In recent weeks, hospitals have suddenly begun to free up hospital beds, with the goal of making 60% of their capacity available so that the institutions will be able to supply people even in the worst-case coronavirus scenario expected. However, a new aspect of hospital evacuations also emerged on Thursday: Gergely Gulyás, head of the Prime Minister’s Office, said at his weekly press conference that it was unnecessary to maintain a hospital capacity that was not justified by the number of patients. From this statement, it seems that the government is taking up the long-running intention of hospital reorganization, and although they have now freed up capacity due to the epidemic, it actually may be a permanent plan to reduce the number of beds altogether.
During and after the days of the Easter holidays, due to hospital evacuations in preparation for the mass infections during the coronavirus crisis, hospitals have unexpectedly dismissed patients who are suffering from chronic diseases or in helpless states, according to many press reports. Both the Ministry of Human Resources and the Chief Medical Officer Cecília Müller stated that they only send home patients who are not in need of constant hospital care and who will be safer in their home environment.
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Minister Miklós Kásler instructed all hospital directors to release at least 60% of beds in their hospitals, which even led to suddenly dismissing a hospital director of the biggest rehabilitation institute for not fulfilling the orders fast enough. Weeks after the instruction, the Ministry said that the occupancy rate of Hungarian hospital beds had been 66% last year, which means that 34% of hospital beds were already “empty.” Additionally, a “significant proportion of patients voluntarily gave up non life-saving surgeries and treatments,” which further increased the number of free beds by 24% by the end of March. Thus, according to Kásler, when he asked for hospital evacuations, “58% of the beds were already vacant nationwide,” so the task was only to provide an additional 2% of free beds.
Chief Medical Officer Cecília Müller also confirmed this statement, saying that 50% of the hospital beds had been vacated, but “patients only had to be sent home from a few places,” as bed occupancy was around 60 to 70% in most hospitals. Although the operative board and the Ministry of Human Resources both claimed until now that the hospital evacuations are mainly due to the preparation of the worst-case scenario of the coronavirus crisis, yesterday, a new aspect emerged in the issue.
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At PMO Head Gergely Gulyás’s weekly press conference, government-critical Magyar Hang asked the minister why the Orbán government is continuing the practice of reducing the number of hospital beds (with a total of 3,000 between 2010 and 2018) if they considered the drastic reduction of 10,000 beds by the former socialist-liberal government “a crime.”
Gulyás said that although the socialist government has committed a lot of crimes in healthcare, downsizing beds or determining the number of beds is a medical issue, not a political one. This is kind of a shift from the previous approach of the government towards the number of hospital beds.
Gulyás added that “as we see, and as it has been discussed in the press, in connection with the debate on evacuation of hospital beds, today the occupancy rate of hospital beds in Hungary is 66-68% per year. Therefore, this issue should be treated as a medical one, and the adequate number of beds should be determined according to the need for it.” Gulyás also pointed out that there are other important circumstances in question. “In many cases, we see that the financing of hospitals also depends on how many nights the patients spend in the hospital, how many people use it as a kind of rehabilitation opportunity.” The minister added that the practice of institutions keeping patients in for several days not because it is justified medically, but because of the funding is not warranted.
Gulyás thinks “we need to think about whether there is enough rehabilitation space, maybe more unused beds are needed. And that’s a math question every year to see how many hospital beds are needed, whether there were free beds, and there may be hospitals where it is even necessary to increase the number of beds.” However, he said that “where beds are operating at 50 or 60% occupancy, it might be better to decrease the number of beds and treat patients in better quality beds, with better and newer machines. There is no need to maintain a capacity that is not justified by the number of patients.”
The words of Gergely Gulyás also shed new light on the issue of the sudden release of beds in recent weeks in preparation for the coronavirus epidemic. In recent days, experts and the press alike were guessing the reason for emptying hospital beds, although the number of registered coronavirus cases in Hungary are comparatively low in Europe. It seems that there is a possible, additional cause for the evacuations and the government sees the current epidemiological crisis as a way to reshape the healthcare system and reduce the number of active beds in hospitals, which will remain unused even after the state-of-emergency ends.
featured photo: Csaba Bús/MTI