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

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Health systems in transition Hungary
is referred to as a maintenance obligation and has special relevance in cases
where service delivery has been outsourced. The types of primary, secondary
and tertiary services whose provision must be ensured by local governments are
defined in Act CLIV of 1997 on Health. The provision (and direct financing)
of certain services, however, is the responsibility of the central government.
These include public health, emergency ambulance services and blood supply.
5.1 Public health
Public health services are the responsibility of the central government, in
particular the State Secretariat for Healthcare, which is part of the Ministry
of National Resources (see section 2.3.3). The State Secretariat for Healthcare
provides these services through the NPHMOS. The NPHMOS was formed
in 1991 on the basis of the State Supervisory Agency for Public Hygiene and
Infectious Diseases, which had its origins in the late nineteenth and early
20th centuries, when the state assumed responsibility for public health, social
medicine and health administration services, to be provided by civil servants
known as medical officers. As part of the Semashko-style health system in
place during the communist era, the sanitary stations of the State Supervisory
Agency implemented successful compulsory immunization and public hygiene
programmes, which led to substantial improvements in the health status of the
population but failed to respond adequately to the transition that made chronic
non-communicable diseases the number one public health problem (see section
1.4). By establishing the NPHMOS in 1991 (1991/1), the government aimed to
address this shortcoming. Although the duties of the NPHMOS were expanded
according to modern concepts of public health, the successful public hygiene
and infectious disease control structures already in place were preserved. At
the same time as the NPHMOS was established, several health administration
duties were deconcentrated, including compulsory registration, licensing and
the professional supervision of health care providers.
The administration of the NPHMOS is divided into three levels: central,
regional and subregional (kistérség; for more details on organizational structure
see section 2.3.3). The NPHMOS is responsible for controlling, coordinating,
supervising and delivering public health services and for supervising the supply
of pharmaceuticals and the delivery of personal health services (2006/22).
The central office, also known as the Office of the Chief Medical Officer, is
responsible for planning and coordinating health promotion and prevention
programmes at the national level. It directs and coordinates public health,