A referendum against the privatisation of hospitals in Hungary

The Parliament of the Republic of Hungary adopted an Act in May 2003 giving the green light to the privatisation of health care institutions and hospitals. This Act - which is in line with the logic of neo-liberal political thinking - will affect the whole of the Hungarian society for everyone, from infants to the elderly, will inevitably have business to do with the health care system from time to time. Privatisation will prevent lower income groups of society from accessing high quality health care services leading to further aggravation of poverty and privation so characteristic of East Europe. Some people will sink into poverty owing to the decline of their health status, others will be affected by a variety of conditions owing to poor living conditions.

In these circumstances a number of social organisations and the Workers’ Party jointly initiated a referendum in order to keep hospitals in state and/or local governmental ownership. According to the relevant effective legal regulations if those initiating a referendum manage to collect 200,000 signatures of citizens in a four month period then the state is obliged to hold a referendum on the issue on hand and the outcome of the referendum is binding on Parliament.

After lengthy legal hassles in November 2003 the Constitution Court gave permission to the collection of signatures. And so the process of collecting citizens’ signatures began. The initiative was joined by a growing number of civil organisations and the trade organisation of doctors gave its public support to the referendum. Activists called on homes and they unflaggingly kept on collecting signatures at busy spots of larger towns despite the unfriendly weather. As a matter of course, vicious attacks were launched against the campaign in the media. We were accused of intending to prevent the modernisation of the health care system and the taking of effective action against corruption. Such a wealth of negative experience had, however, accumulated in East Europe in relation to privatisation during the decade and a half since the system change that it was not possible to manipulate the opinions of citizens. Large numbers of people attached their signatures to the initiative. Even according to - classified - public opinion poll results about two thirds of the population are staunchly against the privatisation of hospitals. Having realised this, the right of centre political parties, which are now in opposition in Parliament, have also publicly joined the initiative. Of course they did not collect any material number of signatures but in the media they talked about their support as much as possible. This then resulted in major confusion and nervous reactions in the ranks and file of the left of centre organisations but finally the overwhelming majority recognised that the historical opportunity for the prevention of privatisation must not be missed.

Consequently, by April 2004 we managed to collect some 300,000 signatures in support of a referendum. After the official verification procedure the Parliament adopted a resolution concerning the holding of a referendum. This resolution was then contested before the Constitution Court. As a result of the political skirmishes surrounding the EP elections in June the Constitution Court has made its verdict on the issue in September after the Coordination Section of the Hungarian Social Forum urged the chairman of the Constitution Court in an open letter in the media to make a decision. The referendum is now expected to take place in early December.

Due to the generally low levels of salaries a system of providing doctors with what is referred to as ‘gratitude money’ has evolved in East Europe. Health services are free for everybody but patients, in gratitude for having been cured, provide gifts and/or money to low paid doctors. As a matter of course, some doctors abuse this popular tradition and tend to give preference to patients paying them for the service. The state supervisory system just does not seem to be capable of eliminating this form of corruption which is a consequence of inadequate social controls and low salaries. It is quite obvious therefore that state ownership is not a sufficient guarantee in the case of hospitals and the health system in general for the termination of corruption and wasteful operations. This is the fact used as a basis for their arguments by business circles that have an interest in privatisation. They assert that wasteful practices are a consequence of state ownership and that privatisation will help cutting costs and eradicating the system of ‘gratitude money’. This argument definitely has to be refuted. We are not against generally the private capital in the healthcare system. But we claim the social control. All of the problems of our healthcare system were born in the missing of the social control. The prevention of privatisation is an essential interest of all political forces left of centre for after privatisation there would be no way to exercise social controls and people living in poverty - about a third of the society - would not be able to afford proper services. It is also clear that the right of centre political parties, now in opposition, so strongly characterised by their demagogic slogans, are interested only in a temporary maintenance of state ownership. Opposing privatisation may promote their election victory whereby they will have access to the public purse again. The politicians of the conservative political right would continue operating the system to earn their own profits and of course they would no longer be so steadily against privatisation. This is proven by the fact that the privatisation of hospitals has been voted for even in some local governments with opposition forming the larger part of the local council.

The social movement has to continue to emphasise that the prevention of privatisation is only the first step for us. The situation may only improve in the health care system if the state decides to devote more funding to the health services for the population and at the same time it prevents wasteful practices and corruption via democratically elected health insurance governments organised on a social basis.

Thank you for your attention