This study is an initial effort to examine the dynamics of efficiency and productivity in Greek public hospitals during the first phase of the crisis 2009–2012. Data were collected by the Ministry of Health after several quality controls ensuring comparability and validity of hospital inputs and outputs. Productivity is estimated using the Malmquist Indicator, decomposing the estimated values into efficiency and technological change. Hospital efficiency and productivity growth are calculated by bootstrapping the non-parametric Malmquist analysis. The advantage of this method is the estimation efficiency and productivity through the corresponding confidence intervals. Additionally, a Random-effects Tobit model is explored to investigate the impact of contextual factors on the magnitude of efficiency. Findings reveal substantial variations in hospital productivity over the period from 2009 to 2012. The economic crisis of 2009 had a negative impact in productivity. The average Malmquist Productivity Indicator (MPI) score is 0.72 with unity signifying stable production. Approximately 91% of the hospitals score lower than unity. Substantial increase is observed between 2010 and 2011, as indicated by the average MPI score which fluctuates to 1.52. Moreover, technology change scored more than unity in more than 75% of hospitals. The last period (2011–2012) has shown stabilization in the expansionary process of productivity. The main factors contributing to overall productivity gains are increases in occupancy rates, type and size of the hospital. This paper attempts to offer insights in efficiency and productivity growth for public hospitals in Greece. The results suggest that the average hospital experienced substantial productivity growth between 2009 and 2012 as indicated by variations in MPI. Almost all of the productivity increase was due to technology change which could be explained by the concurrent managerial and financing healthcare reforms. Hospitals operating under decreasing returns to scale could achieve higher efficiency rates by reducing their capacity. However, certain social objectives should also be considered. Emphasis perhaps should be placed in utilizing and advancing managerial and organizational reforms, so that the benefits of technological improvements will have a continuing positive impact in the future.

Along with the other Southern EU member-states, Greece has moved from a country of emigration to become a migrant-receiving country. The influx of migrants occurred during the 1990s, following the dramatic events in Eastern Europe and the former USSR, with the majority of immigrants being clandestine. The bulk of the immigrant population are nationals of neighbouring Balkan states, predominantly Albanians. Coinciding with the influx of immigrants from the Balkans into Greece were flows of Greek foreign direct investment, or FDI, in the opposite direction. Both phenomena are to be understood as sides of the same coin, and reflect the search for cheap labour on the part of Greek enterprises. In this article, we examine both phenomena. We present empirical material on Balkan immigrants to Greece, focusing on the demographic, housing, employment and other characteristics of the principal immigrant community in the second largest Greek city, i.e. Albanians in Thessaloniki. And we examine Greek investment to the Balkan countries, pointing out complementarities where appropriate.

The dominant characteristic of the process of pension reform in Greece is policy immobility: key measures rationalising the public PAYG pension system have been characterised as ‘extremely urgent’ for the last half-century and remain so today. This policy immobility – or ‘reform by instalments’ – is explained on the basis of key structural features of the Greek pension system, chief amongst which is fragmentation. These features allow short-termism of political actors to thwart reform efforts and to rely on external stimuli to initiate progress. Experience since the mid-1990s, despite some early promise, has largely confirmed traditional patterns.