Bulgaria’s health system is in crisis. Tens of thousands of doctors and other medical professionals have been left without pay rises promised before the government’s sudden resignation froze the financial plan. The Bulgarian Association of Healthcare Professionals announced that it remains on ‘protest alert’ and will continue to insist on a 150% wage increase.
In December, the government led by Rosen Zhelyazkov floated a series of unconventional policy ideas to secure funding for higher wages in the healthcare system of one of the EU’s poorest countries, without increasing the budget deficit.
The cabinet ultimately resigned under pressure from massive street protests against corruption, the lack of rule of law, and inflated state spending planned for 2026.
Just before stepping down, the government announced that it had agreed to redirect €100 million from unused resources under the Operational Programme “Human Resources Development” to finance pay increases for healthcare professionals.
“There is no problem – it can be done, we have checked,” said Kostadin Angelov, chair of parliament’s health committee and a member of the leading ruling party GERB (EPP).
The idea is now expected to be implemented by a caretaker government due to be appointed towards the end of January, in which GERB is again set to wield significant influence.
On protest alert
On 10 December, nurses, midwives, laboratory technicians and rehabilitation specialists staged protests outside medical facilities across the country. The demonstrations were triggered by the governing coalition’s failure to honour its promise that, from 2026, healthcare workers would receive a minimum starting salary of €1,550.
The government had initially planned a state transfer of €260 million to guarantee minimum base salaries of €1,550 for nurses and €1,860 for doctors without a specialisation. These funds were later removed from the draft state budget, which was ultimately never adopted.
The collapse of the current ruling coalition in Sofia, dominated by GERB, also marked the effective end of negotiations with junior doctors and nurses over pay increases.
“In view of the current political situation, the absence of a regular government and the prospect of new parliamentary elections, the leadership calls on all healthcare professionals to remain on protest alert,” the Healthcare Professionals Association’s statement said.
Following the election of a regular government and the presentation of a new draft state budget, protests will resume until a 150% pay rise for healthcare workers is secured.
Healthcare shortages
Bulgaria faces a severe workforce crisis in its healthcare system, with particularly acute shortages of nurses and specialised doctors in hospitals in smaller towns.
The main reason is low pay, which continues to drive medical professionals towards better-paid jobs in wealthier Western European countries. Pay-related problems affect specific hospitals, with several shocking examples cited during parliamentary debates in December. There are still hospitals, even in the capital Sofia, where a highly experienced doctor heading a department earns a basic salary of €1,200, while nurses work for €800. By contrast, the average salary in Sofia is around €1,700.
[VA, BM]
