Friday, April 14, 2006

Polish doctors work for peanuts...

...and soon only monkeys will be left working in Polish hospitals. But Poles don't seem to care.

Q: How much do doctors earn in Poland?

A: Bugger all.

OK, the cost of living in Poland is, for most things, much lower than in the West. But still, the conditions that fully trained doctors are being forced to work under is criminally bad here. What’s worse, Poles don’t seem to be able to grasp the problem.

Reuters reports that, after years of highly technical training:

Their average pay is 1,800 zlotys ($550) a month, only 70 percent of the average wage in industry, forcing many to find second jobs or work overtime. Hospitals are in debt to government, drug supppliers and utilities.

"We are increasingly desperate," said Zbigniew Strzelczak, an obstetrician-gynecologist with a state hospital in the southern city of Czestochowa, who came to Warsaw with his colleagues to protest in front of parliament.

"There are shortages in medical equipment, medicine -- basic stuff. This government, as all its predecessors, does not want to deal with this problem. It just cannot be like this."

An air traffic controller here – who has a job with equal responcibility but with much less training - gets about six times more in basic salary than a doctor!

On April 3 doctors staged a one-day strike, where they only cared for patients needing emergency treatment. They are demanding a 30% increase this year and a one hundred percent increase the year after that. That would bring their wages up to just over 4,000 zlotys a month – still a ridiculously low wage for such a skilled and vital workforce.

You would think that Poles, who rely as we all do on these workers for maintaining our health and occasionally saving our lives, would be up in arms about this and would be keen to lend their support to such protest action, wouldn’t you? Well, you would be wrong.

Many Poles I have talked to about this just sneer at doctors, saying, “Well, they take bribes, you know?”

Yes, I did know that. You can bribe the doctor to move you up waiting lists, etc. That’s been going on here for decades. But is it really surprising that they are taking bribes when they get treated with such contempt by society?

The Health Minister, former heart surgeon Zbigniew Religa, has offered to bring forward a 30% increase this year. And that’s all he says can be afforded.

Reuters again:

Medical workers remained skeptical.

"What they offer is a one-off increase only for some medical staff and the rest is just gibberish. There will surely be more protests," said Krzysztof Bukiel, the head of the Polish Doctors Union. "The situation is hopeless and without any prospects."

Poland spends around 6 percent of its gross domestic product on health, according to 2003 data, among the lowest levels in the OECD club of the world's most developed countries.

Polish doctors are starting to vote with their feet. Since it joined the EU last year 5% of medical staff have left Poland, gone to countries where they get more respect.

One day Poles are going to wake up to discover that there are no doctors left in the country at all. And it will be their own fault.

Will the last doctor to leave Poland please turn off the lights.

See latest developments on this story here and here.


michael farris said...

Wolf Moon if more young people voted, then PiS wouldn't have won both elections and things would probably be considerably better even as I write this. Instead many didn't vote ("because it doesn't matter" or "I'm not interested in politics") and now they have their just deserts. Apathy and planning to emigrate are no way to develop a country.

Let's not forget nurses, the day to day standard care in hospitals depends more on nurses than doctors. And they're paid far worse than doctors (without the chance to get bribes or supplement their earnings in private practices).

Rather than pay them more, the Polish government tried to make sure that Polish nurses training wouldn't be recognized in the EU. But Polish nurses training is still above that of most EU countries and almost all the younger people going into nurse training programs are doing so with an eye to emigrating.

Poland also has one of (or the) lowest budget for medical care as a percentage of GNP (I think around 4%).

michael farris said...

George, IIRC it used by more like the British system (with a large private sector as well but no health insurance, you want private you paid cash).

Then it was reformed 6 or 7 years ago to be more like the German system (Krankenkassen, regionally based universal healthcare insurance funds which purchased services from providers, free care had to be with someone with a contract with the fund in your region, otherwise you had to pay). If you were treated by a contracted provider outside your region you had to pay or arrange a transfer of services between funds. It was all very complicated (in a country where people don't want to do complicated if they can get out of it).

Then the ex-communists won the elections (partly on a platform of undoing said reform which was wildly unpopular). But, realizing that a return to the old system was impossible, the changes made were cosmetic and mostly amounted to changing the name and centralizing things a bit more.

sonia said...

I wonder if it has something to do with the fact that most Polish doctors are women, unlike in the West...

beatroot said...

I see you guys are on form.

Welcome johnc16!

Tell your wife I think she is fab and to keep up the great work, please! If twenty percent of Polish medical staff really do go abroad (as it says in the reuters piece) then we are really in trouble here.

I have had good experience with Polish dentists and on horrendous one, which I won’t scare you with.

Mike is right – the answer to Poland’s problems is with the young. But if they all bugger off somewhere else then we will be left with the very nice and interesting but slightly incompetent older Poles. Not good.

Sonia – don’t know the gender ratios, but there are lots of professions that women traditionally do here that are slightly suprising – like accountancy and banking(which in the west are male preserves, of course)!

But back to my main point – Poles are not getting behind doctors and supporting them in the strike action and campaigns. When the doctors go on a one day strike again – and there will be a next time – workers in other industries should support them.

If Poland does not have decently paid medical staff then the country, and its not particularly healthy population (poverty makes you sick!) will be further impoverished.

Support Polish doctors! It’s the healthy option!

beatroot said...

By the way, John Chapter 16 is the bit in the Bible when Jesus has come back from the dead and is just about to go up to heaven, is it not?

Verily, verily, I say unto you, That ye shall weep and lament, but the world shall rejoice: and ye shall be sorrowful, but your sorrow shall be turned into joy.

I reckon that's right. But if we don't have any doctors...

Anonymous said...

Yes and Hungary is not in a better shape neither.
Seemingly every year Hungary got about 400 doctor leaving the country - that equals to 30 million EUR lost in the form of training subsidies and such.
Also, the healthcare here simply sucks! Stay healthy and pray :)...

Anonymous said...

Another side effect of this low pay is an interesting one. I believe that the pharmaceutical industry in Poland is around the third largest in Europe. If we take a minute to ponder the cause of this here, it won't take you long to figure that this low rate of pay may be related to this difference.

Are Poles hypochondriacs by nature or by gentle steering and financial incentives to doctors from the pharmaceutical companies?

I understand this a bit of a leap, but doctors do have the financial need, and the pharmaceuticals have the finance. A student of mine tells me that her sister was placed in treatment that was not given on the basis of its effectiveness but the fact that the company that provided it offered the doctor some kind of reward for using their treatment.

Of course this is speculation but their is no denying that this financial situation will have effects beyond emigration and cash bribes...

Anonymous said...

Hello. I'm a Polish dentist.I think I've had enough and decided to move to UK. My wife is also a dentist - it'll be easier for us to move as we don't have any children yet. 90% of young doctors doesn't want to stay in Poland - they'll move to UK, Australia, Ireland, Norway, etc. And when they get used to earning a lot of money, getting respect they deserve and generally beeing treated as a human beeings instead of overworked, underpayed slave-labor force - they'll NEVER come back.

Anonymous said...

I from Poland. I crap person from crap country. I come here to work cheap and take job away from english worker. I pay no tax and collect job seekers allowance at the same time I have job. Next year my cousins come here from Romania and Bulgaria. They also crap people from crap countries. Also next year my family come and live with me. No my real family but
I pretend they are to get big free house to live in with them and get plenty benefits too. What you expect from us east europeans? It is our culture to screw other countries! Sorry, I must go now. I have to cash benefit cheque.

Anonymous said...

sphhhffrtdz,shhhrdz shhski shimash.
What? you don't understad me?
WHY? It's not snake it's polish, absolutely nice and beautiful language in the world. the best one by the way.
I am from very famous polish village and I travelled a lot. Our pigsty, for example.
Now you are lucky, I am here in UK.
I work very hard for 1 pound per hour. Soon I become a millionaire. My God, sorry I mean my BOSS likes me very much. He offered me to make him tea on breaks and he kicked out from work all those lazy english. Hi-hi he doesn't know that I am the laziest one. But it is not a problem. Soon all my friends and all my relatives and their friends and relatives come here and work for 1 pound. They already got their one way tickets, because they do not have enough money for return. But I think it is not a problem, because all of them stay here forever. Now it is time for you to learn beautiful polish language.
I am afraid of one thing only: that UK soon become the same crap and shit country as our beautiful poland. But it is not my problem it is yours.
Now it is enough I am very educated and experienced and I have diploma from Shhhkrrzzztsss(poland)computer univercity, but it took me whole day to write this great message.
Now I deserve a lot of relax. I go and buy a lot of vodka and beer. I will be drunk like pig and I will sing beautiful polish folk songs all night until morning.

dorota said...

I am a polish-canadian pre-medical student, and I am appalled by the comments left by anonymous. They are vulgar, and racist.

Anonymous said...

poland is a whore country, poles take and take but give nothing in return. shktrssshshhtsch

Anonymous said...

I made the last comment about about Poland being a whore. I'm sorry, I take it back. People just want to make a better living that's all.

Anonymous said...

I am a different anonymous. I think the comments anonymous made are disgusting. I may be a bit late in adding these comments, but here's my two-peneth worth.

I'm English and I live in Poland. I have a Polish girlfriend. We met at work as English teachers. Generally, Polish professionals are well trained. However, they are without a doubt underpaid. In terms of IT, there is a large IT industry based here, foreign companies outsource to Poland and obviously are pleased with the work.

Pretty much every other graduate leaves or wants to leave Poland. Taxes are stupidly high. With respect to the posters who have said that costs are lower in Poland, this is untrue. Perhaps in absolute terms things are cheap, however in relative terms, and comparing prices to wages, Poland is one of the most expensive places to live in Europe. Food might be cheap, cigarettes and beer might be cheap but try buying branded goods. Take any cosmetic, item of clothing or electrical product and add between 50-100% of what you would expect to pay in the UK. Premium cosmetics are sometimes 150% more expensive.

My girlfriend's parents are doctors. They work in both the private and public sectors because they have to. My girlfriend's father, in a state hospital, as a director of a neurology department earns 5000 zl per month (about 980 pounds). I earn almost twice as much as an English teacher and life is still a struggle unless you want only the bare essentials.

There are massive problems in Poland. Office workers, especially entry level workers are forced to 'bid' for their employment. Pass the recruitment process and then, the final test: "What's the lowest you're willing to work for?" An employer can sack an employee for 'economic reasons' - meaning, they pay you too much. It is perfectly acceptable to then hire someone else for a lesser amount of money. Also, and this is something I wouldn't have believed had it not happened to 3 Polish friends, female employees are made to sign secret contracts which state that they will be sacked if they have children, or become pregnant, within a pre-determined period (usually 5 years).

Obviously it is illegal, but the court system is a joke. More cases in the European courts come from Poland than from any other country. Recently the supreme court ruled that they could not say that homosexuality was not a genetic disease until medical tests had been carried out.

My girlfriend and I are going to move. She went to the best university in Poland and yet struggles to find any new work. It is no wonder that so many Polish people want to leave Poland. Every country has problems, but Poland has huge problems. I do not know how ordinary Polish people afford to live.

Blaming PiS or Platforma is too easy and does not address the problems. Neither does blaming the pharmaceutical companies or other big businesses. They'd act the same way in any other country if they could. The problem is a societal one. It is an irony that so many Polish people complain about the situation, but seem unwilling to do anything to change it. Until people start voting with their feet and unify to demand change it will not happen. Poland needs another Solidarnosc. Social welfare, affordable prices and moderate wages are not incompatible with capitalism. Look at western Europe. It's not perfect, but it is 100% better than the situation in Poland.

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