Slovakia’s Public Defender of Rights, Róbert Dobrovodský, has warned that a “systemic problem” within the healthcare sector is leading patients to pay illegal or unjustified fees, potentially violating the constitutional right to free healthcare.
In an extraordinary report submitted to the Slovak Parliament, Dobrovodský detailed a landscape of legal uncertainty where patients are often unable to distinguish between services covered by public insurance and those requiring out-of-pocket payments. The report, which stems from a self-initiated survey and numerous patient complaints, suggests that these charges are not isolated incidents but rather a widespread failure of the current system.
The financial scale of the issue is significant. Dobrovodský noted that the sector has collected approximately 500 million euros in such fees, comparing the lack of oversight to a street vendor who must use an electronic cash register to avoid fines, while doctors collecting fees of 30, 40, or 50 euros often operate without similar transparency.
According to the Ombudsman’s findings, many patients pay these fees even when they believe they are unjustified because they fear they will be unable to find another physician in their region if they refuse.
The Public Defender characterized the current situation as a combination of two “interconnected deficits”: an unstable and poorly defined legal framework for direct payments, and a failure of supervisory mechanisms to prevent and sanction unauthorized charging. This “gray zone” leaves patients vulnerable, with some facing delays in care or being denied medical services entirely if they refuse to pay.
“Here the state is failing, unequivocally,” Dobrovodský stated during a press conference on April 28, 2026, specifically referring to instances where healthcare is withheld over unpaid fees.
To resolve the crisis, the Ombudsman has urged lawmakers to implement clear legislative changes. He proposed two primary paths: either a total ban on such fees with strictly defined exceptions, or the legalization of patient payments within rigid, transparent boundaries. He emphasized that legal uncertainty in this area is “unacceptable,” as the state is obligated to ensure that the laws governing basic rights are predictable, and understandable.
The report underscores a critical gap in patient protections, suggesting that the current ambiguity effectively signals to medical providers that they are “untouchable.” Members of Parliament are scheduled to discuss the report during their May session.
The Ministry of Health has reportedly promised to introduce changes to address these systemic deficiencies in healthcare fees.
