MP for the ANO movement David Kasal wears many hats: he is the head physician of the pediatric department at Chrudim Hospital, a politician, and a member of the board of directors of VZP. Yet he is not afraid of burnout. “It’s a matter of balancing responsibility, time, and personal limits. If you manage to strike the right balance, it brings positive results for everyone involved. You see the healthcare system from multiple angles and can propose changes that are practical and achievable. You have a greater chance of really making an impact – not only at the patient’s bedside but also through legislation and system design,” he says.
You have extensive experience in pediatrics and neonatology. Which childhood illnesses concern you and your colleagues the most? Have they changed over the last five years?
A lot has changed. In the past, we had what we call textbook cases of pneumonia, asthma attacks, various respiratory and gastrointestinal infections, injuries, and poisonings – mostly from alcohol. We now see a sharp rise in allergies, even in two-month-old infants, which require special nutrition formulas. When it comes to poisonings, drugs mixed with energy drinks or medications in social media “challenges” top the list. Among younger children, there has been an increase in cases of depression, anxiety, behavioral disorders, dissociative disorders, eating disorders, and self-harm. Obesity is also a huge problem, affecting over 25% of children, and with it comes an increase in type 1 diabetes. Chronic inflammatory bowel disease, atopic eczema, and celiac disease are also on the rise.
As a member of the VZP board, you must be aware that this puts huge pressure on funding. Is it manageable?
Most of these illnesses are chronic or lifelong, so they already create significant financial pressure – and it will only increase. Unfortunately, some diseases that had nearly disappeared are back, like diphtheria, whooping cough, and measles. This is partly due to declining vaccination rates, migration, and the effects of COVID, which disrupted immune adaptation. On the other hand, the birth rate is declining. In the last four years, we’ve had about 30,000 fewer births per year, which will lead to the closure of some maternity wards that can no longer be justified medically or economically. In general, children and teenagers are immunologically fragile and psychologically more vulnerable, certainly influenced by social media. They often seek help late, when hospitalization is already necessary – but hospital beds are limited.
There is talk of a shortage of specialist doctors in the regions. How difficult is it to keep young graduates and young specialists?
There is a shortage of doctors throughout the country. For some specialties – like child psychiatry – it’s a nationwide problem; for others, it’s regional, mainly in smaller towns and border areas. We are relatively well off, but only because we make sure to take care of our own needs. We are constantly looking for new colleagues, and the situation has been worsening in recent years. The system for residency placements (state-funded training spots for young doctors) is problematic. Departments must apply for these spots, hire graduates, and train them. But usually, after two and a half years, when they pass their general exam and could work independently in various areas, they leave. They get a better offer from a university hospital and leave – taking the funded residency spot with them. Originally, this system was meant to support facilities that lack doctors so they would stay long term. It doesn’t make sense. We have lost six doctors this way in recent years.
Isn’t the issue partly about living conditions for young doctors?
It is. Housing, finding spots for their children in kindergartens and schools, leisure activities... But it’s more than that. I’ve been training young doctors for over twenty-one years and their approach has changed. It reflects broader societal changes. Many are less independent, they often lack mental resilience, tire more easily, and struggle more with stress. We also face increased pressure from parents of young patients. Feminization is another factor – in some fields, it’s absolute. Female doctors sooner or later start families, stepping away from training and work for years, and when they return, they can’t work shifts due to childcare. This puts huge pressure on staffing in regional hospitals. We are also battling the so-called “internal emigration,” where some medical students leave healthcare entirely (they don’t have to work shifts and earn the same money). Some female doctors, because of maternity, start after age thirty – sometimes later – at an entry-level salary. They move to clerical roles outside the field or switch to part-time outpatient work, so their potential is not fully used.
You experienced a health scare some time ago. Did it teach you to rest more?
While on a wonderful family vacation, I suffered decompensation of a congenital heart defect that no one knew I had. From one minute to the next, I went from doctor to patient. It was a lesson. I survived a ten-hour heart surgery and I must say that despite all its challenges, our healthcare system is highly professional, accessible, and free. It saved my life and allowed me to keep working and helping others. As for rest, my best downtime is time spent with my family and my wonderful partner – she is an endless source of energy and a tremendous support.
The author is a staff writer for Deník
CV BOX
David Kasal (born January 1, 1969, in Chrudim) is a doctor and an MP for ANO 2011.
He studied general medicine at the J. E. Purkyně Military Medical Academy and continued at the Faculty of Medicine, Charles University in Hradec Králové. He holds a level II certification in pediatrics.
In 2017–2018, he completed the exclusive Master of Healthcare Administration program at ADVANCE Healthcare Management Institute, focusing on healthcare management, economics, and law.
He has worked at Chrudim Hospital for over thirty years, first as a pediatrician, and since 2004 as head of the pediatric and neonatology department. He is a member of the VZP Board of Directors and the Government Council for Citizens with Disabilities.
He has been an MP since 2013 and serves on the Healthcare Committee. He has also been a member of the Chrudim Municipal Assembly for fifteen years and served as a councillor from 2010 to 2012.
He played football for SK Chrudim for nearly twenty years. He is divorced and has four children and one grandchild.
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