Many professional health workers are in agreement with the general public. The heads of the Federation of Hospital Doctors of Greece (OENGE), the Association of Hospital Doctors’ Union of Athens and Piraeus (EINAP) and the Federation of Public Hospital Workers (POEDHN) have their own views as to the reasons for ESY’s poor image. The governor of the Sismanogleio Hospital defended the national health service, but admitted that certain aspects of it should be reformed. «If we take the health services as a whole, there is no doubt that people are not at all satisfied,» said Vassilis Laopodis, head of OENGE. «Accommodation at hospitals is not what it should be in this day and age, and staff shortages cause further problems for patients. However, one has to factor in the standard of medical care, which is satisfactory for most patients,» he said. As for the lack of transparency in patient-staff transactions, Laopodis said this was related to the existence of a para-economy in Greece. «However, this lack of transparency can be interpreted in two ways, as it involves not only the health professional but the patient, who is trying to get around the slow functioning of the health system. For complete transparency, the system should pay its staff properly, provide good working conditions and strictly monitor the rules,» he said. EINAP President Stathis Tsoukalos agreed that the greatest problems with ESY at Attica’s hospitals were staff shortages and shabby premises. «Equipment in most hospitals has been in place for many years and is not replaced in keeping with technological developments. Often equipment is so old it breaks down, resulting in patients being sent elsewhere for tests,» he said. According to recent allegations by hospital doctors, the only outlay on new equipment made in 2002-2003 at hospitals in the Second Regional Health and Welfare System was for the purchase of a scanning machine at the Asclepieio Hospital. «The survey reflects the reality, particularly regarding staff shortages,» says Stavros Koutsioubelis, president of POEDHN. «One third of nursing positions provided for at hospitals are not filled. This reflects the way hospitals were organized in the 1980s, which means that now requirements are far greater, given the additional services performed by hospitals. Shortages of staff trained at tertiary level are up to 65 percent, technical college level 30 percent, and high school graduates 22 percent. Koutsioubelis says patients are right to complain about staff shortages, a problem that requires patients have a friend or relative constantly in attendance or spend money on a private nurse. Patients’ companions sometimes even have to take blood and urine samples to the hospitals’ laboratories for tests. Andreas Kartapanis, governor of the Sismanogleio, thinks Greeks are exaggerating. He said the long waiting lists are due to the fact that Attica’s hospitals accept patients from all over the country. He said the lack of beds was not so much due to a shortage as to poor administration. «There should be rehabilitation centers for patients who have reached the recovery stage in order to free hospital beds for emergency cases,» he suggested.