By Vesselin Zhelev

waz.euobserver.com

Three-year old Yusuf Kasim from the town of Kardzhali died of appendicitis on 18 August while doctors treated him for a sore throat. They made the correct diagnosis after a six-day delay when surgery could not help any more.

On the same day, 65-year old Yordan Velichkov narrowly survived when he was consecutively refused treatment in the town hospitals of Veliko Tarnovo and Gorna Oryahovitsa, in central Bulgaria.

Officials there said they lacked the necessary specialists and advised him to look for help elsewhere. A police patrol drove the half-conscious Mr Velichkov to the nearest town of Gabrovo where doctors saved him from a life-threatening throat abscess.

These examples illustrate the dire situation of Bulgaria's health system, plagued by chronic underfunding, brain-drain and a lack of meaningful reform.

Citing lack of cash, dozens of hospitals across the country have stopped planned operations and starkly reduced treatment even of emergency cases, the Physicians' Union announced at the end of August.

It mentioned examples of hospitals where the personnel had not received salaries for four months or which had run out of essential material and were unable even to pay for the washing of bed sheets.

Union chief Dr Tsvetan Raichinov told reporters that leva (BGN) 455 million (?233 million) were missing from the coffers of the state Health Insurance Fund, to which all employed and self-employed Bulgarians are liable to make monthly contributions of 8 percent of their income.

The government, saddled with an excessive budget deficit, has failed to explain the shortage and the party of Prime Minister Boyko Borisov has blocked opposition efforts to set up a parliamentary commission to look into the Health Fund accounts.

Mr Borisov and his Finance Minister Simeon Djankov have instead met doctors and promised to find money to keep the hospitals going.

However the situation had not substantially improved by mid-September. On Wednesday, the doctors threatened to sue the Fund for BGN125 million in outstanding payments that it owes them and to call a protest rally in Sofia.

Mr Borisov's government has been repeatedly criticized for foot-dragging in the area of health reform. Needed is spending streamlining, a clampdown on corruption and mismanagement, and the closure of loss-making hospitals.

In March, Mr Borisov fired his health minister Bozhidar Nanev after prosecutors launched a probe into suspected irregularities in the flu vaccine purchases he had authorised. Mr Nanev's successor Anna-Maria Borisova has made no difference despite having paid lip service to rapid reform.

Instead, a news shock followed last Wednesday. Hundreds of cancer and HIV-positive patients have been without life-supporting medication because health ministry officials have delayed tenders for its purchase, state TV reported.

There was no explanation from the health ministry.

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