Reassessing public health services amid COVID-19

“From one moment to the next, you feel that you may not be embracing those you love again, that you may not have the opportunity to apologize for cutting off a relation for no reason, or that you may not see your favorite small Aegean church again with the Greek flag waving next to it. An inexplicable anxiety that you will never see things you have never actually noticed. It’s very strange how cinematic and romantic Vasilissis Sofias Avenue’s retro street lights can seem from the back window of an ambulance,” wrote the managing editor of the eminent center-right Greek newspaper Kathimerini.

Alexis Papachelas tested positive for COVID-19 on March 18 and ended up in the intensive care unit of one of the oldest and largest public hospitals in the center of Athens. He was discharged a few days ago after a “difficult battle with the virus,” he wrote in his first column after his recovery.

Overcrowded and understaffed, this 19th-century hospital has been trying to manage with the constant flow of COVID-19 cases. Since March, it has managed to treat an impressive number of victims and send them back home. The fact that one of their successful cases happened to be a well-known journalist allowed us to get a realistic picture of what is going on within those white-walled rooms. The difference is, of course, the staff.

“I do not want to forget those real heroes behind the masks, who are fighting for us all, the nursing staff, poorly paid, yet giving their ultimate effort, the ambulance people, whose work cannot be rewarded enough. We must remember them the day after and take care of them when today’s madness passes. I don’t want to forget either of you, the real heroes behind the masks, who are fighting for us all,” Papachelas wrote in the column.

The onslaught of the most contagious virus in recent world history is still going on, bringing down not only human beings but also their institutions, their political certainties and their ideological convictions.

One of the most impressive changes in thinking has been how we fell back in love with the public health system which although “understaffed and underfunded” in most European countries, is proving to be the only health institution which can battle to save lives.

Maybe some of us were always in favor of a free public health service, as well as a free educational system. But this did not apply to the centrist, neoliberal, free-market governments which mushroomed in Europe in recent decades. They were never genuinely in favor of a free health system even if they reluctantly included it in their government program. For many, it was a waste of money and the issue of health (and education) should be given to private enterprise.

But it was the National Health Service (NHS) to which Britain’s conservative prime minister, Boris Johnson, entrusted his health this week, not to a private medical provider. Still, it was his Conservative Party and successive conservative governments that had tried to undermine the NHS to clear the way for the private medical sector. Actually, just before the coronavirus crisis, there was a lot of talk in the United Kingdom that the health policy of the Johnson government after Brexit would be to privatize large chunks of the NHS after a major deal with U.S. President Donald Trump.

In Greece, the situation was different. Having lived through a decade of economic collapse, salvation packages in the form of successive bailout agreements and the pressure of creditors in Brussels and the International Monetary Fund, Greece had no choice but to cut down its public services. Thousands of doctors and health workers had to be laid off and hospitals had to close down in order to “save money;” public hospitals were seen as badly run, money-wasting institutions that prevented the country’s economy from taking a leap forward.

The present prime minister, Kyriakos Mitsotakis, and several of his key ministers previously served before in Antonis Samaras’ conservative government from 2012 to 2015. Under the directives of Greece’s creditors, Samaras’ government applied a strict austerity program of drastic reductions in the number of public employees, including the health service. Samaras’ government was succeeded by the leftist government of Alexis Tsipras, who ideologically supported the public character of health and education. Despite Brussels’ strict directives, Tsipras’ government tried to avoid the policy of public sector layoffs but struggled with a lack of funds.

Mitsotakis was elected last autumn with an impressive majority to lead a center-right government which included several key figures from the Samaras era. The coronavirus crisis came after a serious refugee crisis which cost much of his popularity. But he compensated with his reaction to the health storm. His preparedness and organizational skills, plus the aptitude of his scientific medical team, made him win back his lost points. Greece took preventive measures quickly and brought down the figures of COVID-19 cases and victims to a low level compared to countries in Western Europe. Mitsotakis’ opponents, though, claim that one of the reasons for this optimistic picture was that Greece had not applied tough neoliberal policies on the health system because of the previous leftist government.

Now, Mitsotakis – as well as Johnson – appear to be enthusiastic supporters of their national health services. Together they are now promising new recruitments of doctors and nursing staff, new hospitals and a larger health budget. They sound as though they have suddenly realized the value of free medical care for their citizens.

But let us wait a little, until the crisis is over. Only then we will be able to judge their honesty.