Healthcare in Greece: the ongoing ruination of a public service

It’s 9pm on a Sunday in January, and the emergencies-only shift is beginning at the Evangelismos hospital in Athens. In front of the hospital, paramedics are pulling out stretchers in an orderly rush. They make their way through the throng to a reception hall that is so crowded that the adjoining corridors are filling up too. Patients squeeze in as best they can, standing, lying on trolleys or sitting in wheelchairs. “This is the Greece of 2025”, rails a woman in her sixties, holding her husband’s hand as he lies on a trolley, his complexion pale.

Dr Giorgos Ferentinos, a cardiologist in an intensive care unit, is on duty this evening. He describes the situation to Voxeurop: “There are not enough staff, so the patients turn to anyone dressed like a doctor who comes their way.” Ferentinos is wearing a burgundy coat. A few steps away, other staff are dressed in blue, in green, in white. “These colours in no way indicate our functions. But the hospital doesn’t provide our outfits. So we buy them ourselves!” For Dr Ferentinos, who is also president of the hospital workers’ union, the anecdote is revealing. ”We’ve asked management to provide coats and so on. They refuse. They prefer to put the money elsewhere.”

For some time now, this health centre (the largest in Greece and indeed the Balkans) has been doing everything it can to reduce its wage bill. It employs 3,500 people, and has decided to outsource a number of functions. “We have embarked on a process of privatisation”, explains Ferentinos. “On 1 January, we made 200 cleaning staff redundant. They had been hired directly by the hospital, and were paid €840 a month. Now we use an outside company. It costs €2,400 per employee, but the employee only earns €610. The in-house cost used to be €4 million a year, but now it’s €6 million.” In his view, this approach to management is madness. “The hospital is staffed by 1,100 fewer people than in 2012. In the meantime, however, needs have increased. The number of intensive care beds has doubled, for example”, he recounts.

The 2008-09 crisis and subsequent austerity measures led to an EU-wide reduction in hospital beds. According to partial data from Eurostat, only four countries had more beds in 2019 than ten years earlier: Bulgaria, Ireland, Malta and Portugal. Greece is no exception to the rule. It had 54,704 beds available in 2009, but only 44,817 in 2019.

According to the unions, Greek hospitals are short of around 6,000 doctors. “Before the crisis, 6% to 8% of public-service staff were temporary. Now it’s around 30%. This is another way of breaking the tradition of the public services”, comments Giorgos Yioulos, director of the research institute of the public employees’ union Adedy. The nursing workforce, for its part, was hit hard in the aftermath of 2008. There were 38,422 active nursing posts in 2010, according to partial Eurostat data. Nine years later, the figure was 36,251.

At the same time, most Greeks are concerned about the privatisation of hospitals and the healthcare system. “In hospitals, doctors can now even consult privately in the afternoons”, observes Dr Ferentinos. And yet the nursing staff’s workload is already heavy: eight hours a day, five days a week – not counting on-call duty and overtime.

According to the Confederation of Public Hospital Employees, public spending on healthcare represents only 5% of Greece’s GDP, compared with an average of 7.5% in eurozone countries. The staff shortage is itself a sign of creeping privatisation: nurses are being replaced by care assistants – whose services are then billed to those patients who can afford them. The cost? €80 a day or night, to help with eating, washing or administering care.

Greeks are paying a high price for this deterioration in their healthcare system. It has accompanied that of their economy: according to Eurostat, Greece’s per-capita GDP in 2023 was 67% of the European average. Of the 27 EU members, only Bulgaria was lower.

In Argos, in the Peloponnese, the situation is not much better than in Athens. For Meloni Kostiopoulos, a 27-year-old orthopaedic surgeon, it has become all but impossible to cope with emergencies. “Many positions are vacant. In my speciality, only one of the three available positions is filled. In general medicine, it’s worse. As a result, when the hospital is on call for emergencies – alternating with the hospital in Nafplio, fifteen kilometres away – we have to take on patients from outside our speciality”, says this young doctor.

Given these conditions, Dr Kostiopoulos says he is considering moving abroad, “where the pay is much better”. He details his financial situation: “Here, my basic salary as an intern is €1,268 net during the first year, for a five-day week of seven-hour shifts, plus €820 for five afternoons on call and one day off each month.” To ensure that there is a doctor on call at the hospital, he says he has to do “extra shifts that are paid three months late – if they are paid at all!” Under such circumstances, many young doctors consider setting up practice outside Greece. According to Amnesty International, almost 20,000 young doctors left the country between 2010 and 2020.

The specter of the 2008-09 crisis still looms over the Greek healthcare system. Between 2010 and 2014, the country’s GDP fell by 25%. The explosion of the deficit, the loss of market confidence and the prospect of default forced the country to ask for help from international financial institutions. Drastic structural reforms were demanded in return, including deep budget cuts in the health sector. Both in terms of access and quality of care, the consequences today are obvious and palpable.

Original source: https://voxeurop.eu/en/healthcare-greece-ruination-public-service/.