Abstract

Numerous investigations demonstrate that the problem of corruption in the health sector is enormous and has grave negative consequences for patients. Nevertheless, the problem of corruption in health systems is far from eminent in the international health policy debate. Hutchinson, Balabanova, and McKee have identifed in their Editorial five reasons why the health policy community has been reluctant to talk about it: (1) Problem of defining corruption; (2) Some corrupt practices are actually ways of making dysfunctional systems work; (3) The serious challenges to researching corruption; (4) Concerns that focus on corruption is a form of victim blaming that ignores larger issues; and (5) Lack of evidence about what works to tackle it. In this commentary, we pay a closer and critical look at these five excuses for doing nothing. We conclude that the vast majority of the world population, being the poor in low and middle-income countries (LMICs) who disproportionately suffer from the problem of corruption in health systems, need good people with high moral and ethical principles who have the courage to disregard these five reasons. The poor need good people who understand that it is crucial to first acknowledge this problem, despite the obvious uncertainties involved, before you can change it. The poor therefore need good editors, good policy-makers, good managers, and good clinicians. We agree with the authors that we first need to talk about corruption. But above all, we need good people who are subsequently willing to walk the talk.

Highlights

  • The editorial by Hutchinson et al[1] starts with pointing out that some issues, which are wrong by any moral or ethical framework, are seldom discussed in public

  • The authors notice that our failure to confront this problem is all the more astonishing given that numerous investigations, for instance research performed by Transparency International, repeatedly confirm that the health sector is among the most corrupt in many nations worldwide

  • In the editorial the researchers reflect on the five reasons why it apparently is so difficult for the health policy community to initiate a debate on corruption in health systems: (1) Problem of defining corruption; (2) Some corrupt practices are ways of making dysfunctional systems work; (3) The serious challenges to researching corruption; (4) Concerns that focus on corruption is a form of victim blaming that ignores larger issues; and (5) Lack of evidence about what works to tackle it.[1]

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Summary

Introduction

The editorial by Hutchinson et al[1] starts with pointing out that some issues, which are wrong by any moral or ethical framework, are seldom discussed in public.

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