In 2010, Bulgarian hospitals will have their resources cut by 300 million leva, in accordance with the new budget outlines, Bulgarian National Radio (BNR) reported on November 3 2009.

Resources for prophylactic programmes will also be slashed, according to the report. The tight financial measures will also affect the budget of the National Health Insurance Fund, where severe reductions are earmarked.

The revelations come at a time when the country is still quagmired in an economic crisis, but worst of all, is gearing itself to face the full onslaught of an influenza epidemic without adequate resources, which will make an arduous year ahead for medical establishments, even harsher.

"A small pizza with scanty decorations," is how Finance Minister Simeon Dyankov referred to the state budget for 2010.

"The most worrying part in connection with the budget and the analysis that was made are the long overdue debts of the health care institutions within the hospital system", said Health Minister Bozhidar Nanev for the BNR

"Compared with the previous year these have increased from 33 million leva to 51 million leva. The overdue debts of the municipality hospitals are about 20 million leva. We have undertaken certain measures and demand explanations from the directors of these hospitals how they have accumulated such debts".

The financial strain on the health sector is exacerbated by the fact that, relative to its size, Bulgaria has more than 300 hospitals, and as such, the issue of privatization of hospitals is one of the ever-present burning questions.

Out of a total of 130 provincial hospitals, only nine qualify under international standards as modern multi-profile hospitals and have more than 2000 operations performed annually. Some hospitals in the country exist and absorb financial resources for active treatment when they actually only handle patients with chronic diseases, as well as the poor and the elderly and, as such, only execute social services rather than active medical treatment.

The World Bank says that every Bulgarian municipality currently possesses between 33 and 59 multi-profile hospitals, but this has neither improved the quality nor the safety of patients, or the effectiveness of services, judging by European and world standards. It is precisely those clinics that urgently require restructuring and most need their services and standards improved and made effective.