The cardiac surgeon at Hippocrates Hospital in Athens, Dimitris Lymberiadis, who last Tuesday requested and received from a patient’s wife a thick envelope – though with pre-marked bills – for himself and his team, as he said, represents one of the few bribery incidents in the ESY reported to the relevant authorities this year.

Despite the fact that 89% of Greeks declare in a recent Eurobarometer survey that they clearly “see” corruption in the ESY – at least as expressed through “envelopes” – the reality of official complaints shows that there is a huge gap between perception and the act of reporting and documenting the problem. Social acceptance of blatantly illegal and unethical transactions, citizens’ fear, and lack of trust in the system appear to keep the number of complaints about corrupt doctors asking for a “bribe” very low.

In Five Years
It is indicative that the 1st Health Region (YPE), which oversees 24 major hospitals in Attica, has handled only 24 cases of doctor bribery from 2020 to today. Meanwhile, in the other major Health Region of the Attica, Piraeus, and Islands basin, which has dozens of hospitals and healthcare structures, only one case of doctor bribery has been reported – involving an orthopedic surgeon in an Attica hospital.

At the same time, criminal and disciplinary procedures often overlap and intertwine, creating a long and difficult process that causes delays in issuing decisions and imposing sanctions on corrupt doctors.

“When bribery by an ESY doctor is reported, apart from the criminal case, the disciplinary procedure is also activated, with the latter moving along two parallel and independent axes. At the same time, it also proceeds alongside the criminal process. The doctor is disciplined by his own service as well as by the local Medical Association in the first instance, and in the second by the Supreme Disciplinary Board of the Panhellenic Medical Association (PIS),” says the PIS president, Athanasios Exadaktylos. Regarding disciplinary oversight, he clarifies that “each Medical Association cannot initiate disciplinary proceedings solely based on publications or accusations. A court decision or a complaint from the citizen to the Association is required. Judicial authorities usually notify the Medical Association when a conviction occurs. Disciplinary control can proceed alongside the judicial process or be suspended until its conclusion, but it must occur within a specific timeframe, within five years from the commission of the offense, otherwise the opportunity for disciplinary action is lost.”

Previously convicted for a “bribe” is the director of the cardiac surgery clinic at Hippocrates Hospital, Dimitris Lymberiadis, who was caught again for bribery.

Closure

The Disciplinary Process within the ESY
Last Friday, the day set for the trial of Hippocrates cardiac surgeon Dimitris Lymberiadis for bribery, the defendant claimed through his lawyer that an accident had caused partial immobility and prevented him from appearing in court. The complainant, through her lawyer, also stated that she could not attend as her husband needed her care, making the postponement unavoidable. The new trial date was set for Monday, September 22.

He will make the same claim – that he was not bribed – before the Disciplinary Council of the 1st Health Region (YPE), where he was called for an urgent procedure regarding his potential permanent suspension from his public hospital position. It should be noted that criminal prosecution of an ESY doctor immediately triggers disciplinary oversight within the public health system. This is conducted in three stages: initially by the hospital administration, then by the Disciplinary Council of the corresponding YPE, and finally by the Central Disciplinary Council of ESY Doctors. Mr. D. Lymberiadis, who categorically denies bribery before the investigative authorities, was suspended from his duties by the hospital administration the day after his arrest. This suspension lasts 30 calendar days.

During this period, however, the case (must) be referred to the YPE Disciplinary Council, chaired by the YPE director and including representatives of ESY doctors and the local Medical Association, other hospital administrators, and a lawyer.

Whether the doctor will remain in or out of the hospital during this period is again decided by the Disciplinary Council. In recent years, it seems that YPE Disciplinary Councils place corrupt doctors who demand and receive “bribes” outside the hospital, with continuous extensions of potential or permanent suspension decisions until the court verdict is issued.

Usually, in bribery cases, the respective YPE Disciplinary Council immediately refers the case to the Central Disciplinary Council of ESY Doctors, asking about potential or permanent suspension from the ESY, depending on the severity of the offense according to ESY disciplinary law.

In the case of the Hippocrates cardiac surgeon, the question of permanent suspension referred to the 1st YPE Disciplinary Council seems necessary as it is his second conviction. A decade ago, he was again convicted for bribery with a 10-month prison sentence and was suspended from the hospital for the same period under ESY disciplinary decisions.

Also out of the hospital is the director of Neurosurgery at Volos Hospital since 2023, with successive YPE Disciplinary Council decisions for a potential one-year suspension. The doctor, whose criminal case is ongoing, was accused of persuading his administrative subordinate to provide a false sick leave certificate to the OSE inspector just hours after the tragic railway accident in Tempi.

The decision of the Central Disciplinary Council of ESY Doctors remains “open” until the final court decision is issued, a process that often takes on average seven years. Doctors generally appeal first-instance convictions and file cassation requests when convicted in the Court of Appeals. Recently, however, a doctor in a Northern Greece hospital was dismissed, whose bribery arrest occurred in 2017.

Many Complain, Few Report
In contrast to the strong reflexes shown by hospitals and YPEs in disciplinary matters, with decisions placing corrupt doctors outside hospitals and swiftly referring cases to higher levels, citizens are skeptical and hesitant within this system.

As hospital and YPE officials tell THEMA, complaints about “bribes” are numerous but rarely signed. Citizens often rush to the administration offices, either in hospitals or YPEs, to report that a bribe was requested. However, when encouraged to also report through the police, they often back down, fearing they will lose their turn for the surgery for which the “envelope” is given or face negative treatment from other doctors. In Northern Greece YPEs, there have been cases where complainants withdrew their complaint to the administration because the doctor returned the “envelope” to them.

In major hospitals in Attica, many more oral complaints are made compared to regional hospitals. This happens because in smaller local communities, citizens more easily succumb to doctors’ demands and blackmail, fearing they will otherwise not be able to have surgery locally and will need to travel to another medical facility.

Administrators also note that the first assurance sought by citizens who ultimately decide to report the doctor, and for whom the police are notified, is that the surgery will be scheduled with another doctor, “guaranteed” by the administration.

The Cardiac Surgeon in Larissa
The Central Disciplinary Council of ESY Doctors will soon discuss the bribery case of a cardiac surgeon from the University Hospital of Larissa recorded last June.

This case received major attention as the corrupt doctor was also a professor at the Medical School of Larissa and director of his hospital clinic. In early July, the cardiac surgeon was sentenced to four years in prison, a fine, and exit ban from the country. He was suspended from duties at the hospital and referred for disciplinary review to the relevant council of the 5th YPE of Thessaly and Central Greece regarding permanent removal from the ESY, which in turn referred him to the Central Disciplinary Council of ESY Doctors.

He has also been referred to the Supreme Disciplinary Board of PIS. This cardiac surgeon remains suspended until his case is finalized. During this period, he is unpaid and cannot practice medicine privately.

A similar situation involves an orthopedic doctor from Papageorgiou Hospital in Thessaloniki, arrested last April for bribery. It was the fourth time he faced this charge and he already had one conviction (10 months imprisonment). On April 14, he was again sentenced to one year in prison with a three-year suspension.

Recent Eurobarometer Statistics

• 89% of Greeks believe corruption exists in the ESY
• The 1st Health Region (YPE), which oversees 24 major hospitals in Attica, has handled only 24 cases of doctor bribery from 2020 to today
• One case of doctor bribery was reported in the same period in the Health Region of Attica, Piraeus, and Islands