Almost 60 percent of citizens believe that there is corruption in healthcare

The results in the fight against corruption in the health system are still very modest, despite numerous legal and by-law changes, and the reform processes do not produce the desired results, it was said at the round table, "To heal the health system of Montenegro", organized by the Center for monitoring and research (CeMI).

The executive director of CeMI, Ana Nenezić, explained that the goal of CeMI is to contribute to a greater degree of equality in the realization of the right to health care in Montenegro. "In order to achieve this, and learned from the experiences from previous initiatives and projects, we first conducted a comprehensive analysis of the system of providing health services and protecting the rights of patients in Montenegro, and then we proposed alternative models and policies for improving the work of health institutions and protecting the rights patients".

She pointed out, as reported by the PR Center, that the results in the fight against corruption in the health system of Montenegro are still very modest, despite numerous legal and by-law changes: "Reform processes that are carried out with the aim of improving health care, raising the quality of health care services, and suppression of informal payments and possible corrupt practices in the health system of Montenegro, do not give the desired results. The results of public opinion research, as well as the results of focus groups and direct conversations with both patients and healthcare providers confirm this".

According to Nenezić, the Montenegrin public does not recognize the results of anti-corruption measures, and 58 percent of citizens believe that corruption is present or is present to a large extent in the health system, while only 9,1 percent believe that there is no corruption in that area.

"A comparative view of the data in relation to the same survey conducted by CeMI in 2016 and 2013 shows that there was a significant increase in the share of people who believe that corruption is present. It is particularly worrying that, according to the perception of public opinion, corruption is present to the greatest extent in the patient/doctor relationship. It is worrisome that there is agreement on both sides that corruption is a problem, the difference is only in the perception of the extent of corruption present, and the ways in which this problem should be solved," she adds.

Further, as she said, the strategic approach, i.e. "the absence of key documents, we believe, contributed to this state of affairs". "Namely, the Strategy for improving the quality of health care and patient safety for the period 2019-2023 with the Action Plan for 2019-2020 has not, for the most part, been implemented, and the seriousness of the approach is best reflected in the fact that the action plans after 2020 were not adopted. Also, the innovative Strategy for the period after 2023 was not prepared and adopted".

The Ministry of Health did not prepare and adopt the planned Health Development Strategy of Montenegro for the period from 2022-2026. with the Action Plan for the period from 2022-2023. year, which according to the plan and program of Montenegro's accession to the European Union was planned for the first quarter of 2022, points out Nenezić.

She also said that citizens recognize referral to the same doctor, but to a private health institution, as informal corruption.

"In that case, we have 22,5 percent who indicated that this is the main obstacle they face and which they recognize as informal corruption," said Nenezić.

As the reason for the existence of corruption, Nenezić said that citizens cite the low salaries of healthcare workers, "the moral crisis of society", bad legislation and the complete absence of any penal policy.

Nenezić said that it is positive that 46,2 percent believe that the quality of services has not changed in the last two years.

"Sixty-two percent claim that doctors address them in a friendly manner, while only eight percent do not share this opinion. "Also, the majority of respondents believe that doctors are competent and trained, 57,2 percent of them, and that they have confidence in them," said Nenezić.

She mentioned the right to privacy of patients as a particularly important area, which is not talked about enough. "A really large percentage of our citizens, as many as 43,5 percent, believe that during medical examinations, patients' privacy is violated because it happens that uninvited persons enter the space where the doctor performs the examination." Regarding the rights of patients, first of all, we should to be informed by doctors, the Ministry of Health, the media, and the defenders of patients' rights, she points out.

She also suggested how to solve these problems. "For a successful fight against corruption, especially in the health sector, the existence of a strategic and multisectoral approach is a prerequisite. We propose the preparation and adoption of the Strategy and Action Plan for preventing and fighting corruption in healthcare."

The Deputy Head of the Department for Cooperation of the Delegation of the European Union in Montenegro, Liselot Isakson, said that she hopes that EU support will improve the resilience of the Montenegrin health system, as well as protect the lives of citizens in the future.

"We are now looking forward to seeing the health system development strategy and to see how we can further support this sector," Isakson said.

She said that corruption is harmful in a more comprehensive way, as well as that it destroys the confidence of citizens to improve the community in which they live and belong.

"Corruption is disappearing by itself, because people are starting to think that it is not the only way to get the services they need," Isakson pointed out.

As she said, last year's report shows that Montenegro has achieved a certain level of preparedness in the fight against corruption, as well as that the results in the prevention of corruption have somewhat improved, especially due to the positive trend in the work of the Anti-Corruption Agency.

The State Secretary in the Ministry of Health, Slađana Ćorić, said that they treated the study "Assessment of the risk of corruption in the health system of Montenegro - Report for the period 2020-2022" with special attention, which, according to her, will be of great benefit to decision makers.

"Zero tolerance for corruption was and will be the absolute position of the Ministry of Health, and we have already taken significant steps in that area that will improve the fight against corruption," said Ćorić.

She encouraged all citizens to report any form of corruption that involved offering money.

"I guarantee that if there are such cases, they will be a priority in the actions of the competent authorities," said Ćorić.

Program Director of the Center for Civic Education (CGO) Petar Đukanović said that the fight against corruption is at the top of the priorities in the process of integration of Montenegro into the EU.

As he said, the results of Cemi's research, unfortunately, showed that almost 60 percent of citizens believe that corruption in healthcare is present.

"The emergence of corruption in health care is much more complex because it affects other segments of health care as well, it undermines the rule of law and harms economic development and the modernization of health care," said Đukanović.

He warns that even in moments "when you think that corruption can bring you benefit, we have to understand that it is not good for the functioning of the health system and that it is necessary to report it".

During the presentation of the findings of the study "Assessment of the risk of corruption in the health system of Montenegro - Report for the period 2020-2022", the author of the study, Marijana Laković Drašković, said that for several years Montenegro has not had a strategic framework for the fight against corruption and a method of reporting for specific measures for fight against this social scourge, PR Center reports.

She noted that the publication contains an overview of international standards and documents, and special focus is placed on the area of ​​the health system, which is "the most sensitive to the area of ​​corruption".

Laković Drašković said that the publication deals with the relationship between the health sector and the pharmaceutical industry, public procurement, criteria for the waiting list, supplementary work for health workers and improving the economic condition of health workers.

She pointed out that the Montenegrin public does not recognize the results of anti-corruption measures, because the data "that 86 percent of respondents stated that they or their family members gave money to receive a service, is devastating."

When asked how she comments on the fact that there are no reports of corruption, Laković Drašković replied that citizens hesitate to report corruption, because their health depends on that doctor, nurse.

"More campaigns and education of citizens are needed so that they are free to report corruption and are aware that they will not have any complications if they report it," concluded Laković Drašković.