation for their persecution at the hands of the state.

Miroslav Kusy, former dissident and one of the most prominent Slovak figures of the revolution, told IPS: "I will not attend an event marking the fall of communism where ex-communists are going to talk to me about the fall of communism. It’s as if fascists organised a celebration of an uprising against the Nazis.

"Bringing up the good points of communism is done all the time. It’s like praising the good points of fascism – there was full employment and Hitler of course loved dogs. But the regime as a whole was sick and that applies to communism as well. To highlight its good side goes against normal, healthy, thinking."

The communists took power in then Czechoslovakia in 1948 following a coup. Over the next 41 years hundreds of people were sent to their deaths or tortured, and tens of thousands were imprisoned, or subjected to forced labour for even the slightest show of anti-regime sentiment.

The feared secret police, the StB, used a network of agents and informants to terrorise and punish suspected or potential dissidents, or individuals seen as "uncomfortable" for the regime.

The November 1989 revolution saw the communist party peacefully ousted from power, with the entire government stepping down amid massive nationwide protests.

An interim regime including many communist officials was set up and the first free elections were held months later.

Since then former communist party members have managed to work their way to the very top posts in the country – a fact some dissidents have admitted they have had to resign themselves to.

"I am disappointed but we elected them, democratically and it is that democracy and choice which we wanted at the time of the revolution," said Kusy.

Fico, head of the left-wing Smer party, joined the communist party in 1987. His political career began with the direct successor of the communist party, the Slovak Democratic Left party, before he then formed Smer.

He has openly maintained his left-wing ideology and has publicly said that the November 1989 revolution brought "no real change" in his life. He has refused to condemn all aspects of the former regime, and at a public event marking the May 1 national holiday earlier this year greeted the crowd with the phrase "honour work" – the obligatory public greeting between all people under communism.

His decision to spend Nov. 17, the date of the start of the revolution and a national holiday in Slovakia, this year in London was criticised by some observers as a sign of his attitude to the revolution and a lack of respect to those who rose up against the communists.

But the Prime Minister is far from the only senior figure in the country to have a communist past. The President, Ivan Gasparovic, was a communist party member.

The man Gasparovic took over from as President in 2004, Rudolf Schuster, was the last communist leader of the Slovak parliament in 1989, and stayed in power until the middle of the following year when the communist regime was formerly ended and the first democratic elections took place. He is now retired and lives in a large villa in the east of the country.

Milan Cic, the last justice minister in the Slovak communist regime and whose ministry oversaw the imprisonment of dissidents, went on to become the first post-revolution Slovak prime minister before occupying senior positions in subsequent governments. He is currently head of President Gasparovic’s office.

Former communist secret police officials and agents have also prospered since the Velvet Revolution.

Alojz Lorenc, the last head of the feared Czechoslovak communist secret police – the StB – in November 1989, is now employed by one of the largest financial groups in both Slovakia and the Czech Republic. He founded his own successful IT firm in the 1990s after evading justice for a sentence passed in the Czech Republic for illegal arrest and detention of dissidents during the revolution. He had refused to go to the Czech Republic to serve the sentence after Czechoslovakia split in 1993.

Following the fall of the communist regime others also took up positions in the new Slovak police and secret service, either with or without their superiors having a knowledge of their past. The secret service (SIS) and police deny that any former StB members are in their ranks.

And to the anger and disappointment of many former political prisoners, most of who say they have struggled financially as well as physically and mentally because of the persecution they suffered, former StB officials receive larger state pensions than them.

According to the Sme daily, senior StB members receive up to 800 euros per month pension – the national average is 330. But the maximum paid out to any former political prisoner is 700 euros, and only if they were jailed for ten years or more. Others receive as little as half that amount.

Some experts say that the situation is a combination of apathy and ignorance in parts of society towards the communist past.

The Institute for National Remembrance which was set up to document and archive the crimes of the communist regime says that in schools children are taught little of the events of 1989 and are ignorant of what life was like under communism.

Others say the communist past has been deliberately glossed over by the country’s successive post-communist powerbrokers.

Grigorij Meseznikov, political analyst with the Institute for Public Affairs think tank in Bratislava, told IPS: "The people who led the 1989 revolution were not the ones who took power afterwards, and over the last 20 years the country’s leading political forces have had no interest in discussing issues such as this.

"The people in power today did not expect or plan the changes of 1989, or even want them. But they took advantage of them to move forward."

Kusy added that the nature of the revolution itself may ultimately have led to former communists being able to work their way into powerful positions today.

"We had a velvet revolution, not a bloody one. Perhaps if it had been like that, a hard line drawn with the past, things would be different. But that is not something we wanted and I would still now take the velvet path rather than the bloody one."

All rights reserved, IPS – Inter Press Service, 2009.

This article may not be republished, broadcast, framed, or redistributed without the written permission of IPS – Inter Press Service. Republication of this material without permission from IPS, the copyright holder, constitutes a violation of United States and international copyright laws and may result in legal action.


Filed Under: Europe, History, Politics, Report Tagged With: ,