The authorities constantly talked in 2025 about reforms, modernization and digitization in the health system, but the reality in hospitals, whether public or private, revealed persistent structural vulnerabilities. Several scandals came to shake the already reduced trust of patients in a system whose reform has been announced for so many mandates. The fact that we are no longer hiding the garbage under the rug, but talking about the problems is a sign that we have reached a point from which only action can save us.
The government announced the maintenance of Health as a priority area, but doctors and patient organizations pointed out that the words do not correspond to funding and that the allocations do not cover the increase in the costs of medicines, investigations and innovative treatments. At the beginning of February, patients were waiting for a list of drugs that should have been adopted, but it came almost on the threshold of winter. Dissatisfaction with the blockages in the CNAS computer platform, which worked with repeated syncopes all year, also continued. The authorities have promised the accelerated implementation of PIAS (Health Insurance Informatics Platform), which will bring massive digitization of medical services, such as electronic prescriptions and referrals, integrated reporting, access to data and digitized administrative flows, etc.
Insurance restructuring
The spring also brought to the fore the problems of access to medical services and the quality of the medical act. At the same time, the Ministry of Health announced the expansion of screening programs and the intention to accelerate prevention, especially for oncological and cardiovascular diseases, a positive signal in a system traditionally focused on treatment, not prevention.
In autumn, the authorities announced measures to increase the transparency of hospitals, by publishing some performance and activity indicators, the step being welcomed by civil society, but unevenly applied. Discussions on the subject of human resources also returned instead. Doctors complained about overwork, staff shortages and the lack of real incentives to stay in the public system, and family medicine signaled the risk of collapse in rural areas, in the absence of coherent policies to attract young doctors. From August 1, several categories of patients found themselves uninsured, the notion of co-insured being eliminated, people being forced to pay to continue to benefit from services.
Autumn came with two tragedies produced in two private units: the death of a young mother who chose to give birth to her baby boy in a private hospital in Constanța (serious complications arose, the woman was transferred to the state hospital, but died shortly after); a 2-year-old girl died as a result of anesthesia in a private dental clinic in Bucharest. The cases have brought up longstanding issues of patient safety in the private sector and state controls over private facilities. The Ministry of Health reacted by announcing thematic controls in private units and the verification of emergency protocols. Discussions were started on strengthening the accreditation mechanisms, but civil society criticized the late nature of the reactions.
The 24 hospitals financed by PNRR that remained eight
Infrastructure investment continued in 2025, but the authorities adjusted the original plans. If the National Recovery and Resilience Plan (PNRR) initially announced funding for the modernization or even the construction from scratch of 24 hospitals/hospital buildings, the fall of 2025 brought us down to earth, leaving only eight on the list: Cluj Emergency Hospital, Craiova Emergency Hospital, Bistrița Emergency Hospital, “Agripa Ionescu” Hospital from Balotești, Sibiu Hospital; “Zerlendi” Hospital in Bucharest, Târgu Mureș Heart Hospital, “St. Apostol Andrei” Constanța Hospital. The Ministry of Health instead reported punctual progress: modernization of wards, expansion of equipment and the expansion of some telemedicine services, especially in isolated areas.
After months of waiting and criticism from patient organizations, the drug list was also approved, which does not solve the problem of limited access to innovative treatments, but is a step forward. On the other hand, the authorities announced updates to the lists of reimbursed drugs and promises to simplify administrative procedures. Financially, the situation remains complicated, the need for money at the end of the year being approximately 11 billion lei for CNAS to be able to pay the debts to pharmacies, hospitals and medical leaves incurred by employers. In the context in which the rates paid to hospitals are considered undersized relative to the actual costs of medical services, the financial crisis, in the absence of other measures aimed at balancing the financing mechanisms, may deepen.
Prevention, an ignored topic
“It was a very, very busy year”appreciated for “Weekend Adevărul” Radu Gănescu, president of the Coalition of Patient Organizations with Chronic Diseases (COPAC).
Patient access to treatment, one of the hot topics, faced major challenges, with the list of new molecules being delayed until the fall. “The negative thing is that it did not happen at the beginning of the year to have faster access to those molecules. We hope that from now on things will improve, in the sense that we all know, especially the patients, that every year this list will be updated and changed with new molecules to increase patients’ access to treatment. We support this and believe that the authorities should give more importance to access to treatment, because the appropriate treatment in a diagnosed patient will decrease certainly the expenses”, Ganescu explained.
The discussion about efficiency – which in 2025 was a leitmotif for all fields – should be carried out in health starting from the need for patients to be diagnosed as quickly as possible through screening programs, to institute rapid treatment and to save money that otherwise ends up being spent on patients who arrive at the hospital in a serious condition, increasing expenses and crowding health facilities. “Certainly, the money we don’t invest now we will pay in a month, in half a year, in a year with patients who will have to benefit from more medical services or investigations”, draws the attention of Radu Gănescu.
With or without well-designed prevention programs, the system cannot support the services it has, at least theoretically, undertaken to provide to vast categories of patients. “You can’t treat 15 million and only contribute 5 million to the budget. Either someone has to pay for the other people, or the state has to insure them in one form or another. In the last 15 years, the state has given facilities to various categories, but those facilities have not been established physically, with funding in the state budget. The state has given very little to the Health budget”draws Gănescu’s attention.
The financing of medical services should be accompanied by a strict control of the quality of the services provided. “They have to check if what they’re paying is ok, it’s good for the patient, it’s cost-effective, things that haven’t happened so far,” Gănescu specified. It is also the time for a discussion on the standardization of protocols and the interoperability of databases, and for the last aspect the change of the information system of the CNAS, which is underway, could be the solution.
