The Health and Education Systems continue to feel the ravaging effects of economic and social crisis. This pressure is so strong that it justifies the hypothesis of the rulers creating all kind of artificial problems, to dissimulate tragedies like that of the Health sector, which will thus move out of the public spotlight. The effects of the crisis are so severe that even the positive, well-meant actions turn into their contrary and increase the drama of the Health system. Although the share of GDP allotted to Health increased in the recent years, the crisis of the medical system further deepened.
Because of the conflict opposing family physicians to the National House of Health Insurances, the Romanians who suffer from serious diseases could not be issued medical prescriptions, and mortality soared. This happens in Romania, a country where the “fundamental right to health is guaranteed by Constitution.” What a tragic irony!
An analysis of hospitals’ efficiency is always welcome, and this is why it is being conducted in the EU on regular basis.
But the only purpose of such an analysis is improving the health of the population, by identifying the weak spots and finding the best solutions. This is how the Romanian minister of Health justified the recent assessment of hospitals, which decided the score of each medical unit in Romania. Most hospitals submitted to the analysis were closed, and only 20 of the remaining 461 were awarded the maximum score. But the most painful surprise was the very fact that the minister decided to close hospitals based on this terrible classification, so more than 60 pc of them – which received poor marks – saw their financing significantly reduced.
This kind of treatment is precisely the opposite of what the government should do. The logical thing to do, when you are confronted by poor health standards at country level, is to improve the existing hospitals, rather than close down many of them. It would have been normal for authorities to support the understaffed and under-equipped hospitals until things got on the right track. Instead, the decision to transfer them to local authorities is completely inadequate. Most local administrations have financial troubles themselves, so they will be unable to provide an adequate support to hospitals, which – in turn – are put to extra stress by the precarious health standards of population. We should not forget that Romania has the highest child mortality rate in the EU, with some 2,500 children dying each year before they reach the age of one. The country also has painful records in the incidence of cardio-vascular, kidney and lung diseases, diabetes and even AIDS. Meanwhile, the emigration of Romanian medical staff has increased to the highest level in the EU.
Romania has a brilliant tradition in human medicine. Our medical experts are on par with those of any other nation of the world. Until the late years of last century, most foreign students coming to Romania were attracted by the international prestige of our medical school. However, during the last two decades, our rulers “did their best” to put an end to this beautiful tradition. How was this possible? Simply by under-financing the Health and Education systems. Just an example: Some 3-4 decades ago, admission exams to medical universities attracted more than ten candidates per place each year, now there are more places than students. Of course, in the past too, those who worked in the Health system were paid less than they deserved, but they had at least their professional and social prestige intact. Today, even this prestige is being sapped.
The reasons for this decay are mainly financial. Low salaries forced many doctors and nurses to seek better jobs abroad, with all the problems resulting from a staff deficit across the system – inadequate treatment, patients dying from wrongly prescribed medicines or lack of post-surgery medication. This also amplifies the contradictions between the medical treatment granted to those who can pay bribes and those who cannot.
The contradictions ‘per se’ derive from the fact that rulers ignore the strategic role of the health system, which also has adverse effects for the solidarity of medical personnel. More and more conflicts appear between family physicians and hospital doctors, who benefit from differentiated budgets. The best solution is strengthening the unitary character of the system, rather than temporarily dealing with local conflicts. Same as in Education, the chaotic decentralisation is very damaging to the system. Transferring hospitals under the authority of local administrations bears the risk of having as many different Health standards as local administrations are in Romania. This leads to discrimination, which has the worst effects precisely in the Health and Education sectors.
Asked by the media about the serious problems of the Health system, our rulers hide behind twisted principles. This is no surprise, because in Romania, corruption starts precisely with twisting the principles. The same authorities, on one hand, acclaim or turn a blind eye to the administrative decentralisation and its criminal consequence of local autonomy on ethnic criteria, while on the other, when it comes to their own interests, they make a U-turn and resort to… merging hospitals, and then complaining about how inefficient the merged hospitals are.
Such schemes reflect the corruptibility of the reasoning specific to Romanian politicians. They jump from right to left and back again, as demanded by their interest, which is opposed to the general interest of the population, especially to the imperatives of strategic and national importance. This chain of oscillations, inconsistencies and lies, carefully dissimulated, is the reason why crisis appeared and is still going on in Romania.