Part I — Situation overview

On 1 July 2026 the decision appeared in the Hungarian Gazette: Prime Minister Péter Magyar appointed a new head, in the person of Árpád Tóth, to lead the National Hospital Directorate-General (OKFŐ) — the central directing body of the state hospital network. The change of leadership is significant in itself, but it is not an isolated event. A day earlier, on 30 June 2026, at the ministry’s Semmelweis Day ceremony, health minister Zsolt Hegedűs announced: the methodology enabling the measurement, validation and public disclosure of hospital infections has been completed, and the publication of the data will start at the beginning of the autumn. On the same day a document withheld for ten years also became public: Direkt36 obtained and presented the 2015 review report, which was prepared by the predecessor of today’s National Centre for Public Health (NNGYK), the National Public Health and Medical Officer Service (ÁNTSZ).

The 180-page 2015 report — which examined more than 1,700 wards of 100 inpatient-care hospitals — revealed systemic deficiencies: according to the investigation there was not a single specialty in which every provider possessed all the physical conditions prescribed by law. The document did not name specific hospitals, and its release was not permitted for years; the paper obtained it only after the April 2026 election. From the outgoing government’s side the former health state secretary Péter Takács, in his assessment given to Magyar Nemzet, emphasised the investment performance — 93 renewed hospitals, the Healthy Budapest Programme, EU and national development funds — and disputed that no substantive progress had been made in recent years. The two readings thus paint two different pictures of the same sector: one places the renovated building stock, the other the patient-safety and infection-control deficiencies at the centre.

In MIAK’s reading the infection-measurement methodology now announced and the publicity of the 2015 report make the same deficiency visible: the data on healthcare quality have so far been neither regular, nor comparable, nor accessible to patients. Building renovation and data publication are not each other’s alternatives — the former is infrastructure, the latter makes patient safety measurable and improvable. The real question is not the change of persons but whether data publication becomes institutionalised or remains a one-off gesture.

Part II — Literature foundation

Before turning to MIAK’s concrete proposals it is worth fixing the scientific frame within which public infection-data publication can be understood. Reinhard Busse (a German health economist, professor of healthcare management at the Technical University of Berlin) and his co-authors’ volume Improving Healthcare Quality in Europe (2019) devotes a dedicated chapter to public performance reporting: according to it publicity improves care in two ways — through patients’ informed choice of institution and through the reputational incentive of providers — but only if the data are easily accessible, valid and reliable, and the coverage of institutions is high. The OECD’s Health at a Glance: Europe 2024 report gives the quantitative benchmark: in EU member states some 4.3 million people acquire a hospital infection each year in acute inpatient care, and the associated cost may reach as much as 6% of the hospital budget — that is, measurement is not only a patient-safety but also a management question. The volume Health Systems Governance in Europe gives the third layer: accountability and public information as a governance category — mere data collection is not enough in itself if it is not accompanied by answerability before the public. The detailed literature treatment — by author, with quotations — can be found in section 6.4 Literature in detail.

Part III — MIAK’s concrete proposal

MIAK proposes three measurable measures that turn the present methodological step from a one-off announcement into an institutional, irreversible system.

3.1 Enshrining mandatory, comparable patient-level data publication in law (within 12 months)

The infection-measurement methodology now announced can be launched within ministerial competence, but can also be stopped within ministerial competence. MIAK proposes that the public, institution-by-institution disclosure of hospital infection rates and basic patient-safety indicators be a legal obligation — with a frequency, a uniform methodology and risk-adjusted (case-mix adjusted) indicators fixed in an act adopted by Parliament, so that a hospital serving a more complex patient circle does not appear worse merely because of the harder cases. In the Busse frame (see 6.4.1) this is precisely the condition of “coverage and reliability”: the data works only if it is complete and comparable. Responsible: the Ministry of Health as legislation-preparer, the norm adopted by Parliament; the owner of the data is the NNGYK. Related programme point: E3 — waiting-list transparency, whose data logic is the same.

3.2 The subsequent release of withheld reports and making publicity the default (30–90 days)

The 2015 review remained withheld for ten years, and became public only on a press request, after the election. MIAK proposes that the held, still unreleased healthcare review and quality reports be published with a short deadline, in full (with personal and patient-identifying data redacted), and that in the future the publicity of such reports be the main rule, and withholding a justification-bound exception. This is not primarily about the retroactive accounting of the past but about future trust: a piece of data released only after an election becomes a tool of government risk management, not a patient-safety tool. Related programme point: A3 — the principle of the default of publicity.

3.3 Linking data publication to measurable improvement in patient care (24 months)

Publicity is not a goal but a tool. MIAK proposes that the new leadership of the OKFŐ link infection-data publication to concrete institutional improvement plans: on a ward that in the comparison persistently falls into the worse band, a targeted infection-control programme (hand hygiene, antibiotic stewardship, isolation protocol) should start, with a measurable deadline. The Busse volume warns: public reporting may also produce distorting side-effects (patient selection, indicator-optimisation), and therefore data publication must be paired with audit feedback and risk-adjusted indicators. Data alone does not heal — the institutional learning process heals.

The common principle of the three proposals: patient safety improves if we measure, compare and make it public — but only if this is a legal obligation, not the goodwill of a given government or a given leader. The present announcement is a good direction; MIAK asks that it become irreversible.

Part IV — Expected impacts and risks

Dimension Expected impact Risk
Healthcare / patient safety The visibility of infection rates incentivises infection control; patients can choose more informed Indicator-optimisation, patient selection (avoiding hard cases to improve the statistics)
Public administration Data publication becomes institutionalised; the NNGYK and the OKFŐ become more accountable Extra administrative burden if the report is not automated but built on manual data collection
Transparency / trust The release of withheld reports and making publicity the main rule increases institutional trust Experiencing publicity as “stigmatisation” — institutions may become defensive if there is no improvement support

The main consideration is whether publicity remains an incentive or becomes a punishment. If the wards that fall into the worse band are only exposed but get no support for improvement, the system may turn to defensive data-embellishment — the literature has observed this in a documented way. The proposal works if three conditions are met together: the data is risk-adjusted (so a hospital serving hard cases does not seem unjustly bad), the disclosure is legally mandatory (so it does not depend on daily political will), and a weak result is followed by an institutional improvement programme (so publicity serves learning, not stigmatisation). The absence of any one of these three conditions tips the proposal to the risk side.

Part V — Measurability and summary

5.1 What is worth tracking? (suggested KPIs)

On the basis of the following performance indicators (KPIs, in full: Key Performance Indicator) it will be judgeable whether the present step has become a substantive turn:

  • The actual start of public data publication: whether the institution-by-institution, comparable infection-data publication starts in the autumn of 2026 — suggested target: at least 80% of the acute inpatient-care hospitals covered in the first year.
  • The comparability of the data: the share of risk-adjusted (case-mix adjusted) indicators among the published indicators — suggested target: 100% of the key indicators adjusted within 24 months.
  • The number of earlier reports released: how many previously withheld review/quality reports became public — suggested target: the full set of held, unreleased reports within 12 months.
  • Improvement in the infection rate in the weakest band: the reduction of the infection indicators of the wards persistently falling into the worse band, after a targeted programme — suggested target: measurable improvement within 24 months.

These are MIAK’s suggested indicators; MIAK is not a government actor, and therefore it is worth tracking these, not announcing them.

5.2 Summary

MIAK’s message is simple: the change of leadership and the infection-measurement methodology are a good direction, but the value is not in the announcement but in the institutionalisation. MIAK asks the Ministry of Health and Parliament to raise mandatory, comparable, risk-adjusted patient-level data publication to statutory level, to release the held reports, and to link the disclosed data to institutional improvement programmes. This proposal moves two MIAK foundational values directly: transparency — because patient-safety data serves the patient if it can see it, not if it is kept in a drawer; and data-drivenness — because, as the health minister too quoted Semmelweis’s legacy, “what is not measured cannot be improved”. Precisely for this reason measurement and publicity are not an attack on healthcare but a condition of patient safety.

Part VI — Justifications and further sources

6.1 Press framing by spectrum

The public-affairs-left band (24.hu, Direkt36) framed the infection-measurement methodology and the publicity of the 2015 report from the direction of the systemic deficiencies and the earlier concealment: the emphasis was on the fact that the government had known about the problems for a decade, and the document surfaced only after the election. 24.hu presented the ministerial announcement in a Semmelweis Day context, as the ethical message of patient safety and honest data publication.

The conservative-pro-government band (Magyar Nemzet), by contrast, highlighted the outgoing government’s performance balance: in Péter Takács’s assessment the renewed hospitals, the investment volume and the development funds dominate, and the paper criticised the “empty till” narrative as political communication. The economic band (Portfolio) did not bring the topic into the leading focus on this day. The two main readings do not necessarily contradict each other: one speaks of infrastructure development, the other of the quality and publicity of patient-safety data — according to MIAK both are real, but the two do not substitute for each other.

6.2 Facts and data

Data Value Source
Hospital infection (HAI) per year in EU acute inpatient care ~4.3 million cases OECD Health at a Glance: Europe 2024 (ECDC 2022–23 survey)
HAI-related cost as a share of the hospital budget up to 6% OECD Health at a Glance: Europe 2024
Deaths caused by antibiotic-resistant infections in the EU per year ~35,000 OECD Health at a Glance: Europe 2024
Hospitals examined in the 2015 ÁNTSZ report 100 hospitals, 1,700+ wards Direkt36 (24.hu, 30 June 2026)
Announced start of public infection-data publication early autumn 2026 Zsolt Hegedűs’s announcement (24.hu, 30 June 2026)

6.3 Policy aspects

  • Healthcare (programme points) — patient safety, quality indicators and waiting-list transparency are the core of the area; the present methodology links directly to these.
  • Public administration and e-government (programme points) — data publication is sustainable if it is an automated, measurable and regular administrative process, not a one-off manual report.
  • Transparency and anti-corruption policy (programme points) — the release of withheld reports and making publicity the default is an accountability question.

6.4 Literature in detail

6.4.1 Reinhard Busse and co-authors: Improving Healthcare Quality in Europe

Chapter 13 of the volume treats public performance reporting as a distinct quality strategy. The authors, following Berwick, James and Coye, distinguish two mechanisms of effect: the path of “improvement through selection” (the patient chooses the better provider) and “improvement through change” (the provider improves because of the reputational risk). The volume, however, also honestly records the limits:

„While use of publicly reported information by patients is (still) relatively low, public reporting may lead to improvements in the quality of care by incentivizing providers and professionals to improve their practice. To be effective, information has to be easily accessible and indicators should be valid and reliable."

The authors also warn of the distorting side-effects — the risk of patient selection and indicator fixation — and therefore propose pairing data publication with audit feedback and validated indicators. In the case of Hungarian hospital infection-data publication this means: publicity alone is too little; the indicators must be risk-adjusted, reliable and complete, and a weak result must be followed by institutional improvement, otherwise the data incentivises embellishment rather than improvement.

📖 Source: Reinhard Busse, Niek Klazinga, Dimitra Panteli, Wilm Quentin (eds.): Improving Healthcare Quality in Europe (European Observatory, 2019)

6.4.2 OECD: Health at a Glance: Europe 2024

The OECD’s biennial comparative report gives the international benchmark of Hungarian infection-data publication. According to the volume, in EU member states, as well as in Iceland and Norway, some 4.3 million people acquire a hospital infection each year in acute inpatient care, and the associated cost may reach 6% of the hospital budget:

„Approximately 4.3 million people acquire a healthcare-associated infection (HAI) each year in acute care hospitals in EU countries, Iceland and Norway. HAIs lead to increases in patient morbidity, long-term health complications, extended hospital stays and mortality."

The report emphasises in the same place that the data can be meaningfully compared only in a risk-adjusted way (adjusted according to patient age, length of hospital stay and patients’ comorbidities). The Hungarian methodology fits international good practice if it applies the same adjustment — otherwise hospitals serving hard patients may appear unjustly bad, which would push the system precisely towards the patient selection to be avoided.

📖 Source: OECD: Health at a Glance: Europe 2024

6.4.3 Health Systems Governance in Europe

The volume gives the institutional layer of healthcare governance: public information and measurement become an improving force only if embedded in genuine accountability mechanisms. The authors warn of the limits of “soft” governance tools (information-sharing, dissemination of good practices, monitoring) — these can bypass the traditional accountability controls if there is no binding force and public forum behind them. In the Hungarian case this is a direct argument that infection-data publication should rest not on ministerial goodwill but on a legal obligation and public answerability: a report withheld for a decade shows precisely what happens if publicity is not an institutional main rule but the subject of case-by-case discretion.

📖 Source: Health Systems Governance in Europe

6.5 International comparison

Public patient-safety data publication has been spreading in Europe for two decades. According to the Busse volume the effectiveness of the strategy depends greatly on the possibility of provider choice: the Danish free hospital choice (frit sygehusvalg), for example, works precisely because the patient can really choose, and public data thus turns into “voting with one’s feet”. The experience of the United States, however, also warns of the side-effects: the publicity of individual surgical results there led to patient selection, while in the predominantly public-hospital-based British system this effect was less pronounced. The Hungarian system is overwhelmingly publicly financed and public-institutional — this is closer to the British model, so the risk of patient selection can be moderated if the indicators are risk-adjusted and the emphasis is on institutional improvement.

Healthcare

  • E3 — waiting-list transparency
  • E4 — prevention data programme
  • E2 — digital healthcare system

Public administration and e-government

  • KI3 — measurable bureaucracy reduction
  • KI8 — Drucker-style efficiency measurement in public administration

Transparency and anti-corruption policy

  • A1 — public-money dashboard (the principle of public, real-time data publication)
  • A3 — publicity of asset declarations (the principle of publicity as the main rule)

Suggested new programme point: Mandatory, comparable patient-safety data publication — for the Healthcare area, which would prescribe the statutorily fixed, risk-adjusted, institution-by-institution public disclosure of infection and quality indicators.

6.7 Source register

Press sources (MIAK press monitor, 1 July 2026 — topic 8):

Knowledge-base references (literature):

  • 📖 Reinhard Busse, Niek Klazinga, Dimitra Panteli, Wilm Quentin (eds.): Improving Healthcare Quality in Europe
  • 📖 OECD: Health at a Glance: Europe 2024
  • 📖 Health Systems Governance in Europe

Note: the local file path of the books does NOT appear in the blog’s visible text — only the author and the title. The file path is an internal matter of the generation process.

MIAK internal materials:

  • MIAK policy area: Healthcare (programme points; programme point ID: E3, E4, E2)
  • MIAK policy area: Public administration and e-government (programme points; programme point ID: KI3, KI8)
  • MIAK policy area: Transparency and anti-corruption policy (programme points; programme point ID: A1, A3)
  • MIAK press monitor, 1 July 2026 — topic 8, score: 72/100

Additional public data sources:

  • ECDC — Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (2022–23)

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