Brain Drain: A Ticking Time Bomb for Romanian Healthcare

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According to a 2015 United Nations International Migration Report, since Romania joined the European Union in 2007, around 3.4 million Romanians have left the country in search of a better quality of life and economic opportunity.

 

In 2019, the number of babies born in Romania was approximately 182,000, making it the second year in which the number of newborns outside of Romania exceeded those in the country

László Attila, Committee of Public Health

 

As Dr László Attila, the president of the Committee of Public Health in the Romanian Senate, laments, “a large part of our young population is living and working abroad. In 2019, the number of babies born in Romania was approximately 182,000, making it the second year in which the number of newborns outside of Romania exceeded those in the country.”

 

In an incisive February 2020 opinion piece, Romanian MEP Clotilde Armand highlights the severe toll this westward flow is taking on healthcare systems in Eastern European countries like Romania. She cites, “a single doctor’s education costs the Romanian public coffers around EUR 100,000 (USD 109,670)” – considering that between 2009 and 2015, Romania lost half of its doctors to western European countries, she suggests that this should be seen as a “de facto transfer of wealth – a big one”.

 

Particularly after the 2008 global financial crisis triggered a devastating economic downturn in the country, the rising exodus of healthcare professionals from Romania’s already-ailing healthcare system has been a perennial cause for concern. Coupled with the rapidly ageing population remaining in the country, the population time bomb is counting down. While the over-65s only constituted 18.2 percent of the population in 2018, 1.5 percent lower than the EU average, the rate of ageing is accelerating with the proportion of over-65s expected to nearly double to 30 percent by 2050. Even worse, only 23.4 percent of Romanians over 65 years of age rate their health condition as good or very good compared to the EU average of 41.4 percent, according to a 2018 Eurostat report.

 

Bayer country head of pharmaceuticals Jorge Levinson points out that although “Romania has a strong legacy in medical education, developing well-prepared and competent physicians, which is a great advantage for patients, many highly educated physicians often seek opportunities for development abroad,” taking their experience and expertise along with them.

 

Previously, 250 to 350 patients were allocated per specialist but [today] we have exceeded 500 patients per specialist

Sorin Petcu, IQVIA

 

The country has attempted to remedy the situation, notably in 2018 when the government raised the salaries of public doctors nearly two-fold. However, it may not be enough to reverse the negative trend, which affects all medical specialties. One of Romania’s largest healthcare federations, Solidaritatea Sanitara, estimates that the Romanian public healthcare system has a deficit of nearly 40,000 healthcare works, or 17.5 percent of the overall staffing needs. As IQVIA general manager Sorin Petcu enumerates, “previously, 250 to 350 patients were allocated per specialist but [today] we have exceeded 500 patients per specialist.”

 

With the outbreak of the COVID-19 pandemic in 2020, national experts and stakeholders have questioned the ability of Romania’s beleaguered healthcare system to weather the coronavirus storm. In particular, the intensive care specialty has been disproportionately hit by brain drain. To compound the problem, Romanian’s aging population and brain drain have also resulted in the aging of Romanian medical professionals, with the average age for a family doctor falling between 50 and 60, elevating their risks of developing more serious complications if infected by the virus. As of 30 March 2020, it is estimated that one in five people infected with coronavirus in Romania is a healthcare professional. With over a decade of brain drain gone unchecked, the country has to brace itself for the perfect storm it finds itself in.

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