Health Systems in Transition - Hungary - World Health Organization ...

Health systems in transition Hungary 107
year: for example, for the 2011–2012 period, local governments can apply for
a matching grant of over HUF 1 million (€3630) to purchase anaesthesiology
and intensive therapy equipment, with a minimum local share of 25% (2009/7).
The third component of the system used to be a budget that had been
devolved to the county councils for regional development, which decided on
the allocation of funds among various applicants. Target-type decentralized
grants (céljellegű decentralizált támogatás, or CÉDE) were introduced in 1997
(1997/13), but were eliminated in 2006 when EU funding became the main
source of capital grants in the health sector (2006/9).
For the 2007–2013 budget period of the EU, Hungary is the recipient of
€22.4 billion from the various structural and cohesion funds, out of which the
government decided to spend €1.8 billion on various health care infrastructure
development projects, including the renovation of hospitals, polyclinics and
primary care surgeries, and on the building of new polyclinics and health
centres in primary care (2006/4). In preparation for the grant agreement
between Hungary and the EU, major changes were implemented in the existing
capital financing system. Not only was the decentralized component (that is,
the CÉDE) of the earmarked and target subsidy system eliminated in 2006,
but the National Assembly also suspended new conditional capital grants and
authorized the government to harmonize actual investment decisions and
ongoing projects with upcoming EU funding (2006/11). Since 2008 the scope
of matching grants has been limited to a specific health care purpose (2007/10).
There is no doubt that EU funds have become almost the only source of capital
investment, although local governments must still make efforts to provide
the required local share. Providers often have to contribute from their own
resources (for example, income from paying services or donations to hospitals
founded by charities). It is worth noting that private providers are also eligible
for the various public grants if they supply services to the population of a local
government under the territorial supply obligation.
Other important capital financing options are the various capital grant
programmes run by the Ministry of National Resources/State Secretariat for
Healthcare to replace medical equipment or to support providers in meeting
minimum standards. These programmes also shrank during the phasing in of
EU funds. For the most part, the health sector did not participate in the largescale
public–private partnership (PPP) investment programmes initiated by the
government in power from 2002 to 2006. The only health care related examples
are two higher education PPP projects at Semmelweis University, Budapest.