Slovakia is facing a major public procurement controversy involving the tendering of its emergency medical services. The EUR 2 billion contract, covering both ground and air ambulance operations from 2025 to 2031, has become the largest healthcare tender of the current government – and is now mired in allegations of cronyism, lack of transparency and possible breaches of procurement law. Political tensions, media scrutiny and prosecutorial involvement have converged to make this one Slovakia’s most significant governance crises of 2025.
Tender overview
The Operational Centre of the Emergency Medical Service, on behalf of the Ministry of Health, launched the tender to allocate licences for 344 ground ambulance stations and 7 air ambulance bases nationwide in May 2025. The aim was to ensure the provision of high-quality, continuous emergency services across Slovakia. The winning bidders would secure operational rights for a six-year period, with the contract value estimated at EUR 2 billion (The Slovak Spectator, 2025a).
Transparency concerns
Criticism quickly emerged from opposition parties, the Slovak Medical Chamber and transparency watchdogs. They highlighted opaque selection procedures, including a refusal to disclose the names and qualifications of tender committee members.
In July 2025, preliminary results of the tender and the names of the commission members were leaked to the media, which confirmed concerns about poor transparency and fairness of the tender (The Slovak Spectator, 2025a).
One particularly contentious claim is that the tender process might be structured to favour certain bidders, notably Agel SK, Slovakia’s second-largest private healthcare provider, and a relatively unknown entrant, Emergency Medical Solutions (EMS). Both have reportedly been in positions to gain a disproportionately large share of contracts (The Slovak Spectator, 2025b). EMS was later proven to be linked to the second largest coalition party, HLAS-sociálna demokracia, which also nominated (as of this writing) incumbent Minister of Health, Kamil Šaško.
As a consequence, on 8 August 2025, Penta Hospitals, Slovakia’s largest private healthcare network, withdrew its bid, citing serious concerns over transparency and suggesting possible breaches of EU procurement law (The Slovak Spectator, 2025b).
The Slovak National Party (SNS), another governing coalition partner, demanded not only the cancellation of the tender but also the resignation of Health Minister Šaško. Prime Minister Robert Fico publicly acknowledged that the process could be scrapped or restarted if doubts persisted (TASR, 2025).
The General Prosecutor’s Office, led by Maroš Žilinka, initiated a preliminary review into the tender process. This action signals potential criminal investigations for alleged mismanagement of public funds and violations of procurement rules (The Slovak Spectator, 2025b).
Nevertheless, the management of the Operational Centre of the Emergency Medical Service delivered the results of the tender to the Ministry of Health on 11 August, thereby de facto announcing the successful selection procedure. On the same day, Minister of Health Šaško, announced that he would not sign it and would cancel the tender procedure, and would come up with an alternative for procuring emergency services in Slovakia, pending agreement within the governing coalition. Conclusions of such discussions are expected by the end of August 2025.
The opposition and experts claim that Health Minister Šaško could not terminate the tender and did so in violation of the law, which may cause the bidders to suffer lost profits, and are therefore demanding his resignation (TASR, 2025b).