BAPHC calls for revision of salary provisions in the 2026 NHIF budget

The Bulgarian Association of Professionals in Health Care (BAPHC) expressed serious criticism regarding the provisions in the 2026 NHIF draft budget concerning the minimum remuneration of medical specialists. In a position statement structured in seven key points, the Association warns that the proposed mechanisms are “wishful thinking,” lacking real guarantees and sufficient financial backing.

The main arguments of BAPHC are as follows:

1. Lack of sanctions for non-compliance with minimum wages: The texts do not describe control mechanisms, a supervisory body, or specific administrative penalties for violations. This creates a risk that minimum remunerations will remain only on paper.
2. No mechanism for regular salary updates: Against the backdrop of inflation and a dynamic labor market, the lack of a regulated procedure for updating minimum rates is a serious omission.
3. Lack of precise definition for “healthcare professionals”: Insufficient clarity allows for potential abuses—such as renaming positions to avoid applying minimum wage requirements.
4. Insufficient financial resources: The projected €260 million does not cover the needs even for healthcare professionals alone. According to BAPHC calculations, approximately €264 million would be required to guarantee minimum wages for roughly 28,000 specialists.
5. Risk for small and municipal hospitals: In the absence of targeted funding, the burden will fall on healthcare facilities, which may be forced to cut staff or fail to meet requirements.
6. Unclear control over private hospitals: There is no mechanism linking the implementation of minimum remuneration to NHIF contracts or clear state control.
7. Lack of a transition period for the new rules: Hospitals will not have time to adapt financially and organizationally, which poses a risk of systemic shock.

The Association insists on a substantial revision of the bill before its adoption. According to BAPHC, the following are necessary:

• clearly defined sanctions;
• stable and full financial backing;
• a mechanism for salary updates;
• a regulatory body with specific powers;
• a realistic transition period.

Only under these conditions can the reform be effective, leading to more motivated specialists and higher quality healthcare services, the Association emphasized in its position.