The head of the Niš Clinic for Cardiac Surgery, Dragan Milić, became known to the general public at the beginning of last year, when he and his team, with free work for twelve weekends, managed to abolish the waiting list for surgery at his institution. This move was strongly welcomed by a large part of the public, while a smaller part - took it to heart. For not very clear reasons, the director of the University Clinical Center Nis, Zoran Perišić, and the minister, Danica Grujičić, harshly criticized the unquestionably humanitarian act.
The criticism was followed by a whole series of "unpleasant things" that Milić and his associates perceive as an organized, fierce, political campaign. Apart from the media attacks, strange criminal charges were filed against them, to say the least, the police interrogated them on several occasions, and then Milić was removed from the position of vice-dean of the Faculty of Medicine in Nis. And that's not all: the decision was made that there is no place for him at the university. The climax was reached a few days ago - the administration of the University Hospital Nis made it impossible to procure reagents for the laboratory of the Cardiac Surgery Clinic, which is why it had to stop its work. Patients are at risk, and a new waiting list will be created. Milić considers waiting lists to be the cancer of our healthcare system.
Although the final decision has not yet been made, it is very certain that the citizens of Nis will be able to vote for the Group of Citizens led by our interlocutor and his associates in the upcoming local elections. If the opposition agrees to boycott the elections due to bad, i.e., unchanged conditions, this list, as Milić tells us, will not be on the ballot either.
"WEATHER" What is this really about?? How to explain the relationship of the Administration of the University Hospital Nis to your clinic, that is, the attitude of the Medical Faculty of Niš towards you personally?
DR. DRAGAN MILIC: This is a campaign led by the Serbian Progressive Party, especially its Niš part, and the head of the UKC and the dean of the Faculty of Medicine are only the executors of the work. What is happening to me, that is, to us, is also happening to people in other places, under the motto: kill each one of his own! Their problem is that they were not quick and efficient enough to scare and silence us. Some people in Niš, and not only in Niš, go through the same or similar things in public companies, schools, post offices, kindergartens... Therefore, this is not just a story about me and my colleagues, but the case of many, who are not as visible as we are. Unlike others, doctors have a greater chance to go public and share their troubles with citizens.
photo: lenka pavlović...
Pa, What is the essence of the conflict?, or campaigns, what do you call it? Why are you bothering them??
The first, basic "crime" is eliminating the waiting list. We hear from the authorities how it bought thousands of mammograms, scanners, magnetic resonance imaging, how it built, renovated and painted numerous health facilities, and so on. And I ask them: well, if you are so successful, why are there still waiting lists that for many people, especially those who have no money, mean certain death? Isn't it a shame that people wait so long for treatment? Those who have money go to private treatment, but what will we do with the poor? Are we living in a time when only the rich have the right to health care? The disease is commercialized, private clinics are advertised on billboards around us, and health has become the most expensive product! When we abolished the waiting list, we believed that it could be an example for others, that they too, in accordance with their possibilities, should make an effort and eliminate the famous lists, so that we can finally be doctors worthy of a white coat. The health system could have organized and helped. But it became clear, especially after the brutal attacks on us, that the health system doesn't want that, and let them do whatever they want.
Why?
I don't have a precise answer. Is it about the support of the private sector? I don't know. In any case, waiting lists are an incredibly big problem spread throughout the country, and this can be seen from the huge support we have received and which we receive every day from all parts of Serbia. They are actually a cancer-wound of the healthcare system, and they also show what our society is like, what are its values. If you are poor, then you have no right to treatment, but if war breaks out, we will mobilize you while the children of the rich will be protected. It is an injustice of cosmic proportions. Well, when we dared to announce it in some way publicly, many people looked down on us. Our case, that is, the attack on us was also a demonstrative link: they wanted to prevent others from doing the same.
Since, I guess, and other reasons for attacks?
They were also annoyed that we referred to the statements of the Minister of Health, Danica Grujičić. I remind you, upon taking office, she promised that the waiting lists would be abolished. She was the one who said that all those who are eligible for a pension must retire, and that young health workers who are now fleeing Serbia should take their place. I supported all that, I hoped that those promises would be fulfilled, but that did not happen. Waiting lists, we see, still exist and are getting bigger, and those who have met the conditions for pension are still working. But not as doctors, but as leaders, and doomsday leaders. Their functions will obviously last until the day of judgment. So, our second sin is that we reminded of the minister's promises. And she said, for example, about the director of the University of Nis, who turned 65 in February, that he should continue to manage the institution because he "knows how to do it". Now we see how he knows, because of him our clinic ran out of reagents. On the other hand, the Clinical Center employs 3.500 people. And no one else knows how it works? Come on, don't joke! She also said that he should prepare a successor in the next two years, as long as she extended his office. That is a scandalous statement! So, are health care positions some sort of monarchical functions? Where will we end up if executives choose their successors?
And how much they were bothered by the announcement that you will enter politics, that is, that you will participate in the local elections in Niš in some format?
Yes, that's the third thing. When we saw that, unfortunately, we could not achieve any of our goals other than to enter politics and when we publicly announced our intention, the campaign began to intensify. They are kicking me out of the faculty, I am no longer a vice dean, they are illegally delaying my appointment as a full professor, and so on. Tragicomic criminal charges are also coming. With all their might, they are brutally breaking the law in order to deal with me and my associates. However, in spite of everything, we did not expect that their attack would go so far that the patients suffer, that their lives are endangered, that is, that they take away the reagent without which we cannot work. Such a scandal is unparalleled. I've been working at the University of Applied Sciences in Nis since 1995 and I don't remember anything like that. There was no such thing in the announcement. Just amazing and scary!
We will return to your political involvement later. Now I'm interested in what he recommends for managers in health care institutions? What are their qualities, so they are "immortal functionaries", What did you once call them??
For one, you have to be a party henchman. The whole of Serbia is prey to politics, parties and politicians. When the elections are over, they distribute businesses, resources, institutions as the spoils to be distributed. Once someone takes office, they are there for 12 years. Look at how many directors and chiefs there are who should have retired a long time ago. I guess they are the only ones who are authoritative, there is no one else. And in fact, there must be someone in office who has been verified, in whom they must have confidence, who will be an evet-effendi, a noob, who will carry out all orders, whose first priority is not the interests of patients and citizens, but the party.
When you canceled the waiting list, many warned that it was a systemic problem, which you are now confirming. And that it must be solved in a systemic way. Do you agree with our interlocutor in the last issue?, public health expert Predrag Đurić, who said that the healthcare system in Serbia experienced a cataclysm a long time ago and that in his life how much-only the enthusiasm and effort of doctors and health workers sustains so much?
Yes, I agree that the healthcare system has experienced a cataclysm. It's not too hard a word. I would add that it is kept alive through enthusiasm, but also through a kind of inertia. I would also like to add that, as rotten as it is, it is maintained thanks to the possibility of doctors to have a dual employment relationship, that is, they can work in both state and private clinics at the same time. Dual employment is a direct conflict of interest, visible from the plane. How many, for example, are there directors and heads of state hospitals who are also owners of private clinics! And that's not normal. The government, however, will say: well, that's fine, they work in state clinics in the morning, and take a lot of care of them, and in the afternoon they develop their private business. Come on, please, let's not be naive! Do we live Monty Python's Flying Circus or Alan Ford? We also have Superhik, who steals from the poor to give to the rich.
I grew up in the old Yugoslavia, a country that I love very much, that had its flaws, but where we could be human and know what is something that is valuable and what is something that is unacceptable. We knew that human life represents the greatest value. Meanwhile, we forgot about it. I keep asking if someone can tell me the value of a human life, and no one wants to answer that question. How much money can we spend to save someone's life? Why do we allow such a blatant conflict of interest, such as dual employment, to take place? Why are there waiting lists? Is it so that some could work privately in the afternoon, to treat patients who cannot wait for their turn in state clinics and still have money? I guess some must have income during the afternoon as well because they are used to extra earnings? With waiting lists, we force people to seek private treatment. And where is the poor? Only when the waiting lists are cleared will anyone have bragging rights for investing in the healthcare system!
By the way, in state health institutions, various much-needed medical devices are often not in operation. And in private ones, look at the miracles, they never break down. How do all those private magnetic resonance and ultrasound machines work without problems, while in state health institutions they are broken little by little? Who's crazy here? This is not a system, this is a ruin of a system.
The problem is, Many people point out, and the mass departure of doctors and health workers from Serbia...
Of course. However, people don't just leave here for financial reasons or because they have much better working conditions somewhere. They will not experience harassment from party henchmen. We will not be able to recover from all this not for years, but for decades.
The issue of changing the health system is complex, we don't have much space now to elaborate on what should be done in that regard. I would like to ask you something though.: how to solve the problem of private and public relations in healthcare, Speaking of which?
Actually, the answer is simple: equalize private and public healthcare. Let the market solve the matter, but only when there is no waiting list. Patients should then decide where they will be treated. But do you know what the problem is with private healthcare in Serbia? It mostly cures cosmetic problems. There are private clinics that perform difficult but not complex operations. Why? They will not get into a situation where they charge, say, ten thousand euros, and then someone loses their head. The most complex operations are performed in public health. And then we will operate in the private sector on cysts, veins, gall bladders, things that we can charge well without having much responsibility. If there was no state healthcare, even patients who have money would die en masse.
The solution, therefore, lies in the equalization of services, the equalization of prices, but before that, the possibility of a dual employment relationship should be abolished. Because that, I repeat, is a conflict of interest. It's just not normal. We were accused of working on weekends to get off the waiting list. Like, there is Burn out syndrome, we are overworked and cannot perform operations well. How is it that something like that applies to us, and not to those powerful doctors who work in state clinics in the morning and in private clinics in the afternoon? Obviously, money solves the problem of fatigue. This kind of weird system suits quite a few people and that's why we go through the way we go.
Let's go back to political engagement. You said that you are getting closer to the decision to participate in the local elections in Niš, that you will lead the list of citizens' groups?
All this we are talking about is literally forcing us to enter politics. How are we going to solve all these problems differently? How are we going to prevent Niš from remaining a black hole in the healthcare system, and not only the healthcare system, when all important decisions are made by politicians, not experts? How is it possible that the citizens of southern Serbia do not have the right to organize a health system like Belgrade and Vojvodina? Why does Niš have no clinical-hospital centers and institutes? We have estimated that we can fight for all that only if we get into the political mire. We have been talking about problems for years, asking them to be solved, but no one listens to us. Our clinic survives only thanks to the donations we receive from abroad. Without that, I don't know what we would do. And at the same time, the government says that it invests billions of euros in healthcare. How can some of that money not reach us and others who work in extremely difficult conditions? Not only our clinic has problems, but also others in Niš, and not only in Niš, but people there are silent for fear of going through what we are going through. We believe that the citizens of Nis will recognize us, that they will say: well, these are people who have done something good and who really want to fundamentally change things. We also believe that, if we have the opportunity, we will solve all the waiting lists in the Clinical Center in Niš within six months.
When you speak in the first person plural, Who exactly are you referring to?? Who are the people who will be on your election list?, I guess it's not just those who work at your clinic?
The core will be people from the clinic. I have infinite trust in them, and they have in me. We have been working and fighting together for 15 years. But, of course, it won't be just them. There will be other doctors, lawyers, journalists, people who are experts in other fields. And what unites us? We want to change the freakish system, which is ruled by the NN persons who destroyed our city. They have to go.
Who are these unidentified persons??
Progressives from Nis. Twelve years in power is a very long time, and during that time they have shown that they know nothing, that they are completely incompetent. It's time for them to rest a little. If they knew something, I guess they would have shown it by now. We talked about the cataclysm of the healthcare system, which is the most visible in Nis, out of all the big cities. In addition, in Niš, for example, there is not a single street without potholes. Niš has a significantly lower average personal income than the national average. We have 30-40 thousand less earnings than the people of Belgrade and Novi Sad. The budget of Nis is about 15 billion dinars, Novi Sad 45, and Belgrade 205. Belgrade and Novi Sad are getting new residents, and Nis has lost 10.000 of them in the last ten years, even though people from all over southern Serbia gravitate to our city. South Serbia is dying, there are 85 fewer of us than ten years ago. If that's not a red flag, I don't know what is. All of these are the results of the policy of NGOs, that is, progressives. We will not be silent about it for the sake of some kind of intellectual comfort and regardless of the consequences.
photo: lenka pavlović...
You fiercely criticize the progressives, and some from opposition circles claim that you will actually be progressive in the next elections in Nis "Trojan Horse". How about that?
Citizen groups obviously bother everyone. We have built our lives and our careers outside of politics, and we have face. Everyone carries their own cross and everyone chooses their own path. We can only deceive our patients, our citizens and our friends once. And never again. Do you think it can be paid for? Believe me, when it comes to us, it can't. There is no price for which I will sell myself and change my beliefs. Because if I do that, what kind of example am I setting for my daughter or the students I teach the Hippocratic Oath and how the patient is the most important thing. When a student enters the operating room, the first question I ask him is: who is the commander in the operating room? Is it the surgeons, the anesthesiologist or someone else from the large team? They usually say: well you, you are the operator. I say, no. Then they say the anesthesiologist, he gives the green light. Wrong answer again. The main patient on the table is the commander. When we learn that, we will have a future. Otherwise, no.
The funniest thing is that we are called a "Trojan horse" by those who have changed five or six parties so far. Some of them had various benefits from the progressive government.
Who are your possible political partners then??
Our partners are all those who are advocating for the change of the monstrous government in Niš, which destroyed the city and turned it into a ghetto.
As far as I understand, you rule out the possibility of pre-election coalitions?
We had talks with some people from the opposition, we reached an agreement that was broken the very next day. In addition, this horror-campaign against us has been going on for months, expulsion from the faculty, destruction of the clinic, senseless criminal charges (because, imagine, we did scientific research work during the pandemic or because we are not in some kind of video-surveillance system), and no one from the opposition spoke up because of all that and said that what was being done was inappropriate. And now they say we are a "Trojan horse"!? All that, however, will not prevent us from cooperating with the opposition parties after the elections, but on a sound basis. The goal is not only to change the freakish government, but also the freakish system, i.e. partocracy and centralism. The commander and remote control of local politicians must not be in Belgrade. I guess we in Niš also have the right to think and organize our own lives. In the end, Belgrade itself was destroyed by centralism. Serbia is a hydrocephalus organism, there is a huge head that eats the body. Then he dies. The body cannot handle such a big head. Serbia must decentralize in order to survive. If we do not abolish centralism, if we do not carry out departmentalization, if we do not return expertise and responsibility, we have nothing good to hope for.
When you talk about decentralization, you will hardly be able to realize it even if you are part of the local government in Niš. Who are your possible partners on that project??
We sincerely hope that similar political forces will appear in other areas, that we will create a broad front for the decentralization of the state and the partisanization of society. We are sure that there are many people throughout Serbia who think the same or similar to us. The problem is fear. When we drive away fear, when the light comes on and when the darkness is not so strong, you will see that the so-called wake up the inside. Right now, the pain is everywhere. It is even easier for us, because Nis is still a big city, it is more difficult to carry out terror here than in some other, smaller place. It is easier for us to be brave and organize.
By the way, of all the political actors, I support the people gathered around ProGlas the most. Because they are professionals and professionals. I didn't sign ProGlas just because I think their step is up in the air. They had to go all the way and engage more concretely politically. I think it's a mature core worth rallying around.
When you mentioned ProGlas, this initiative came out with a list of minimum election conditions. They believe that it is not worth going to the next elections if those conditions are not met. What's your take on that?, what will you do if the opposition parties decide to boycott the local elections?
We will certainly stand in solidarity with the majority. We will not be the ones to undermine the common position. We will not be free shooters. However, I am sure that the next election will be different. Too much attention is focused on Serbia at the moment, there will be a lot of microscopes. Any chess combinatorics will not go unnoticed.
