Merryn's Blog

Greece's sick health service could lead to disaster

Europe needs to get to grips with the state of Greece's physical and mental health. If we don't, we could unleash far more than a mere economic catastrophe.

The Greek government has cut spending on healthcare by $2.5bn in the last two years. That's 13%. And in a continuation of its attempt to meet the bail-out conditions imposed by the rest of us, it will be cutting another $1bn this year. Worse, all this comes at a time when hospitals are already in a ropey state.

According to The Lancet, hospital budgets dropped significantly between 2007 and 2009, something that means that the medical sector entered this crisis already understaffed.

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But just as the hospitals are getting less, they are being asked to do more. Huge rises in unemployment have meant that the percentage of the population with private medical insurance has fallen sharply. So public medial facilities have seen a 25% plus rise in patients.

That means longer waiting lists, worse service all round and, possibly worst of all, a fall-off in the provision of basic but non-urgent treatment: the vaccination programme is already falling behind for example. The lack of fundingalso means a massive shortage of drugs: already pharmacists are telling of cancer sufferers unable to get their hands on drugs, and of everything from antibiotics to heart drugs being in short supply. Indeed, according to the Panhellenic Pharmaceutical Association, there are alreadly "300 medicines that are not readily available".

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But even the rise in public patients doesn't tell the whole story of the number of people needing treatment. In Greece, social security covers health costs for the employed. However, the unemployed are only covered for their first year out of work. After that, they have to stump up €5 for each visit and have to find the cash to pay for prescriptions, too. That makes them more likely to delay getting treatment, something that makes their treatment even more expensive when they eventually do get it.

And it isn't just the rise in the number of unemployed that is pushing up patient numbers. It is the fact that unemployment (and the crisis) are often the cause of ill health. According to the New Scientist, the collapse in morale that comes with unemployment tends to lead people to "risky behaviours" such as smoking, drug use and drinking. There has already been a spike in new HIV infections attributed to a rise among drug users.

All this is obviously connected to mental health as well. Suicides rose 40% in the fist half of 2011 on the same quarter in 2012, while, says the NS, "violence, theft and homicide rates have also risen". The incidence of panic attacks and depression is also rising fast.

Greece's location isn't helping either: diseases such as West Nile disease, foot and mouth, and malaria are common beyond its southern borders, and any compromise of its disease surveillance and control operations will surely mean they will soon be as common in Greece. There has already been an outbreak of malaria a disease that hasn't been seen in Greece for nearly 40 years.

Europe has already committed vast sums to bailing out Greece financially. But this will be of no use in the end unless it focuses on what really matters - physical and mental health. If it doesn't and Greece can't meet the basic human needs of its people - civil unrest is almost a given.

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As the New Scientist notes, "those who think this is far fetched should recall that modern Greece has only been truly democratic since 1974 the same year as it happens that it originally eradicated malaria". Add political instability to economic disaster; chuck in a health crisis; and we may soon be reminded (again) that it doesn't take long for advanced economies to go into meltdown.

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