Slovakia is aging, and demand for long-term care is growing faster than its funding. Experts agree that it is not about copying foreign models, but about prudent investments, linking the health and social systems, and greater availability of services. The key is stable financing, less bureaucracy, and early prevention.
Money that determines reality
Slovakia spends approximately 0,8 % of GDP on long-term care, while the Czech Republic spends around 1,5 % and Germany roughly 1,6 %. Denmark invests approximately 2,5 % of GDP. This difference directly explains why we have too few caregivers and nurses and why many professionals leave for better wages in neighboring countries. The costs of energy or food are similar; the difference lies in the wages that public financing makes it possible to pay.
Meanwhile, facilities are caring for increasingly demanding clients: a large share have psychiatric diagnoses and most fall into the 5. and 6. levels of dependency. In practice, this means higher demands on qualified staff as well as on nursing procedures. If standards rise but finances and staffing do not, a permanent tension arises that exhausts providers. The result is pressure on quality, capacity, and the availability of services.
Global inspiration, not copying
Denmark is often mentioned for its integrated approach—from prevention and mental health, through work with the community and family, to decentralized management—while investing approximately 2,5 % of GDP in long-term care. Inspiring elements also exist in Portugal, the Netherlands, and Sweden, and outside Europe in Canada and Australia. However, transferring solutions must respect our possibilities and priorities: availability of services, staffing, and sustainable financing. Linking domestic practice with evidence and the expertise of international organizations, for example, WHO, can also help.
What’s happening at home: projects, reform, and disputed competencies
A national project is currently underway that supplements, from EU funds, the home care service under the competence of municipalities; the allocation of around 100 million euros has already been exceeded by requests. The project does not cover residential facilities and is meant to bridge the next two years. A change in financing is to follow under the Recovery Plan, with the ambition to adopt legislation so that it takes effect from 2026. At the same time, there is an emphasis on investing in prevention and community support so that dependency is not addressed only at the most acute stage.
The Gordian knot is that municipalities bear more competencies than they have resources, which triggers disputes—such as over the obligation to co-finance non-public providers. The sector is also reporting a growing administrative burden and regulatory inconsistencies which, in conditions of a shortage of nurses, push services into improvisation and discourage managers. Experts therefore call for a stable source of financing (e.g., personal budgets for clients and a single payment to the provider) and for a simplification of rules. Without political will and resources higher by orders of magnitude—it is said to be in the hundreds of millions up to a billion euros—the shortage of personnel and capacity risks deepening.
