The exodus of doctors: the tragedy of Romania’s bribe-infested health system

Millions of Romanians have emigrated in recent years for better-paid jobs in societies where individuals are judged on their skills, effort, and achievement, rather than wealth or social connections.

Among them are thousands of doctors and health officials who left Romania and found good jobs in hospitals in Britain, France, Germany and elsewhere. This is a great loss of human wealth for Romania, economically, socially and politically.

Medics left Romania for higher salaries, but they were also frustrated by a corrupt health system that functioned on informal payments and bribes from the top to the bottom, and all the way through the middle. The system is crooked and stressful not only for patients, already anxious about their illness and a hospital stay, but also for medics whose attention is diverted by money and illicit gain and not on treating the sick.

Three years since the Social Democrats raised medics’ wages, patients are paying fewer bribes which is a good thing. Some hospitals have a notice saying medics don’t accept “atentii” or “thank you gifts,”  while some health staff are concerned that patients may film or record them accepting cash or favors. Other medics are grateful for the long overdue salary hike and have stopped taking cash. Others never took gifts to begin with.

But old habits die hard. There is a lingering belief that if you don’t profit in some way from the system, you must be stupid. I heard a story the other day from a medic who refuses illicit cash and as a result is ostracized by some colleagues. “Don’t you talk during surgery?” I asked. “No,” he said.

Heaven help us if an operation goes wrong because an anesthetist refused to talk to the surgeon. The surgeon is in charge of the operation and if or she refuses to take kickbacks, the anesthetist can’t make extra money on that operation.

But the big corruption in the health system is not the so-called “envelopes” stuffed with cash, and 10 lei bills slipped into doctor’s white coats, or the hens and smoked cheese gifted by rural patients in lieu of cash: it’s corruption at the top. It’s the hospital managers who demand percentages from profitable acquisition contracts and senior doctors who take cash to promote people to sought-after posts, something a former health minister has just been charged with. It’s cronyism and corruption rolled into one.

In recent days, the news cycle has been dominated by the case of an ex-health minister who has been charged by anti-corruption prosecutors of taking a bribe of 35,000 euros in her current capacity as hospital manager. The kickback is allegedly one in a series of bribes she received in exchange for awarding a contract to a private company. She has denied wrongdoing.

Behold the reaction. The mayor of Bucharest (both women are senior members of the Social Democratic Party) suggested the case was politically motivated and the bribes were merely „thank you gifts.” The ex-minister, who in an ironic twist herself had led a campaign to reduce bribery, insists she’s innocent. The news has focused on handcuffs, her health and whether she was caught red-handed or not.

The story has gone on and on, and it misses the point. The real problem is not the case of one allegedly crooked hospital manager; frankly the country is full of them. The real scandal is the thousands of Romanian medics who left Romania in recent years because the system worked against them.

They left, not just because they wanted to be paid a decent wage, but because they had lost faith in an efficient and transparent healthcare system.

 U.S. ambassador Adrian Zuckerman expressed it well in comments he made to the American Chamber of Commerce.

Romania was losing workers, he said, “not because they can make more money elsewhere, they are leaving because they are losing hope.”


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