What are Supposed to be Free Services at State-run Hospitals and Clinics are Not Always Free

By Mehriban Dilaverli

A doctor at Traumatological Hospital in Baku observes as a nurse performs physical therapy on a patient.

Some residents of Baku suggest that on many occasions they are forced to pay for medical care at state facilities that are supposed to provide services free of charge.

A decree by the Minister of Health provides free care for all citizens at state medical facilities effective February 1st. In a telephone interview, Anar Gadirli, the head of the Press Service of the Ministry of Health, said all services are supposed to be free. "From now on, even the most difficult surgeries are free of charge, " he said.

However, just six days after the decree was issued, Baku resident, Kamila Valiyeva, said she was told to pay ten manats in order to obtain an X-ray at state-operated City Clinical Hospital Number 4. She is not encouraged by the decree. "It is not going to change. If you don’t pay they will neither examine you nor do the tests. It doesn’t matter if there is a decree. Doctors and nurses do not follow these new rules. It is not going to change by simply saying this. All patients suffer from it, " she said.

Unlike Kamila Valiyeva, 70 year old Agashah Mammadov, who underwent a medical examination at the same hospital claims he didn’t pay anything for his medical examination. “Nobody asked money from me,” he said.

Gadir Mammadov, who was standing in the line at the hospital to undergo a medical examination, looks at it in a philosphical way: “Everything depends on us, if we don’t pay, doctors won’t take bribes.”

Another patient, Vali Mammadov, in turn, said he doesn’t believe he will receive a proper examination unless he pays the doctor. Therefore, he said he reaches into his pocket as soon as he arrives at the hospital. “ When you pay money you feel calm. Not a single patient will go for a free of charge surgery. I will not do it, ” he added.

Rauf Rzayev, the deputy head doctor for treatment at City Clinical Hospital Number Four, denies that some people are forced to pay for services. “It can’t be like this. There is a decree, it must be complied with. Apparently, there is a misunderstanding,” he said.

However, Sadagat Valiyeva, the chief doctor at the state-run Special Hospital Number Four for Tuberculosis Treatment, didn’t deny that patients voluntarily give money to doctors. “It could be that patients give money to doctors. I instructed our doctors not to take the money. However, I can’t control them everytime,” she said.

A nurse attends an elderly patient at City Clinical Hospital 4 in Baku's City Center

43-year old Nadir Agayev who underwent a medical examination at Special Hospital Number 4 says he paid five manats to the doctor. “He didn’t ask for money, I paid. I am a patient here. I used to pay and I pay now as well,” he said. Another patient, Gulnisam Mammadova, who underwent an X-ray at the same hospital claimed she had to pay five manats in return for the medical care she received.

The head of the x-ray department at the hospital, Firudin Najafov, said the payment is a way of showing respect to the doctor. “Doctors were always supported by people. It is not a bribe, it is a tribute. Not taking the money a patient is offering to a doctor means the doctor doesn’t accept that tribute. This shouldn’t happen,” he added.

The average monthly salary of doctors and nurses at Special Hospital Number 4 is 89 and 79 manats, respectively, according to Dr. Sadagat Valiyeva said. Nationwide, the average salary at state-run hospitals is 88 manats for doctors and 66 manats for nurses, according to Anar Gadirli, the spokesman for the Ministry of Health.

Gadirli suggests that any patient who has complaints, including being forced to pay bribes for what is supposed to be free medical care, can contact the Ministry at 012-495-3539 or 012-495-4015 or log onto the Ministry’s website www.sehiyye.gov.az ".

At the website, citizens are given a chance to ask the Minister of Health questions. However, the last question answered by the Minister of Health was dated April 17, 2007.

Neither the decree nor the hotline phone numbers were posted at the four hospitals that were visited by this reporter. They included Maternity hospital Number Seven, The Institute for Lung Disease, City Traumatological Hospital, Children’s Dental Polyclinic Number Four and City Clinical Hospital Number Four.