Doctor Drain: What to do?

For years now, Romania’s public healthcare system has been struggling with major problems. Whether we talk about the shortage of hospital capacity, or the lack of equipment, about basic hygiene standards or about the shortage of staff, particularly outside the capital city Bucharest, all of them can be blamed on the under-funding of the system. The EU accession has brought some funding for specific projects, but this did little to change the system as a whole. Moreover, by allowing and encouraging the free movement of healthcare workers, the EU accession has generated a worrying phenomenon, namely the massive migration of Romanian specialists to richer Member States. MEP Cristian Busoi, a member of the European People’s Party and a doctor of medicine, gave us some details:

"The doctor drain is a very serious problem for the Romanian healthcare system. Over 14,000 doctors have left the country over the past few years, according to statistics from the Physicians Association. This is a lot. It means fewer trained people, in whom the Romanian state has invested, to the benefit of the Romanian public healthcare, and ultimately it means that Romanian patients receive lower-quality healthcare services.”

Romania is not the only country to face this problem. Biljana Borzan is an MEP from Croatia, a member of the Progressive Alliance of Socialists and Democrats. She is also a member of the Committee on Environment, Public Health and Food Safety in the European Parliament. We asked her what the Union can do to stop the migration of healthcare staff from the East to the West. Biljana Borzan:

“There are no poor Member States that found some kind of solution to that problem, because it’s normal for educated people to try to find better life, better salary or better conditions. But I have to say that, in my country, Croatia, we have few examples that doctors left for Germany or France, and then they decided to come back. Because in Croatia doctors don’t have big salaries as doctors in France or Germany, but they have a little bit more normal life, I would say, working hours and maybe some kind of conditions, and also expenses for groceries or whatever you need for normal,  everyday life, are cheaper in Croatia. So you can maybe get a smaller salary, but you can buy more things than in a Western European country. So people go there, they realize that the salaries may be a little bit higher, but the expenses are much higher, and  they also don’t live in their country and they don’t speak their mother language. And sometimes it becomes really stressful. So I think that we have to give people the opportunity to move, because this is one of the most positive things in the European Union, to move, to see what’s going on there, and probably or possibly or hopefully to come back”.

Romanian officials are not very optimistic about Romanian doctors returning back home, and that is why they are looking for solutions. Here is Romanian MP Cristian Busoi again:

“First of all, physicians’ incomes must be further increased. Clearly, salaries in Romania as they are today, although they have been raised lately, are still not attractive enough, and I would dare say, they are not even balanced or fair. Especially given that we would like this system of informal payments to disappear and institutions in the legal sector have undergone serious actions to put a stop to this phenomenon. Therefore, the process must continue. We have to invest more in the health infrastructure, in new hospitals, in better equipment. And, of course, in a more transparent, effective and fair working conditions, without wasting or illegally spending public money. Thirdly, we must change the way in which health-care institutions in Romania are organized, hospitals in particular. Many doctors leave not only because their salaries are low and working conditions are improper, they also leave because, even if they are good and do their job properly, there are no guarantees that they will be properly promoted.  The promotion system is still biased and based on interests other than professional performance.”

At the end of the day, it’s all about a better organisation and a better allocation of funds that are needed to properly fund the Romanian health-care system. We hope that political decision-makers will be able to eventually find better solutions than before. (Translated by A.M. Popescu & M. Ignatescu)