OPINION

Health sector reform

It is common knowledge that the public health sector has for years been a very problematic area. The establishment of the National Health System (ESY) failed to meet public expectations, even though it would be unfair to downgrade its social contribution. The ESY services, however, neither meet demand nor justify the money that is spent on them. As a result, reform of the health sector has been widely deemed an imperative. Yet for many years responsible ministers had been confined to day-to-day management – perhaps because they knew that the slightest change would touch upon organized interests and have wider reverberations. In the summer of 2002, a few months after taking office as health minister, Alekos Papadopoulos announced an ambitious reform plan. The Cabinet approved the plan, but soon the minister was all alone. The small and large interests that were threatened by the attempted reform got a foothold inside the government – especially the all-powerful faction of university doctors, which spearheaded the overall campaign against the reform. At first, Papadopoulos was urged by top Socialist officials and the prime minister himself not to abolish the scandalous privileges of university doctors. His refusal to back down triggered the countdown to the end of his career as health minister. They did not come into conflict with him at an official level, but they began to undermine him and raise obstacles against the attempted reforms. This suffocating climate inevitably played a decisive role in Papadopoulos’s decision to withdraw from politics. The appointment of psychiatry professor Costas Stefanis confirmed that Papadopoulos’s dismissal was in fact connected to the underlying conflict over reform. Reassurances by the government spokesman that Papadopoulos’s replacement will not entail a change of policy were unconvincing, a fact reflected in the commentaries in yesterday’s press. The new minister is in the front line of university doctors and recently he has openly sided against the ministry’s policy. As a consequence, it would be absurd to assume that he took office in order to implement a policy he disagrees with. Stefanis will most likely avoid introducing any radical changes right away. But then, there is always the tried and tested method of «trimming,» which yields the same results in the long term.