Cash in envelopes for doctors: gratitude or crime? The habit persists in Latvia
Industry experts on Latvian Radio say the practice of handing doctors cash in envelopes has not disappeared. Some gifts are genuine thanks, but at other times they reflect hopes of buying better care — something the system should never allow.
Latvia's healthcare system continues to suffer from a shortage of funding, leaving patients facing long waiting lists for appointments and procedures. According to industry specialists, this situation creates fertile ground for illicit dealings aimed at bypassing the official system.
The Latvian Radio programme "Kā labāk dzīvot" discussed how widespread the habit of giving doctors or other medical staff cash in an envelope still is. Experts note that this tradition has not disappeared from society, even though it carries legal and ethical risks.
Gratitude versus an attempt to buy advantages
Specialists explain that some such gifts can be seen as a genuine expression of gratitude rooted in a long-standing cultural tradition, with patients wanting to show appreciation for help received. However, there is another category of cases where envelope money is given with a specific expectation — to secure faster or better-quality care than what every patient is equally entitled to.
Industry representatives stress that this kind of practice is fundamentally unacceptable, as it undermines the principle of equal access to healthcare and can be considered a criminal offence. The length of waiting lists and the lack of funding in the system are cited as factors that indirectly encourage such practices, leaving patients feeling that quality care may be harder to obtain without an extra incentive.
Participants in the broadcast called for a clear distinction between honest gratitude and an attempt to purchase advantages, since the latter can damage both trust in the system and the interests of other patients waiting in line for the same service.
