A country that is dying to leave the euro
Published by The Mail on Sunday (14th June, 2015)
How does a nation die? This week, in the beleaguered hospitals of Athens, I saw a glimpse of the shocking answer. It is when its own people die in their thousands simply because the state cannot afford to heal them.
In the Reichstag in Berlin, it is now said openly that Angela Merkel is ready to discuss putting Greece out if its misery – to let it ‘Grexit’ and parachute free of its colossal European debt, which could have a huge impact across the globe.
Yet to pay down this debt, Greeks have been battered by austerity measures that make Labour complaints about Osborne’s cutbacks utterly laughable.
There is no greater metaphor for a country’s health than its own healthcare system. And it is only when you see for yourself the horrors convulsing Greece’s NHS that you realise just how insane it is for this once-proud nation to continue as it is. If it was your country, it would make you weep with pain and shame.
In its overloaded hospital wards, I either saw or heard first-hand accounts of babies held hostage for payments and dying patients left unattended; of porters sent out as paramedics, patients told to bring their own sheets, brakes failing on ancient ambulances travelling at high speed and hospitals running out of drugs and dressings.
Operating theatres have been shut and staff numbers slashed because there simply is no money left. Five years ago, Greece spent £13 billion on the health of its 11 million population – above the European average. It is now spending about half this. Worse still, in the first four months of this year the 140 state hospitals received just £31 million, a 94 per cent fall on the previous year.
And to make matters even blacker, any reserves have just been taken back by the government in its desperate scramble for cash to pay public servants and international debts.
There are claims of an astonishing three-year fall in a Greek person’s life expectancy in just five years since the country’s economy crashed. If confirmed, this would be without precedent in modern Europe.
And the individual human stories are pitiful, verging on the macabre.
I met Costas, a 37-year-old waiter from Corfu, pushing himself slowly along the hospital road. He was struggling with a wheelchair held together with masking tape. His efforts were hampered by having one arm wrapped around a large, unwieldy item in a black bin liner.
He told me that a serious motor-cycle accident had meant the amputation of his right leg. He should still be in the hospital now, he explained, but there were no beds left; he had been asked to leave despite his protests. ‘They just said go home,’ he said. ‘I am scared because I do not have the money to get by.’
As he pushed himself on, I asked what was in the bag. ‘My leg,’ he replied, opening the bin liner to show me his prosthetic limb.
At several hospitals in the capital, almost every doctor, every nurse, every ambulance driver had horror stories to tell me of a system teetering on the brink of breakdown. ‘This no longer counts as Europe,’ said one surgeon bitterly.
The crisis has become so severe that humanitarian group Médecins Sans Frontières is preparing an action plan to aid the country if things get worse, similar to its work in the world’s worst conflict zones.
‘The situation is like a war zone without the bullets,’ said one source at the charity. ‘If things keep going the way they are, we could see a totally collapsing health system.’
The new Left-wing government is bickering over the terms of another bailout – yet for all its posturing has done little to help the health service beyond widening access.
The tragic consequences could be seen visiting Nikaia hospital in the port of Piraeus, as a handful of night-time staff struggled to cope with patients pouring in for emergency care.
One old lady with a deathly countenance lay immobile on a trolley in a corridor, abandoned for the four hours I was there since she appeared to have no family to fight her corner.
Five more elderly people lay on trolleys, two clearly in pain and one in a neck brace, amid a scrum of patients with smashed faces, scraped bodies and fractured limbs being aided by relatives. Police officers escorted a blood-covered prisoner in chains.
The daughter of an 84-year-old woman curled up in agony under a coat told me they had been there for four hours, staff shortages forcing her to wheel her mother to the X-ray unit and for blood tests. ‘Greek hospitals are like hell,’ she told me.
Another man escorting his father-in-law, who suffered from Alzheimer’s and had acute stomach pains, said the system was despicable. ‘I feel anger and sadness when I see this,’ he said.
He added that his own father had suffered a stroke in Crete and after eight hours the ambulance had not turned up, forcing them to cross the island by taxi at a cost of £108.
One woman held a drip over her mother. Another, left suddenly bereaved, was led out wailing in anguish. Then, as I began chatting to a consultant he was screamed at by a paramedic to treat a badly-battered wife with severe head wounds.
Panos Papanikolaou, a senior neurosurgeon, said staff shortages due to a four-year state freeze on hiring meant the busy hospital was only using five out of 11 operating theatres. Nurses were in especially short supply, with just 450 remaining – 300 fewer than they need.
Since remaining nurses were owed so much holiday, only three theatres would be in use for the next two months – then none except for extreme emergencies in August, a peak month for tourism.
‘The decision to stop all hirings of medical staff was a criminal action in my view,’ said Papanikolaou. ‘Intensive care doctors estimate we lose 2,000 people a year that should not be dying.’
Nurses told me there were no sheets so patients had to bring their own; at night, they placed nappies and light mattresses on top if patients bled or wet the bed since there were no replacements.
In one ward, they clubbed together to buy a blood pressure monitor and thermometers due to equipment shortages. Since pay has been cut by one third as pressures surge, such actions highlight the heroism of some medical staff struggling to keep the system afloat.
I found Panayota Conti, 35, working as sole night nurse on duty for 20 patients in the urology surgical ward, nine of whom had had serious operations that day.
‘Often there is more than one person in distress and I have to choose who to help,’ she said. ‘The patients understand but they are getting less good care than before.’
Or as another nurse put it: ‘If two people are dying, only one can get help – it is that bad.’
When I asked what it was like to work under such conditions, Conti said she felt like jumping out of the window at times, adding: ‘The only way to survive is if you love your job.’
She knew of seven colleagues at her hospital – two doctors and five nurses – left so dejected they went to work in England. A cardiac surgeon told me 59 Greek heart specialists had moved to the UK’s NHS.
Later, I talked to an ambulance driver who told me of a recent incident in which the brakes on his 11-year-old vehicle had failed as he rushed a car crash victim to the hospital. He only avoided another collision by destroying the gearbox.
‘We often have crashes with these vehicles,’ he added. ‘But if you arrive by ambulance, at least you get priority treatment.’
There have been recent cases of hospitals running out of petrol for their ambulances – and even painkillers for patients. At another unit, one driver confessed he was a porter given 15 days’ training and then sent out as a paramedic dealing with the most severe incidents. ‘It’s crazy,’ he said. ‘We do not have the right training.’
Among the worst hit are cancer patients, who can wait four months for diagnosis and then six months for key treatments. Union representatives at Agios Savvas in Athens, Greece’s biggest oncology centre, said staffing levels had fallen to almost half the numbers needed.
‘If you have a six-month wait to start radiotherapy there’s no point coming – either you die or the cancer is so advanced it is pointless,’ said Petros Athanasiades, a radiographer.
After seeing one patient nearly die because he lost his job and consequent right to treatment, cardiologist George Vichas set up a free community clinic staffed by volunteers, with 39 similar set-ups across the country.
The consultant said they had even come across five cases at a maternity hospital where new-born babies were held hostage until their parents paid for their treatment. ‘We have seen an absolute collapse of the state health system,’ he said.
How did it ever come to this? And what does it means for the nation’s future in the eurozone – and the eurozone as a whole? Before the crash, Greece’s health service was inefficient, badly managed and corrupt like the rest of the public sector – yet it provided well-trained staff and one of the world’s most comprehensive healthcare systems.
But after the crisis struck and the country was ordered by international lenders to cut costs, new benefit rules and rising unemployment saw the number of Greeks without health cover soar from 500,000 to 2.5 million people.
The surging poverty and deteriorating medical care led to an increase in problems, from diabetes to depression, drug addiction, heart problems, HIV and tuberculosis. Both infant mortality and suicides are also reported to have risen sharply.
At the same time, patients migrated from the private to the public sector, adding to the state’s burden, while often they delayed seeking treatment allowing conditions to worsen because of the cost of drugs and doctors – many of whom demand under-the-counter payments.
The EU and the eurozone were projects designed to bring countries closer together. Instead, they have sparked poverty, decay and division.
Yet still the euro-zealots demand further austerity, while the latest set of Greek politicians seem as incapable of resolving the crisis as their hapless predecessors. The country and its blighted people are trapped between many more years of this slow stagnation or the sharp pain of euro exit. No wonder the latter increasingly seems a better bet.
It’s easy to see why a default on part – or even all – of its €320 billion debt is dreaded in Europe: It could trigger a domino effect, starting in Spain and Portugal, which could ultimately end the euro dream.
It would plunge Greece into crisis. But without debt repayments, the country runs a surplus. Outside of the euro, it would at least attract huge inward investment, its exports would soar and it could rebuild. And it could do the one thing that is the modern definition of a nation: it could begin to cure its own people of their ills.
Ultimately, what could be the rebirth of Greece may be the death of the original European dream.