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

Health systems in transition Hungary 37
The role of the central government as the direct provider of services has
continued to decrease since the mid-1990s, but its role as a funder (see subsection
Revenue collection in section 6.1.2), purchaser and regulator has grown. Indeed,
successive governments since that time have gradually restored more central
control, mainly focusing on the NHIFA as a way to limit health spending. For
example, whereas the supervision of financing for health services and the
control of the NHIFA were delegated to the Health Insurance Self-Government
in 1993, these duties were reassumed by the central government in 1998.
Another example is the regulation of the medical profession, which was partly
delegated to the Hungarian Medical Chamber in 1994, but partly centralized
again in 2007 when the government abolished compulsory membership in
the Chamber for practising physicians and withdrew some of the Chamber’s
disciplinary rights (2006/7). Similarly, the consultation rights of the Chamber
of Pharmacists in the licensing of new pharmacies was curtailed with effect
from 2007 (2006/8).
However, there have also been developments in the opposite direction.
Successive governments between 2002 and 2010, for example, have revitalized
the idea of regional planning and development, providing the legal basis and
financial support for regional health councils entrusted with the elaboration
of regional health plans on a voluntary basis (2003/4) (see section 2.3.9 and
subsection Capacity regulation in section 6.1.1).
With regard to health care providers, although the legal background for
the different types of privatization was created in the early 1990s, significant
privatization has taken place only in primary care (section 5.3) and among
pharmacies (section 5.6). A few hospitals have been given back to their original
church owners and are run on a non-profit basis, but the majority of providers
of specialist health services remained in local government ownership. In
secondary outpatient care, many physicians offer part-time private clinics in
addition to their public sector employment. In addition, some private polyclinics
have been established, where patients pay for services out-of-pocket. The role
of private capital in inpatient care remains controversial in Hungary and is
described in detail in subsection Ownership and management of health care
providers in section 6.1.1.