"Blue Bulgaria" has come up with a proposal for immediate solutions that eliminate the reasons that led to the emergence of imitation homes for the sick elderly, which have become known as "houses of horrors"
"The crisis that has been growing for years with the shortage of places for long-term treatment and care for the elderly requires urgent action, which Bulgaria's government has refused to take for more than 10 years. The clear demographic picture that draws a future with a rapidly growing number of adult citizens requires immediate action so that we stop living in the movie "Houses of horrors". The solution is before the eyes of the government, but no one has taken the necessary steps," commented from "Blue Bulgaria" and add:
The elderly in the horror homes we see on television need primarily medical care, that is, care provided by nurses and rehabilitators under medical supervision. In these homes, they do not receive it because there are simply no such specialists there. There are such staff in hospitals. And if Bulgaria has any comparative advantage over other European countries facing the same problem, it is the presence of a huge number of hospitals, a large part of which are practically empty. The meaningful management action is to ensure that the public need is met with the available unused resource that can meet it. The lack of such management actions leads to the absurdity in which on one side of the street in your city is the hospital, in which 80% of the beds are empty, and on the opposite sidewalk someone uses the objective need of many families and accommodates the elderly without having the staff, resources and conditions for this. This is the recipe for the existence of “houses of horrors“.
Bulgarian hospitals have focused their activities mainly on active treatment, but there is a massive lack of structures for follow-up, rehabilitation and palliative care. The result - thousands of elderly and seriously ill patients remain without access to the necessary medical care after discharge, but on the other hand, every day in Bulgarian hospitals there are over 23,000 free beds, which if used for their intended purpose, a large part of the problem would be addressed.
To overcome this collapse, we propose five strategic changes that do not require radical legal reforms, but can ensure real progress within a year:
Requirement for comprehensive treatment - every hospital that treats strokes, heart attacks and severe surgical cases must also guarantee the possibility of long-term treatment - through their own structures or a contract with another medical facility.
Easing the requirements for clinical pathways – heavy and formal conditions currently deter hospitals from engaging in long-term and palliative care activities. The requirements must be reviewed and brought into line with real needs and resources.
A simplified procedure for opening long-term care beds – medical facilities in areas with a shortage of such beds must be able to quickly open new structures or transform part of the active beds without cumbersome administrative obstacles.
Restructuring excess beds for active treatment – NHIF has thousands of contracted beds that are empty. It is time to select contractual partners according to objective criteria and redirect resources to long-term treatment, where the need is real and growing.
Targeted subsidization of long-term treatment – The Ministry of Health already subsidizes municipal hospitals, but the funding does not stimulate the provision of care for chronically ill and terminally ill people. A new methodology is needed, tied to actual activity and the needs of the population.
A large part of these measures is fully feasible within the current budget and administrative capacity. It is not a question of spending more money, but of a reasonable redistribution of existing resources. Another part of these measures could come into force as early as the beginning of 2026 with the new National Framework Agreement and would be a decisive step towards building a decent system of care for the elderly and the most vulnerable patients in Bulgaria.
Blue Bulgaria will send these proposals for a solution to the Ministry of Health and to the Health Committee in the National Assembly. We will also seek assistance from the parliamentary parties for their adoption and implementation.