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

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118 0.7 0.6 0.5 0.4 0.3 0.2 0.9 0.8 0.7 0.6 0.5 0.4 0.3 Health systems in transition Hungary Fig. 4.7 Number of dentists per 1000 population in Hungary and selected countries, 1990–2009 (or latest available year) Source: WHO Regional Office for Europe, 2011. Fig. 4.8 Number of pharmacists per 1000 population in Hungary and selected countries, 1990–2008 (or latest available year) Source: WHO Regional Office for Europe, 2011. Slovakia 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Slovakia 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 EU15 Czech Republic EU27 Austria Hungary EU12 Poland EU15 EU27 Poland Austria Hungary Czech Republic EU12
Health systems in transition Hungary 119 The salaries of health workers, especially of physicians, have remained low compared to those in other sectors of the economy and in western Europe, even after the change from the Semashko-style health system in place during the communist era (see also section 3.7.2). The practice of informal payments was and has continued to be widespread, but these are not evenly distributed among health professions or medical specialties. As a result, well-paying specialties such as surgery or gynaecology became particularly attractive to new entrants, while other specialties, such as diagnostics, public health and the paramedical professions began to exhibit general shortages well before Hungary joined the EU in 2004. The shortage of nurses and health care support personnel has forced physicians, including specialists and family doctors, to carry out nursing and administrative duties in addition to their regular responsibilities (Gál et al., 2003; Orosz & Holló, 2001). Moreover, low salaries and informal payments have kept medical doctors working well after the age of retirement because state pensions have been too low to enable decent living standards. Altogether 8.2% of practising physicians were over the age of 61 in 2007 (Ministry of Health, 2009c). Successive governments have failed to formulate effective policies to tackle these problems. Although the share of physicians working as private entrepreneurs has been increasing steadily, public employees with low salaries still form the majority. The health workforce is ageing, affecting physicians and nurses alike, and Hungary is a net donor country regarding health care worker migration (see section 4.2.2). Together, these factors have created a human resource crisis in health care, which requires increased attention by the government to avoid the collapse of the single-payer health insurance system. 4.2.2 Professional mobility of health workers Health professionals who intend to leave the country to work abroad must have their diploma certified by the OHAAP. The process is lengthy, and applicants must pay a fee. Because data on the actual number of health professionals leaving Hungary are lacking, the number of certification requests can be used to estimate outflow. Of all health professionals applying for certification in Hungary between 1 May 2004 and 31 December 2009, an estimated 4901 were physicians, 1316 were nurses, 749 were dentists and 226 were pharmacists (Eke, Girasek & Szócska, 2011). Here it should be noted that these numbers include both applicants who were residing in Hungary during this period and those who were not. Of those not resident in Hungary, the vast majority are likely to have been individuals who were already living and working in another EU Member State and required retrospective certification from their employer after Hungary
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Health Systems in Transition Vol. 1
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Health Systems in Transition Péter
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Contents Preface
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Preface The Health Systems in Trans
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Acknowledgements The Health System
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Health systems in transition Hungar
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xii Health systems in transition Hu
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xiv Health systems in transition Hu
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Abstract Hungary has achieved a suc
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Executive summary Introduction Hung
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1. Introduction 1.1 Geography and s
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18 NATIONAL/CENTRAL LEVEL REGIONAL
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3. Financing 3.1 Health expenditure
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8. Conclusions Since the mid-1990s,
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10. Appendices 10.1 References Ád
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The Health Systems in Transition pr
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The European Observatory on Health
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