Report of the deliberative event “How to eradicate informal payments in the healthcare sector?”

09. January, 2022

On 4 December 2021, the Ministry of Health of the Republic of Latvia, in cooperation with the Providus think tank, organised an experimental consultative event to develop solutions to the problem of unofficial payments, including gifts, in the Latvian health care sector. This measure was included in Latvia's Fourth National Open Government Action Plan for 2020-2021 as a special commitment (pilot project for good practice in participation and citizen involvement).



Full event’s report can be found here!


One year before the event, in September 2020, the SKDS research centre commissioned a survey requested by the Ministry of Health, the Providus think tank and the Friedrich Ebert Foundation, the results of which showed that in the last two years, 18% of Latvians have given a gift or money to medical staff in addition to official payments for health services. Although the most common motivation for such a gift has been a desire to say “thank you”, many gift givers wanted to gain confidence that in this way the service will be received faster, the service itself – better quality, attitude – kinder. It is also worrying that only 65% of Latvians believe that an informal payment to medical staff is never acceptable.


In order to find a solution to the problem of unofficial payments, the Ministry of Health, for the first time as a Latvian state institution, used the deliberative consultation method – the full-day discussion was attended by 32 Latvians selected according to demographically representative criteria, representing different age groups, different regions of Latvia, as well as different mother tongues. Their task: to develop recommendations for solving the problem of informal payments during the day as part of a moderated event.


This is the first time that the Ministry of Health has used this type of public involvement – deliberative consultation – in organising policy planning. Deliberative consultation methods are now becoming an increasingly popular method in various parts of the world for listening to the experiences and ideas of people who do not usually participate in public debates. In France, for example, proposals have been made to tackle the climate crisis, and in Ireland, recommendations have been made on abortion and gender equality. Today, 800 citizens in the European Union are making recommendations for Europe’s future. As this method is experimental for Latvian state institutions, representatives from other state and local government institutions participated in the 4 December event as observers.


The event was financially supported by the Active Citizens Fund, the British Council Latvia, and the Friedrich Ebert Foundation.

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