Price of a specialist. How much do doctors in Belarus cost?
The relative expenses in Belarus for healthcare and for healthcare workers are higher than in Ukraine and Kazakhstan, but less than in other neighbouring countries, as well as in some European countries.
Thinktanks.by came to this conclusion having compared budgetary spending on health care with the number of people working in healthcare in Belarus, Russia, Ukraine, Poland, Lithuania, Latvia, Estonia and Kazakhstan. It is clear that the lion’s share of the allocated funding goes to the maintenance of infrastructure, equipment, medicines and other items of expenditure. However, such a comparison can provide a general idea of the level of costs for the industry.
The experts proceeded from the fact that the expenditures of the consolidated budget for health care in 2020, according to the Ministry of Finance of Belarus, amounted to BYN 6 billion 871.3 million, which is equivalent to €2.475.4 million.
For comparison (data for 2019 or 2020):
- Russia – €59,707.7 mln.
- Kazakhstan – €3,243.1 mln.
- Ukraine – €5,687.3 mln.
- Poland – €24,895.1 mln.
- Lithuania – €3,035.0 mln.
- Latvia – €1,291.8 mln.
- Estonia – €1,498.5 mln.
According to the National Statistics Committee of the Republic of Belarus (Belstat), as of January 1, 2021, there were 55.8 thousand specialist physicians (of which 43.1 thousand are practicing physicians) and 125.4 thousand paramedical workers in our country. That is, a total of 181.2 thousand people worked in the Belarusian healthcare system.
Finance / healthcare workers
If we correlate the budget with the number of employees, it turns out that last year there was an amount of €13,650.00 per Belarusian physician, or €1,138.00 per month. By the standards of Western Europe, this is not a big salary. It roughly corresponds to the minimum wage in Belgium (€1,126.00) or in France (€1,219.00).
However, for Belarusian healthcare workers, it is a fabulous fantasy that is not destined to come true. After all, we recall that the lion’s share of this amount will go to the maintenance of infrastructure, equipment, medicines and other items of expenditure.
As a result, in 2020, the nominal gross average monthly wage of healthcare workers in the country, according to Belstat, amounted to BYN 1144.1, or €410.00 at the average annual exchange rate.
Comparison with neighbours
However, if we compare the conditional “price” of a Belarusian physician – €13,650.00 – with the prices of medical personnel in neighbouring states, it turns out that this rate is not the lowest one:
- Russia – €16.9 thous.
- Kazakhstan – €9.3 thous.
- Ukraine – €10.5 thous.
- Poland – €45.7 thous.
- Lithuania – €37.9 thous.
- Latvia – €93.3 thous.
- Estonia – €53.1 thous.
Despite the assurances of certain representatives of the Belarusian health care stating that everything is fine in the healthcare field, hospitals are equipped with everything necessary, and doctors and nurses do not need anything, we can confidently say that the situation is even better in most of the countries around us. At least, in terms of financial security.
Do doctors work not for money?
And in what way does all this affect the provision of the population of Belarus with healthcare workers? Judging by the statistics – in no way.
In 2020, there were 46 practicing physicians per 10 thousand inhabitants in Belarus. This rate is above the average on the continent.
It should be noted that in Minsk there are 61 physicians per 10 thousand of the population, and in the Minsk region – 34 specialists. However, this discrepancy is typical for all European capitals.
In 2020, per 10 thousand inhabitants, there were:
- in Belarus – 192.7 physicians
- in Russia – 244.7 physicians
- in Kazakhstan – 186.6 physicians
- in Ukraine – 123 physicians
- in Poland – 143.6 physicians
- in Lithuania – 286.3 physicians
- in Latvia – 72.7 physicians
- in Estonia – 211.8 physicians
Based on the processes taking place in the countries studied, it seems likely that we can talk about different approaches of governments to financing health care. For example, both Latvia and Ukraine have faced a serious outflow of medical personnel. However, funds have been found in one country to keep doctors, in the other – not yet. Although, according to the plans of the Ministry of Finance of Ukraine, in 2021, healthcare spending will grow from 3.4% of GDP to 4.2% of GDP, and in 2023 it will reach 5% of GDP. In Belarus, in 2021, these expenditures should amount to almost 4.6% of GDP. In Latvia, it was planned to spend more than 6% of GDP on healthcare in 2020 – an amount that was comparable to spending on defense, security and law enforcement combined.
Based on the figures obtained, we can conclude that the “price of a specialist” does not directly correlate with the extent to which the population is provided with the services of medical personnel.
For example, in Latvia and Ukraine there are relatively few physicians per 10 thousand inhabitants. However, completely different budgetary expenditures are provided for their activities.
At the same time, in Lithuania and Estonia, there is a very high rate in the number of medical personnel, with a high level of costs per healthcare worker. This is a good level of ratio between quantity and quality.
There are many healthcare workers in Russia, Belarus and Kazakhstan; however, the support of their work leaves much to be desired. The high percentage of healthcare personnel per 10 thousand inhabitants here is more due to the Soviet and post-Soviet tradition, rather than due to a really high-quality approach to the organization of medical services. And in these countries there may be problems with the outflow of personnel abroad, the same as in Latvia and Ukraine, which should be resolved sooner or later.
The shortage of medical personnel in Belarus is already emerging. In the nationwide job bank, as of October 20, 2021, Belarus lacks 2,950 physicians, just over 2,800 nurses, about 1,000 paramedics and almost 400 physician assistants. In total, more than 7,000 healthcare workers are already required in the country.
The reasons for the shortage of medical personnel are different. One of them is the low “price of a specialist”. At the same time, the Ministry of Health is not inclined to dramatize the situation. Firstly, because the demand for doctors exceeds the supply in Belarus, and secondly, because there are no mass layoffs of doctors.
It can also be noted that the highest number of physicians per 10 thousand people (84 physicians as of 2018) is observed in Cuba where salaries have never been high. But Cuba is an island, and Belarus is not. And judging by the trends, healthcare workers, albeit not very actively, keep on “going away” from the country.