Slovakia’s health minister facing potential no-confidence vote following turbulent summer

Summer strife deepened conflict between Slovakia's health minister and the opposition, as Slovakia's state-owned health insurance company continues to report a staggering loss, with no solution in sight.

Hospitals are not making payments on time, the threat of EU fines looms large, and now a no-confidence vote is on the horizon.

Opposition MPs returned to parliament with a bang after the summer break. On their first week back, they started gathering signatures to trigger another no-confidence vote against Health Minister Zuzana Dolinková after a previous failed attempt in May.

In response, the Minister described it as “theatre and politicking”, stating that she is ready to defend her post.

Compared to May’s recall vote, this time, the Minister’s coalition partner, Andrej Danko, head of the Slovak National Party (SNS/ID), did not nuance his words. Danko described the Ministry’s management as “a big mess".

The opposition based the no-confidence vote on the Minister’s poor management and lack of attention to the key issues Slovak healthcare is currently facing.

Delayed payments

SK+MED, the Slovak association of medical device and supply providers, warned that the state is failing to meet its payment obligations on time.

The association highlights the ongoing issue of the state hospitals’ inability to reimburse suppliers for their services, with the outstanding debt growing daily. The current amount owed now exceeds €120 million.

To protect European businesses against late payments, the EU adopted a Directive on combating late payments in commercial transactions in February 2011.

Hospitals failing to pay their invoices within 60 calendar days, as per the Directive, are in breach of the EU legislation.

On September 19, the Court of Justice of the EU will decide on possible sanctions that Slovakia will be forced to pay due to state-run hospitals paying their obligations and commitments with a delay.

According to the Supreme Audit Office, there is an average delay of 397 days.

Slovakia faces a one-off fine of €700,000 - €800,000, followed by tens of thousands in penalties per day until non-compliance with the EU directive is rectified.

"After receiving and studying the valid ruling of the Court of Justice of the European Union, the Ministry of Health will inform the public," the Ministry told Euractiv when asked about the next steps. 

Painted pipes, a faltering cardiology department

Adding to the list of issues the country’s health system faces, Trenčín Hospital, in Slovakia’s northwest, earned unwanted attention in recent weeks.

In 2019, the hospital hired a company called Camase and ordered a renovation of the hospital’s boiler room, heat distribution system, and pipes. Reports surfaced by the Investigative Center of Jan Kuciak (ICJK) that the hospital stopped paying the company under the suspicion that wiring and pipes were not replaced but only received a new coat of paint.

IJCK possesses indications and testimonies that the company did not replace the pipes at all.

The opposition claims to be in possession of the hospital’s water analysis, proving the water running in the pipes contains legionella bacteria.

Last Friday, to prove the allegations are false, the Minister countered by drinking a glass of water from the hospital tap.

Coincidentally, a former member of the supervisory board of Camase, Tomáš Lorenc, became the head of the service office at the Health Ministry in June this year. This is the third highest post after the minister.

Furthering this scandal, the head of Trenčín Hospital, Michal Plesník, removed the head of the hospital’s cardiology department. In protest, six cardiologists resigned, putting the department in a state of near-collapse, with staff patching shifts together to keep it running. 

Insurance company

As Euractiv reported, the state-owned General Health Insurance Company (VšZP) found itself with a predicted €169 million year-end loss.

After months, the issue persists. In August, Dolinková fired the head of VšZP, Michal Ďuriš, who was nominated for the position by the Minister only four months prior.

The Healthcare Surveillance Authority ordered the health insurance company to present a recovery plan to improve its financial outlook. VšZP did not find consensus with the Healthcare Surveillance Authority and chose to appeal this decision.

Whether the Ministry will step in and provide financial support to the VšZP or the health insurance company comes up with a plan of its own should be clear in the coming days.

[Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]