BHA and NAPB: Scholarships for Young Doctors Instead of Guaranteed Salaries

The Bulgarian Hospital Association (BHA) and the National Association of Private Hospitals (NAPB) have presented a position stating that the fixed salaries for young doctors proposed in the 2026 NHIF Budget draft are inappropriate and contradict the financing principles of the healthcare system. Instead, the organizations insist that funds should be directed toward scholarships for newly graduated doctors and financial support for healthcare professionals, regardless of where they specialize.

According to the Chairperson of the BHA, attorney Svilena Dimitrova, the proposal for fixed salaries is in “absolute imbalance” with the “money follows the patient” model. She emphasizes that such an approach does not account for the actual work performed or the quality of care, which could lead to a systemic deadlock. An additional issue is that the proposal covers only certain medical facilities, creating inequality.

Dimitrova specifies that a more sustainable approach would involve financial support coming from the Ministry of Health and being distributed through professional organizations. According to her, a proposal for amendments to Ordinance 1, prepared after a meeting with young residents, is also forthcoming.

The Chairperson of the NAPB, Krasimir Grudev, recalled that young doctors protested throughout the summer, demanding stable conditions for specialization and motivation to remain in Bulgaria. According to him, the proposal introduced between the first and second readings creates discrimination, as all specialists will have the same obligations but different rights, while the methodology is assigned to the NHIF Supervisory Board without the participation of professional organizations. He believes this could directly harm patients, as it does not guarantee quality under a “per capita payment” system.

The Deputy Chairperson of the BHA, Andrey Markov, added that remuneration in the system must be linked to labor performed and results achieved. He expressed the position that a much more adequate solution would be to use the funds for scholarships and targeted programs to support young personnel and provide lasting solutions for their development.