Radical proposal: fewer hospitals, entirely new structure
A study prepared in 2020 at the request of the Hungarian Ministry of the Interior outlined a comprehensive reform of the country’s healthcare system. The document was produced by an international consultancy firm as part of a contract worth several hundred million forints. One of the most striking elements of the proposal was a major restructuring of healthcare institutions. According to the calculations, the number of hospitals operating in 2019 – 108 in total – would have been reduced to roughly 70 by 2035.
The number of outpatient care facilities would have decreased even more dramatically, falling from more than 500 to just under 200. The aim, according to the plan, was not simply closure but the concentration of healthcare services. The logic was straightforward: fewer institutions, but ones that are better equipped and operate at a higher professional standard.
A new patient pathway: polyclinics at the centre of the system
A key element of the reform would have been a two-tier outpatient care model. The first level would have consisted of so-called polyclinics, designed to treat the most common illnesses and accessible within a 15–30 minute journey.
The second level would have been larger, more complex outpatient centres offering diagnostic services and a broader range of treatments. These facilities would have been reachable within roughly an hour for most of the population. The hospital system would also have been reorganised: each county would have had one regional hospital, complemented by smaller local hospitals serving surrounding areas.
Not closures, but transformation?
According to HVG, hospitals that ceased to operate in their previous form would not necessarily have disappeared entirely. Many facilities would have been converted into chronic care centres, rehabilitation institutions, or social care facilities.
Plans included the creation of care homes for older people, daytime centres for patients with dementia, and other specialised social care services. The goal was to ensure that acute hospital beds were not occupied by patients who primarily required long-term care.
At the same time, the reform would have strengthened home care services and community-based healthcare.
GPs, telemedicine and higher salaries
The proposal would also have significantly strengthened primary care. It recommended a substantial increase in general practitioners’ income – potentially by 30 to 40 per cent – to make the profession more attractive and help reduce doctor shortages, according to Hungarian news outlet HVG.
To improve access to healthcare in rural areas, the plan suggested expanding the use of telemedicine. This would have allowed patients to complete certain examinations or consultations online. The role of the health visitor network – a distinctive part of the Hungarian healthcare system focusing on maternal and child health – would also have been reorganised, with closer cooperation between paediatricians and health visitors.
Why was it kept secret?
Experts say that many elements of the healthcare reform were professionally well-founded, even if some proposals remained controversial. However, the suggested changes would likely have carried significant political risks, particularly due to the planned reduction in the number of hospitals.
The document was ultimately never discussed publicly, and the government did not implement the full healthcare reform. According to the authors of the study, however, such changes could have reduced the number of preventable deaths in the long term and improved the overall health of Hungary’s population.