Health workers have begun protests at hospitals throughout Greece in opposition to the chronic underfunding of the public health care system during the coronavirus pandemic.
On April 7, protests were held by the Federation of Greek Hospital Doctors’ Associations (OENGE) to coincide with World Health Day. Demands include increase in permanent front-line staff, intensive care unit beds and a full supply of personal protective equipment (PPE).
Medical staff protested at hospitals all over Athens, including outside Evangelismos, which is the capital’s main hospital. Protests also took place outside hospitals in the second largest city, Thessaloniki, as well as smaller cities such as Volos, Trikala and Karditsa.
Police units intervened under the pretext that the protests were in contravention of the lockdown—which prohibits assemblies of more than 10 people in public places. The situation was particularly tense outside Evangelismos, where police entered the hospital and tried to break up the protest but were forced to withdraw.
Since the lockdown measures were introduced, there have been numerous reports of police abuse such as imposing fines on people with the necessary documentation to justify their outings, such as shopping for necessities. Fines have even been imposed on homeless people. Another case of police brutality saw officers reportedly tearing up the document of a migrant worker justifying his need to be outside.
With 2,170 cases and a death toll of 101, Greece has not yet seen the high death toll experienced by other European countries. Belgium, which has a similar population, has recorded 31,119 cases and 4,157 deaths.
The relatively lower death toll is largely a result of strict lockdown measures implemented earlier than other European countries. Before a death had been recorded in the country, carnivals were cancelled at the end of February. Schools were shut March 10, while commercial businesses except for supermarkets, bakeries and grocery stores were shut in the week that followed.
Foremost in the minds of the ruling elite was that after a decade of relentless austerity at the behest of the European Union (EU) and the International Monetary Fund, the health care system would collapse under the weight of an unchecked pandemic.
Fearful of the backlash from workers and youth, the government felt compelled to take measures. In an interview with CNN, New Democracy (ND) Prime Minister Kyriakos Mitsotakis bluntly stated that the health care system was “battered after 10 years of austerity, so we were painfully aware of the fact that we were at bigger risk compared to other EU countries.”
Over the last decade, Greece’s health budget was slashed by 50 percent. Just 5 percent of GDP is spent on public health care, 2 percent lower than the EU average. Greece only had 560 intensive care unit (ICU) beds as the pandemic began. In 2012, as the austerity programme began to intensify, Greece had just six ICU beds per 100,000 inhabitants. This compared to 29.2 in Germany. In the intervening eight years, Greece's ICU bed availability has no doubt worsened.
Speaking on a live broadcast by omniatv over Facebook to mark International Health Day, Meropi Mantaiou, a lung specialist at Sotiria Chest Diseases Hospital—which has seen more than half of COVID-19 hospital admissions in Greece—said: “Everyone is scared stiff, especially the government, in case the ESY [National Health System] collapses. Because if the ESY collapses, we will witness biblical scenes.”
There are currently 30,000 job vacancies in Greek hospitals, while 4,000 workers, many of them frontline staff, are employed on temporary contracts. Their extension for another year was approved by the Health Ministry last September. Chronic understaffing, combined with the lack of PPE, has meant that even with the relatively lower hospital admissions, Greek hospitals are struggling during the pandemic. Many health workers have been infected by coronavirus. Speaking to iEidiseis.gr, Dimitra Stamatelou, a member of OENGE’s executive and a health worker at Nikaia Hospital, stated, “129 of our colleagues are sick with the virus and more than 500 are under quarantine.”
The conservative government has hired just over 2,000 new doctors, nurses and paramedics, with plans for hiring another 2,000. This is a drop in the ocean. The new staff are to be employed on a temporary basis and no doubt will be discarded once the pandemic is over.
Even this small increase is deceptive, as Mantaiou made clear. Speaking to Balkan Insight, she said, “Very few new doctors have actually integrated in the [Sotiria] hospital. Transfers from other hospitals and clinics have provided more nursing and support personnel, but they are inexperienced. You can’t use people in ICU without training. This is a patchwork.”
The government is using the pandemic to bolster the private health sector. This was already under way with the launch of the Public Private Initiative in the Greek health care system in January. While this was to be initially piloted in three hospitals, ND has used the pandemic as a pretext to increase the private sector’s presence at an even faster rate. The government plans to increase ICU capacity to 910 beds by leasing beds at private clinics at an exorbitant daily rate of €1,600—double the usual cost charged by private hospitals!
Another area where the government is bolstering the private sector is coronavirus testing. While the rate of testing has increased in recent weeks, with just 4,055 tests per 1 million inhabitants, this is around a quarter of the rate in Germany.
At the start of the epidemic, the bulk of tests were carried out at just one lab at the Institute Pasteur in Athens. Capacity within the public sector was increased, mostly thanks to initiatives taken by medical schools nationwide, independently of the government. Instead of providing support to these initiatives, the government allocated €30 million to increase testing through the private sector.
At current market prices, this will amount to just a few hundred thousand tests. Private labs in Greece are reportedly charging as much as €300 for a COVID-19 test. Medical schools, in contrast, have offered the use of their facilities for testing at a fifth of the cost of employing the private sector.
Public labs at Athens University are having to rely on donations such as the 20,000 test kits donated to Athens and Thessaloniki Universities by the Ioannis Latsis Foundation and Syn-Enosis, a philanthropic foundation run by Greek shipowners.
No trust can be placed in a private-sector-led testing programme where commercial considerations constantly cut across public health ones. This is underscored by the 500 new privately owned mobile testing units recently procured by the government to conduct COVID-19 tests at patients’ homes. According to the government decree, staff contracts at the units will only be for three months with the possibility of a further three months.
The lack of any systematic testing has led many in Greece’s scientific community to criticise government policy, which has so far relied solely on social distancing measures. Sotiris Tsiodras, the infectious disease specialist appointed as the Health Ministry spokesperson, responded to such criticisms by conceding that any test regime is based on the “capabilities of the health system” while insisting “at this stage physical distance is better than testing.”
As is the case across Europe, the Greek ruling elite is making plans to enforce a return to work nationally. In a TV interview with the Mega Channel, Health Minister Vassilis Kikilias announced that some lockdown measures may be lifted in May. He claimed that this will be accompanied by extensive testing “to determine whether parts of the population have developed antibodies and are therefore immune, which will then determine what steps are taken thereafter.”
No one should believe such reassurances when no serious effort has been made to strengthen the public health system, even as Tsiodras warns that a second wave of the pandemic in the autumn is highly likely and may well be more deadly.
The chief concern of the Greek ruling class is the strengthening of the repressive apparatus of the state in anticipation of an inevitable backlash. Anticipating a growth in social unrest, veteran journalist and commentator Alexis Papachelas wrote in Sunday’s Kathimerini, “Decisiveness will be demanded and a ‘war-like’ government that can get the country back on its feet economically and that can say ‘No’ at the appropriate time when it’s under great pressure.”