Nevertheless, Gaal and McKee (2005) argue that distrust in the system could motivate health care professionals to ask for a “fair” remuneration and patients in return could accept it. The short-lived experience of introducing user fees in Hungary was partially an attempt to formalise informal payments. There is no firm evidence that user fees had an appreciable impact on reducing informal payments (Kutzin et al, 2010). While it is less likely to produce results when introduced alone, condemning informal payments as a corrupt practice publicly and seeking sanctions through the legal system or professional organisations could become a supporting pillar.