Bolojan: Some hospitals spend 90% of their budget on salaries. Analysis requested by next week

Acting Prime Minister Ilie Bolojan explained on Thursday, at a press conference held at the Victoria Palace, the situation regarding posts in the Healthcare sector. According to him, staff costs in hospitals, measured against the amount contracted with the National Health Insurance House (CNAS), represent an average of 65%, but there are approximately 50–60 hospitals where this figure rises to 90% of the total contract value.

"What this means is that such a hospital is no longer focused on patients, because those running it have no money left for medicines, treatments, tests, or combating nosocomial infections. So there are hospitals that are, in practice, dedicated to their employees," said Bolojan.

The Prime Minister also provided further figures relating to staff in the public health system. Out of a total of approximately 193,000 employees, the authorities have recently received requests to unfreeze 26,000 posts — representing more than 10% of the total number of existing positions. At the same time, of the 132,000 hospital beds in Romania (90% of them in the public sector), the average occupancy rate is just 63%. Bolojan noted that there are hospitals where the occupancy rate drops to 40–45%, meaning that half of the beds remain unoccupied.

Regarding the evolution of costs over time, the Prime Minister pointed out that staff expenditure in Healthcare started at approximately 6,000,000,000 RON in 2015 and has since risen to over 25,000,000,000 RON today — a fourfold increase.

Bolojan also stated that managers of public hospitals in Romania receive two thirds of their salary funding even in the hypothetical scenario where no patients were treated, with the remainder coming from the tariffs contracted with the Health Insurance House for services provided to patients.

The Prime Minister explained why there was reluctance to approve all 26,000 requested posts in full: of these, the Ministry of Health proposed to the Ministry of Finance the approval of 7,700 posts. Had all 26,000 posts been filled from next year onwards, the additional cost would have been approximately 1,000,000,000 RON, without the structural problems within Healthcare being examined and addressed.

"Today, in the Government meeting, in addition to adopting the memorandum on emergency cases at Marie Curie, I asked the Ministry of Health and CNAS to complete, by Monday, an analysis in which hospitals whose staff costs exceed the national average should be penalised when submitting further requests for staffing increases, and hospitals with an occupancy rate below the national average should likewise be penalised," Bolojan stated.

According to the Prime Minister, where both situations occur simultaneously at the same hospital, a section-by-section analysis is required: sections with no activity should have their bed numbers reduced, and staff should be redirected to active sections or to newly established ones. Bolojan cited the example of palliative care beds, noting that Romania has only 4,000 such beds, even though demand for this type of care — particularly relevant for elderly patients and serious cases — is far greater.

Regarding medical personnel, the Prime Minister noted that approximately 27,000 doctors work in the public sector. Each year, around 7,000 students graduate in general medicine, half of them fee-paying and half tuition-free (fully funded by the Romanian state). Of these, 4,000–5,000 go on to complete their residency, and ultimately only 1,000–1,500 end up actually employed within the system. Bolojan concluded that the number of graduates exceeds the system's actual requirements.