(Repeats story published late on Thursday)
* Austerity in east EU states causing healthcare exodus
* Fifth of Czech hospital MDs threaten to leave their jobs
* Baltics, Romania also seeing outflow, Germany hiring
* Departure could hit govt popularity
By Roman Gazdik and Robert Mueller
TABOR, Czech Republic, Oct 20 (Reuters) - After years of
long hours and low pay, Czech doctor Petr Klimak is threatening
to quit and join an exodus taking many to western Europe.
Making less than a skilled carpenter or plumber, and facing
government austerity measures that will cut funds going to
healthcare, Klimak and thousands of other doctors in the east of
the European Union are looking to fill higher-paid jobs abroad.
Although healthcare in the developing region has largely
improved since the 1989 fall of communism, compensation and
working conditions from the Baltics to the Balkans pale in
comparison to those in Germany or Britain.
Now an increasing number of doctors fleeing the region could
lead to hospital closures and erode support for governments
whose cost cuts in public administration -- and state healthcare
-- have prompted public outcry.
"My pay as a head physician is 250 to 300 crowns (10 to 12
Euro) per hour, less than a skilled workman," said Klimak, an
ear, nose and throat doctor in the industrial town of Kladno,
just north of the Czech capital.
"If nothing happens here I will quit my job and leave,
probably for Germany."
As the new Czech right-of-centre government pursues
austerity measures that will hit the state-run health sector,
Klimak and other doctors fear a years-long fight for higher
salaries will be thwarted.
He and some 3,500 other doctors -- more than a fifth of all
practitioners in public hospitals here -- have pledged to leave
by the year end if their wages do not rise.
They are not alone. Similar complaints have erupted in other
countries in the European Union's ex-communist east and happen
to coincide with a push in developed EU states to attract more
specialised workers.
Analysts say there may be little chance of an immediate
collapse, but a large outflow of doctors and potential closing
of hospitals will hurt ruling parties across the region as it is
health care where people immediately feel any state cuts.
"It would make people very nervous and it would bring about
an unpleasant mood, which would certainly hit political
preferences," said Jan Kubacek, a political analyst at Prague's
Charles University. "A doctor, a nurse, these are symbols which
touch every single person."
Last year, a fee of about a euro -- equivalent to the cost
of a tram ticket -- helped bring down the previous Czech
government, as patients protested against paying for healthcare
that had been completely free.
"WE'RE LEAVING"
Czech healthcare has improved considerably since Communism
fell 20 years ago. The Czechs boast the best care in the region,
surpassing Portugal and Spain, and are level with Britain and
Italy, according to think-tank Health Consumer Powerhouse, which
monitors health care systems in 35 countries.
But salaries average around 45,000 crowns a month (1,834
euros) and can include 80-hour work weeks. Hundreds of doctors
have left for Britain or Germany, where new graduates can earn
4,000 euros a month, five times the Czech equivalent.
Now, Prime Minister Petr Necas's right-of-centre government
plans to slash the total public sector wage bill by 10 percent.
The move has prompted public demonstrations and contributed
to worse-than-expected results for his Civic Democrats in
municipal elections this month. It also helped push support for
the three ruling parties to under 50 percent in a recent poll.
Necas has pledged not to touch doctors' salaries, but an
expected 5 to 7 percent fall in the healthcare budget next year
has angered doctors who have waited for decades for better pay.
Pavel Vavra, an organiser of the signature campaign dubbed
"Thank you, we're leaving", said he was ready to leave.
"I work three positions now," said Vavra, 37, who drives a
decades-old ambulance with other doctors around the country
lobbying for their cause. "I don't want my son to know me only
from photographs, which is quite likely with my extra hours."
And it is not just Czech doctors who are feeling unwanted.
The head of Latvia's doctors' association said dozens were
leaving each month. In Estonia, years of budget cuts have
prompted more than 100 doctors to leave the country of 1.3
million for Sweden, Finland, the United Kingdom and Germany.
In Romania, the EU's second poorest state, the government
has slashed public pay by 25 percent to avoid economic meltdown.
"Since 2007, about 3,000 doctors and 8,000 nurses have left
for other countries because of low pay and bad work conditions,"
said Marius Petcu, head of Romanian health sector union Sanitas.
"If this continues, I expect by the end of next year Romania
will not be able to provide medical services for the public."
GERMANY NEEDS DOCTORS
Last month, the German Hospital Institute released a study
showing clinics there needed 5,500 more doctors, a number that
could rise to around 37,000 by 2019 if current trends continue.
Some 30 clinics will be visiting Prague at the end of
October to fill more than 100 positions.
According to Arne Bjornberg, chief operating officer at
Health Consumer Powerhouse, such initiatives could cause a shock
to the emerging region's health sectors.
"Rich countries should increase the numbers at medical
faculties and train their own doctors," he said. "It's downright
immoral for the wealthier part of Europe to solve their problem
with a shortage of doctors by importing from eastern Europe."
The Czech Health Ministry has said it does not expect all of
the doctors who have said they will leave to make good on their
pledge and that the healthcare sector can manage if they do.
But the Czech Association of Patients says if even 500
depart, it will put pressure on an already strained system,
restricting services, causing hospital closures, and squeezing
the availability of care.
For David Hoza, a Czech neurosurgeon who works in Halle in
Germany's Saxony Anhalt region, the choice is clear: "I am
content there. I would recommend that the others leave as well."
(Additional reporting by Reuters bureaux in central and Eastern
Europe; editing by Michael Winfrey and Charles Dick)
