Zsolt Hegedűs, Hungary’s Incoming Health Minister, Announces Major Changes at State Foundation Responsible for Life and Death Decisions

The Batthyány-Strattmann László Foundation for Healing is a state backed public benefit organization that plays a key role in Hungary’s healthcare financing system. The foundation’s primary task is to provide support, on a case by case basis, for expensive, rare, or otherwise non funded medicines and treatments that are not automatically covered by the national health insurance system. Recently, Zsolt Hegedűs, the incoming health minister of the future Tisza government, sharply criticized the foundation’s operations.

The foundation makes decisions based on individual applications submitted by doctors, taking into account medical evidence, cost effectiveness, and principles of solidarity. It manages substantial resources in 2026, for example, it will operate with a budget of 47 billion forints and receives as many as 800 to 1,000 applications each month. However, increasing criticism has emerged regarding the transparency of its operations and decision making processes, according to an article by Index.

What Did Zsolt Hegedűs Say?

Zsolt Hegedűs, who spent ten years working within the UK’s NHS and was one of the leading figures of the “1001 Doctors Without Gratitude Payments” movement, recently voiced serious concerns about the foundation’s functioning. According to him, it is unclear what criteria are used when decisions are made, and applications are often processed too slowly a particularly serious issue when life saving therapies are involved.

Hegedűs argued that decisions regarding the funding of life saving medicines cannot take place inside a “black box,” and that the lack of transparency raises not only professional but also ethical and trust related concerns. He also warned that the uncertainty of the current system could worsen during a potential political transition, making reform increasingly urgent.

The minister designate shared his detailed plans on social media.

Learning from International Models

Hegedűs proposed studying international examples while emphasizing that no foreign system can simply be copied into the Hungarian environment. From the British NICE model, he highlighted transparency and publicly available decision-making criteria as key strengths. He also praised the German system for its clear separation of responsibilities.

In Germany, one body carries out the scientific and professional assessment, while a separate committee makes the final decision based on social, financial, and ethical considerations.

At the same time, Hegedűs pointed out that Hungary operates with fewer resources, lower institutional trust, and a different social and political environment. Therefore, he believes the country needs a smaller but cleaner and more transparent system. He proposed implementing a “mini hybrid model” that would combine international best practices with Hungary’s domestic realities.

Planned Reforms

Under the proposed reforms, the foundation’s structure would be reorganized to include a strong professional evaluation unit alongside a separate decision-making body. The committee would include doctors, healthcare economists, bioethicists, and patient representatives.

According to Hegedűs, the public release of decision summaries should become mandatory, along with the establishment of clear ethical principles balancing fairness, medical necessity, effectiveness, and cost efficiency.

As he put it:

“There is no such thing as a perfectly fair decision only principles that are openly accepted and consistently applied.”

The incoming minister also emphasized the importance of patient communication. In his view, clear explanations and understandable reasoning behind rejected applications are just as important as the decisions themselves. Patients often feel vulnerable not because of the outcome, but because they do not understand why a decision was made.

Hegedűs stressed that when it comes to life saving treatments, professional and ethical principles must be transparent, consistent, and communicated in a way that patients themselves can clearly understand.

Part of a Broader Healthcare Reform Agenda

The restructuring of the foundation could become one of the key elements of the planned healthcare reform package. Hegedűs has already announced plans to dismantle facial recognition systems in hospitals and launch independent investigations into public procurement deals made during the Covid 19 pandemic.

The proposed reform of the foundation fits closely into his broader agenda of transparency, accountability, and professional renewal within Hungary’s healthcare system.

Following the formation of the new government, the structural transformation of the foundation is expected to become a top priority, with the goal of creating a cleaner, more accountable decision making framework.