Stradiņš Hospital's negative budget impact to reach €36.7 million over five years

The Latvian government has taken note of an informational report on the planned impact of the state-owned Pauls Stradiņš Clinical University Hospital (PSKUS) on the general government budget balance from 2026 to 2030. The document calculates that the hospital's negative impact over this period will total €36.7 million, reducing the fiscal space, or budgetary room for manoeuvre, available to the health sector.

Annual figures

The revised impact on the budget balance is €7,433,768 in 2026, €8,607,110 in 2027, €9,716,731 in 2028, €6,373,805 in 2029 and €4,545,947 in 2030. Boriss Kņigins, Deputy State Secretary at the Ministry of Health, explained that the negative balance arises mainly because tariffs do not match actual costs, and because of the hospital's investment projects, which require state co-financing.

Prime Minister Andris Kulbergs said the report should be accepted for information, but should not "go beyond the budget". Before the discussion, the Finance Ministry had not endorsed the document and on 13 October submitted a series of clarifications, though it was said at the cabinet meeting that most disagreements had been resolved.

Hospitals Association objections

In its negative opinion, the Latvian Hospitals Association said that if compensation is sought within the Health Ministry's budget, it will be covered by other medical institutions. The association asked for a clause stating that compensatory measures would not be carried out at the expense of other hospitals' funding. The final cabinet minutes contain no such clause. They also omit a task requiring proposals by 1 April 2027 to review the methodology for calculating tariffs.

Warning on financial position

The report states that, if current trends continue, the hospital's financial stability could deteriorate significantly. One-off extra funds would give short-term support but would not resolve the structural causes, so the financing model for state-paid services needs to be reviewed.

The hospital lost €12.9 million in 2025, while its investments reached €23 million, 15% more than in 2024. A significant part of these funds is earmarked for specific projects and cannot be used for core operating expenses.