Though I knew moving to a new country would mean adjusting to new healthcare policies, I hadn’t anticipated just how different Hungary’s healthcare system would be from the Dutch system I was used to.

The differences between Hungary’s healthcare system and that of The Netherlands were stark. I had anticipated and prepared myself for change; Despite my mindset, I was nonetheless caught off guard.

I do not envy the policymakers, politicians, and healthcare professionals who are responsible for dealing with healthcare reform. It’s a tall and thankless task — fixing a system in deep financial troubles plagued by structural inefficiencies. In an industry as big as healthcare, reform requires a system-wide overhaul, complete with a long-term organizational strategy and relentless determination not to get discouraged by the sheer weight and size of the task.

Improving healthcare delivery in a systematic way that involves all stakeholders is quite a challenge. I have talked to many passionate people who are approaching healthcare reform from different angles. All of them want to implement real change, and yet, their genuine motivation and work ethic don’t suffice when it comes to initiating fundamental change in the system.

The issues that need to be solved are so large. It’s difficult to know: how or where do we begin? As I see it, these are the major challenges that Hungary faces in reforming its healthcare system:

Financial

• Most hospitals in Hungary are in significant debt. This has, in exceptional cases, led to patients going without a hot meal for several days because the hospital could not afford to provide a hot meal.

Decrepit Infrastructure

• Many hospitals are old and in desperate need of repair. These conditions also lead to medical quality and access issues, as many overcrowded inpatient wards lack air-conditioning and modern ventilation.

Education / Communication Issues & Inefficiencies

• There is a significant knowledge gap among healthcare professionals in specialized centers and city hospitals. For too many patients, these gaps result in delayed diagnoses, which decreases their chance of making a full recovery.

Regional / Geographic Demand

• In certain areas of the country, Hungary’s subpar medical care is reflected in larger-than-usual discrepancies in life expectancy. Depending on where you live in Hungary, the life expectancy for women varies by nearly 13 years and for men, by 7 years.

Cancer

• Hungary’s oncology mortality is currently the highest of all OECD countries.

“Brain Drain” / Doctor Shortages

• Scores of health care professionals leave Hungary because they can find better opportunities elsewhere. Wages are significantly higher and working conditions are much better abroad. The shortage has resulted in facility and temporary hospital department closures.

Inpatient Treatment / Drug Access and Resources

• More and more hospitals face insufficient funding for advanced antibiotics, perinatal nutrition, and other treatments for patients admitted with terminal cancer, often resulting in cancer patients dying within two weeks of admission.

Insufficient Health Literacy

• Many Hungarians lack basic health education and they fail to realize and/or become aware of symptoms until it is too late. Some patients avoid going to the doctor altogether, and others delay appointments so that they are diagnosed in the late stages of their illness without much hope of recovery.

Informal payments

• In a system where informal payments are still common, people pay health care professionals to be prioritized for surgery or have a more private room.

As this long list of issues shows, there isn’t a magic bullet or a panacea when it comes to reforming Hungary’s healthcare system. I commend, admire, and respect all of the people who are working tirelessly to make a difference wherever they can. In light of my own experience, I’ve asked myself: how can I contribute to a solution?

Obviously, it’s impossible to tackle every issue that I have mentioned here. And yet, doing nothing isn’t an option. So, how can value be added?

Facilitating a dialogue among different stakeholders is a good place to start. Due to the overload of challenges experienced by all wishing to contribute to improving healthcare, there is often not enough time nor possibility to truly listen and understand each other. That makes it very difficult to identify where synergies and small steps forward can be found. This dialogue can become even more meaningful when supported by additional research that incorporates the perspective of patients. Taking a true patient-centric approach brings down barriers, further helping to find small improvements or even real solutions.

Initial feedback to this approach has been positive. Currently, an ongoing in-depth myeloma study in which haematologists and the patient association collect data and detailed qualitative information from patients has yielded promising results. This method is useful because it allows haematologists to learn about disease from the point of view of their patients, as they