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Chance to clean up culture of bribery

March 2009 - From the Print Edition

With the country in a state of social and financial insecurity, Romania now faces the danger that all the skeletons the country has piled up in its cupboard over the last years will suddenly burst out and engage in a merry dance across the country, terrorising the population.
The first example is a sudden and bizarre crime wave which has emerged since January. Violent bank robberies, thefts of automatic rifles and gunfights on the streets of Romania have never been weekly events until now. Many believe that for the last decade Romania has indirectly ‘outsourced’ many of its criminals abroad, taking advantage of the open borders to allow the hard bastards to skip the country. Petty thieves and career criminals have been far happier to steal and defraud in the west, where the prize is much larger than the offer at home.
But with the global downturn reducing every nation to the same state of misery, some of these criminals, and those from other countries, may see benefits in coming to Romania. The country’s lack of experience in combating violent crime, its under-funded police and some out-of-practice security firms make the country an attractive target.
However this moment is also an opportunity for the Government to invoke the fear of national security as a means to enforce tough measures on the daily crimes that destabilise the country, such as the culture of bribery. Black market deals, which also risk further resurgence, mean more money stolen from the country’s weakening budget.
Healthcare is the most critical area. With bribery from patients to health workers topping 300 million Euro per year, this is a hefty haul of black money by-passing the cash-strapped state. Doctors, nurses and other medical staff have failed, in great numbers, to own up to the gravity of the problem, which has held the nation’s health to ransom for two decades. What senior medical groups have not publicly declared is that for one doctor in Romania to take cash from a patient before or after an operation is a crime. This is the principle for politicians or judges – so why is this so hazy when it comes to the medical profession?
But it is not as simple as putting in prison all doctors who pocket black money, although such punishments are necessary. There needs to be a mature discussion between everyone involved in this issue – citizens, local authorities, the Ministry of Health, doctors, pensioners’ groups and nurses – to pragmatically end the practice through incentives, threats and the willingness to accept a cultural shift. The sickness must be identified and the patient must want to accept the remedy, before the cure can be delivered.
Decentralising healthcare is necessary. If hospitals are placed under the control to local authorities, rather than the Ministry of Health, doctors will be more accountable to their patients. Patients, after all, are the ones who vote for the local mayor and city council. Romania needs more money for its health system – its spending is the lowest in the EU and under that of India and Albania. The private sector also has a strong role to play in improving the efficiency of the system. But to overly privatise the health service would create a mirror image of the current problem – that patients with the most cash receive the best care.

Michael Bird

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