The widespread view that the ongoing financial crisis has reduced the amount of bribes given and taken at Greek hospitals – usually in the form of the customary cash-filled “fakelaki” or “little envelope” – is not backed up by facts.
According to Ioannis Kyriopoulos, a professor of health economics at the National School of Public Health, under-the-table payments to doctors in the public and private sectors increased by about 300 million euros between 2009 and 2014. These payments can be made in a formal manner, such as by overbilling at private clinics, or informally, via fakelakia.
“According to a study of family budgets conducted by the national statistical authority (ELSTAT), people have been paying more for visits to doctors since the beginning of the crisis although households’ hospital spending has actually gone down,” Kyriakopoulos told Kathimerini.
According to the same data, total household spending on health services has gone down from 6.7 billion euros in 2009 to about 5.6 billion in 2014.
More specifically, household spending on primary healthcare was reduced by half, spending on dental care was also halved, while spending on health supplies excluding medicines was trimmed by 30 percent. Meanwhile, households spent 20 percent more on medicines and hospital care. A Transparency International survey also reported a small reduction in corruption.
“From my experience, the nature of the [bribes] cases and the price tags has not changed,” said Kristina Tremonti, a student who gained publicity in 2012 after setting up the Edosa Fakelaki (meaning “I paid a bribe”) website, in a bid to urge citizens to defend themselves against blackmail by anonymously reporting cases of corruption.
After a relative lull in traffic, the whistleblower site has seen a new surge of interest after it gave users the opportunity to make a complaint against specific individuals. The goal was to prompt the state mechanism into action.
“We do not reveal the name of the person making the complaint, for his or her protection. However, after we have collected a considerable number of reports involving a specific doctor or clinic, then we push these to the authorities,” Tremonti said.
Although the site is designed to protect the identity of those who have the courage to break the silence and report on a specific incident, only 17 individuals have done so up until now.
“They are concerned they might get caught up in some legal dispute, or that other doctors will refuse them treatment in the future,” she said. “However, unless people take action the phenomenon will go on.”
Dimitris Varnavas, president of the federation of Greek hospital doctors’ unions (OENGE), believes that the wrongdoing has been contained. “It will never completely go away,” he said. “But we are trying to minimize it.”
The Greek Health Ministry is working on a new disciplinary framework to deal with corruption, but officials would not comment on the measures that this will contain.