As a second wave of coronavirus hits, it’s time to fix the healthcare imbalances between old and new Europe
For weeks during the worst period of the Covid-19 pandemic, we applauded our health sector workers who were battling this terrible disease, helping keep friends and family alive. Signs thanking them have appeared in windows and on roadsides across Europe. As cases rise again, these brave and committed professionals will return to the forefront of the public imagination.
Even before the crisis, we had become increasingly aware of the number of healthcare professionals in western Europe who come from elsewhere in the world, particularly the newer EU member states in central and eastern Europe (CEE). Many of the people to whom we are so thankful have left their home countries to come and work in the hospitals and clinics of the more affluent countries of the continent. Perhaps it is time to think of the places they have left, and their health systems – now often creaking under the strain of Covid.
The brain drain of medical professionals from CEE has undoubtedly brought benefits to the source countries, in terms of remittances and opportunities for ambitious young people to gain experience abroad. But it has also left gaping holes in health coverage in some of the EU’s poorest member states.
The UK has been the single biggest recipient of doctors from other EU countries, welcoming 3,355 from Romania alone in 2007-2020. But shortages of trained medical staff in CEE are becoming acute. Romania lost 50 per cent of its doctors between 2009 and 2015. Slovakia has lost more than 25 per cent of its physicians since 2004, a trend that continues.
More than 10 per cent of Romanian communes have no doctors and Romania cannot provide cancer treatment to children under seven due to a shortage of staff. They are instead sent elsewhere for treatment – mostly to Austria – at considerable cost to parents. Bulgaria currently has less than half the doctors it needs – and as a massive 90 per cent of medical students plan to seek work abroad, that situation looks set to worsen. Even in Poland, a relatively affluent country and an economic success story of the past three decades, 60 per cent of medical students plan to work abroad. Even at ordinary times, many CEE countries struggle to meet patients’ needs.
This process continues despite the WHO code of practice stating that countries “should discourage active recruitment of health personnel from countries facing critical shortages of health workers".
Meanwhile, of course, CEE countries continue to train young medical professionals at considerable cost to their cash-strapped exchequers – it costs €100,000 (£89,948) on average to train a doctor. If this doctor then leaves for elsewhere soon after graduation, what benefits accrue to the country that invested in them?
This is why as a Romanian MEP I am proposing a Medical Works Compensation Fund into which countries recruiting foreign medics would pay, to help support health systems in source nations. Initially, this would be a voluntary scheme. The money raised would help finance the education of doctors and nurses in origin countries, and offset medical costs for patients in these places requiring medical treatment in destination countries.
As well as providing a short-term mitigation for the shortage of personnel in countries, it can help contribute to creating a longer-term equilibrium between healthcare systems in Europe, and close the gap between old and new Europe. Countries in CEE are often told to show greater European solidarity and European values. What better solidarity and values to show than supporting the development of healthcare in countries facing shortages, in the midst of a terrible pandemic?
For too long, EU funding has been seen by too many as a one-way flow of aid generously bestowed on new Europe by old. The benefits of freedom of movement of labour and capital to affluent western Europe have been overlooked. This crisis has brought those benefits in just one area, healthcare, sharply into focus.
Indeed, the epidemic has highlighted the need for greater global cooperation on health. Should the Medical Works Compensation Fund prove successful at European level, it would be logical to extend the scheme to other origin countries in Africa, Asia, and the Americas.
Applause and solidarity with health care workers is welcome, and has helped us think of what we as citizens owe those on the frontline. But our solidarity can and must go further, and redress growing imbalances in European healthcare.
Clotilde Armand is a Romanian MEP from the Renew Europe Group
Read more
