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

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Health systems in transition Hungary
in such a way that it encouraged the corporatization of public providers while
restricting their privatization (2001/12). The government that came into power
in 2002, however, suspended some of these restrictions (2002/16, 2002/17) and
replaced the 2001 law with a new one that gave decision-makers more room
to facilitate private investment in the health care system (2003/5, 2003/6). To
support changes in the ownership of health care facilities, the government
even offered subsidized loans to employee groups that intended to privatize
public providers (2003/12) – a clear signal that the government preferred private
investors to take a more active role in the health sector. The 2003 law was later
annulled by the Constitutional Court, however, as the National Assembly had
not devoted enough time to discussing the objections raised by the President
of Hungary (2003/23).
Increasing privatization of many health services has actually been taking
place since 1990, when dialysis services were privatized, following by diagnostic
imaging (CT-MRI) services in 1994 and laboratory services in 1998. This was
followed by a second wave of privatizations in the area of hospital background
services, such as laundry, meals, energy and accounting. Subsequently, in
2004, a third wave of privatizations, involving the entire management of public
providers, began in 2004 with the outsourcing of the management of a public
hospital in the city of Kiskunhalas to Hospinvest, a company established in
2000. By the beginning of 2009, there were eight private companies running
sixteen health care institutions (including hospitals and outpatient centres) in
this manner (NISHR, 2009).
In the second half of 2008, the National Assembly approved a law regulating
the legal status and financial management of public institutions, making it
possible to corporatize hospitals (2008/8). According to a report published
by the NISHR, 36 of the 126 state and local hospitals in Hungary had been
transformed before the 2008 law was repealed by the government brought into
power in April 2010 (2010/12) (NISHR, 2009).
In 2009, Hospinvest, which by that year was managing five local government
hospitals and five outpatient care facilities, filed for bankruptcy and was forced
to return the management rights of these facilities to the local governments. The
company had played a leading role in the privatization of management in health
care facilities owned by local governments and, as a result, its activities had led
to intense public and media debate across the country. The European Bank for
Reconstruction and Development, which had invested €4 million in 2007 into
the company and owned 30% of its assets (NISHR, 2009), had already sold its
share in March 2009, just half a year before the bankruptcy of the company