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

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122 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
Health systems in transition Hungary 123 (CEO) post or three years’ experience to be eligible for either of the other two posts. Applicants whose degree course is in progress or who commit themselves to obtain the degree within five years are exempted. Exemptions can also be granted by the owner of a health care delivery organization (2002/4), but this has to be approved by the professional governing body of the institution in question. The members of this professional governing body include the medical director, the nursing director (or senior assistant) and the heads of medical departments or the senior consultants in a matrix hospital (2003/11). The academic career path is regulated in detail in Act CXXXIX of 2005 on Higher Education, but the pay scale of the various positions is contained in Annex 2 of Act XXXIII of 1992 on the Legal Status of Public Employees. There are two to three grades in each category, and the salary is determined relative to the university professor grade 1 (100%). An assistant professor (university trainee) grade 1 earns 37% of this salary, whereas a university professor grade 3 earns 106%. The base salary in 2010 was HUF 437 300 (about €1576) per month (2009/6). Aside from general university positions, there is a separate career path for academics who work mainly on research projects. Positions consisting of at least 90% research must be defined as scientific research positions, but individuals in these positions have to take part in teaching activities as well. The starting position is the junior scientific assistant, and the most senior position is the research professor with a guaranteed salary 40% and 100% of the university professor grade 1 respectively (2005/7). The professional career path for physicians and other health care professionals is not regulated in detail by the aforementioned acts or decrees. Act XXXIII of 1992 on the Legal Status of Public Employees has no provisions specific to health care, and the related governmental decree, which regulates the health care-specific implementation of the provisions of the Act, deals only with the classification of various health professionals (physicians, paramedical workers, nurses and assistants, and non-medical jobs) into the various categories of the public employee pay scale; the categorization of managerial positions and the extent of managerial allowance as described above; and the definition and extent of health care-specific supplementary allowance (diagnostic, assistant, traumatology, intensive therapy, infectology, psychiatric and nursing allowances). For instance, recent graduates of medicine, dentistry and pharmacy are classified into category H; medical doctors, dentists or pharmacists who recently qualified in their specialization are classified into category I; clinical specialist psychologists are classified into category I; and dieticians, diploma nurses or physiotherapists are classified into category F (2010/2).
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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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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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