Part I — Situation overview

Health minister Zsolt Hegedűs declared on 11 July 2026, in a joint video report by Deutsche Welle and Telex: a minimum 20–25 percent pay rise is needed in healthcare. The minister also spoke about new ministerial commissioners, the reduction of waiting lists, a patient-centred system and the appointment of hospital directors. The announcement is a focal one because in the Tisza government an independent Ministry of Health oversees the area — so the pay rise is not a professional wish, but a question placed on the governmental agenda.

The pay question, however, arises in the midst of an acute care-security crisis. In the Budapest Uzsoki Street hospital maternity care stopped for around ten days: according to the news it is expected to operate again from 20 July, after the air-handling equipment — an old-type fan ensuring the circulation of the air — broke down. A few days earlier one of the investments of the HUF 3.6-billion package earmarked for hospital cooling systems had been presented at the very same place. In the Bajcsy-Zsilinszky hospital meanwhile — according to the report of RTL Híradó — those arriving at the emergency department waited on outdoor benches, in air-conditioned military tents, because a new computed tomography scanner (CT, that is, a layer X-ray) is being installed in the building; according to the institution the new machine will be brought into operation by 23 July. These two cases are not an isolated malfunction, but a symptom of the fact that the system operates without reserves and reserve capacity: a single technical failure can paralyse a whole ward.

The third strand is the private sector. According to Portfolio’s 8 July 2026 market survey the largest private healthcare providers confidently increased their revenue in 2025, consolidation intensified, and the market reached close to a total revenue of a thousand billion forints. MIAK’s reading: the pay rise is a necessary and long-overdue step, but in itself it solves neither care security nor equitable access. The problem of Hungarian healthcare is not a single number, but a structural imbalance — pay, workforce retention, the burden on primary care and the private–public boundary move together, and can only be settled together as well.

Part II — Literature foundation

Before turning to MIAK’s concrete proposals, it is worth fixing the policy frame in which the effect of the pay rise can be assessed. According to the OECD (Organisation for Economic Co-operation and Development) Health at a Glance: Europe 2024 report, in 2022 the EU faced a shortage of some 1.2 million doctors, nurses and midwives, and for retention, alongside pay, the improvement of working conditions is also indispensable — that is, pay is important, but not a sufficient tool. The American nursing researcher Linda Aiken and her co-authors demonstrate, in the 66th policy brief of the European Observatory on Health Systems and Policies (European Observatory), that nurse retention requires not individual but organisational-level, coordinated interventions, and that foreign recruitment is only a semblance of a solution. Edwards and his co-authors argue, in the 74th brief of the Observatory, that the performance of urgent and emergency care improves not in itself, but through strengthened primary care. And the IMF’s (International Monetary Fund) 2025 Fiscal Monitor report shows that a smarter allocation of public spending — the reallocation towards human capital — increases the return even without expanding the total budget. The detailed literature treatment — by author, with quotations — can be found in the 6.4 Literature in detail section.

Part III — MIAK’s concrete proposal

MIAK proposes three measurable measures that fit the pay rise into a lasting retention and care-security programme.

3.1 Closing the nurse–allied-health pay gap and a clinical career path (within 3 years)

The 2023 doctors’ pay rise moderated the emigration of doctors, but the settlement of allied-health pay was left out, and so the system became “top-heavy”. Along the nurse-retention package (E6) MIAK proposes raising the minimum pay of nurses and allied-health staff to 65 percent of the doctors’ minimum pay over three years, in parallel with a clinical — not managerial — career path: with specialised clinical expert, research-nurse and specialist-hospital-nurse positions. This builds directly on the evidence of Aiken and her co-authors, according to which retention depends, alongside pay, on professional autonomy and advancement as well (see 6.4.2). The closing of the pay gap is financed by the National Health Insurance Fund Manager (NEAK) — the estimated HUF 80–100 billion annual additional expenditure is, over the medium term, fiscally neutral or positive with the improvement of retention and the decrease of doctor overload. It is expedient to set pay onto a track along the regular guidelines of a tripartite wage-bargaining forum (FO10) built on productivity and cost-of-living data, so that the settlement is not a one-off gesture, but a predictable process.

3.2 Strengthening primary care and relieving the emergency department (12–24 months)

The case of Uzsoki and Bajcsy cannot be solved purely by expanding hospital capacity — a significant part of the emergency congestion stems from the fact that patients end up in hospital because of weak or unreachable primary care. MIAK therefore proposes strengthening the capacity and on-call system of family-doctor care: practice-based, local triage (emergency classification), primary care outside surgery hours and the speeding-up of hospital discharge to resolve the “exit block”, that is, the congestion caused by the lack of a freed-up bed. Linked to this is the system of real-time, public waiting lists (E3), which directs the patient to the institution with the shorter queue, and gives an automatic alert when the clinical threshold is exceeded. The workforce-side cover is provided by the targeted retraining programme sharpened for healthcare (FO3), speeding up the entry of nurses and assistants. The system approach is grounded by the finding of Edwards and his co-authors: urgent and emergency care can be improved not in isolation, but with the joint reform of primary care and hospital discharge (see 6.4.3).

3.3 The transparent separation of private and publicly financed care (autumn 2026)

The concentration of the private sector raises the question of equitable access: if access depends on ability to pay, not on need, that weakens the universality of the system. MIAK proposes that the settling of the state–private relationship promised by the minister himself for the autumn should be given a transparent, data-based frame. Concretely: the unified, mandatory patient-satisfaction and care-quality data platform (E2) should extend to private providers as well, and the money flows of publicly financed and privately financed care should be itemisedly, publicly separated — so that it is visible where the public money goes, and where private and public care cross patient pathways. The publicity of waiting lists (E3) is a key here too: without it, “voting with one’s feet” — the free choice of institution — remains blind. This separation is not the squeezing-out of the private sector, but the clarification of the rules: the state is at once regulator, financer, competitor and training provider, and these four roles must operate in a transparent order free of conflicts of interest.

The common principle of the three proposals is allocative efficiency: it asks not simply for more money, but for more smartly allocated money into healthcare. Pay is the entry ticket of retention, the career path and primary care are the conditions of lasting operation, and the transparent separation is the guarantee of equitable access — the three together turn the pay rise from a short-term gesture into lasting care security.

Part IV — Expected impacts and risks

Dimension Expected impact Risk
Budget Closing the allied-health pay gap improves retention; over the medium term, with the decrease of overload and replacement costs, it is fiscally neutral or positive In the short term HUF 80–100 billion/year additional expenditure at NEAK; if the career path and the primary-care reform are left out, the pay seeps away without a retention effect
Care security Primary care and triage relieve the emergency department; waiting-list transparency shortens the queues Capacity expansion is slow; the public waiting list may incentivise “cream-skimming” (preferring easy cases) without risk adjustment
Labour market The clinical career path and wage bargaining reduce emigration; internal retention instead of foreign recruitment The resistance of the doctors’ trade union because of the relative pay convergence; training only produces headcount in 4–6 years
Equity The private–public separation and the unified data platform make access transparent The concentration of the private market is faster than the regulation; a data-protection risk at the patient-satisfaction platform

The main question to weigh is timing. The pay rise is politically striking and fast, while the career path, primary care and the separation are slow, institution-building work. If the pay runs ahead but the other three are left out, the system conserves the “top-heavy” distortion: even with raised pay the workforce seeps away, because the working conditions and the advancement do not change. The proposal works if the three measures start at the same time, reinforcing each other — the downward-pulling spiral described by the OECD (shortage breeds further shortage) can only be reversed this way. And the private–public separation tips into risk if the regulation is slower than the market concentration; it is therefore worth keeping the autumn deadline signalled by the minister.

Part V — Measurability and summary

5.1 What is worth tracking? (suggested performance indicators)

The success of the proposal is worth tracking with a few suggested performance indicators (KPIs, in English: Key Performance Indicator) — these are suggestions, not governmental commitments:

  • Nurse density: the number of nurses per 10,000 inhabitants rises from 64 to 75 by 2030 (EU average ~85);
  • Emigration: the rate of allied-health emigration decreases by at least 50 percent by 2030;
  • Waiting lists: the share of waiting lists longer than 30 days halves within 3 years;
  • Transparency: by 2027 the unified patient-satisfaction and quality data platform covers 100 percent of state and private providers;
  • Fiscal direction: the share of public health spending relative to gross domestic product (GDP) substantively approaches the EU average, following the allocative-efficiency principles described by the IMF.

5.2 Summary

MIAK’s key message: the 20–25 percent pay rise is right and urgent, but it only retains if it is part of a package. MIAK asks the decision-maker to tie the pay settlement together with the allied-health career path, the strengthening of primary care and the transparent separation of private–public financing — and to conduct the consultation promised by the minister for the autumn in a public, data-based frame. This topic moves two MIAK foundational values most. Data-drivenness, because the effect of the pay rise, retention and access must be measured, not asserted on the basis of mood — the suggested indicators make exactly this trackable. And universal representation, because alongside the expansion of the private sector, equitable, need-based access can only be preserved if the boundary between public and private care remains transparent and accountable.

Part VI — Justifications and further sources

6.1 Press framing by spectrum

In the left-liberal and public-affairs band Telex and 24.hu focused on the amount of the pay rise (20–25 percent) and the minister’s personal tone, in the frame of the Deutsche Welle report — the emphasis was on the intention and the promise. HVG, within the same band, put on its front page not the announcement but the care disruptions: the shutdown of Uzsoki’s maternity ward and the patients waiting on outdoor benches at Bajcsy’s emergency department — that is, its framing is critical, showing the fragility of the system, as opposed to the governmental future-vision communication.

In the economic band Portfolio chose an entirely different cross-section: it analysed the business performance of the private healthcare market, the consolidation and the state’s four roles (regulator, financer, competitor, training provider), and treated the pay rise as a factor moving at once the cost side and the demand of private providers. The conservative and pro-government band (Magyar Nemzet, Mandiner) did not bring healthcare care security into the top focus on this day — its attention concentrated around the constitutional amendment and the EU funds. The differing framings together yield the full picture: the announcement (Telex, 24.hu), the real care situation (HVG) and the market-structural background (Portfolio) can only be interpreted together.

6.2 Facts and data

Item Value Source
Proposed pay rise in healthcare minimum 20–25% Telex / 24.hu, 11 July 2026
Uzsoki Street hospital — shutdown of the maternity ward ~10 days, expected restart 20 July 2026 HVG, 10 July 2026
Bajcsy-Zsilinszky hospital — installation of new CT by 23 July 2026, emergency patients waiting outdoors HVG / RTL Híradó, 10 July 2026
Hospital cooling-system package (with the Uzsoki investment) HUF 3.6 billion HVG, 10 July 2026
Hungarian private healthcare market — median EBITDA margin (TOP25) 8.5% Portfolio, 8 July 2026
EU healthcare workforce shortage (doctor, nurse, midwife) ~1.2 million (2022) OECD: Health at a Glance: Europe 2024
Additional investment needed for retention ~0.6% GDP (EU average) OECD: Health at a Glance: Europe 2024

EBITDA denotes operating profit before interest, taxes and depreciation — an indicator of the profitability of private clinics; the 8.5 percent median level is low, which shows the narrow room for manoeuvre of the market. The data together support that the cover and sustainability of the 20–25 percent pay rise cannot be separated from the wider financing and structural questions — this is exactly what the package formulated in Part III unfolds.

6.3 Policy aspects

  • Healthcare (programme points) — the nurse-retention package (E6), waiting-list transparency (E3) and the digital health data system (E2) provide the policy backbone of the pay rise, care security and transparency;
  • Employment policy and labour market (programme points) — the targeted, healthcare-tailored retraining (FO3) and the tripartite wage-bargaining forum (FO10) are the institutionalisation of the workforce supply and the wage bargain;
  • Social policy (programme points) — the financing reform of long-term care (SZ13) and the logic of targeted, need-based support (SZ1) tie equitable access to the wider care system.

6.4 Literature in detail

6.4.1 OECD: Health at a Glance: Europe 2024

The OECD’s 2024 report is the opening publication of the State of Health in the EU cycle, with two thematic chapters: the healthcare workforce shortage and healthy ageing. The report documents a shortage of some 1.2 million doctors, nurses and midwives in the EU in 2022, and marks out three intervention directions: training more professionals, retaining the existing ones with better working conditions, and innovation for productivity. The report highlights the combination of pay and working conditions:

“In the short-term, improving working conditions and remuneration are critical to increasing the attractiveness of the profession and retaining current health workers.”

The report also warns of the downward-pulling spiral: understaffing creates stressful working conditions, this leads to resignation and to declining interest in the career, which breeds further shortage. In the case of the Hungarian pay rise this means that raising pay in itself is not enough — without working conditions and a career path, pay does not reverse the spiral.

📖 Source: OECD / European Commission: Health at a Glance: Europe 2024

6.4.2 Aiken et al.: Strengthening Europe’s Nursing Workforce (Policy Brief 66)

Greenley, Aiken, Sermeus and McKee present the strategies of nurse retention, building on the data of the Magnet4Europe consortium (308 European hospitals, six countries). Their central finding is that of the three ways of increasing the workforce, training is slow, and international recruitment is only a semblance of a solution that empties the sending countries — the key is the retention of existing professionals. This requires organisational-level, coordinated intervention:

“Staff retention requires systematic action at an organizational (not just an individual) level with interlinked actions reinforcing each other.”

Good working conditions — a manageable workload, supportive leadership, professional development, a positive organisational culture — are the basis of retention. In the case of the Hungarian allied-health pay gap this means that the pay rise only retains if it is paired with a clinical career path, autonomy and good leadership — this is exactly the logic of proposal 3.1.

📖 Source: Greenley, Aiken, Sermeus, McKee: Strengthening Europe’s Nursing Workforce — Strategies for Retention (European Observatory, Policy Brief 66, 2024)

6.4.3 Edwards et al.: Dealing with the challenges in urgent and emergency care (Policy Brief 74)

Edwards, Lewis, Chaouali, Zapata and Richardson analyse the structural crisis of European urgent and emergency care: growing demand, congestion, long waiting and the “exit block” (the blockage caused by the absence of hospital admission). Their main thesis is that primary care should be the first point of contact, but this is often bypassed, because family medicine cannot retain enough professionals, and patients’ trust is also shaky. The solution is therefore system-level:

“Primary care is at the heart of responding to the need for urgent and emergency care as it should be the first point of contact for most patients.”

The emergency congestion at Bajcsy-Zsilinszky is, in this frame, not merely the consequence of a CT replacement, but a symptom of the fact that primary care does not pre-filter a part of the patients — proposal 3.2 would strengthen exactly this pre-filtering and relieving function.

📖 Source: Edwards, Lewis, Chaouali, Zapata, Richardson: Dealing with the challenges in urgent and emergency care — What are the policy options? (European Observatory, Policy Brief 74, 2025)

6.4.4 IMF: Fiscal Monitor: Spending Smarter (2025)

The IMF’s October 2025 Fiscal Monitor report focuses on the efficiency and allocation of public spending, distinguishing technical efficiency (maximum output from a given resource) and allocative efficiency (resources flow to growth-serving programmes). The report’s key claim is that even the rearrangement of a fixed spending envelope can bring significant returns:

“Many countries have significant scope to reallocate […] Redirecting public spending can deliver significant gains in output.”

The Hungarian relevance of the report is direct: the Hungarian health GDP share is below the EU average, and it operates below the efficiency frontier. The cover of the pay rise can thus be raised not only from new resources, but also from prioritising prevention and primary care, from a smarter allocation — this is the common fiscal logic of the proposals of Part III.

📖 Source: International Monetary Fund: Fiscal Monitor — Spending Smarter: How Efficient and Well-Allocated Public Spending Can Boost Economic Growth (October 2025)

6.5 International comparison

The international patterns of beyond-pay retention reinforce MIAK’s proposal. The Magnet4Europe programme (Belgium, the Netherlands, Germany, Ireland, Norway, Sweden) validated the Aiken model: according to the data, each additional patient per nurse increases mortality by about 7 percent — that is, headcount and workload are a direct patient-safety question. The risk of excessive reliance on foreign recruitment is well seen from the fact that in 2023 in Ireland more than half of nurses were trained abroad, which deepens the shortage of the sending countries. For waiting-list management Denmark’s “free hospital choice” model offers a template: if the wait exceeds a threshold (typically 30 days), the patient is entitled with state financing to other — even private or foreign — care, which significantly reduced the queues over five years. The common lesson of these examples is that the pay rise brings a lasting result only with the joint reform of retention, primary care and access.

Healthcare

  • E2 — Digital health system
  • E3 — Waiting-list transparency
  • E6 — Nurse-retention package

Employment policy and labour market

  • FO3 — Targeted retraining programme
  • FO10 — Wage-bargaining modernisation, tripartite wage-bargaining forum

Social policy

  • SZ1 — Targeted support
  • SZ13 — Pension adequacy and long-term care

6.7 Source register

Press sources (MIAK press monitor, 12 July 2026 — topic 6):

Knowledge-base references (literature):

  • 📖 OECD / European Commission: Health at a Glance: Europe 2024
  • 📖 Greenley, Aiken, Sermeus, McKee: Strengthening Europe’s Nursing Workforce — Strategies for Retention (European Observatory, Policy Brief 66, 2024)
  • 📖 Edwards, Lewis, Chaouali, Zapata, Richardson: Dealing with the challenges in urgent and emergency care (European Observatory, Policy Brief 74, 2025)
  • 📖 International Monetary Fund: Fiscal Monitor — Spending Smarter (October 2025)

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

MIAK internal materials:

  • MIAK policy area: Healthcare (programme points; programme point ID: E6)
  • MIAK policy area: Employment policy and labour market (programme points; programme point ID: FO3)
  • MIAK policy area: Social policy (programme points; programme point ID: SZ13)
  • MIAK press monitor, 12 July 2026 — topic 6, score: 80/100

Additional public data sources:

  • OECD Health at a Glance: Europe 2024 — healthcare workforce and spending data
  • NEAK — health-insurance financing data

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