Programme of the "Decade of Health"

The Government launched the "Decade of Health" programme, consisting of three major elements:
-creation of a health promoting social environment
-consolidation and modernisation of the health care system
-financing reform of the health system

The "Decade of Health" Government programme aims at improving the health status of the Hungarian population. To enhance this process, the Government is committed to consolidate  and modernise the current health care system as well as to carry on the financing reform of the health system. The Government implements a  health- centred governmental strategy, which mobilises  all economic means and entire mental capacity of society in the interest of each individual.

A health system is being developed in which
-the most important objective is to improve the health status of the population, the increase of  life expectancy at birth and to facilitate the quality of life determined by health
-individuals and communities play an active role in preserving and restoring their health, and  the state provides organised support to it
-nationals have equal opportunities to access generally accepted health services within  the mandatory health insurance system
-health system is reorganised to become a service provider, which provides accountable, effective services with controlled quality can be financed as a result of modernised and consolidated organisation and its effective functioning provides decent livelihood for those providing the care
-resources are distributed according to the regional strategic concepts aiming at mitigating  regional inequalities as well as promoting equal opportunities
-public financing will remain considerable, although some private resources may be involved for better implementation of community objectives as well as for widely satisfying the needs of individuals
-instead of the traditional role of maintaining public institution, the Government applies the principle of sectoral neutrality and favours service provider functions
-the ownership structure of health care providers becomes diverse and the efficiency of  management is to be improved
-the living conditions and prestige of health professionals will increase in line with their social role.

In order to manage the Government Programme of the "Decade of Health", a programme office  was established, being responsible for the  design, governmental management and implementation  of each sub-programme.

Since the development of the "Decade of Health" programme, the following steps were taken  within the different sub-programmes:

1. Last year, the new "B?la Johan" National Public Health Programme" was designed and  submitted to Parliament. The programme was adopted by the entire consensus of Parliament and  its implementation started already in April 2003. This year?s calls for applications were published in  13 sub-programmes, dealing with, inter-alia,  child- health, development of healthy life-style,  reducing smoking, improving the quality of life of the elderly etc. The objectives of the programme are to develop healthy life-styles, prevention and to  create opportunities for early diagnosis of diseas (screening etc.).

2. The following measures have been taken so far, aiming at implementing the programme  for consolidating and modernising the Hungarian health care system:
-An average of 50% wage increase was implemented in the health sector.
-A debts-release programme was launched, based on applications. Some 3,1 billion HUF, as a total, was provided for 30 hospitals with liquidity problems, with the condition to develop their efficient management and to reconstruct the professional structure. Acontinuous monitoring was launched  for the implementation of this programme as well, being supported by a network of expertise.
-An agreement was concluded between the Ministry of Health, Social and Family Affairs and the Ministry of Education to foster mutually the conditions of education, research and curative medicine carried out by medical universities.
-In order to provide equal opportunities in access to health care services, the capacity of the health care system has been assessed, regional disparities in the health care system have been analysed  and structural tensions in the health care system have been revealed.
-Based on this assessment, the establishment of regional level patient management as well as  health care provision system is currently in progress, for which a call for applications will be published  in autumn this year.
-The creation of locally organised associations, to support co-operation on regional level and on  the level of minor regions, has started. The Ministry has approached local governments and institutions to make the necessary professional preparations and arrangements.
-In order to enhance professional, proprietary and civil consultations, a series of regional conferences has been initiated.
-A 15 billion HUF-programme has been launched to upgrade the basic radiology and anaesthesiology equipment pool. This programme is also based on call for application, where regional development needs are taken into consideration.
-Changing the service purchasing and financing role of the National Health Insurance Fund is  under preparation.

3. Financing:
-Pilot projects for the managed care of patients have been extended and made accountable within social insurance financing. Acode of Outpatient Care has been adopted in order to ensure transparent and equitable financing as well as more efficient control, and rules of the inclusion of certain services have been redesigned.
-In line with the Government programme, employers? contributions burden - including health contribution - has been mitigated. The Ministry of Health, Social and Family Affairs, together with the Ministry of Finance, is currently working on new possibilities of involving resources, as well as on supporting different forms of self-provision, such as developing systems of supplementary health  insurance, voluntary health funds, as well as the introduction of individual health accounts.
-The contribution reform is also dealt with, aiming at the implementation of measures defined in  the Government?s programme in such a way that it does not generate obstacles to economic growth nor to the functioning of the health system.
-A fundamental element of a welfare transition is to eliminate the separation of nursing and  social services. A new nursing scheme is currently under development, which would be  appropriately costeffective, ensure the co-operation of service providers and be based on individual savings and selfprovision.
-A programme aiming at involving private capital for public purposes is currently under elaboration (Public Private Partnership). Based on the decision of the Government, a pilot programme will be launched this year.

The modernisation of the Hungarian health system cannot be successful without appropriate  IT development. Therefore the following measures were taken during the first half of 2003:
-The health version of the national information society programme was elaborated.
-The internal structure of the Ministry of Health, Social and Family Affairs was redesigned, and the
IT Department was replaced by the Department of Information Policy.
-A sectoral (health and social) IT co-ordination body was established.
-The development of sectoral indicator-set has started as well as the establishment of a sectoral database.
-A public procurement procedure has been launched for the creation of a sectoral portal.
-Sectorally neutral development supporting principles for health care providers were elaborated.
-A closed sectoral private network has been designed. (V.P.N.)

The modernisation and financing reform of the health care system demands the reorganisation  of health administration at the same time. Thus the following measures were taken during the first  half of 2003:
-Sectoral interest conciliation fora became existing organisations and they work actively (NET, ESZ_T etc.).
-Wide social debate on these changes have been carried out, including a parliamentary open debate,
organising conferences, active participation  in different professional and social events.
-An organisational model of Regional Health Councils (RET) has been designed, and the  Ministry of Health, Social and Family Affairs preliminary invited county self-governments to establish Regional Health Councils.
-Professional and political consultations are carried out on possible alternatives for the supervision of social insurance funds.
-A ministerial commissioner was appointed to redesign the system of professional supervision.
-Preparations have been started aiming at reorganising national institutions.