‘An arena of unrelenting war,’ where major interests act behind the scenes

You have been in charge of the Peloponnese PeSY for almost two years. How would you describe this time? Tough and productive. The health sector is an arena of unrelenting war, where major interests act behind political and theoretical arguments. I’m not saying anything new; it’s just that I’m experiencing it. But it was productive. More has been done in a few months than was done in years. The regional formation of the national health system (ESY) is here to stay. It is a new foundation. The ESY of tomorrow will be different from the one we have known. What obstacles did you face there? Are you disappointed, or was it worth the effort? Th two obstacles are Greek state bureaucracy and the inertia within the health system. Everyone complains about ESY, but many people have done well for themselves out of the whole mess. But we mustn’t only talk about obstacles. In ESY there are tremendous forces for renewal that are eager for an opportunity to act. In PeSY, doctors in hospitals have organized visits to remote areas on their own initiative. Young staff, nurses and administrators see improving patient admission procedures as a personal challenge. We are doing the best we can to pave the way for them. Yes, it’s worth the effort. What made you, an activist doctor, accept a high state appointment? For me the challenge is to remain an activist doctor in what you call a high state appointment. I think the choice of people like me has political meaning. It reflects the decision of Prime Minister Costas Simitis’s government to open up the public sector to society, and let fresh air in. What unites and separates humanitarian action and political/ administrative work in ESY? Both have the same ultimate objective – public welfare, but a different agent. NGOs are based on the private initiative of a group of citizens. Politics is based on state mechanisms that have developed over centuries. Do you treat an illegal immigrant in hospital nowadays the same as you would have a few years ago in a Doctors Without Borders polyclinic? The Doctors Without Borders experience helps me deal with matters more substantively. As for hospitals, they certainly don’t operate like polyclinics. But, as I promised, no illegal immigrant has been handed over because they came to seek care. Besides, the law has changed in the direction of strict observance of medical ethics. Do you miss Doctors Without Borders? Yes. What kind of relationship does Greek society have with the health system? Confused, I’d say; something of a love-hate relationship. Unlike Western Europeans, Greeks have an emotional, not a logical, relationship with their doctors and anything that offers medical care. I think Greeks would like to love their health system. But as they can’t, that desire is transformed into suspicion and aggression. Of course ESY doesn’t deserve one or the other. What changes has health reform brought to the Peloponnese? Big changes have already taken place, but they haven’t become fully visible; because they are institutional changes for improvements that will happen gradually. But chiefly because they are overshadowed by the commotion of war and the recent outbreak of rumors. Hospitals in the Peloponnese are getting a new image; they are becoming more patient-friendly. We have three new hospitals; the first regional oncology center is opening; we have new intensive care units in Corinth; the Kyparissia Hospital is the first in Greece to acquire ISO quality certification for one of its units; 230 staff have been trained in patient admission procedures; and for the first time in the history of Greek hospitals there is a proper inventory of assets. These are just a few things, but for the first time we have reversed a trend. Remember that in the other European countries, regional organization took 20-30 years. If all the obstacles facing you magically disappeared, what would you do? I would like to develop a «third sector» in Greece, like the one in France: non-state, non-profit, social and part of ESY. It’s a big issue – perhaps the next reform.