With 1.5 million unemployed and 30% of the population uninsured, with slashed wages and pensions not being enough to cover basic needs like food and heating, the need for healthcare in Greece has grown.
Published data for the last two years is shocking: the use of drugs associated with cardiovascular problems has risen by 36%. One in six people have psychiatric problems; anti-depressant use increased by 40%, anti-psychotics by 32%.
The government is doing nothing to meet this increased need — quite the opposite.
Five austerity programmes within the space of two and a half years have reduced the health system in Greece to the level of a developing country and stripped working people of the basic right to adequate medical care.
In order to save €1.74 billion, patient contributions for basic drugs are to be increased, expenditure by public hospitals on medicines is to be reduced, and overtime work by doctors restricted.
Plans for hospital “reform” to reduce costs will result in more staff reductions. From 2014, an increase in the daily fee for hospitalisation will be increased — from the current €10 to €25. This will discourage pensioners, the homeless, and families with children from seeking emergency hospital treatment.
The three-party coalition government plans to merge (i.e., shut down) 50 hospitals, closing 631 clinical units and scrapping 10,400 beds! The Minister of Health has already cut 4,000 hospital beds, cut in half hospital psychiatric treatment and cut beds in “intensive” units. Medical tests which were free have been reduced or abolished.
The EOPYY (National Health Service), the new single health insurer, is 40% funded by the Greek social security system (IKA), with payments being prioritised to private clinics, diagnostic centres, etc. From this month, the wages of the hospital staff (60% of operating costs) will be covered exclusively by the imposed hospital fees. In other words the state is withdrawing from its minimum legislated obligation to support “self-funded” hospitals.
Provincial hospitals in northern Greece, Evia, and Crete, are being transformed into health centres, provoking the mobilisation of local communities.
The Bank of Greece, with its unknown shareholders, on the eve of the deal under which outstanding Greek government bonds were swapped for new ones of lower face value, decided to “invest” hospital funds in government bonds. That resulted in a 70% drop in those funds.
More people are reliant on the national health service as they cannot afford private treatment. This puts greater pressure on hospitals which are already underfunded and collapsing.
Most hospitals lack essential basic materials such as disposable gloves, plasters and catheters.
Poorer women have to give birth at home because they cannot afford a hospital birth, which can cost €700-€1,500. Children can only be vaccinated with cash payments.
Control of infectious diseases is no longer guaranteed due to the lower standards of hygiene throughout Greece. Chronic respiratory diseases, skin diseases, and tuberculosis are all on the increase. Outbreaks of malarial infections have been reported in five parts of the country (the disease had been thought be eradicated in 1974).
“We have children who are starving, dehydrated babies”, complains Nikitas Kanakis, president of the network Doctors of the World.
At the same time, the country is suffering from an unprecedented exodus of doctors. Due to the austerity measures, a consultant will earn just €1,007 a month from January 2014. This is less than a quarter of what she or he could expect in Germany.
While the poor and working people of Greece are exposed to these inhumane conditions, the wealthy are increasingly turning to medical care abroad. Hospitals in Northern Europe report an increase in operations for patients from the south of the eurozone. The Greek left needs to urgently organise resistance to the privatisation and the dismantling of public health. Such things as sabotaging (i.e., refusing to collect) the €5 entrance fees are a place to start.
Direct taxation of the capitalist class can ensure health care is completely public, free, and fair for all. A united front is needed, made up of trade unions, committees of hospital workers, neighbourhood assemblies and committees, workers from other parts of the public and private sector.
That kind of organisation can reverse the Memorandum health policy and contribute to the overthrow of the three-party coalition government.
Health workers’ general strike
A 24-hour nationwide strike and rally in Athens has been called for Thursday 31 January by healthworker unions.
Doctors, nurses and hospital staff are joining forces in order to confront the Memorandum.
The strike follows many mobilisations of hospital workers in recent months; action which have successfully prevented closures and mergers under government “restructuring” plans.
Doctor’s union OENGE has said: “The Health Ministry is keen to show a reduction in hospital beds by 11,000 and merging or closing 660 departments and clinics. The cut in the state budget for ‘doctors on call’ by 45 million euros is outrageous and will exacerbate the precarious conditions of emergency services”.
The strike needs to be organised with general meetings, and debates in all hospitals. Its success will pave the way for escalation of the struggle and development of multiple form of actions such as strikes, sit-ins, occupations, demonstrations in coordination and cooperation with the rest of the public sector workers whose jobs are threatened, as well as with local neighborhood assemblies and neighborhood community movements.
The first step towards the coordination of public sector workers (and a united front of all) was achieved by those who participated in strikes and occupations last December.
Case Study: Patisia
Since 2011 all Greek governments have been working at closing down hospitals in order to reduce numbers to 80 in place of the existing 131. The three hospitals of Patisia (Athens) are among the first victims of this policy.
Until June 2011 the three hospitals in Patisia — General Hospital Patision with 110 beds, 7th IKA with 100 beds and Pammakaristos with 200 beds, together with Agia Olga at Nea Ionia, with 280 beds — met the needs of one million people in Athens and several neighboring municipalities.
Between these four hospitals, there was coverage for emergencies almost every day of the year. Despite their relatively small size, the four hospitals dealt with large numbers of people, providing superior service.
On the initiative of their doctors they developed specialist services which patients from larger hospitals often turned to. Thousands of people have signed petitions against the closure of these hospitals.
The lousy argument used by the government and its media parrots is that these hospitals have low occupancy (i.e. are inefficient). But this intentionally conceals the fact that these hospitals had a very high occupancy until 2010.
During 2007, the doctors of the General Hospital Patision organised dynamic protests over how emergency attendance via ambulance was exceeding the capabilities of the hospital. Decreases in hospital attendance after 2011 are down to government policy: decimating staff (not filling vancancies and recruitment freezes); dramatically reducing funding, in particular that associated with emergency services; abolishing or greatly reducing emergency services and hence the ability of patients to access them.
Since 2010 the general hospital of Patision has been staffed by two pathologists, two cardiologists, three surgeons. For a year the CT scanner was switched off (the maintenance of it costs €1200 euros per month), and for 15 months the blood centre had only one doctor.
Pammakaristos has the lowest ratio of nurses to beds across the country.
When one pathologist at the 7th IKA retired, it was left with only one pathologist. That virtually stopped emergency operations and other units (biopathology, cardiologists, surgeons) were transferred gradually to the Agia Olga. The government preferred to do that instead of hiring temporary staff or an auxiliary pathologist. There was a gradual wind down. In March 2012 the emergency unit was stopped and in September 2012 the government decided to transfer doctors and staff to Agia Olga and Holy Anargyroi Kato Kifissia Hospital. In the 7th IKA there are now only dialysis machines with very low levels of safety for patients as there is no longer anaesthesiology coverage. Meanwhile valuable equipment, such as the magnetic scanner, remains unused.
The closing down of 7th IKA was done supposedly in order to enhance the operations of Agia Olga and Holy Anargyroi hospitals. An emergency service was introduced at Holy Anargyroi hospital, but it is very difficult to reach, served by only one bus line.
In this way the government has achieved the closing down of the 7th IKA, which until one and a half years ago had a fully functioning emergency service. It has made valuable equipment unusable, and filled the Agia Olga hospital with surgeons from the former 7th IKA who have no space even to sit.
In July 2011 Loverdos suggested that the general hospital Patision become a health centre and its staff transfer to the Holy Anargyroi hospital. The plan was withdrawn after the fierce protests of the hospital workers and residents and the neighbourhood committees in the area. However it was decided that the administrative interface of the Pammakaristos would be with Agia Olga hospital and that of the general hospital Patision would be with Holy Anargyroi hospital.
Since then, Patision and Pammakaristos have become poor relatives, facing severe shortages of staffing and funding.
The government wants to close these two hospitals and merge them with Agia Olga and Holy Anargyroi hospitals, starting, again, among other things, with the discontinuation of the clinical pathology service. Other consultancy specialties are under extinction. Meanwhile the government propagates the usual garbage about the lack of efficiency of the hospitals.
The general hospital Patision had serious shortages of doctors and staff even before the advent of the memoranda. Those were partially covered by temporary doctors. The deficiencies began to take a more dramatic form during the memorandum years due to the cumulative effects of retirements and a freeze on recruitment of both permanent and temporary staff.
Nevertheless, thanks to the heroic efforts of staff, until March 2012 an emergency service was readily accessible to the residents of the neighborhood.
From March 2012 the emergency service was stopped due to the halving of the overtime paid to doctors and consultants.
These policies have deprived Athens of 100 of 700 hospital beds and reduced emergency 24-hour coverage in the region. If the plans are not halted, an additional 300 beds will be lost.
The unions of the general hospital Patision and the 7th IKA, together with residents and collectives in the region, have now been fighting for one and half years to prevent the closure of Patision. In this fight they have as their allies the political parties, collectives and local parties of the left.
At this crucial hour we need an escalation of the struggle, in which the forces of the left should take the lead. We lost the battle of the 7th IKA, but we must not lose the war.