Health Minister Kamil Šaško (left) and an ambulance in Bratislava. (source: TASR)
On a clear July morning, a blue flatbed lorry pulls up outside a low industrial building in Vlkanová, a central Slovak village. On its trailer are three brand-new yellow ambulances from Poland, their paint glinting in the sun, waiting to be driven into a warehouse whose doors are already wide open to receive them.
For weeks, there have been similar deliveries almost daily and the warehouse now, by some accounts, holds more than 80 ambulances. All seem to belong to Agel, one of Slovakia’s largest private healthcare groups, and to the newly established firm Emergency Medical Solutions. Officially, they might be planned for use in their patient transport service or for sale elsewhere in the European Union. But their steady arrival, just as Slovakia is in the midst of awarding the most lucrative ambulance station tender in its history, fuels suspicions in parliament and the press that the bidders already knew they had won.
“It’s evident that [spending] €12 million on ambulances would be too risky a move if they didn’t know in advance they would win,” Marek Krajčí, a former health minister from the Slovensko movement, said at the time.
Now that €2 billion tender – intended to decide who would run the country’s ambulance network for the next six years – has been thrown into limbo. On 11 August, Health Minister Kamil Šaško of the Hlas party posted a short video announcing that the tender would be cancelled over legal and transparency concerns.
“This tender has been lawfully cancelled. Anyone who questions that is lying,” the minister declared two days later. Yet experts and opposition politicians are left pondering how such a move could have been carried out within the law.
Critical of the tender, Prime Minister and Smer chair Robert Fico has likewise asserted that it “is now over” and has again sought to shift public debate from his government’s scandal to alleged British interference in Slovakia’s 2023 elections.
Air rescue workers treat an injured miner in a car park outside the Nováky mine on Wednesday, 26 April 2023. A methane fire broke out at the mine that evening. (source: TASR)
The stakes
The tender would have awarded six-year licences for 344 ground ambulance stations and seven helicopter bases, locking in hundreds of millions in guaranteed monthly payments and mileage fees. The Health Ministry initially put the value at €1.2 billion. Jana Ježíková, a former state secretary and health policy expert, recalculated it at €2.046 billion, using official figures from a draft decree, released in March this year, on the allocation of public health insurance expenditure by type of healthcare for 2025 and applying conservative growth estimates. Ministry officials did not dispute her numbers.
“This is not just another procurement,” Ježíková said. “It is the single largest decision and contract ever made in Slovak healthcare” – larger even than building the long-delayed Rázsochy hospital in Bratislava or the planned new military facility in Prešov, eastern Slovakia.
Estimated value of the tender (ambulances in the left column and helicopters in the right column), according to calculations by expert Jana Ježíková. (source: Facebook - Jana Ježíková)
The sheer scale had made it a political flashpoint. Opposition parties called the process “tailor-made” to benefit favoured bidders, accusing the ministry of a lack of transparency and threatening protests unless it was scrapped. Criticism also came from nurses, doctors and watchdog groups.
The Slovak National Party (SNS), part of the governing coalition, was also sharply critical of it. It publicly urged President Peter Pellegrini to press Šaško to cancel the tender, declaring: “Peter Pellegrini, as honorary chairman of Hlas, bears full responsibility for the Health Ministry. It is in his hands whether this tender will be cancelled or not.” Hlas dismissed the demand as “completely divorced from reality” and called on SNS to stop “pointless attacks” on both the party and the head of state.
Before Šaško’s announcement that the tender would be cancelled, the Health Ministry had repeatedly insisted that the selection process was being conducted properly, transparently and in line with its stated conditions.
But the Public Procurement Office (ÚVO), citing a 2020 finding by the European Commission, maintained that the rules underpinning the tender were incompatible with EU law.
Hlas’s shadow over the process
The tender was run by the Emergency Medical Services Operational Centre (OS ZZS SR), part of the Health Ministry, which is controlled by Hlas – the party founded by current president and former prime minister Peter Pellegrini.
