In times of scarcity such as these, discourse inevitably shifts towards a discussion of materials, the scarcity of which means that service cannot continue at the level it operated previously. It is of course extremely important for such things as sutures, bandages, alcohol, scalpels to be available so that they can be used as needed. The same is true of drugs, whether generic or proprietary. Yet what the imminent dismissal of 1000 EOPYY staff indicates, is that personnel is only seen as a burden on the system, an ‘extra expenditure’, which must be cut in order to fulfill the arbitrary goal of 6% spending on health. Thereby people acquire a status equal to things, which we must get rid of during our ‘spring clean of health care’. This case study exemplifies the poor planning and lack of vision which has plagued the Greek health care system since its inception.
Lack of planning for health care means that, over the years, the number of medical students has grown and grown, the only criterion for entry into medical school being high marks
It is a widely acknowledged fact that Greece has far too many doctors relative to its population. But doctors did not magically appear one day out of nowhere, knocking on EOPYY’s door and demanding work. Lack of planning for health care means that, over the years, the number of medical students has grown and grown, the only criterion for entry into medical school being high marks. Qualified doctors coming out of this system now populate the ranks of EOPYY. Some of the medical students currently (not) training will be asked to join them. Others will presumably populate the private sector. Or emigrate.
In my attempt to conceptualize the way that changes are being introduced, I keep coming back to Athina Vlachantoni’s excellent metaphor. In making redundant 1000 doctors, the government is moving the goalposts. It does not acknowledge any responsibility for those practicing medicine under contract with EOPYY, those currently training to be doctors, nor does it, crucially, acknowledge any responsibility towards patients and citizens. The redundancies, in combination with a failure to implement the European Working Time Directive, do not sufficiently safeguard quality of care, highlighted as a pillar of health care reform in WHO’s 2008 report ‘Primary Care – Now more than ever’ (which, ironically, was tweeted about by Adonis Georgiadis – evidently he has not read it). In the end, doctors are seen as units of product to shift, like books. And if you can shift 1000 books, why stop at only 100?
This shows a fundamental lack of understanding of how the human body works, and of what practicing medicine actually entails. The discourse on dismissal treats doctors as Lumpen proletarians, interchangeable with one another, to be told what to do, and how long to do it for, by technocrats at the health ministry. Thus the practice of medicine becomes only the sum of its parts, namely the prescription of drugs, surgery and examination. Currently proposed health policy overlooks the more crucial aspects of medicine, like judgement, compassion, sociability, care and quality of service. Only what can be quantified is measured, and the narratives of doctors and patients being failed by the system are overlooked. This seals their status as inanimate objects.
