The Association for Emancipation, Solidarity and Equality of Women reported today at a press conference with journalists at ESE that various forms of corruption continue to be present in healthcare, such as money and gifts before receiving a service, vouchers, referrals to private appointments, payments for services that should be free, as well as recommendations for certain medicines, laboratories or pharmacies. Their research included 410 healthcare workers and 21 directors of public healthcare institutions. According to the results, nearly 84 percent of healthcare employees believe corruption is somewhat or very widespread in the sector where they work, while only 14 percent said they had personally been involved in or had directly witnessed a corrupt act in the institution where they work, Portalb.mk reports, relayed by Zhurnal.
Although they are aware that corruption exists, most healthcare workers treat it as a normalized phenomenon and do not report it.
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Borjan Pavlovski, coordinator for public health and women’s health at ESE, said that more than 74 percent of respondents who had experience with corruption identified the direct taking of money from patients or their family members as the most common form. According to him, this is followed by the acceptance of gifts, referrals for private check-ups, recommendations to buy a specific medicine, and charging for a service that in public healthcare should be provided free of charge. He also stressed that corruption is most often demanded or offered in order to secure a faster appointment with a specialist or a certain medical service, admission to a specific doctor, as well as to obtain a hospital bed or surgical intervention without waiting for months. Pavlovski underlined that the research clearly shows that corruption in healthcare should not be seen simply as an isolated case of bribery, but as a broad systemic problem linked to access to healthcare services, power relations within institutions, the safety of patients and healthcare workers, as well as trust in the system.
According to the study’s findings, the presence of informal payments in gynecological and obstetric services is particularly alarming. Bribery is most often used to “buy” a Caesarean section without a medical indication, but also to choose a gynecologist or a specific team for childbirth.
At the briefing, ESE Executive Director Jasminka Frishçiq stated that in gynecological and obstetric services, healthcare workers identified pregnant minors under the age of 18, women without health insurance, Roma women, women from rural areas, women with disabilities, migrants and refugees as particularly exposed groups. According to her, this shows that the risk of corruption is not distributed equally among all patients, but is higher when the patient has less power, less information, limited options for choice and greater dependence on the system.
The research also identified cases of requesting or expecting intimate favors in exchange for healthcare services, documents or professional advancement.
It was said at the briefing that every fifth healthcare worker has heard or learned that a colleague requested or expected sexual favors from patients. Likewise, sexual abuse is also present within healthcare institutions themselves, as 6.3 percent of healthcare workers have been exposed to pressure, inappropriate comments or requests of a sexual nature from a colleague or superior. One of the main conclusions of the research, as emphasized there, is that a clearly expressed anti-corruption culture exists in healthcare institutions. Only seven percent of those who had information about corruption reported the case, while the others either ignored it or rejected it without reporting it. The main reasons for this approach remain systemic and persistent: distrust that anything will change (55%), fear of consequences or damaging collegial relationships (56%), lack of evidence (36%), and the perception that the case is not serious enough.
The data also show a lack of preparedness among healthcare workers to recognize and act in cases of corruption and sexual abuse. Precisely 77.6 percent have never received any training on this issue, while in tertiary healthcare this figure reaches 82 percent.
Survey participants stressed that tackling corruption requires systemic measures, including the protection of whistleblowers, stronger sanctions and controls, greater transparency, as well as better salaries and working conditions.
We recall that research into citizens’ experiences, perceptions and attitudes regarding corrupt practices in the healthcare system had also highlighted that corruption in healthcare has become a normalized phenomenon that patients often do not identify and that almost no one reports. Although most respondents consider it a serious problem, only a small number confirmed that they had encountered corruption in practice, Zhurnal.mk reports.
