Demand

The deputy director of the Czech national health insurer described hospital purchasing of centre drugs as sitting on a grey zone of retrospective bonuses worth an estimated 3.5 billion CZK, against VZP centre-drug spend of 22.5 billion CZK in the previous year, and argued that letting insurers tender these medicines jointly would produce savings in the hundreds of millions and more transparency. He confirms hospitals as public contracting authorities are already obliged to tender medicines.

“U nás ve VZP to bylo za minulý rok 22,5 miliardy Kč u centrových léků”

NKU audit 24/03, published 3 March 2025, found that the Culture Ministry, which spent 446.7m CZK on library digitisation in 2017-2023, set goals too vague to evaluate, did not track the effects of its VISK grant programme and assessed applications non-transparently, with conflicted committee members left voting. It paid 12.7m CZK of grants above the legal limit, funded 24 projects in breach of the rules, and carried out a single public-administration inspection of VISK in seven years.

“Ministerstvo netransparentně hodnotilo žádosti, poskytovalo dotace v rozporu s nastavenými podmínkami a za sedm let provedlo pouze jednu veřejnosprávní kontrolu u programu VISK.”

NKU audit 23/14, published 17 February 2025, found facts suggesting a breach of budget discipline in 7 of the 19 brownfield-regeneration projects it audited at 17 grant recipients (about 255m CZK), and doubts about value for money in three. The Regional Development Ministry counts only signed contracts, keeps no data on the area of brownfields regenerated, and missed two measures of its own national brownfield strategy.

“NKÚ však hodnotí jako nedostatek, že MMR kromě počtu smluv neeviduje např. údaje o výměrách území brownfieldů a nevyhodnocuje údaje o územích již zrevitalizovaných díky poskytnuté podpoře.”

NKU audit 24/01 found support for building and renovating pavements and pedestrian routes (9.5bn CZK over 2014-2023) was largely not spent purposefully: ministries do not know what overall outcomes they want or achieved, support was not steered where most useful, and 17 of 23 audited projects were assessed as non-purposeful or only partly purposeful (10 also uneconomical). NKU recommends redesigning the whole support system.

NKU audit 23/10, published 20 January 2025, found that the Interior Ministry spent 2,373.9m CZK on Police uniforms and kit in 2018-2022 without the kit standardisation it had promised since 2017, so it bought surplus stock in some items and ran short in others. In 8 of 12 sampled contracts it did not claim contractual penalties for late delivery, and part of the claims had lapsed by the time it acted.

“NKÚ na kontrolním vzorku 12 veřejných zakázek na pořízení výstroje zjistil, že MV při pozdním dodání výstroje u osmi z nich bez jakéhokoliv objektivního důvodu neuplatnilo a nevymáhalo smluvní pokuty.”

NKU audit 23/31 found complex land consolidations — key for farming access, erosion and drought resilience — are finished in only 24.9% of cadastral areas after 33 years and 36.2bn CZK; completing the remaining 9,186 areas would need at least 144.9bn CZK and ~50 years at the current pace. The Agriculture Ministry does not track effectiveness and has no cost estimate of its own.

An ombudsman survey of the regional authorities and ministries that handle second-instance complaints about healthcare providers found that only 7 percent (147 of 2,115) of complaints filed in 2018-2022 were upheld, with rates per inhabitant varying almost ninefold between regions. 53 percent of the authorities report obstacles in securing independent medical experts in most specialties and 59 percent in convening independent expert commissions, citing experts' workload, fear of conflict with complainants and low pay averaging 409 CZK an hour.

“Více než polovina správních orgánů (53 %) uvedla, že vnímá překážky při zajišťování nezávislých odborníků ve většině oborů.”

The MPSV Statistical Yearbook 2024 (tab. 5.9) records 70,209 unsatisfied applications for domovy pro seniory and 37,849 for domovy se zvlastnim rezimem as of 31 Dec 2024, plus 4,043 for homes for people with disabilities. Families apply to many homes at once, so these figures are a demand-pressure index of queue intensity, never a headcount of waiting persons.

“POČET NEUSPOKOJENÝCH ŽÁDOSTÍ O SOCIÁLNÍ SLUŽBY K 31. 12. 2024”

8th Brno participatory budget: 20,493 voters (near the 20,676 record) split 35M CZK among 7 winning projects, each just above 4,000 votes. Two of seven winners are street-tree planting projects; rest: playgrounds/sport access, community garden, culture.

At a Transparency International Czech Republic round table on corruption risk in hospital procurement and hospital board appointments, the supreme audit office stated that the largest volume of failings it finds sits in medicines and medicine purchasing, where buying often happens without proper competition, directly. A second speaker put the share of pharmaceutical purchases actually tendered at around 60 percent, up from a situation in which tendering medicines was the exception.

“Za nás nejvíce pochybení dochází v oblasti léčiv a nákupu léků. To pochybení je v jejich samotném nákupu, ke kterému často dochází bez řádné soutěže, tedy napřímou”

Ombudsman research (2023, 239 of 280 municipal building authorities responding) found authorities denied only 10 of 305 requests (3%) for exemptions from the barrier-free construction decree, fewer than one in ten (9%) ever used a supervisory measure, and 29% of appellate building authorities never assessed accessibility at all. Completed buildings are rarely checked for actual accessibility, hollowing out the CRPD-based rules.

Ombudsman research (2023) found deinstitutionalization of disability care has stalled: 126 new community-housing (CHB) facilities were created in 2007-2015 but only 26 in 2016-2022 (a ~80% slowdown), while the number of institutional DOZP facilities was 208 in 2022 versus 205 in 2007. No region reported having transformed all facilities and only 11 regional development plans target community services by concrete criteria.

Petition against demolishing Plzen-Line airport for a VW gigafactory and for keeping the military air rescue (LZS) base collected 8,200+ signatures in ~3 weeks (2023) and was handed to the regional governor. Core fear: emergency-care coverage for W. Bohemia.

Petition against closing ~300 Czech Post branches (3,220 -> ~2,100 network plan) gathered ~105,000 signatures from 840+ municipalities within weeks in spring 2023. Citizens demand physical service-point access, esp. for seniors and small towns.

Ombudsman research analyzed 726 files of children in temporary foster care (PPPD) across all regional authorities and found systematic record-keeping failures - missing inter-regional cooperation records, suitability notices and court decisions. All regions except two waited nine months or more in at least one case before asking other regions to find a child a permanent foster or adoptive family (Usti region: 15 such cases, 6 over a year), prolonging children's stays in what should be short-term care.

The Czech competition authority published guidance for healthcare providers on buying medicines under the public procurement act, saying it was meeting the problem ever more often in its decision-making and methodological work. It acknowledges that delivery timing for medicines is frequently critical, that providers must be able to issue and fulfil individual orders within hours, and that there is no healthcare exemption from procurement law.

“se při své rozhodovací i metodické činnosti stále častěji setkává s problematikou nákupu léčivých přípravků”

Zalohujme petition for a deposit-return system on PET bottles and cans was handed to Parliament with 35,596 signatures (Feb 2022); combined Zalohujme+Greenpeace campaigns counted ~250,000 supporters. Demand preceded the 2024-25 government bill.

Petition against cutting passenger trains on 12 Central Bohemian routes (2,862 signatures) demands preserved timetables, unified PID train/bus pricing and modular rolling stock. Same ask recurs region after region whenever timetables shrink.

The Czech health ministry agreed with the innovative pharmaceutical industry association to build a database of real unit prices of medicines delivered to the hospitals it directly manages, in pilot from 1 January 2019 and full operation from 1 February 2019, so that it could for the first time compare purchasing efficiency across those hospitals. Reports show each product's weighted average price and its highest and lowest actual unit price, and the unit prices are contractually barred from being published elsewhere.

“u každého léčivého přípravku údaj o váženém průměru jeho ceny a o jeho nejvyšší a nejnižší reálné jednotkové ceně uvedené v databázi”

The Czech supreme audit office found that Fakultni nemocnice Brno, Fakultni nemocnice v Motole and the central military hospital bought medicines and medical supplies very often without any tender, by direct order, over 2014 to 2016. Prices for identical products differed sharply between them even from the same supplier — MEROPENEM KABI cost one hospital 956 CZK a pack and another 3,300 CZK, and PIPERACILLIN/TAZOBACTAM KABI 385 CZK against 2,103 CZK.

“Například lék MEROPENEM KABI nakupovala ÚVN po 956 korunách za balení, FNB jej pak pořizovala za 3 300 korun za balení.”