Dogged by corruption, low wages and poor working conditions, Hungarian hospitals now face shortage of doctors as many young doctors are leaving Hungary for better working conditions and better pay abroad.
The lure of working abroad for many young doctors in the former communist country is proving irresistible, especially during a period of economic unrest at home.
AdvertisementOn average a junior doctor in Hungary takes home around 140,000 forints (420 euros, $555) per month -- at least five times less than their colleagues in Britain, Germany or Scandinavia -- all favoured destinations for Hungarian doctors, according to Emese Batizan, head of the Budapest branch of the A-Team Medical Recruitment agency.
"Hungarian doctors are sought after in the West due to their good clinical skills and strong work ethic," she told AFP.
For a young Hungarian however, there is more than just money fuelling the decision to leave for many doctors.
"I work 60-90 hours a week, but the atmosphere is stimulating and open-minded and there are enormous opportunities for learning and development," Daniel Gero, a 27-year-old Hungarian surgeon who left to work in a clinic in Lausanne, Switzerland, told AFP.
"There are always interesting cases to work on and we use the most modern treatments and practices here," he said.
In contrast, back home the health service is chronically underfunded: spending per capita is around half the OECD average according to the organisation's latest statistics.
The health service is also dogged by deeply embedded corruption: most patients pay doctors an agreed cash sum in an envelope -- untaxed "gratitude money" for services rendered.
This hinders the training of younger doctors, said Istvan Eger, president of the Hungarian Doctors Association (MOK).
"An older doctor often won't let a younger one carry out an operation as he would be missing out on money from patients," he told AFP.
Young graduates hence face a difficult future if they stay in Hungary.
"The staff are exhausted and demotivated, professional development is very difficult and the technical conditions are deplorable," said Eger.
Exactly how many doctors have left is unknown but according to statistics from the National Health Fund (OEP), a record 1,600 doctors -- around two-thirds of them under 40 -- applied for permits to work abroad in 2012, up from around 1,400 in 2011.
These figures would imply the crisis is growing. Eger estimated that around 5,000 doctors have sought work abroad since Hungary joined the European Union in 2004. The exodus has gathered pace after the economic crisis hit in 2008, he added.
Since then Hungary has twice fallen into recession, with growth returning only in recent months.
This departure of young doctors has only added to the problems of the already beleaguered health service. Tellingly, since 2008, the number of those seeking permits to work abroad has exceeded the number of new graduates.
-- STAYING HOME --
Despite all this, many decide to stay despite the paltry pay and conditions.
Bela Koves, a 32-year-old urologist, did an internship in Sweden but opted to stay for work in his native Hungary with his wife, also a doctor.
"Once you've left, it's very difficult to come back, and we don't want to live outside Hungary forever," he said.
"I find the corruption disgusting for both the doctor and the patient," he told AFP.
"But it won't disappear without a significant increase in our ridiculous salaries."
Earlier this year, the government introduced a scholarship system to bolster the basic salary of young starters, in return for a contractual commitment never to accept "gratitude money".
In July, the Human Resources Ministry said the number of doctors applying for permits to work abroad had fallen to 454 in the first half of 2013, down from 542 during the same period last year.
Hungary must drastically increase salaries however, despite the struggling economy, said Istvan Eger.
"Other similarly cash-strapped economies manage to spend much more on their hospitals and doctors than we do," he noted.
He also urged a ban on cash payments, with stiff punishments for those who infringe.
But change will take time.
"Even in the best case, it will take at least 10-15 years to repair this system," he said.