Two billion for university hospitals: instead of necessary renovations of medical facilities, mainly purchases of equipment were supported
PRESS RELEASE ON AUDIT NO 24/09 – 18 AUGUST 2025
Although university hospitals (UH) are a fundamental part of the backbone network of hospitals in the Czech Republic and an irreplaceable provider of healthcare services, including highly specialised care, they are located in outdated facilities and buildings that do not meet the current requirements of modern medicine. State financial support in the amount of CZK 2 billion, provided by the Ministry of Health (MoH) from 2016 to 2022 under the Programme for the Development and Renewal of the Material and Technical Base of UH, was intended to contribute to changing this situation and improving the quality of healthcare provided in UHs. Although the reconstruction and modernisation of medical and other facilities at UHs was supposed to be a key part of the programme, the purchase of medical equipment and other machinery and devices prevailed. At the same time, some of the purchased equipment was ultimately used only to a limited extent by UHs, precisely because of unrealised construction projects. This was revealed by an audit of the Supreme Audit Office (SAO) focused on these funds.
"We found that none of the parameters relating to construction projects, renovations, and modernisations of UH buildings were met. For example, operating rooms were not modernised. On the contrary, university hospitals prioritised the purchase of medical equipment and other machinery and devices. Here, the plans were even significantly exceeded. For example, 14 vehicles were purchased for patient transport, even though the original plan was to purchase only one,” summarised Vladimír Koníček, a Member of the SAO Board, who lead the audit.
The MoH repeatedly provided funds from the state budget for the development and renovation of UHs without sufficient information to make decisions on the allocation of this support. The Ministry did not have a comprehensive concept for the development of the material and technical base of UHs, nor did it have the necessary analysis of the construction infrastructure of the hospitals. Although the MoH provided a total of CZK 2 billion to subsidy recipients, it did not carry out any public administration audits on them, in violation of the Financial Control Act. This means that it did not physically verify compliance with legal regulations, conditions for drawing funds from the state budget, or compliance with the principles of effectiveness, economy, and efficiency. The SAO has repeatedly pointed out the absence of audits of subsidy recipients. At the same time, the MoH committed itself to improving its own audit activities in 2014 after the SAO Audit No 13/13.
Based on a sample of eight audited investment projects, the SAO found that the MoH assessed grant applications in a non-transparent manner, thereby treating grant recipients unequally. An example of this is a situation where applicants for subsidies submitted their investment plans after the deadline for five projects. In this case, the MoH violated its own rules by not rejecting these investment plans and providing subsidies worth more than CZK 111 million.
The SAO audited three university hospitals – UH Hradec Králové, UH Olomouc, and General University Hospital in Prague (GUHP). At the latter, the auditors found that a total of CZK 2.2 million had been spent ineffectively and in an uneconomical manner. The amount of CZK 1.8 million is related to the plan to build a new central emergency room at the GUHP. The GUHP paid this money to the contractor for project documentation, which, however, was not and will not be used. By 2024, construction of the emergency room, which had been planned since 2010, had not even begun. The GUHP therefore continues to operate the emergency room in unsuitably located buildings. The remaining CZK 351,000 of the amount spent in an uneconomical manner relates to the purchase of a lead window (for the CT scan examination room), which, however, remained unused until the end of the SAO audit, i.e. for almost four years.
At UH Olomouc, auditors found, for example, that the expected scope of construction work had been incorrectly assessed for one of the projects, which increased the scope of the work and raised the price from the original CZK 1 million (excluding VAT) to CZK 4.4 million (excluding VAT).
Communication Department
Supreme Audit Office