Healthcare Is A Corruption Hotspot In The European Union, New Report Shows


When European Union (EU) leaders hosted President Joe Biden at the US-EU Summit in Brussels this week, a shared commitment to global public health was on the agenda.

But even in the EU, where access to healthcare is considered a fundamental right, some citizens have resorted to bribery and other forms of corruption to access medical care, according to a new report from Transparency International. 

The Global Corruption Barometer (GCB) – European Union 2021, published this week, surveyed more than 40,000 people from 27 EU countries. The survey measured respondents’ views and experiences with corruption in their countries. 

Approximately three in ten people surveyed reported paying a bribe or using personal connections to get access to public services, including healthcare. Bribery rates varied across the EU, from 20% in Romania to approximately 1% in Denmark, Finland, and Sweden.

Within healthcare specifically, 6% of respondents overall reported paying a bribe to access a public clinic or hospital in the prior 12 months, double the number reporting paying bribes to the police, public schools, or to get official documents. Respondents in Romania and Bulgaria reported the highest healthcare-related bribery rates at 22% and 19%, respectively.

Bribery may be the most explicit form of corruption, but more common is the use of personal connections to access public services, according to the GCB. 

Twenty-nine percent of survey respondents overall had tapped into person connections to get medical care. Again, this tactic was more prevalent in certain places; 54% of people in the Czech Republic had relied on personal connections to access healthcare services as had 46% of people in Portugal and 41% of people in Hungary.

“Across the EU there is great variation in the way in which healthcare services are delivered. But one thing is clear: no one should have to pay or use personal connections in order to access care,” said Jonathan Cushing, head of the Global Health Programme at Transparency International. 

According to Cushing, many factors can enable or create opportunities for corruption within public services, such as lack of oversight and underinvestment.

“If services are under-resourced, and under pressure, waiting times may increase, leading people to pay a bribe or use personal connections to jump the queue,” Cushing said. “People seeking healthcare are especially vulnerable—they need care, and often need it fast.”

That underlying vulnerability or outright desperation may be on the rise.

Most respondents in the GCB think corruption is getting worse or stagnating. Nearly one-third of respondents said they think corruption increased in their countries over the past year; another 44% did not think corruption got any better in that time.

The Covid-19 pandemic may have exacerbated the conditions that lead to corruption. Between elevated demand for health services in the height of the crisis and vaccine distribution campaigns, scarce resources have increased pressures on public health systems and the citizens who rely on them. 

Many residents in the EU have relatively little confidence in their own governments. Only 43% of people across the EU reported that their governments are effectively tackling corruption and 49% said they think their governments are doing a poor job. Results varied widely by country; 70% of people in Finland gave their government high marks for managing corruption compared with just 17% of people in Cyprus who viewed their government’s response favorably.

“The findings from the survey suggest that EU member states need to do more to ensure that national health systems are set up in a way to ensure that bribery or personal connections are not needed to access healthcare,” Cushing said.

Specific oversight mechanisms that may reduce corruption include reporting hotlines, whistleblower protections, government transparency, and digital platforms that prevent “queue jumping,” according to Cushing. 

In Estonia, for example, Cushing said the survey found low levels of bribery (2%) and use of personal connections (12%). There are also high levels of digitalization, making it easier to detect wrongdoing when it occurs. 

Perhaps the most optimistic finding in the GCB: 64% of people across the EU think that regular citizens can make a difference in the fight against corruption.


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