NHS hiring drive hurts Hungary

“Every day, for six years, three doctors and two nurses have left Hungary,” János Bélteczki, head of the Hungarian Doctors’ Association, says of the uphill struggle all the EU’s central and eastern European countries face in trying to keep hold of their highly trained health workers.

“We have always spoken about this problem: the salaries are 10 times higher in Sweden, Norway, Germany, the UK, wherever, than in Hungary,” said Bélteczki, who has called for a strengthening in regional solidarity on the issue and tripling the average Hungarian doctor’s monthly wage, to around €1,500 (£1,120).

The government has promised 20bn forints towards new doctors’ salary bonuses in a bid to slow the outflow of graduates to western countries. However, in Hungary’s cash-strapped hospitals, such a move has proved divisive, as new doctors who have signed five-year handcuff agreements can now be earning more than senior specialists. “What the administration is doing is chaotic,” said Gyula Prinz, who is head of the infectology department at Budapest’s Szent László and István hospital.

A-Team Health Recruitment places its customers into NHS hospitals in the UK and Ireland from its small company office near the Budapest opera house. “It was really hard to persuade NHS hospitals that even though there has to be a recruitment fee, it is much cheaper to work with us than hiring a locum doctor,” company placement manager Emese Tóth-Batizán said. The company now has good relations with hospitals in Northern Ireland, Leicester, Newcastle and around London. While they specialise in placing doctors in the British Isles, other companies concentrate on Norway, Sweden or Germany. “There are a lot of niches in the market,” Tóth-Batizán added.

Prinz rues the loss of the “mid-generation of well-trained and knowledgeable doctors, most of whom left for England with the young ones because a bonus scheme was never formulated for them”.

“There are some very good experts who have left and are there to stay,” he said.

The young anaesthesiologist who spends a month in England each year to legally supplement his annual Hungarian salary is the exception to the rule. Most move over, and over two-thirds of the Hungarian doctors already working in the UK have no plans to return home, pollster Szinapszis found.

Nearly a quarter of the doctors questioned named endemic corruption in the Hungarian health sector as a key factor against a return home.

The routine “pocket payments” that grease the wheels of Hungary’s health services are a legacy of the socialist regime. The anti-corruption website Fizettem (I have paid) contains thousands of anonymous accounts of Hungarian patients and their families paying set bribes to ensure the attention of the doctors and nurses.

One says: “My mother had cancer, she had several operations and received regular chemotherapy treatments. With the help of a pocket payment we secured an appointment in two weeks instead of the usual two months. In that year and a half when my mother had cancer, we must have given the doctors between 350,000 and 500,000 forints in ready cash.”

Another account tells of a dentist in north-east Hungary demanding a pocket payment for every local anaesthetic: “Root canal surgery, pulling a tooth, getting a filling, whatever; if you don’t have the extra cash, no painkillers for you.”

State undersecretary for health, Gábor Zombor, named the abolition of pocket payments as a necessary “first step in putting the sector in order” in his maiden speech.

However, Bélteczki says “we are speaking about healthcare reform, but the truth is we don’t have enough money for healthcare,” adding that “now, in Hungary, you have to work for less money, or work much more.”

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