The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes informal payments. The reception has been overwhelmingly negative, with thousands of health professionals indicating that they would not sign the new contracts, and the policy also contains serious technical and feasibility concerns. Although the first statistics show that only about 3-5% of the active workforce did not sign the contract by 1 March 2021, the implementation of the reform still faces serious challenges.

Experiencia cubana en Cooperación Sur-Sur / The Cuban experience in the south-south cooperation

Hoy se viven situaciones de crisis a nivel mundial pero la económica financiera es la que amenaza con serias repercusiones a nivel global sobre todos los aspectos del desarrollo de una nación, incluida la salud. Una de las peores consecuencias ya palpable es la reducción de la Ayuda Oficial al Desarrollo que proviene de las 22 naciones más ricas del mundo y se dirige hacia los países pobres y de bajos recursos. Se pretende profundizar en la importancia de la Cooperación Sur-Sur para enfrentar situaciones de crisis y dentro de ella, un buen ejemplo de la efectividad en este tipo de cooperación lo constituye Cuba. Esta cooperación se realiza mediante la colaboración triangulada entre países del sur, transferencia de tecnologías y ayuda médica, derivados del desarrollo del Sistema Nacional de Salud cubano, además de ser parte de la política exterior del país. Cuba es un ejemplo de ayuda solidaria y desinteresada que se desarrolla desde el año 1963 con buenos resultados y demuestra que la cooperación es una vía eficaz de solución a los problemas de salud de las poblaciones siempre y cuando se trate de una ayuda justa y solidaria, dirigida a fortalecer las capacidades nacionales y acorde con las prioridades del país que la recibe.

The people are living today amid difficult situations caused by the world crisis; however, the financial-economic crisis is the one threatening the nations with serious global impacts, mainly in all aspects of development including health. One of the worst tangible consequences is the reduction of the Official Assistance for Development given by the 22 wealthiest countries to the poor and the resource-limited nations. This paper was intended to delve into the importance of the south-south cooperation to face crisis situations and a good example of the effectiveness of this type of collaboration is Cuba. This cooperation is based on the triangled collaboration among the southern countries, the transfer of technologies and the medical assistance derived from the development of the Cuban Health Care System, which is also part of its foreign policy. Cuba is an example of solidarity and unselfish assistance that has been put into practice since 1963 with good results. At the same time, it has proved that cooperation is an effective way of solving the health problems of the populations whenever this assistance is just and cooperative and aimed at strengthening the national capacities according to the priorities of the recipient country.

Experiencia cubana en Cooperación Sur-Sur / The Cuban experience in the south-south cooperation

Hoy se viven situaciones de crisis a nivel mundial pero la económica financiera es la que amenaza con serias repercusiones a nivel global sobre todos los aspectos del desarrollo de una nación, incluida la salud. Una de las peores consecuencias ya palpable es la reducción de la Ayuda Oficial al Desarrollo que proviene de las 22 naciones más ricas del mundo y se dirige hacia los países pobres y de bajos recursos. Se pretende profundizar en la importancia de la Cooperación Sur-Sur para enfrentar situaciones de crisis y dentro de ella, un buen ejemplo de la efectividad en este tipo de cooperación lo constituye Cuba. Esta cooperación se realiza mediante la colaboración triangulada entre países del sur, transferencia de tecnologías y ayuda médica, derivados del desarrollo del Sistema Nacional de Salud cubano, además de ser parte de la política exterior del país. Cuba es un ejemplo de ayuda solidaria y desinteresada que se desarrolla desde el año 1963 con buenos resultados y demuestra que la cooperación es una vía eficaz de solución a los problemas de salud de las poblaciones siempre y cuando se trate de una ayuda justa y solidaria, dirigida a fortalecer las capacidades nacionales y acorde con las prioridades del país que la recibe.(AU)

The people are living today amid difficult situations caused by the world crisis; however, the financial-economic crisis is the one threatening the nations with serious global impacts, mainly in all aspects of development including health. One of the worst tangible consequences is the reduction of the Official Assistance for Development given by the 22 wealthiest countries to the poor and the resource-limited nations. This paper was intended to delve into the importance of the south-south cooperation to face crisis situations and a good example of the effectiveness of this type of collaboration is Cuba. This cooperation is based on the triangled collaboration among the southern countries, the transfer of technologies and the medical assistance derived from the development of the Cuban Health Care System, which is also part of its foreign policy. Cuba is an example of solidarity and unselfish assistance that has been put into practice since 1963 with good results. At the same time, it has proved that cooperation is an effective way of solving the health problems of the populations whenever this assistance is just and cooperative and aimed at strengthening the national capacities according to the priorities of the recipient country.(AU)

Participación de los colaboradores holguineros en la formación de recursos humanos durante las misiones médicas internacionalistas / Participation of collaborators from Holguín province in the formation of human resources during the international medical missions

Partiendo de las ideas estratégicas definidas por Fidel en relación con la formación y preparación continua del capital humano en salud, y el desarrollo vertiginoso de la colaboración médica cubana, se realizó este trabajo de recuento histórico sobre la participación de los colaboradores de la provincia Holguín en estos procesos y en especial en la Misión Médica Cubana Barrio Adentro en la República Bolivariana de Venezuela. Se abordó la formación académica del posgrado con sus principales figuras: la especialización, maestrías y doctorado y las bases que sustentaron el desarrollo del pregrado. La participación de los colaboradores holguineros materializa la formación de capital humano en el sector de la salud, y mantiene vigente el principio de solidaridad de la revolución cubana y sus trabajadores en la meta de lograr la excelencia en los servicios de salud y cooperar activamente en la formación de los recursos humanos para Cuba y el mundo.

Taking as a basis the strategic ideas defined by Fidel about the formation and permanent preparation of the human capital in the field of healthcare, and the accelerated development of the Cuban medical cooperation, a historical account was made on the participation of medical collaborators from Holguin province in these tasks, particularly Cuban medical mission known as "Barrio Adentro" in the Bolivarian Republic of Venezuela. This account addressed the post-graduate academic formation such as specialization, master´s courses and PhD´s courses and the foundations behind the development of the undergraduate education. The participation of collaborators from Holguin province supports the formation of human resources in the health care sector and shows the validity of the solidarity principle of the Cuban revolution and its workers.