‘Hospitals within hospitals’ drain Bulgaria
Government has even had to extend cash to cover months of delayed salaries for staff
If public health care in Bulgaria had a face, it could well be the crumbling facade of the public hospital in Lovech, brought to the edge of bankruptcy by a controversial contract with a private sector clinic.
Weary-looking doctors and medical workers have been protesting outside the hospital — situated in one of the poorest regions of the EU’s poorest country — to demand their delayed salaries.
Earlier in May they blocked the road to the hospital in the north-central city for days on end, shouting: “We are hungry!”.
Lovech’s hospital is a victim of a controversial use of the public health care system now being investigated with private clinics installed inside public hospitals, amounting to “hospitals within hospitals” like Russian dolls.
For more 10 years, Lovech was host to a private cardiac surgery clinic which detractors say drained vital resources from the public health fund and left the hospital on the brink of ruin.
“They only did the most expensive surgeries that are reimbursed in full by the fund,” nurse Nevyana Borisova said.
“But the patients were prepared for the surgery in our hospital, which also takes care of them afterwards. They made the profit and we got the costs,” she explains.
Anaesthetist and local trade union leader Sevda Kulinska says that as more and more money went into the clinic run by the Cardiolife company, other units in the hospital suffered severe underfunding and four of them had to close.
Corruption?
Under Bulgarian law, using private operators in public health provision is allowed but is meant to add services not already being offered by the public system.
According to chief prosecutor Sotir Tsatsarov, this mechanism has been misused and turned into “one of the main instruments for the misappropriation of public health funds.”
In the case of Lovech, Cardiolife recently moved out of the hospital and its management denies any wrongdoing.
“The regional hospital fell victim to flaws in its own management: the personnel is ageing and there is a lack of initiative,” Cardiolife chief accountant Iliana Kostova told journalists.