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Hungarian Patients Wait Months on ‘Secret’ Hospital Registers for Surgery

Bence lives in a municipality in the Hungarian region of southern Transdanubia. Last April, he was put on the waiting list for hernia surgery, but he will almost certainly not have the operation this year.

“Before I went to the surgeon, I checked the official hospital waiting list database. It showed that where I was waiting, the average wait for this type of surgery was 13 days in the last six months. Even though I struggled with maths in high school, I could work out without a calculator that six months is not 13 days,” he told Atlatszo, a Hungarian independent media outlet.

Bence got an appointment for abdominal surgery a month-and-a-half after receiving his diagnosis. Since then, he has visited several hospitals, all of which have predicted similar waiting times.

Bence’s is just one of more than 200 responses to Atlatszo’s April survey on patients’ experiences of Hungarian hospital waiting lists.

The law states that patients on the list must be informed of the reason for the wait and the expected time. The doctor must also explain the possible consequences of the waiting time. However, according to the Atlatszo survey respondents, this is not the case.

The national waiting list register, managed by the National Health Insurance Fund Management, NEAK, determines the order in which patients can access the care they need. The doctor determines the need for surgery and registers the patient in the system. At the same time, patients receive a secret identification number, which they can use to track their medical records and scheduled surgery dates in the online register.

‘Almost every hospital has a secret waiting list’

A healthcare professional who asked to remain anonymous confirmed the existence of unofficial, hidden, waiting lists.

“The real numbers are hidden. Almost everyone has another waiting list to record patients. It can be a notebook, an Excel spreadsheet, or a specifically designed program, but it certainly doesn’t always match the official figures,” he said.

The Hungarian government has spent 13.6 billion forints, or 38.3 million euros, since the COVID-19 pandemic and 58 billion forints, or 163.4 million euros, in the last ten years to reduce hospital waiting lists. Yet, it has failed to reduce waiting times for several operations.

The situation in Hungary is even worse in some other European countries. Yet there are certain types of surgery, such as hip or knee replacements, where Hungary is one of the leaders with long waiting times.

Eva lives in Budapest, the capital, and has a progressive deterioration in her hip joint. Her doctor recommended hip replacement surgery in December 2020. The waiting list for these operations is one of the longest in Hungary, with nearly 6,500 people waiting for surgery. The average waiting time is 189 days, over six months.

But the hospital said Eva would have to wait more than a year for surgery. She was only put on the official waiting list after a preliminary, unofficial list. Twice as many people were waiting on the unofficial list at the institution, and most of them did not even know it. Because of the pain and the long wait, in spring 2022, Eva decided to go to a private clinic in the summer. She paid two million forints, equal to 5,200 euros, for the operation.

Pay or travel

Eva is not alone: more Hungarians are opting for the private sector. According to the National Health Insurance Fund Management, NEAK, last year 80 per cent less patients were treated in public healthcare compared to 2019.

Private healthcare is not the only option for those who want to shorten waiting times. Twenty-three Atlatszo respondents said they did not go to their local hospital. Data show that many patients travelled 100 to 200 kilometres to receive care.

In some cases, patients travelled hundreds of kilometres not to reduce waiting times but because they had no other choice, since some operations are not performed in all hospitals.

The Hungarian Medical Association has not seen significant improvement since the pandemic. They say it is impossible to separate the issue of long waiting lists from the anomalies of the healthcare system.

Fragmented health structures, staff shortages, and underfunding are all problems that need to be solved, and until then, “all intervention is quick fixing with low effectiveness,” they told Atlatszo.

Waiting almost four years for surgery

The longest waiting time reported by Atlatszo respondents was for a minor orthopaedic procedure, a bunion and hammer toe operation. Last year, doctors predicted waiting times of 1,390 days, or nearly four years for these.

Based on personal experience, patients waited years on an average for gallstone operations (an average of 739 days, or two years), knee replacement (an average of 592 days) and inguinal hernia surgery (an average of 512 days).

Most patients have not been informed about why they should be on the waiting list and what the health consequences could be. Institutions explained the long waiting times by a lack of money, equipment or staff. In another case, the hospital did not know when an operating theatre would be available, so they estimated a waiting time of two or three years.

Bence has not yet received his ID number, so is not on the official waiting list. He will receive more information about his surgery date in the autumn. By then, he will have been waiting five months – while the official database shows that the average wait for abdominal and inguinal hernia operations with implants in the South Transdanubia region has been one-and-a-half months over the last six months.

Source : balkaninsight