Polish public health care crumbling as doctors seek greener pastures elsewhere

Polish doctors seem to have a good reputation all over Europe - except maybe in Poland. Even before Polish accession to the EU, Polish doctors could work out special deals to work abroad. The trend has continued, with more and more doctors working all over Europe or even in the Middle East. Five percent of doctors are estimated to have left the country, and according to the Polish Ministry of Health, as many as 20% of the physicians in Poland are willing to leave for work abroad. Will the doctors all leave the sinking ship? Gabriel Stille reports:

One of them is Edmund who is currently working in two different private clinics in Warsaw. It's not that he's so greedy; he simply couldn't make ends meet on the average doctor's wage of just over 500 US dollars a month.

"I had contracts abroad, so I know countries like France, I had an internship in Vienna, in Montpellier, in Germany; in Hamburg, and for the last contract I was in the Middle East for two years. So I am, I think, an experienced enough doctor."

For Edmund, the private sector provides him with the added satisfaction of being able to plan his time in a flexible way, see more patients and perform more interesting surgery. But, of course, it is first and foremost a question of money:

"I'm working in a private hospital now. When I was in a public hospital I had one job in a university hospital, and I gained not to big money monthly. It was not sufficient amount to give the proper accommodation to the family."

At Edmund's old hospital, where he received some of his training, you meet the people who cannot afford to go to the private clinics. It is a huge, old grey building, where many of the patients in the entrance hall are old and clearly in pain. It is a fact that people without the means to go to a private clinic are at the mercy of an inefficient system, which is now losing more and more doctors and nurses by the day.

(Woman at hospital) "I think it is very bad because I have a not very wealthy mother and this going to doctors and hospitals, it is a really difficult experience. A lot of waiting in cues. Sometimes, like for example today, you can meet with really good doctors. But they are very rare examples of Polish care because I the most popular I think is people who has too many patients, too many duties and no time for single persons."

The Polish doctors have repeatedly held strikes for higher wages - the average Polish earns 70 % of the average industry wage and Polish public spending on health is among the lowest in the developed world. The government is promising changes - but it is too little too late.

Back to Edmund's current place of work. It's a major private clinic in downtown Warsaw that caters to the needs of all kinds of patients, provided they can pay for it. It gives the impression of a clean and modern office building. Most people here look young and well off. To make this kind of modern, world class clinic available for everyone, political action and investment are required. Dr Edmund hopes that one day working in a public hospital will be no different from working in a private clinic. But for young Polish doctors, this prospect seems too far away.

"Young doctors can meet somebody and they can build their carriers outside. But my generation, middle-aged people, 40 to 50 years old, they have property here in Poland and they think that they will come back, rich in experiences, and that they can bring in the future the new view of the properly managed health service sector. And the students are graduating every year..."

Even middle aged specialists like Edmund are tired of waiting for things to change. Emund himself is shortly going to Spain, on a three-year contract, after the borders opened completely for Polish citizens in May:

"I think I can give high quality service in one place. I could have more satisfaction; I could have not much bigger but a little bigger salary. As well, I think of the new possibilities, new country, new people, sunny weather..."

In the end, the one demand a doctor like Edmund shares with patients is a call for political reform - more efficient public hospitals and general health insurance. But for doctors, who have tasted the riches of the world outside, to return to public hospitals, there would also have to be significant pay increases. And the Polish government seems unlikely to meet these expectations.