Part I — Situation overview

The VIP ward of the Uzsoki Street Hospital in Budapest will close in November — this was announced on 18 September 2026 by György László Velkey, member of parliament for Zugló. The hospital’s acting director general confirmed to RTL that from November no further patients will be admitted to VIP care, only those booked in by then. According to Portfolio’s summary, the hospital could charge up to 2.5 million forints for operating on someone within a few weeks, bypassing the waiting list. In state care the waiting time is substantially longer. According to HVG’s report, priority treatment could be bought through a private company, Magyar Egészségügyi Szolgáltató Kft., and the company was linked to a former mayor of Zugló. The hospital’s previous director general was dismissed at the end of August. Zsolt Hegedűs, Minister of Health, promised strict regulation: both the bypassing of the waiting list and the steering of patients into private care will be regulated, and he also held out the prospect of settling the question of conflicts of interest.

The announcement came alongside a larger funding package — and that is where it meets the real constraint. At the conference of the Hungarian Hospital Association, reported by Portfolio following Népszava, hospital managers said that the main question is not the long-term programmes but who will be at work tomorrow. According to Zoltán Balogh, president of the Hungarian Chamber of Health Professionals (MESZK), 60 per cent of those working in adult hospital nursing are in the last ten years before retirement, while the generation entering work over the next two decades may amount to a quarter of those leaving. At the turn of the millennium 900–1,000 graduate nurses qualified each year, today 300–400, and in vocational-college training there may be barely more than 200 graduates nationwide in 2026. According to the minister, the largest part of the 500 billion forint sectoral surplus planned for 2027 would be spent on settling the pay of some 123,000 nursing staff, along a pay scale of six salary classes and 15 grades. ATV highlighted the same tension: the shortage of professionals is even more pressing than the money.

MIAK’s reading: ending paid queue-jumping is in itself a right and long-overdue step, but it does not abolish the demand, it only makes it invisible. The market in priority treatment arose not from a moral aberration but from two measurable shortfalls: waiting times are not public, and capacity is scarce. If the ban is not accompanied by public waiting-list data and a regulated route between public and private care, the same demand will migrate into the grey zone or into unregulated private care — only now without any trace. Settling the pay of 123,000 nursing staff is necessary but not sufficient: pay can retain existing staff, whereas the lack of new entrants can only be made good with training capacity, and its lead time is measured in years.

Part II — Foundations in the literature

Three reports provide a framework for the three questions of the topic. The joint publication Health at a Glance — Europe 2024 by the OECD (Organisation for Economic Co-operation and Development) and the European Commission treats waiting time as a separate access indicator. The report shows that in order to work off the accumulated surgical backlog most countries either expanded supply with additional funding or contracted private providers — that is, access is a question of quantity, not of discipline. The report State of Health in the EU 2025 by the European Commission and the OECD records in the Hungarian country profile that one of the named reform objectives for the use of EU funds is precisely the reduction of informal payments, and that the share of out-of-pocket payments by households is high in Hungary. The present ban is therefore not an isolated Hungarian step but part of a reform direction already undertaken. The report European Health Report 2024 by the WHO (World Health Organization) breaks down the causes of the workforce shortage: demand for care is growing faster than the supply of professionals, and supply is being depleted simultaneously by ageing, internal and international migration, and attrition due to poor working conditions. The detailed treatment of the literature — by source, with quotations — is in section 6.4 Literature in detail.

Part III — MIAK’s concrete proposal

MIAK proposes three measurable measures. The first creates transparency of waiting times, the second makes the route between public and private care a regulated one, and the third prescribes a quantified plan for recruiting nursing staff. The three work together: the ban is sustainable only if an answer is also found to the shortfall behind it.

3.1 Public waiting-list data broken down by institution — updated monthly (first publication by 1 January 2027)

MIAK proposes that a publicly accessible, searchable interface be built from the existing waiting-list register of the National Health Insurance Fund Manager (NEAK), showing actual waiting times and the number of people on the list by institution and by type of procedure. The data should be updated monthly, and the interface should also preserve the values of earlier months, so that anyone can see the direction of change. Without two additions the indicator would be misleading. First, waiting time must be published risk-adjusted, that is, taking into account the severity of the cases the institution concerned treats — otherwise institutions have an interest in favouring easy cases, and the statistics improve while the position of complex patients worsens. Second, the clinical threshold must be identified for each type of procedure (for example the deadline for starting oncological treatment), and the number of cases in which it was exceeded must be indicated separately. This is the direct implementation of the E3 waiting-list transparency programme point, and its technical basis is provided by the E2 digital health system. The OECD’s methodological discussion (see 6.4.1) shows precisely that comparable measurement of waiting time is not self-evident: without fixing the starting point of measurement and the case mix, the figures cannot be compared.

3.2 A written rule on the route between public and private care, and enforcement of the ban on priority treatment (legislation in the first half of 2027)

MIAK proposes that, alongside the ban on selling priority treatment, the legislation should also include the procedure that handles demand legally. Three elements are needed. First: the relationship between the private practice of a doctor working in a state institution and state care should be settled by a written conflict-of-interest rule — namely that the same doctor may not move the same patient up the state list he or she manages on the basis of a relationship formed in private practice. Second: if for a given procedure the state waiting time exceeds the fixed clinical threshold, the patient should acquire the right to obtain care from a contracted provider at public expense. Third: every private company providing services on the premises of a state hospital must have a public contract and public ownership details. The Uzsoki case showed precisely that priority treatment arose through a private company, within the walls of a state institution. This proposal builds on the E3 and E5 patient decision support programme points, while the publicity of provider contracts falls within the scope of the A5 whistleblowing system: reporting on informal payments in hospitals only works if there is something against which to report.

3.3 A nursing recruitment plan with numerical targets (as an annex to the 2027 budget bill)

MIAK proposes that alongside the 500 billion forint sectoral surplus a public recruitment plan be drawn up that counts not in pay but in headcount. The plan must contain four figures broken down by year up to 2032: how many nursing staff retire, how many graduate from degree and vocational-college training, what the actual entry into the system is, and how large the remaining gap is. Where the gap cannot be closed by training, the plan should name what other instrument it uses — task reallocation, the regulated employment of foreign professionals, or restructuring of the care system. The distortion of the training structure must also be addressed: according to the chamber president, in some fields more professionals graduate than the system can absorb, while there is a severe shortage of nurses — training quotas must therefore be aligned with actual labour demand. This supplements the E6 nurse retention package with the recruitment side, and the alignment of training quotas follows the logic of the FO8 human capital investment framework. The WHO’s analysis (see 6.4.3) shows that the workforce shortage stems from four different causes, so a single instrument — even a pay settlement — does not solve it on its own.

The three proposals share one principle: informal payments and paid queue-jumping are not primarily a moral problem but a problem of information and capacity. Informal payment arises where the patient does not know how long the wait will be and the system cannot deliver in time. The capacity-expansion logic described by the OECD and the WHO’s workforce analysis together say this: access improves if more care takes place — the ban creates a necessary condition for this, but does not substitute for it.

Part IV — Expected effects and risks

Dimension Expected effect Risk
Healthcare Public waiting times improve the choice of institution even in the short term; exceedances of the clinical threshold become visible When the indicator is introduced the measured time may rise, because until now it was not recorded comprehensively — this may appear as politically bad news, although it is an improvement in data quality
Society Separating the wallet from the order of treatment reduces inequality in access If capacity does not grow, waiting after the ban may be longer for everyone — the short-term experience may worsen
Public administration The route rule gives legal certainty to doctors and institutions alike Too strict a conflict-of-interest rule could drive further doctors out of state care
Budget Publicly financed use of contracted private capacity is a more predictable expenditure than the later cost of an untreated backlog An entitlement based on exceeding the threshold creates an open-ended expenditure item if there is no budget envelope and procedural limit for it

The main trade-off lies between fast access and equal access. The system of paid queue-jumping did indeed give some people fast care — in MIAK’s view, however, this came not from additional capacity but from buying a place in the queue, that is, at the expense of other patients. The proposal tips to the risk side if the ban takes effect before the route rule and the capacity plan are ready: in that case demand does not cease, it merely takes an unregulated form. That is why MIAK proposes that the three elements — ban, data, route — come into operation simultaneously, and that the recruitment plan be completed at the latest together with the 2027 budget.

Part V — Measurability and summary

5.1 What is worth following? (suggested KPIs)

MIAK proposes the following key performance indicators (KPIs) for monitoring. These are proposals, not government decisions:

  • Whether the public waiting-list interface broken down by institution is launched by 1 January 2027, and whether it covers the most frequent elective procedures (yes/no, then the number of procedure types covered).
  • The share of cases exceeding the clinical threshold, by type of procedure — a declining path year by year is worth expecting.
  • The annual number of graduates from degree and vocational-college nurse training, against the number of those retiring; the difference between the two is the real indicator.
  • The actual change in the number of nursing staff in the system, not the sum spent on the pay settlement.

5.2 Summary

MIAK’s request in a single sentence: alongside the ban on paid queue-jumping, the public waiting-list data, the written route rule and the recruitment plan backed by figures should all be completed this year. Without these the ban remains a fine-sounding measure that does not solve the problem but removes it from sight.

Two of MIAK’s foundational values are at stake in this topic. Universal representation, because the order in which people obtain care is one of the most direct ways a community expresses whose time and health is worth how much; if the order can be bought, the system is not only unjust but also ranks citizens by implication. And data-drivenness, because waiting time today is largely experiential knowledge: the patient hears from someone else where the queue is shorter. As long as this is so, the informational advantage is in itself a privilege — public data abolishes that privilege.

Part VI — Reasoning and further sources

6.1 Press framing by spectrum

The economic segment treated the topic as a systemic question. Portfolio broke the matter down in three separate articles: the closure of the Uzsoki ward, the workforce data from the hospital association conference, and a separate analysis of the conditions for the lawful coexistence of public and private care. This was the only segment that put the amount (2.5 million forints) and the systemic constraint (the figures on nurse recruitment) side by side — that is, it ran its coverage not to the scandal but to the chain of cause and effect.

The left-liberal and public-affairs segment highlighted the political and institutional side of the decision. HVG introduced the news with the words of the MP who announced it, and placed the ownership background of the private company behind the VIP ward, together with the dismissal of the previous director general, at the centre of the story — that is, it followed the accountability thread. The same segment also brought another item, less spectacular but closely related to the topic: an interview on the patient-safety risks of management culture. 24.hu reported on an admissions freeze due to infection at a neonatal ward in Szeged, which illustrates the connection between the capacity question and the quality question.

The pro-government conservative segment dealt on that day not with the VIP ward but with another element of the government’s package of announcements: Mandiner highlighted the possibility of making membership of the medical chamber compulsory. In this framing the ban on paid queue-jumping appeared not as a topic in its own right but as part of a series of announcements. This is consistent in so far as the segment focused on the question of professional self-government — but the question of inequality in access was thereby left out of the coverage.

What appeared in none of the segments: what will happen to demand from November. Not one piece of coverage explored the scenarios after the ban — grey zone, unregulated private care, or actual capacity expansion.

6.2 Facts and data

Data Value Source
Price of a priority operation at the Uzsoki Street Hospital up to HUF 2.5 million Portfolio / RTL, 19 September 2026
Date of the closure of VIP care November 2026 the hospital’s acting director general, RTL / Portfolio
Planned sectoral surplus for 2027 HUF 500 billion Zsolt Hegedűs, Minister of Health, Portfolio, 19 September 2026
Nursing staff affected ~123,000 people Portfolio, 19 September 2026
Structure of the planned pay scale 6 salary classes, 15 grades Portfolio, 19 September 2026
Share of those working in adult hospital nursing who are within 10 years of retirement 60% Zoltán Balogh, president of MESZK, Portfolio, 19 September 2026
Annual number of graduate nurses qualifying 900–1,000 at the turn of the millennium, 300–400 today Zoltán Balogh, Portfolio, 19 September 2026
Graduates of vocational-college nurse training in 2026 barely more than 200 nationwide Zoltán Balogh, Portfolio, 19 September 2026
An institutional example from Józsefváros: average age of nursing staff 64 years conference of the Hungarian Hospital Association, Népszava / Portfolio

Read together, the figures give the reason for the proposal: the ratio of the departing to the entering generation is four to one, while the pay settlement affects the existing staff. The target value of the E6 programme point — raising the ratio of nurses per ten thousand inhabitants from 64 to 75, against an EU average of 85 — cannot be reached without a recruitment plan.

6.3 Policy dimensions

  • Healthcare (programme points) — E3 waiting-list transparency provides the direct basis of the proposed public waiting-list interface, E2 digital health system its technical background, and E5 patient decision support the legal framework for the choice of institution; the E6 nurse retention package is the answer on the workforce side;
  • Transparency and anti-corruption policy (programme points) — the A5 whistleblowing system is the reporting channel for informal payments in hospitals, and the publicity of the contracts of private companies operating in hospitals is its precondition;
  • Employment policy (programme points) — the FO8 human capital investment framework provides the methodology for aligning training quotas with labour demand.

6.4 Literature in detail

6.4.1 OECD: Health at a Glance — Europe 2024

The joint publication of the OECD and the European Commission discusses accessibility in a separate chapter and treats the waiting time for elective surgery as a distinct indicator. In its analysis of the post-pandemic recovery the report describes a mechanism that also applies to the present Hungarian situation: the reduced number of procedures does not build back by itself, and most countries took active steps to deal with the accumulated backlog:

“Many countries have taken actions to reduce backlogs of elective surgery created during the pandemic by providing additional funding to boost supply and/or contracting private providers in countries where public and private systems co-exist.”

The report also warns that returning to the earlier level of activity is not in itself enough to work off the backlog. This proposition supports two points of MIAK’s proposal. First, the publicly financed use of contracted private capacity is not an ideological question but an established instrument — the essential thing is that it should happen by rule and in public, not on the basis of an individual payment by the patient. Second, the measurement of waiting time depends on methodological decisions: the report discusses the question of definition and comparability in a separate section, which is why MIAK proposes that the Hungarian interface should also fix the starting point of measurement and the case mix.

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

6.4.2 European Commission and OECD: State of Health in the EU 2025

The Hungarian country profile of the report lists the reduction of informal payments by name among the objectives of EU funding:

“Investments support key reforms, such as upgrading infrastructure, reducing informal payments, enhancing digital tools and strengthening primary care.”

The profile also records that a significant part of Hungarian households’ spending on medicines comes out of pocket, and that the mechanisms of financial protection need to be developed. Read together, the two findings amount to this: in the Hungarian system the amount paid directly by the patient is not an exception but a structural element — buying priority treatment was the extreme case of this structure. MIAK draws the conclusion that reducing informal payments is a reform objective already undertaken, so the present ban can be assessed and held to account not as a one-off measure but as part of that reform path. This also means that the result of the step can and must be measured regularly, in international comparison.

📖 Source: European Commission / OECD: State of Health in the EU 2025 (Hungarian edition: Az egészségügyi helyzet az EU-ban 2025)

6.4.3 WHO: European Health Report 2024

The WHO’s European report traces the workforce shortage not to a single cause but to four mutually reinforcing processes:

“Several factors are reducing the supply of health workers: (i) ageing of health workers […]; (ii) increased internal mobility from rural areas to urban areas and from the public to the private sector; (iii) increased international migration of doctors and nurses after the COVID-19 pandemic; and (iv) increased attrition of health workers driven mainly by poor working conditions and poor mental health.”

The report adds that the region faces a persistent shortage even though it has never had so many health workers — because demand is growing faster than supply. Translated to the Hungarian situation, this means that the pay settlement affects the fourth factor (attrition) and in part the second (the flow into the private sector), but barely touches ageing and international migration. That is why MIAK proposes that the recruitment plan should count not in pay but in the difference between the numbers entering and leaving — this is the indicator that shows the resultant of all four factors.

📖 Source: WHO Regional Office for Europe: European Health Report 2024

6.5 International comparison

The most developed European example of linking waiting-list transparency with an access guarantee is Danish practice: in the system of free hospital choice, if the state waiting time exceeds a fixed limit, the patient becomes entitled to obtain care from a private or foreign provider with state financing. The essence of the solution is not that it brings in a private provider, but that it attaches a legal consequence to crossing the threshold — so waiting time does not remain a statistic but generates an obligation. This is the operational equivalent of what the OECD report writes about the instruments of capacity expansion. The Estonian e-health system approaches the same thing from the information side: the unified register not only reduces duplicated examinations but also makes care pathways traceable — without this the quality of waiting-list data cannot be improved on a lasting basis.

Healthcare

  • E2 — Digital health system
  • E3 — Transparency of waiting lists
  • E5 — Patient decision support
  • E6 — Nurse retention package

Transparency and anti-corruption policy

  • A5 — Whistleblowing system

Employment policy

  • FO8 — Human capital investment framework (vocational training guarantee)

Proposed new programme point: Written rule on the route between public and private care — for the Healthcare area, as a supplement to E3 waiting-list transparency.

6.7 List of sources

Press sources (MIAK press monitor, 20 September 2026 — topic 5):

  • [Portfolio] Akár 2,5 millió forintot is elkértek a gyors műtétért a magyar kórházban, de novembertől hirtelen mindennek vége — https://www.portfolio.hu/gazdasag/20260919/akar-25-millio-forintot-is-elkertek-a-gyors-mutetert-a-magyar-korhazban-de-novembertol-hirtelen-mindennek-vege-863928
  • [Portfolio] Milliárdos mentőövet dobna a kormány, de pillanatokon belül kiürülhetnek a hazai kórházak — https://www.portfolio.hu/gazdasag/20260919/milliardos-mentoovet-dobna-a-kormany-de-pillanatokon-belul-kiurulhetnek-a-hazai-korhazak-863874
  • [Portfolio] Köz- és magánellátás az egészségügyben — lehetséges a jogszabályoknak megfelelő együttélés? — https://www.portfolio.hu/gazdasag/20260917/koz-es-maganellatas-az-egeszsegugyben-lehetseges-a-jogszabalyoknak-megfelelo-egyutteles-863290
  • [HVG] Velkey György László: Megszűnik a VIP-részleg az Uzsoki Utcai Kórházban — https://hvg.hu/itthon/20260918_uzsoki-utcai-korhaz-vip-reszleg-megszunes-velkey-gyorgy-laszlo
  • [HVG] Hegedűs Zsolt: A toxikus vezetés egy súlyos betegbiztonsági kockázat — https://hvg.hu/itthon/20260917_hegedus-zsolt
  • [ATV] 500 milliárdot öntene az egészségügyre a kormány, ám valami még a pénzhiánynál is égetőbb — https://www.atv.hu/belfold/20260920/egeszsegugy-kormany-szakemberhiany/
  • [24.hu] Egy hete felvételi zárlat van a szegedi klinika koraszülött osztályán kórházi fertőzés miatt — https://24.hu/belfold/2026/09/18/szegedi-klinika-koraszulutt-osztaly-zarlat-fertozes/
  • [Mandiner] Itt vannak Magyar Péter bejelentései: újra kötelező lehet a MOK-tagság az orvosoknak — https://mandiner.hu/belfold/2026/09/ujra-kotelezo-lehet-a-mok-tagsag-az-orvosoknak-ra

Knowledge-base references (books):

  • 📖 OECD / European Commission: Health at a Glance — Europe 2024
  • 📖 European Commission / OECD: State of Health in the EU 2025 (Hungarian edition: Az egészségügyi helyzet az EU-ban 2025)
  • 📖 WHO Regional Office for Europe: European Health Report 2024

MIAK internal materials:

  • MIAK policy area: Healthcare (programme points; programme point ID: E2, E3, E5, E6)
  • MIAK policy area: Transparency and anti-corruption policy (programme points; programme point ID: A5)
  • MIAK policy area: Employment policy (programme points; programme point ID: FO8)
  • MIAK press monitor, 20 September 2026 — topic 5, score: 86/100

Supplementary public data sources:

  • NEAK — waiting-list register and institutional data reporting
  • KSH (Hungarian Central Statistical Office) — health and social sector statistics
  • OECD Health Statistics — international access and workforce data

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