Eastern Europe: UN labour agency warns of crisis in health care

The grim economic situation in Eastern Europe is taking a heavy toll on State-run health services, creating a severe "crisis in care" for an impoverished population left increasingly vulnerable to disease, the United Nations labour agency said today.

According to new surveys by the UN International Labour Organization (ILO) and Public Services International, the economic and social situation in several East European countries has caused the near collapse of some health care systems while afflicting health sector workers with high stress, poor working conditions and salaries at or below minimum wage - "if and when they are paid."

"Rapidly increasing rates of sexually-transmitted diseases, HIV/AIDS, tuberculosis and numerous chronic diseases have created a crisis of care made all the more dramatic by diminishing public health structures, lack of training of health care professionals and general de-skilling of the workforce," said Guy Standing of the ILO, who coordinated the studies. "All of this has surely contributed to the catastrophic fall in life expectancy rates in Russia, Ukraine and some other countries in the region."

Known formally as the ILO People's Security Surveys, the studies found that 88 per cent of families in Ukraine were unable to afford basic health care, while 78 per cent of healthcare workers in the country said their wages were lower than average. In the Republic of Moldova, the poorest country in Europe, "the health service is close to collapse and workers are paid months late, if at all," the ILO said.

The agency blames the crisis on government cuts in public funding, which have prompted doctors and others in direct contact with patients to demand or expect illegal payments. In Russia, for example, such "under the table" arrangements represent an estimated 40 per cent of all expenditures by persons seeking medical care, the ILO said.

The results of the Surveys - which covered healthcare workers in the Czech Republic, Lithuania, Romania and Ukraine as well as unions representing healthcare workers in all the countries of Central and Eastern Europe - were presented at an ILO conference of trade unionists and specialists held in Geneva from 6 to 7 December.