Croatian doctors lured west, giving newest EU member a headache

By Zoran Radosavljevic

ZAGREB, April 21 (Reuters) - The strong turnout at Careers in White, an international jobs fair for health workers last month in the Croatian capital, was good news for organisers but poses a headache for the newest member of the European Union.

Since Croatia joined the EU in July 2013, making it easier for its citizens to seek work across the bloc, 752 of its doctors, or 4 percent of the total, have applied for papers to demonstrate they are qualified to work abroad, according to the Chamber of Doctors, a licensing body.

The Health Ministry says only 233 doctors and 98 nurses have actually left so far, and it is working on a package of incentives to lure more to stay, including pay rises and better career opportunities.

But many doctors and nurses say they are fed up with conditions that compare badly with other EU states, and suspect that the official statistics understate the problem of a medical brain drain.

"Everything abroad is better than here, from the salary to working conditions and social status," said Matej, a Zagreb anaesthesiologist who asked not to use his surname to avoid trouble at work from the suggestion he was considering leaving.

Gordana Miskulin, a representative of the Nurses Initiative, a group fighting for nurses' rights, said she believed as many as 500-600 nurses had left in the past year.

"There are already too few of us; we're constantly working overtime, it's no wonder that even nurses in their 50s are leaving," she told Reuters.

"My hospital has not bought me a new uniform in 17 years and the last one I got was from a foreign donation. We now buy uniforms with our own money on Ebay; they're cheaper than those made here."

A senior surgeon, agreeing to speak about his employer on condition he not be identified, said six anaesthesiologists had left his Zagreb hospital in the past year.

"We are expected to work more and more every year, for modest salaries, with dated equipment and declining budgets," he said.

STRAIN

The trend is putting a strain on Croatia's already indebted public health sector, once a source of national pride for its high-quality services free to all, but which successive governments have failed to reform since independence in 1991.

With the collapse of the country's communist-era industry in the 1990s, and a rise in unemployment, the public health sector found itself on the ropes, with funds falling just as demand grew from an ageing population.

Hospitals funded from the state budget struggle to make ends meet. Last year alone, they generated losses of around 1.2 billion kuna, Tatjana Prendja Trupec, the head of the state health fund HZZO, told a news conference in March.

The senior surgeon said patients had become too accustomed to getting services for free or very cheaply. A specialist examination that is not covered by basic insurance costs just 20 kuna, around $3.

"For that kind of money, I can't even get a plumber to come to my house."

Dr. Ivica Babic of the national trade union of doctors, HLS, told Reuters Croatia was already short 4,000 doctors, particularly general practitioners, to meet European standards.

"The problem is all the more serious as those who are leaving are doctors in their prime and we cannot say how many more will leave," said Babic.

Dr. Davor Milicic, dean of Zagreb's Medical Faculty, said that if the outflow persists, Croatia will have to start importing doctors "from countries where the level of medical education is of poorer quality than here".