Corruption in healthcare — a threat to healthy societies

What allows hospitals and doctors to care for people 24/7, whether it’s a harmless rash or a life-threatening emergency, is also what makes healthcare systems vulnerable to corruption. They have large workforces and diverse stakeholders, millions to billions of dollars in funding, and huge procurement systems that make them ready to help us when we need it. But with so much money at stake and so many moving parts, they are also attractive targets for criminals.

Criminals find ways to exploit healthcare systems’ vastness to funnel away money and curry favour: from improper procurement, to falsification or manipulation of licencing and authorisation processes, to cronyism or nepotism in appointments and awarding contracts. This diverts resources, increases service costs, and leads to employment of poorly qualified decision makers, care providers, and staff.

Not only does this burden our economies, destabilize our societies, and disrupt our political systems, it drives the quality of care down and affects patient outcomes, deepening our vulnerabilities in some of life’s most challenging moments.

Many people worldwide rely on public, or state-funded, healthcare. In an area like South-Eastern Europe where the average rate of unemployment is 13%, many people cannot afford private treatment. So when corruption erodes the standard of public services, private healthcare becomes the only means for quality medical care, intensifying financial pressures.

Dealing with and preventing corruption in the healthcare sector takes understanding how corruption takes hold of these systems in the first place. One way of rooting that out is by evaluating judicial cases. That’s what we’re doing in South-Eastern Europe.

The OSCE’s Regional Trial Monitoring Project — Combatting Organized Crime and Corruption in the Western Balkans, funded by the European Commission, is currently monitoring 230 cases in Tirana, Sarajevo, Prishtinë/Priština, Podgorica and Skopje, several of which relate to alleged corruption in the healthcare sector.

By monitoring corruption and organized crime cases, we can better understand the challenges affecting the healthcare system and how these cases are being prosecuted and adjudicated. This in turn is essential to staying ahead of and properly prosecuting corruption to prevent a culture of impunity.

With reliable, evidence-based findings, we can help policymakers and stakeholders take steps to implement anti-corruption measures to protect healthcare and minimize its vulnerabilities. Some of these anti-corruption measures include well-regulated and transparent procurement processes, adequate oversight and review of licencing and authorisation processes, protection of whistle-blowers, and enforcing codes of ethics to foster a culture of integrity.

A safe, secure, and prosperous society cannot function without protecting the health of its people. Our project will produce a set of recommendations in 2024 to address areas of concern uncovered in corruption and organized crime cases across sectors, including health care, and to build on good practices both at local and regional levels. With policies rooted in evidence, we can help protect the systems meant to help us so that, ultimately, we can build healthy societies where all people thrive.