Justice Ministry Study: doctors most corrupted professionals in Estonia
Two major studies compiled by the order of Estonian Justice Ministry and launched in June 2010 and September 2009 have revealed that medical doctors are the most corrupted professionals in Estonia. According to the study revealed by Justice Ministry in June 2010 as much as 9% of those polled said doctors have asked them for a bribe during last 12 months. Among most corrupted professions that request and do not request university level education, doctors in Estonia rank as 2nd, with only those evaluating the vehicles listed as more corrupted (by 11% of those polled).(See below also Estonia: new initiative with zero tolerance about bribing doctors launched, new Tartu University study about corruption and fraud in Estonian health care).
The both major corruption studies (in Estonia) can be found at the Estonian Justice Ministry homepage at www.just.ee . Regardless of the widespread corruption in medicine very few Estonian doctors have been punished for requesting and taking bribes. The question - WHY? - has a simpler answer - what happens in hospitals and in medicine has been above the law in Estonia since Soviet era with that time doctors and their mentality still strongly ruling the system that seems not to understand that breaking the laws and admitting bribes damages also the reputation of doctors who never take bribes and in difference of their colleagues respect and follow also human rights.
Doctor and Tartu University anatomy lecturer Ivo Kolts: Estonian health sector needs urgent changes and the end to the long time cover-up practice in medicine
"Estonian health sector needs urgent changes and the long time cover-up practice in medicine has to end. Health quality monitoring and objective complaints handling system are practically not existing in Estonia, people who reveal their own experiences about what they have witnessed in hospitals are punished with public revenge, hospitals themselves are often interested only about the money they get for treating patients and not the quality of medical treatment. As a doctor I can confirm that the horrible stories about the brutal experiences from the hospitals are just a tiny part of the disorganization in Estonian health care. As a doctor I keep being told by my patients about similar cases again and again. Unfortunately such publicly revealed cases also damage the reputation of those good doctors in hospitals who have nothing to do with this kind of behaviour and misdoings," said dr. Ivo Kolts, lecturer on anatomy at the Tartu University who attended a seminar about the violation of patient rights in Estonian hospitals and relevant proposals at the Conference Centre of the Parliament at Toompea on Monday, February 21, 2011.
The speakers at the seminar were Pille Ilves - the head of the Estonian Patient Advocacy Association, doctor Ivo Kolts - anatomy lecturer at Tartu university, Urmas Reinsalu - Head of Parliament Social Affairs Commission, MP Toomas Trapido who made a summary whether and what has changed for better in health sector since the last similar seminar at the Parliament Conference Centre nearly a year ago.
History teacher Endla Lindmäe spoke about her son´s case whom the doctors at Tallinn biggest hospital gave no hope at all for survival, left the 22-year old without relevant treatment that causes lot of moving problems still five years later, who was starved to 33-kg in Estonian hospital before the parents took their son home upon the advice of nurse who said he will otherwise die in days in hospital - but instead came out from comatose later at home and five years later has not even any brain damage.
The initiative to force Estonian government to admit the existing problems in Estonian hospitals and to encourage the government finally to compile and adopt Patient Rights Law was initiated last year by Estonian MP Toomas Trapido, myself and some other people who have faced the brutal treatment of their relatives in Estonian hospitals.
By winter 2011 two Estonian parties - Fatherland and Pro Patria Union and also Social Democrats have included the Patient Rights Bill into their parliament election program but the two biggest parties - the ruling Reform Party and Central Party have been still ignoring the need for Patient Rights Law and the need to handle the claims about the violation of human rights in Estonian hospitals.
Estonia government that compiled its last Human Rights Report to UN recently that was discussed in Geneva early February decided to ignore all the matter this time with excluding the Patient Rights Association first time ever from the list of NGOs who were asked to express their opinion and make proposals about the fresh report.
In January Estonian Patient Rights Association sent a letter to Social Ministry informing the ministry it withdrews from current medical quality commission that is considered not objective and its members are not punished even if they lied or falsificated documents. Estonian Patient Rights Association that has stressed repeatedly that human rights of patients are often violated in Estonia has made also several proposals to authorities to change the legislation and monitoring system and to set up a completely new health sector monitoring commission that will include also lawyers.
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Estonia: new initiative with zero tolerance about bribing doctors launched
November 8, 2011
Zero tolerance is needed against the corruption in Estonian health care that people see as a major problem in a country that joined EU in 200 but where thousands pay bribes to doctors annually before the treatment, according to the new major health sector corruption and fraud study.
The study that was compiled at Tartu University health care department and maps the main problems and areas of corruption in Estonian health care was ordered by the Justice Ministry in 2010 after two annual corruption studies had indicated that doctors are the most bribe asking professionals in Estonia, with around tenth of people polled saying they have been asked for bribe by their doctor.
The study revealed that patients pay bribes to doctors mainly to get quicker appointment time or better health care treatment.
"Out of 2213 people polled in 2010 in 8 hospitals 8 percent said they had paid money, promised some favor or made gifts to doctor before the treatment. Accounting that peope have already paid for health services via their taxes nothing should be paid extra," one of the authors of the study, health care professor Raul-Allan Kiivet said.
"Taking bribes shows the lack of ethics and it is the Soviet relict, low ethical level of many doctors that keeps the corruption strong, in difference of doctors in neighbouring Nordic states," Anne Veskimeister, Head of Communications of Estonian Patient´s Union told AFP.
"Many people bribe doctors because they know doctors are not offering all patients same quality treatment. Another reason that keeps corruption strong is the lack of objective health quality control system that has created environment of no responsibility in health sector," Veskimeister added.
The study found also that the current financing scheme of Estonian health care is not transparent, promoting fraud and corruption.
"Patients are confused what is legal and what is not and third of patients regard also paid health services as corruption and another third as unethical," Kiivet said.
The study indicated that one of the problems in Estonia´s health sector is the practice of doctors to work both at state paid hospitals and run their own private health business aside, often using state paid services for treatment of patients invited to doctors private business treatment for extra appointment fee.
The study also outlined incorrect tender procedures, making biased decisions for a bribe, providing fictitious certificates, prescriptions and sick leave certificates, incorrect recording of healthcare services rendered, ill-grounded treatment, association of doctors with companies importing medicines or medical devices, training trips for doctors being paid for by companies exporting medicines or medical devices and other corrupt behaviours like influencing.
"Quarter million people of Estonia´s 1.3 million population are currently in line for doctors appointment. Every single percent of patients paying unofficially to doctors means thousands of people. We need implement zero tolerance against unofficial payments to doctors," Justice Minister Kristen Michal commented the study results.
"The draft of new corruption law sent to all ministries for final comments will enable to judge better also doctors for corruption," Michal added.
However, the proposal by Tartu University scientists to make in new corruption law doctors equal to any other officials who are paid from state budget but take bribes is not accounted in new bill of corruption law compiled by the justice minister.
