Hungary’s ageing health system suffering traumatic personnel loss [Advocacy Lab Content]

The professional standards of Hungarian healthcare providers are under scrutiny following the introduction of a new framework of healthcare regulations. An ageing population is being cared for by an ageing medical workforce.

Ageing populations pose a double threat to healthcare systems across the EU, but especially in Hungary, with older patients on one side, and ageing health professionals on the other – one-in-five Hungarian doctors are approaching retirement age.

A growing number of older patients with a multi-morbidity of complex medical problems and a healthcare sector facing a serious shortage of medical professionals in the coming years due to retirements is being met with a reduction in hospital capacity.

Since the pandemic, the proportion of ageing physicians in Hungary has started to rise again – more younger doctors are choosing to work abroad.

According to the State Secretary for Health, Péter Takács, after the implementation of the new healthcare regulations package, healthcare providers nationwide are checked whether they meet the minimum personnel and infrastructural requirements.

He admitted: “In the capital’s hospitals, acute inpatient care has been cancelled more and more recently, so the patient would sometimes lie in the ambulance for hours until a hospital finally picked him up.”

Ageing is a challenge

There’s also a rise in hospital wards being closed due to a lack of staffing.

Obstetric care may cease at the hospital in Veszprém due to a shortage of doctors, two retired doctors currently treat patients.

In the hospital in Kecskemét, hand surgery, orthopaedics, mammography, and allergology departments have been suspended since March. While in the hospital in Csorna, neurosurgery outpatient care has stopped because of insufficient personnel.

In April, it was announced that in a hospital in Siklós, pulmonary care would only be available for eight hours a week due to a lack of human resources.

There is no physician age limit in Hungary, physicians can decide for themselves how long they will continue working, though their licenses must be renewed every five years.

Hospitals plagued by shortages

Hospital departments are being closed due to a lack of staffing, and 700 GP practices are vacant, according to the National Health Insurance Fund.

Hungarian Chamber of Medicine’s data show that most general practitioners are currently between the ages of sixty and seventy-one; there are 1,616 of them, with 859 general practitioners over the age of seventy, and 61 family doctors who are already in their eighties. There are also two who are in their nineties.

The statistics also revealed that the proportion of female doctors rose to 58 per cent last year from 51.4 per cent 20 years ago.

In the next ten years, many physicians are expected to retire but won’t be replaced, aggravating the situation further. “We have lost the motivation of the old, professionally varying standard of general practitioners somewhere, too,” Balázs Rékassy, a health economist, told ATV news.

The nursing field has also been impacted. The number of nurses aged 35-44 decreased from 30,600 to 21,500 in 2017-2023, while those aged 50-54 increased from around 15,000 to close to 19,000.

Based on Independent Health Professional Organization data, in 2022, only 25 per cent of the graduated nurses took jobs in Hungarian healthcare.

Mihály Pálosi, head of the National Health Insurance Fund (NEAK), said at the Hungarian Hospital Association’s Conference that “Currently 47,000 patients are waiting for surgery in Hungary, 7,000 more patients in May 2024 than in April last year,” reported Economxed.

Doctors move abroad

Last year, nearly 800 physicians applied for official certificates to work in Germany, Austria or England, among other countries, the Hungarian Hospital Association stated.

According to the Hungarian Medical Union, despite doctors receiving a salary increase, the problems of the healthcare system have not been solved.

Hanna Páva, Head of the Human Resources Development Hospitals’ Directorate, delivered a speech at the XXXV Congress of the Hungarian Hospital Association, in which she highlighted that the migration trend among physicians is not changing at present.

Since salaries were settled, the reasons for leaving the country are no longer financial, but other health system conditions are driving doctors abroad – extra workload, and burnout syndrome among medical professionals are prevalent.

Reducing capacity in hospitals

The government’s HUF 200 billion (about EUR 508 million) allocation for salary increases for 84,000 health professionals continued in March, with a 20 per cent increase in the average basic salary after an 18 per cent increase last July. The former, less transparent wage system was simplified by incorporating various allowances into it.

Hungary spends only five per cent of its GDP on healthcare, while equally developed countries spend around eight per cent.

At a recent conference, Péter Takács said that hospitals are changing their functions and that capacity needs to be reduced in many places. He said: “The healthcare system must be tailored to the size of the country.”

According to Takács, reorganisation plans are needed as “Smaller or unfilled GP practices would be merged or eliminated, and new district boundaries are to be decided.”

There will be regional and city hospitals, but “City hospitals would be significantly transformed, as only one-day surgeries, internal medicine, obstetric and emergency care, and prevention activities would remain there. Equipment and human resource intensive care would be concentrated in regional hospitals.”

[By Zsolt Kopári, edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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