The practice of making informal payments for health services is deeply embedded in the Hungarian health care system and is therefore persistent. According to the survey conducted by the Euro health consumer index in 2015 Hungary was among the European countries in which unofficial payments to doctors were reported most commonly. Although the relatively low salaries of medical doctors and other health workers have been a major contributing factor, eliminating informal payments will require concerted action to restore the lost confidence in public services. The majority of patients “are no longer tolerant to gratuity“. Semmelweis University is deeply involved in support the “livable Hungarian health” movements.
Take jobs abroad after graduation is an important issue among Hungarian medical students. Around half of the newly graduated doctors are going immediately abroad. The reasons are low salaries, poor working conditions and “gratuity” payments. In 2016 Resident and Specialty Practitioners’ Union and “1001 doctors group for gratuities free healthcare” initiated a movement for “Livable Hungarian health”. They would replace gratuity payments with regulated charges, to provide a human-centered, money-laundering and corruption-free health service. As a results of this movement salaries in Hungarian health service has increased significantly and this motivates the majority of medical students to start their career at home instead of going abroad.
Low wages and gratuities are the most important external factors of insufficient health care in Hungary. Despite of several official campaigns against them, the state-socialist health care system not only tolerated informal payments but also included them in the calculation of salaries of medical doctors and even required that they be taxed. Because of hope of gratuity interventions are generally performed by older physicians, dispensing the learning opportunities for young people. Medical students perceive that the teamwork is paramount in the treatment however they also can realize that the gratuity against this, because it only gets a single person. According to a survey of Hungarian Association of Residents 62% of medical students reject gratuity system, but consider it as necessary component of Hungarian health care, a further 20 per cent completely reject it. Only 56 percent would not accept gratuities, if their current salary would doubled.