Fifteen percent of Lithuanians say they have given a bribe or other form of compensation for medical services in recent years, according to a new survey conducted by the polling company Baltijos Tyrimai for LRT.
Doctors and the Special Investigation Service (STT) say the situation is slowly improving but remains stubbornly persistent, driven by long-standing cultural myths and low medical salaries.
Some patients still arrive at hospitals and clinics with envelopes – or even bags – of gifts, said Auristida Gerliakienė, a board member of the Lithuanian Medical Movement. Items can range widely, she said, from honey, eggs and smoked pork to chocolate, wine and champagne.
Although illegal gratuities appear to be declining, Lithuania’s “envelope culture” remains widespread. Data collected a few years ago by the Lithuanian Junior Doctors’ Association found that half of respondents viewed the health system as the country’s most corrupt sector. One in five said they had offered money in a clinic or hospital, and one in 10 said they had done so in a regional facility. Another 20% said they had been directly asked for cash.
The STT stresses that any form of material reward – even apples from a garden or a jar of homemade pickles – is illegal if offered in exchange for a doctor’s professional duties.
Benas Aldakauskas, head of the STT’s Anti-Corruption Education Division, recalled one case in which a homemade cake brought in as a “thank you” was shared across a department and with patients. The cake later tested positive for bacteria, he said, and “the entire department went down”.
Survey data
According to the Baltijos Tyrimai poll, 15% of respondents said they had recently compensated a doctor or medical worker with money or other gifts. Three-quarters said they had not done so, and nearly 10% said they had not visited a medical facility at all in recent years.
Women were somewhat more likely than men to offer unlawful payments, as were older residents of major cities, retirees and people from households earning less than €1,200 per month.
Members of the Lithuanian Medical Movement warn that ongoing health-system reforms could exacerbate the problem.
The belief that “if I give something, I’ll get help faster or receive better-quality care” remains strong, Gerliakienė said. While an illicit payment will not improve quality, she added, there is a risk that it may influence waiting times: “There is a real danger that this culture could flourish.”
Address the situation
Irmina Frolova-Milašienė, communications adviser to the health minister, said recent legislative changes are intended to make the system more transparent and ensure patients clearly understand the services they are entitled to, including in the private sector.
Corruption in medical settings can also be two-sided, authorities note. A doc tor may be offered an illegal reward, but patients may also face pressure or hints to provide one.
Aldakauskas said both sides should confront such situations directly. “If you feel a doctor is asking for something, ask what they want. And if a doctor senses a patient wants to give something, ask why they think they need to compensate you,” he said. “Do not be afraid to address the situation and have a dialogue.”
He said patients should report suspected bribery to a hospital administrator, the police or the STT. Depending on the case, offenders – whether patients or medical staff – may face administrative or criminal penalties, as well as disciplinary action.
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