THE TOP post at the state-run health insurer left vacant after Marcel Forai resigned in late September over allegations of nepotism was promptly filled by his former subordinate who, however, also does not have an immaculate record.
On October 1, Miroslav Vaďura, who until then served as a board member and economic section director of Všeobecná Zdravotná Poisťovňa (VšZP), was appointed its general director.
Following Forai’s resignation, Health Minister Viliam Čislák said that the two members of the VšZP board – Vaďura and Antónia Borovková – will lead the health insurer until the results of the investigation by the Health Care Surveillance Authority (ÚDZS) are known. The minister pledged to reappoint Forai to head the insurer in the event the allegations are disproved but a few days later the minister officially appointed Vaďura as general director.
Forai’s resignation was forced by suspicions raised by opposition MP Miroslav Beblavý and the Sme daily that he had preferred seven companies where his 70-plus years old aunt Anna Sučková is a partner. Beblavý backed his accusations with 69 agreements worth €14 million which VšZP has signed with these companies since 2012.
After Vaďura took office, media were quick to point out that he too had relatives doing business in health care, namely his brother-in-law, Zbyhněv Stebel. Vaďura and Stebel, whose wives are sisters, even did business together in the past, Sme reported. Stebel is a partner in the Novapharm company that owns the Železničná Nemocnica hospital in Bratislava. Vaďura was employed by that hospital in 2005 as its financial and economic director. The majority shareholder of the hospital is Procare, now owned by the Penta financial group.
Novapharm was based in Košice until 2011 and moved to Bratislava on January 1, 2012. During its time in Košice the company signed some contracts with the Košice regional branch of VšZP, then led by Forai. Shortly after the 2012 elections Forai was appointed as the VšZP head.
Vaďura’s own CT scandal
However, Vaďura had been connected with some earlier scandals as well, according to Transparency International Slovensko (TIS).
The man who has been a member of the VšZP board and also served as one of its top managers since 2012, headed the University Hospital Kramáre in Bratislava between 2008 and 2010. In 2009, he bought a CT scanner for the hospital for €1.4 million; i.e. €400,000 more expensive than Ostrava (Czech Republic) paid for the same type scanner in the same year. It was also curious, TIS points out, that one of the conditions in the tender was that the device must be cooled with water – nonsense, according to a radiology expert cited by Transparency International. This condition, however, excluded all other bidders, leaving the winner as the only one remaining.
Vaďura also sold the plots under the heliport at Kramáre, although with a condition – easement of having unlimited right to access and use for medical services. However, the then-health minister Ivan Uhliarik (KDH) recalled him in 2010 from this position.
“The sale did not violate the law from the point of view of purchase price,” Uhliarik said, as quoted by the Sme daily on October 5. “Nevertheless, I think that the sale of plots under the landing area for helicopters at Kramáre contradicts common sense, and thus I dismissed him.”
Both the Health Ministry – led by Viliam Čislák who appointed Vaďura – and VšZP defend the latter, the sale itself and also the price; the heliport, adjacent hospital park and surrounding plots (totalling 67,000 square metres) were sold for €5.7 million, which was equivalent to the official expert opinion; but TIS argued that the market price might have been as high as €39 million.
Vaďura, before being appointed to lead the Kramáre Hospital by then-health minister Richard Raši (of the ruling Smer party), had been Raši’s deputy – as the head of the University Hospital Kramáre – for economy and technology.
In addition to the dubious contracts with the relatives of Forai and Vaďura, MP Beblavý also pointed out the unusually high benefits for these managers, and cited the property returns of Vaďura and Forai revealing that Forai was in fact earning more than the country’s prime minister.
Fico’s property return shows his income at €44,674 last year, while Forai as the president of board of VšZP earned over €67,000 in 2014, including a €22,000 annual bonus, plus as the general director of the insurer he received a separate salary of up to €60,000 a year.
Vaďura and Anna Borovková, the remaining two board members, earned similar sums last year, more than one hundred thousand, according to Beblavý.
“The board of VšZP donated the whole sum of their 2014 bonuses after taxes for the purchase of two devices for patients in the hospital for children at Bratislava’s Kramáre hospital,” VšZP reacted through its spokeswoman Petra Balážová, as quoted by Sme.
The spokeswoman also stressed that the rules for salaries of board members have not changed since the Radičová government introduced them, and that after the arrival of Forai the salaries were decreased by 30 percent for the general director and by 15 percent for board members.
The monthly salary for VšZP board members is determined by a government decree, while an additional annual bonus can be granted by the Health Ministry.
The information regarding what criteria the ministry uses to determine the benefits for VšZP top managers were not publicly accessible and therefore Beblavý requested the Health Ministry to disclose this information. On October 14 Beblavý reported that the Health Ministry published the criteria, the most decisive one being the profit of the insurer. To receive the maximum bonus (which in Forai’s case amounted to €149,415 over three years in which he held the post), it was enough for the insurer not to sink into red numbers.
“Marcel Forai and his colleagues did not need to return any exceptional result – it was enough that they did not mess with anything,” Beblavý claimed.
The zero profit criterion was first used in 2011, when VšZP ended in red numbers following the term of Zuzana Zvolenská (health minister under the current government until one year ago) as its general director. But the following year, the insurer recorded a profit of €5 million.
Another standard used to determine benefits for the top managers of VšZP was to fulfil the goals of the collection of insurance premiums, which the management arranges with the Health Ministry in the financial plan.
“It all resembles the Greek system, where until 2010 some public officials received special benefits for coming to work on time,” Beblavý claimed.
The ministry defended itself by pointing to the fact that under the government of Iveta Radičová, monthly salaries in VšZP were even higher than that: the general director was earning €6,500 and board members and section directors were earning €4,700, the ministry’s spokesman Peter Bubla told Sme.
Opposition wants Čislák out
Following the turmoil around VšZP and the information that the media reported about its former and current boss, part of the opposition suggests that the situation is serious enough for Health Minister Čislák to step down.
While Miroslav Beblavý gathers and publishes information that would discredit some of the major stakeholders in the sector, the Christian Democrats are calling on the prime minister to dismiss Čislák. Fico, however, has ignored their calls and the Christian Democratic Movement (KDH) has launched a petition among MPs to initiate a no-confidence motion in the parliament.
“The prime minister didn’t act and said that it’s only KDH theatre,” KDH’s Pavol Abrhan told the TASR newswire. “We don’t think so, however – the minister should be held accountable for the situation in health care.”
If KDH collects at least 30 signatures, Speaker of Parliament Peter Pellegrini will have to convene a parliamentary session with a no-confidence motion on the agenda within seven days. Meanwhile, all opposition parties have already told TASR that they are in favour of ousting Čislák, who has already survived a no-confidence motion in April.
KDH is accusing Čislák of being idle in the face of corruption and embezzlement of public finances in health care. Nevertheless, Fico recently confirmed that Čislák has his full confidence.
Disclaimer: Penta financial group has a 45-percent share in Petit Press, the co-owner of The Slovak Spectator.