site.btaWithout Adopted State Budget, New National Framework Agreement Cannot Be Signed - BMA Chair

In the absence of a budget, a new National Framework Agreement cannot be signed and the previous one will remain in force, said Dr. Nikolay Branzalov, Chairman of the Management Board of the Bulgarian Medical Association (BMA). He was speaking to journalists ahead of the start of the 79th extraordinary meeting of the BMA.

The delegates will vote on the parameters under which they would sign the National Framework Agreement for 2026–2028. The National Framework Agreement sets out the conditions, medical activities, and rules under which medical professionals work in both outpatient and inpatient care. The contract also specifies the volumes, activities, and their prices included in clinical pathways. The effective National Framework Agreement for medical activities for 2023–2025 was signed between the BMA and the National Health Insurance Fund (NHIF) on September 1, 2023.

“Today we will brief our colleagues on what we have achieved in the negotiation process. We will present the prices of medical activities as they were in the latest draft budget, which in any case was withdrawn. We will leave it to our colleagues at the meeting to decide what course of action we will choose going forward,” Dr. Branzalov said.

 “Political squabbles, the resignation submitted by the government, and the resulting lack of a budget will affect every Bulgarian citizen. That is why I call on them to show political wisdom and, wherever they can help Bulgarian society, to do so. Because that is their job, they are members of parliament,” he said.

According to him, healthcare in Bulgaria is severely underfunded. A difficult political decision must be made to increase the health insurance contribution. If this does not happen, by around 2040 Bulgaria will suffer very large losses. Not only the people who work in the healthcare system, but society as a whole, Branzalov said.

“There are quite a few positive provisions in the new framework contract, negotiated for both patients and doctors, but they will not come into effect in such a situation. In the absence of a budget, a National Framework Agreement cannot be signed,” Dr. Branzalov explained.

“We support the increase in remuneration for all medical professionals, both young doctors and all other colleagues working in our system,” he said in response to a question about what will happen to the planned pay increase for junior doctors. “Our position has not changed—we are against financing structures. We are in favor of financing activities, as is currently the case. I hope that a precise, targeted policy will be implemented through the Health Ministry to cover all these colleagues and provide them with additional funding throughout their specialization. Our position also applies to healthcare professionals. In the first five years after graduation they should receive targeted financial support, after which they should enter the free labor market, as all the rest of us do,” Dr. Branzalov further said.

Following another wave of mass protests, Prime Minister Rosen Zhelyazkov announced on Thursday that the government was submitting its resignation. If Parliament does not adopt the State Budget Bill by the end of this month, the government will submit a bill to extend the 2025 budget, Zhelyazkov said. “No budget will be considered by us,” GERB leader Boyko Borissov said later the same day. “We will take care and try to help ensure that prices do not rise, but people need to know that a government in resignation no longer works,” Borissov also said.