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Last Updated: Wednesday, 1 February 2006, 09:30 GMT
Medical corruption 'global issue'
Doctor and young patient
Corruption means a lesser service for patients
Corruption in healthcare systems remains a global problem in both poor and rich countries, and more must be done to stamp it out, a report says.

Anti-corruption body Transparency International looked at the more than $3 trillion (1.7 trillion) the world spends on health services each year.

It said that at least 5% of funds could be being lost, be it Cambodia's or the US's Medicare public healthcare scheme.

The body has called for strengthened codes of conduct and more transparency.

Its Global Corruption 2006 report found that the health sector remains an attractive target for abuse, due to the large amounts of money involved and the complexities of many healthcare systems.

Corruption multi-faced

At best corruption can mean hospitals or patients having to overpay for services, at worst it can mean people dying because of counterfeit drugs.

Even in countries where regulations are in place, it can be hard to police
Alan Maynard, York University

Transparency International (TI) also found - perhaps unsurprisingly - that the poor were worst affected by corruption, because they were less able to afford to pay the small bribes that can sometimes be demanded in some countries.

It recognised five general areas of healthcare corruption:

  • Embezzlement and theft - which it said could occur at any level down from central government to the actual patient.

  • Corruption in procurement - engaging in collusion, bribes and kickbacks in purchasing drugs or equipment, resulting in overpayment or reduced quality.

  • Corruption in payment systems - such as waiving fees or falsifying insurance documents.

  • Corruption in the pharmaceutical supply chain - drugs diverted or stolen.

  • Corruption at the point of health service - such as doctors demanding or accepting bribes in order for a patient to secure quicker treatment.

    In its recommendations to better tackle corruption, Transparency International said, "Measures must be tailored to fit the particular context of a country's health system."

    But whichever the nation, it said corruption needed to be tackled through greater transparency, such as the publication of health budgets and performance; and improved codes of conduct and training.

    Transparency International also called for health authorities to allow more oversight from members of the public, and that corruption could further be better tackled through greater protection for whistleblowers, decent wages for medical staff, stricter conflict of interest rules, and more rigorous prosecution.

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