The elimination of mandatory membership in the Medical Chamber in February 2023 is not the first time that the role and responsibility of the Chamber have been changed. In 2006, similar to today, the government wanted to introduce substantial healthcare system reforms and also faced opposition from the Chamber. The mandatory membership in the Chamber was abolished as part of those reforms and reinstated again following a change in government in 2011. In this sense, the current situation parallels the historical example. The newly passed amendment can be viewed in light of the reform package from December 2022, which aims to transform the healthcare system (see Policy Analysis from 30 December 2022).
The Medical Chamber objected to the reform package and the further centralisation of the health system; it believes that the new regulations would result in a command-based, inflexible system, which would decrease the availability of publicly funded services and drive patients to the private sector. Thus, it called for the government to withdraw its initiatives and urged drafting a long-term strategy for the health sector with the involvement of political parties, professionals, and patient organisations. Furthermore, the Chamber also formulated a set of immediate demands, including specific steps to strengthen primary and dental care services, ease specialised medical doctors’ working conditions, and increase wages for allied health professionals from January 2023. Although the reform package contains plans to increase wages, it will start in July 2023, and not sooner, as proposed by the Chamber.
As the demands had not been met, in February 2023, the Chamber decided to pursue a pressure campaign, leveraging another piece of the reform package, the progressive reorganisation of out-of-hours services (see Country Update from 20 January 2023). Until the demands are met, the Chamber called on its members not to sign their new contracts to provide out-of-hours services and deposit a notice of termination of their contracts establishing voluntary overtime work. The resulting tension between the Chamber and the government triggered the presentation of the amendment proposal.
The rationale for the proposal has been what the government estimated to be “an abuse of power” on the part of the Chamber, which, in the government’s view, used its position to exert pressure on its members and thus threatened the right of citizens to healthcare. However, the Chamber refuted these claims in an open letter, contending that the government politicised a professional disagreement.
The current situation may have implications for the ongoing dispute between the European Commission and the Hungarian government regarding the rule of law and access to EU funds. To resolve the dispute, last year, the government made a series of commitments, one of which was to ensure that – with certain defined exceptions – public consultation would precede the passing of new legislation. However, according to the Chamber, no such consultation took place. Thus, passing this amendment might constitute a hurdle in accessing EU funding.