The topic of this paper focuses on informal patient payments in Kosovo public health care system, and it includes an analysis of current anti-corruption institutions and policies as well as a description of findings from focus groups with regard to perceptions of doctors’ and patients’ about informal patient payments.
Former director of Hospital in Veľký Krtíš goes to prison for ten years, as he has tried to sell Hospital for € 100. According to a spokeswoman of Regional Court's Office in Banska Bystrica Nina Spurna, court found guilty former director of hospital of a particularly serious crime as breaching of duties in the management of foreign assets in the trial stage. Mr. Vachula as statutory of non-profit organization General Hospital in Veľký Krtíš signed a contract with a private company from Banska Bystrica, for just symbolic one hundred euros. This happened three years ago. According to him, reason for the sale was only to save the property of the hospital, which allegedly wanted some interest groups defraud and liquidate.
Former management of hospital in Trnava has signed the contract for reconstruction, but did not know the price offers of others. Hospital has chosen a supplier of reconstruction works without knowing the prices of the competition. Public procurement was not even announced. The construction works were not carried out through the contract for work, but on the basis of partial offers. Invoiced amount significantly exceeded the coverage.
Anti-corruption measures in healthcare system proposed by Medical Trade Union are non-conceptual and contrary to several acts. This is claimed by the Association of Hospitals in Slovakia. Proposal, according to the Association, gives on one side a great power to supervisory boards which do not have any responsibility for the operation of hospital and on the other side reduces the competency of the director by managing and increases his/her criminal liability.
Public Health Office has established the hotline on which people may report the suspicion of corruption. According to the spokeswoman of the Office, Lenka Skalická, number +421 907 753 397 and e-mail address email@example.com can be used for reporting of suspicion of committing a crime of accepting a bribe, bribery, indirect corruption or abusing of authority. Public can report the suspicion of corruption considering the activities of all regional public health offices in Slovakia.
From the next year the pharmaceutical companies should inform about which doctors they plan to meet, or which they have already met. Lists should be published on the website of Ministry of Health (MoH). Doctors and pharmaceutical companies do not like this proposal involved in the amendment to the act on pharmaceuticals. Doctors are afraid that this measure will disturb the personal data protection. They also claim that amendment does not clearly define the aim, which the MoH wants to reach. Association of the Suppliers of Pharmaceuticals and Slovak Association of Pharmaceutical Companies also stated that such a collection and publishing of personal data represents an unauthorized intrusion into privacy.
Public procurement in hospital should be more transparent. This should happen thanks to the central public procurement of certain commodities, which is being prepared by the Ministry of Health. Ministry plans to centrally provide the electricity, gas, special medical material and consumables. From this step Ministry expects financial savings in amount of 10% next year.
Medical Trade Union believes that any doctor does not perform his/her mission because of possible vision of chocolate or flowers. He, however, also claims that designating the patient, who after providing of health care bring doctor the chocolate or flowers as briber, deeply abases his worthiness. Medical Trade Union considers as accepting of bribe each situation, when doctor directly or through an intermediary for him/herself or for other person receives, requests or accept the promise of bribe to act or refrain from acting by breaching of his obligation under his employment, profession, position or function.
When hospital announces the public procurement, averagely 1.7 companies apply for it. In other departments in an average less than three applicants enter the competitions. Data results from the analysis of the INEKO Institute and Transparency International Slovakia. From January 2009 until March this year hospitals paid for purchased goods, services or construction services more than € 800 million. According to analysts, if there were two or more subjects concerned in the competition, hospitals could from 2009 save almost € 120 million.
Medical Trade Union has started the anti-corruption campaign, which aims to improve the relationship between patient and doctor and to ensure the more transparent environment in the healthcare system. Doctors involved into the initiative will wear the badges with slogan of the campaign (“Thank you, I don´t take bribes”) and they will also be a part of the list on the website of Medical Trade Union, where the patients can find them. Medical Trade Union also gave the Ministry of Interior a proposal for establishment of anti-corruption lines.