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Feature

Doctor bribes: Romania finds rare success among persisting healthcare corruption across Europe

BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q307 (Published 23 February 2024) Cite this as: BMJ 2024;384:q307
  1. Vedrana Simičević, freelance journalist
  1. Rijeka, Croatia
  1. vedrana.simicevic{at}gmail.com

Data show small improvements in the fight against corruption and bribery of doctors for treatment across Europe, finds Vedrana Simičević

When it comes to patients having to bribe doctors for healthcare, Romania was among the worst affected countries in Europe.

According to data from Eurobarometer, the European Commission’s official polling body, for the past decade Romania had the most respondents in the European Union—19% consistently for the past five years—who said they felt they had to make an extra payment or gift to healthcare providers for services to which they are legally entitled. This is far above the EU average of 3%.

In Greece, 14% of respondents said they had done so, whereas the figure was 6% for Austrian and Bulgarian respondents and zero for Sweden and the Netherlands.

Figures from 2023 saw a glimmer of hope. According to the 2023 Eurobarometer report, bribery in healthcare settings is on the decline in 14 of the 27 EU member states compared with 2022. And in Romania it halved from 19% to 9%.1

Examination of the figures shows that efforts to improve doctors’ working conditions, including pay, was a factor, but also the importance of countering the impression that corruption is commonplace and acceptable.

Romania up, bribery down

Although Romania remains one of the countries with the lowest percentage of gross domestic product allocated to healthcare, from 2012 to 2020 the country saw the largest expansion in healthcare expenditure among EU members—118.5%. This was driven by several reforms that aimed to improve the quality of healthcare services.

Among other things, in 2018 the Romanian government substantially increased health professionals’ wages by 70-172% across the public sector. In a paper published in March 2023,2 researchers from Romania and the Netherlands investigated whether this had made a difference to reported bribery.

They were able to do …

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