20 years ago in Latvia, thanking a doctor in the form of money in an envelope or an expensive drink was the norm rather than the exception. Although the level of corruption in the fields of medicine and education in Latvia is still higher than the average in the European Union (EU), it has decreased over twenty years.
In the last 12 months, about 10% of Latvians have given a bribe to a medical institution, but 4% have paid an educational institution to get what they want, according to the Global Corruption Barometer - EU 2021 report by the international organization Transparency International.
The results of the study show that, on average, 6% of the EU population has paid a bribe to receive medical care in the last 12 months, while 29% have used personal connections. The highest levels of corruption in the medical sector among EU countries are in Romania and Bulgaria, where 22% and 19% of the population have given a bribe in the last 12 months, respectively. In the Czech Republic, Portugal and Hungary, on the other hand, there are higher hopes of getting to a doctor quickly if there are personal connections. 54% of respondents in the Czech Republic, 46% in Portugal and 41% in Hungary admitted that they were able to receive medical services due to this aspect.
The situation is more moderate in the Baltic States. About 19% of Lithuanians surveyed admitted that they paid "a bonus" for medical care, and 25% used acquaintances. In Estonia, 2% and 12% of respondents admitted this activity, respectively. At the same time, 10% of the surveyed population in Latvia had given a bribe to specialists working in medical institutions, but 30% used personal connections.
A 2005 study found that illegal healthcare payments in Europe are estimated at between 3% and 10% of the healthcare budget.
Until 20 years ago, "gratitude payments" to a doctor was a common practice. A survey conducted by the Baltic Studies Center of the University of Latvia in 2002 showed that up to 70% of the surveyed Latvians were willing to make illegal payments in medical institutions. 50% of respondents did not consider that a bribe to a doctor (in monetary terms) would be considered corruption. 45% thought that paying a doctor was a normal thank you, 14% said that doctors had to be paid extra because they had low salaries, and 6% hoped that this would grant them more attention. 62% of respondents answered that they would never report a doctor who asked to pay in addition to the price set by the state or institution. 56% of respondents were willing to pay so as not to have to wait in line for medical treatment. 50% believed that corruption in health care had increased significantly over the last three years.
In 2007, Valdis Zatlers, the then Chairman of the Board of the Hospital of Traumatology and Orthopedics and doctor, became the President of Latvia. One of the biggest accusations, when he took office, was accepting "gratitudes" as a doctor. V. Zatlers did not hide from society that he accepted money in an envelope as an additional payment for the work done in his doctor's practice. However, he emphasized that he had never asked for a bribe. In the Latvian television program “100. pants” when asked if he could ever guarantee that he had never claimed illegal payments from patients, before taking up his high post V. Zatlers replied that he could not only guarantee but could also swear that he had not demanded such payments. At the same time, he stated that he must be honest, so he must admit that he has accepted payments from patients. In 2007, accepting "gratitudes" from patients was not an obstacle to becoming President.
However, in 2007 Juris Dārznieks, an otolaryngologist at Jelgava Hospital, was sentenced to 100 hours of community service for demanding a bribe. He had asked a patient 100 lats for nasal surgery.
Although in 2002 the majority of respondents admitted that they would not report a doctor for requesting a bribe, this does not mean that there were no such cases at all. In 2018, the Corruption Prevention and Combating Bureau (KNAB) had asked the Prosecutor General's Office to prosecute a doctor who had accepted a “gratitude” of 800 euros.
Several years ago, Latvia was struck with the bribery case of the Children's Hospital, in which the accused were fined heavily, given suspended imprisonment, as well as community service. However, in this case, the bribery case was related to procurements and not to the gratitude payments of patients or their relatives.
Although the situation with bribery in the health sector has improved over the last twenty years, Latvia's indicator in 2020 was twice as high as the EU average (5%), according to Eurobarometer survey data on corruption in EU member states published by the European Commission.
A study conducted in 2020 reveals that every tenth Latvian respondent who has visited a state health care specialist in the last 12 months, in addition to the official payment, has given an additional payment or a valuable gift to a nurse or doctor or donated to the hospital in exchange for care services.
In the spring of this year, KNAB received several alerts about possible corrupt violations in connection with vaccinating people out-of-line and against the state procedure, LETA reported. KNAB had seen in the public sphere and received a number of alerts that could contain information about possible corrupt violations in connection with vaccinating people out-of-line and against the state procedure. "Cases where medical staff request, accept or receive illegal benefits to provide services to the population or violate the order of patients, including in the vaccination process, are unacceptable," KNAB stated.
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