Ivkova: State Hospital Debts Reach €426 Million, €56 Million in Projects at Risk

The debts of state hospitals have reached €426 million, of which over €21 million are overdue. This was announced by the Minister of Health, Katya Ivkova, during her first press conference after taking office, where she presented the actual state of the system, the main problems in the sector, and the priorities of the Ministry of Health’s leadership.

“The goal of this first meeting is transparency. We want to clearly state from the very beginning what the real condition of the healthcare system is, what the main challenges are, and where we are starting from,” Ivkova stated.

According to her, the problems in the sector have accumulated over years and cannot be resolved in a short period, but it is important that they are clearly defined and that a specific direction for action is taken.

“Despite the difficult legacy, the healthcare system functions thanks to all the medical specialists who stand behind it,” the Health Minister emphasized.

Ivkova presented data from a report she requested regarding the financial and staffing status of the system. As of March 31, 2026, medical facilities with over 50% state participation have accumulated total liabilities exceeding €426 million, with over €21 million of these being overdue.

According to her, 17 state medical facilities also have bank loans, which is an indicator of serious financial pressure on the system.

“It is important to emphasize that there are different reasons and different situations behind these numbers. Not every hospital with large debts is poorly managed,” Ivkova noted.

She specified that among the medical facilities with the most serious financial difficulties are St. George University Hospital – Plovdiv, Pirogov Emergency Hospital, and Alexandrovska University Hospital, but emphasized that all three hospitals have no overdue debts.

The Minister also announced that meetings have already been held with state representatives on the boards of directors of 64 state medical facilities. They have been requested to submit monthly reports on financial status, staffing, and opportunities for improving performance indicators.

“We have set a requirement that if a medical facility is not making a profit, it should at least not be operating at a loss,” Ivkova added.

During the press conference, it also became clear that there is a risk of losing over €56 million in projects funded by European funds. According to the Minister, there have been serious delays in the implementation of a number of projects over the last three years.

“I have already requested a detailed analysis of the status and implementation of each project. Upon its completion, we will publicly present the results and the specific actions we will take,” she stated.

The total amount of expenditures made by the Ministry of Health up to April 30, 2026, amounts to €188.38 million. Of these, €156 million are for financing medical activities outside the scope of mandatory health insurance, and €32 million are transfers to the National Health Insurance Fund (NHIF).

Minister Ivkova also commented on the National Children’s Hospital project. She pointed out that the public procurement for design and author’s supervision, with an estimated value of €5.041 million, has been suspended due to a complaint to the Commission for Protection of Competition.

According to her, the company engaged in the project has €47.5 million at its disposal, which must cover design, project management, and current expenses.

“For the last three years, the only work completed on this project is the design support provided by the consortium with the European Bank for Reconstruction and Development,” Ivkova said.

Among the main priorities of the Ministry of Health’s leadership, the Minister highlighted prophylaxis and prevention, maternal and child health, mental health, staffing the system, the development of e-health, and the introduction of real indicators for the quality and accessibility of medical care.

She also announced the start of an update to the National Health Map, including an assessment of the possibilities for its digitalization.

“This will be one of our focuses as early as this year,” the Minister stated. “We will not promise quick results and easy solutions. But we will work for the sustainable development and upgrading of the system,” Katya Ivkova concluded.