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

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Health systems in transition Hungary
elementary education or vocational training, whereas Category J requires either
a university degree plus a specialization and a doctoral degree, or membership
of the Hungarian Academy of Science (Article 61). In each category, the grade
level is determined by the years of service (Articles 62 and 64). The public
employee is upgraded by one grade for every three years in service (Article
65). In 2010 the guaranteed minimum salary in grade 1 of category J was HUF
154 000 (about €555) per month, and in grade 14 this is multiplied by 1.8725
(2009/6). Special rules apply to heads of organizational units and organizations
(managerial path), and to teachers and researchers at institutions of higher
education and at research institutes (academic path). Since 2009 managers have
been divided into two groups: (1) appointed directors (kinevezett vezető), who
are full-time managers, and (2) acting managers (megbízott vezető), who carry
out their managerial duties part-time in addition to their regular professional
work (1992/5, 2008/5). In a health care service delivery organization, this means
that acting managers (for example, heads of departments) are allowed to treat
patients whereas appointed directors are not. Individuals in the former category
receive a so-called managerial allowance, which supplements the basic public
employee salary, and managers in the latter category have an entirely different
pay scale, which consists of two levels (manager and higher-level manager) in
three categories (secondary education, higher education 1 and higher education
2). In 2010 the base salary was HUF 120 000 (about €433) per month, the
highest category had a multiplier of 2.4, and the base managerial allowance
was HUF 20 000 (about €72) (2008/5, 2009/6).
The governmental decree mentioned above regulates only the amount of
managerial allowances in the various managerial positions of health care
organizations (2008/12). The highest allowance, which is 300% of the base
managerial allowance, is for the directors working for providers of health care
services at the national level and members of their governing bodies (2010/2).
There are no higher-level managerial positions specified by the decree, however,
for which the rules of the appointed directors must be applied. Health care
delivery organizations that provide publicly funded health services must have
a four-member top management team, including the chief executive officer
and three deputies, the medical director, the nursing director and the financial
director. Outpatient providers do not have a nursing director, and long-term
or nursing care providers do not have a medical director (2003/11). Applicants
for the top management positions of publicly funded health service delivery
organizations, including the chief executive officer and the medical and nursing
directors, are required to hold a degree in health services management and have
a minimum of five years’ experience to be eligible for the chief executive officer