By Erl Murati
Although public healthcare is free under the social insurance coverage in Albania, bribing doctors for their services is a widespread phenomenon.
In 2011, the UN Office on Drugs and Crime published a report on bribery in the country. The findings indicated that “in many cases bribes are paid to facilitate bureaucratic procedures … 70% of citizens who participate in a bribery act do so to receive better treatment.”
More than 70% of citizens who pay bribes pay them to doctors, while almost 50% bribe nurses, the report said.
The results of the Albanian Institute of Statistics questionnaire on corruption from November 2011 shows that the healthcare sector is the most corrupt in the country.
“We buy medicines with our money, although I have been paying social insurance my entire life. Rooms are congested and the diagnosis is always delayed because of lack of equipment,” says Gezim Ismaili, 55, a patient at the cardiology unit at Hospital 1 in Tirana.
Ismaili waited ten days to have a magnetic resonance exam, though his name had been on the hospital list for the exam for weeks.
“They tell us we have to wait months because there are so many requests [for exams]. In Albanian hospitals you can come in healthy and come out of a hospital sick,” Ismaili told SETimes.
In August 2011, the World Bank office in Tirana cancelled $1.1m in funding to purchase hospital equipment after the Bank said that the health ministry’s organisation of the tender was in breach of its rules.
The ministry’s Management Politics head, Pellumb Pipero, says citizens are partly responsible for the declining healthcare situation in Albania.
“Only 25% to 30% of population pays healthcare insurance — the state is still the biggest donor to the system. Our citizens think that health is not a ‘product’ needing maintenance, therefore, ordinarily they don’t pay for it,” Pipero told SETimes.
With 2.1% of the country’s GDP earmarked for health care, Albania has the lowest health care budget in the region.
“Citizens must be aware of their obligations. The health insurance contribution is only 3.4% of the average salary,” Pipero told SETimes.
However, some progress has been made. Doctors say that facility adjustments and food service in the hospitals are positive changes.
“There are steps forward made in some directions, but we haven’t seen them in the basics, such as with the working equipment and medicine supplies. There are medicine tenders but the drugs never reach patients. Proper lab work is often lacking,” Dr Gjystina Proko told SETimes.
Former Health Minister Leonard Solis told SETimes that the health care system has three main problems.
“The first is the non-development of reforms which are still on paper. The second problem is that ministry and hospitals have done poor homework, therefore, services have not improved; and thirdly, preventative care has made satisfactory achievements, but not in the hospitals.”