Hungary’s Health System Has Radical Surgery

The bill also includes a ban on "gratuity" payments to doctors that have plagued the health service for the last 70 years, undermining general trust in the system and giving patients the illusion that by tipping doctors they would receive favourable treatment in public hospitals. No government, either under communism or during the democratic transition, has dared to target these untaxed payments, estimated to run into the billions of forints a year.

"Most people are so grateful to doctors and nurses for being treated that they think it is almost mandatory to give something," Zsuzsa, a middle-aged woman battling cancer, tells BIRN. "I generally give some money to nurses and then I have the impression they treat me better and behave nicer. But you can also jump the waiting list if you know whom to talk to, and then you try to express your gratitude somehow. If you feel your life is at risk, and there are people who can save you, you do not really mind paying the money."

Tibor, who had knee surgery in a public hospital two years ago, recalls that he never spoke with his doctor about money, nor did he pay anything before the operation. But, afterwards, he felt the need to "show his gratitude" by handing over an envelope with 100,000 forints (280 euros).

Opinion remains divided over whether this constitutes corruption or is merely a genuine expression of gratitude. However, from March all informal payments to doctors and nurses were banned, and those who make them will be subject to criminal prosecution and a possible jail sentence of up to a year. The government has even set up an internal law enforcement unit to monitor and oversee the relationship between doctors, nurses and patients to ensure that this corruption is eliminated.