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

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Health systems in transition Hungary
health informatics, health economics, health systems sciences and technology
assessment since 2004. The Institute also helps inform health policy-making
at the national level.
The National Institute of Pharmacy is responsible for registering and
licensing pharmaceuticals (1982/1, 2006/22). The Authority for Medical Devices,
which is an office of the State Secretariat for Healthcare, runs a similar system
for medical equipment, including medical aids and prostheses (2000/5). The
Authority replaced the Institute of Hospital and Medical Engineering, which
was renamed and serves as one of several organizations responsible for quality
control and audit in this area (1990/2).
On the basis of the provisions of Act CLIV of 1997 on Health a new body,
the National Health Council, was established in 1999 to advise the government
on health policy and promote consensus on health priorities, thereby
facilitating their implementation. The members, with a four-year mandate, are
representatives of the relevant stakeholders such as professional and patient
organizations, unions and local government representatives (1997/20, 1998/28) 4 .
2.3.9 Local governments and the regional health councils
A two-tiered system of local government – that is, at the county and municipal
levels – was established in 1990, replacing the council system (tanácsrendszer)
in place previously. Since then, local governments have become key actors in
the health sector in Hungary. Although central government policy determines
the broad local policy framework, the Hungarian constitution guarantees the
right of local governments to take decisions on local affairs; disputes regarding
authority between the central and local governments can be settled by the
Constitutional Court (1989/4).
Act LXV of 1990 on Local Government defined the basic structure, rights
and duties of local governments, as well as their sources of funds. Local
governments share responsibilities based on the principle of subsidiarity. This
means that county governments take over only those public services that
municipal governments cannot undertake and are willing to transfer to the
county level (1990/3). The Act also assigned responsibility for planning and
providing local health services to local governments. The responsibility for
primary care rests with municipalities and that for secondary care with counties,
but both tiers of local government are allowed to contract out service delivery
to private providers. A large proportion of primary care has been contracted out
4 The Council is to be eliminated in 2011.