Government abolishes the NHS 40 years after its institutionalization
Dear member,
This is our weekly round-up from Greece.
Free public healthcare has now essentially been abolished in Greece. The government voted for a law prioritizing access to healthcare for those who can afford it.
The NHS was institutionalized in the early 80s. In the years of the crisis, the unemployed had been deprived of free hospital healthcare over a period and then the same happened to migrants.
An interesting piece of information: The leading private investment company in healthcare in Greece had been reported as having employed the PM’s daughter after their last purchase. Coincidental? Conflict of interest for sure.
If you don’t pay, you die - It’s as simple as that
It did not come as a surprise. The ND party had NHS privatization on its agenda. Only the pandemic came their way. Yet, the pandemic did not make this government review its stance on free access to all state and National Healthcare Systems. They did not change their plans.
With Greece having paid a huge toll in coronavirus-related deaths, many of them caused by state intransigence to not boost the NHS, the government passed a bill on Friday essentially abolishing the NHS. All 156 government MPs voted (Si apre in una nuova finestra) in favor of the bill, with all the opposition voting against it.
The bill clauses which have been mainly targeted by outraged doctors and citizens are Articles 7 and 10, which provide (Si apre in una nuova finestra) for a labor status change for doctors employed by the NHS. Under these clauses, doctors working for the NHS will from now on be entitled to not be fully and exclusively employed by the NHS, as they were required until now. Fully employed NHS doctors can now simultaneously run a private practice or provide their services also to private clinics, laboratories, etc. At the same time, private doctors will be entitled to be employed part-time at the NHS.
These articles abolish the cornerstone NHS principle introduced in the early 80s by the PASOK government which brought the NHS into being and which provides for all its personnel to be fully and exclusively employed.
Why will this change prove decisive? Because it indirectly yet clearly abolishes free state healthcare for all.
Now doctors would be able to easily admit patients to hospitals ‘from the back door after they have previously visited them in their private practice.
The bill also provides (Si apre in una nuova finestra) for the set-up of so-called ‘evening surgeries’ (like the already established ‘evening practice’ where patients pay their visits). The patients who can afford it would then be able to pay to undergo surgery in the ‘evening surgeries,’ surpassing the very long waiting list in the NHS morning surgeries.
Given that the Greek NHS is greatly understaffed and underfunded (with patients already queuing for long hours to receive healthcare or waiting for months to undergo surgery or even being asked to bring their own medicine because the hospital is lacking them), it goes without saying that now the patients will indirectly be pushed to pay in order to be prioritized in healthcare.
What will happen to those who can’t pay? Well, they will most probably die sooner or later.
Plus, the greatly understaffed NHS keeps going till now only because its doctors work long hours. Since they are now entitled to their own private practice, they could stop doing over hours - with patients who won’t have to pay for priority, waiting even longer, or not being able to get basic medical services at all.
It is important to keep in mind that citizens in Greece were already spending a lot of money to get essential healthcare. As the NHS is overburdened, they often have to resort to private laboratories and clinics if they don’t want to die waiting for an urgent examination.
All doctors and hospital staff unions appeared outraged against the new bill and several demonstrations took place.
The bill “will open the gates to the direction of undermining health services,” Athens Piraeus Hospital Doctors Union EINAP stated (Si apre in una nuova finestra) in a press release. Should this become law, there would be “a commercialization of Health and the services provided will be downgraded.”
Greece’s Hospital Doctors Unions Federation OENGE characterized the bill as a “BLACKMAIL (their emphasis)” “The patients are blackmailed to put their hand even deeper in their pocket to pay from their slashed income for their health. Otherwise, they would be condemned to many months, of long waits for a single examination, a surgery, risking their health and life. And they have the nerve to present this as freedom of choice. They went as far as to claim they give a choice to whoever ‘wishes it’ and ‘do not spare money for their health’ to do it. This is what the governing party’s inventor of this bill told OENGE in a meeting,” they stated (Si apre in una nuova finestra).
“If they ‘want’ to increase their income, NHS doctors are blackmailed to get out there in the market and use public hospitals as a pool to fish clients from,” they added.
Finally, they deconstruct the bill’s provision for increases in hospital doctors’ wages. The bill suggests they will get a 10% wage increase.
In the same line, Greece’s Federation of Public Hospital Employees POEDIN stated (Si apre in una nuova finestra) that the bill “will further increase private health spending and the triggered services demand, something which has already started to happen with the institutionalization of the evening paid-for surgeries.”
In fact, there has not been a single medical body, be it state or private doctors, to endorse this bill, as the Panhellenic Medical Association General Secretary Giorgos Eleftheriou clarified (Si apre in una nuova finestra). He added that the bill is in favor only of the private clinics' interests, while it creates different strata of doctors within the NHS.
A bleak past and an even more obscure future
Greece’s track record of dismantling the NHS, free public healthcare, goes back to the beginning of the financial crisis in 2010.
As of 2011, tens of thousands of people who had lost their jobs and therefore did not have national health insurance were also deprived of their right to receive healthcare in public hospitals.
As a result, the part of those citizens who urgently needed healthcare went through a nightmare.
There were reports (Si apre in una nuova finestra) on the “disastrous healthcare spending” which was threatening many households when one of their members was facing a health problem - as these people were now required to pay the hospital expenses. For example (Si apre in una nuova finestra), for a grave leg injury, a patient was charged 6,500 euros only for the surgery and the materials used, while for another minor surgery the cost was 900.
Doctors were back then in continuous negotiations with the Welfare Service who were issuing absolute poverty certificates - only with this, they could escape being charged. Terrible bureaucracy plus a mountain of added preconditions to issue such a certificate resulted in very few being able to finally get it - and with most of the others either finding themselves in huge debt or avoiding surgery altogether.
In 2014, then Health Minister Adonis Georgiadis (today Development Minister) announced (Si apre in una nuova finestra) a system where those without insurance could avoid paying the cost, but actually, the patient had to have his request approved by a Committee. The ND government than had been accused of actually pushing people to beg these committees.
Ex-alternate Health Minister with SYRIZA government Andreas Xanthos has stated (Si apre in una nuova finestra) that when SYRIZA was elected into power, in 2015, they found 28 million in debt with the tax office due to people being provided healthcare -a debt then registered with the tax office (Si apre in una nuova finestra)- and 150 million in debt registered with the hospitals accounting departments.
SYRIZA reinstated free access to healthcare for people with no social insurance, plus they abolished the 5 euro hospital entrance ticket which had also been introduced before. They also gave free access to the NHS to migrants and refugees by providing them with a National Security Number (AMKA).
When ND came to power in 2019, first they abolished (Si apre in una nuova finestra) the clause providing AMKA for migrants. Then, they introduced a new system (Si apre in una nuova finestra) for refugees, giving them something like a temporary health ID conditioned on the asylum process.
Now, ND limited access to the NHS for all those without enough money to pay for it - independently of whether they have social insurance or not.
An interesting connection
In recent years, American leading global alternative investment manager CVC has developed an important investment presence in Greece. The company is leading in private healthcare in Greece.
CVC Capital Partners is reported (Si apre in una nuova finestra) as the largest foreign investor in Greece, as it has purchased food company Vivartia, but also the private hospitals Ygeia, Metropolitan, Mitera, and Iaso, while the latest purchase was private insurance company Ethniki Asfalistiki.
A few months after the company purchased Ethniki Asfalistiki, it was reported (Si apre in una nuova finestra) that CVC had hired PM Mitsotakis’s daughter Sophia as investors relation manager at its London offices. The information was published by Ethniki Asfalistiki Employees’ Association Rizospastiki Protovoulia and made its way to the Press.
Sophia Mitsotakis in her Linkedin CV indeed mentions (Si apre in una nuova finestra) she works at CVC.
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Dear member, that's all for this week. We'd be more than happy to answer any questions so you can understand deeper what's going on in Greece. Stay safe! AL
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