Interviews

Tom Philipp: Population aging is the biggest challenge

Published: 29. 9. 2025
Author: Luboš Palata
Photo: archives of Tom Philipp
logo Share

Healthcare is always – and doubly so before elections – a hot topic. It is rare to come across someone who evaluates this field rationally, practically, and without emotional outbursts. Tom Philipp certainly meets these criteria. As a KDU-ČSL MP, physician, and chairman of the board of VZP, he sees the issue from every angle.

How has Czech healthcare changed over the past four years? Where do you see progress and where, on the contrary, challenges that still need to be addressed?
Czech healthcare has gone through a very demanding period in the past four years. Nevertheless, I am convinced that it has proven to be stable and resilient. As chairman of the board of VZP and at the same time a doctor, I can see the situation from both angles. The positives include, in particular, the introduction of regular indexation of payments for state-insured patients. European funds have also been very important – roughly 30 billion CZK has been invested over four years into equipment and hospital renovations. This has enabled modernization of equipment and facilities for providing care in many places. As a hospital department head, I see it every day: new technologies and better facilities bring higher quality of care and better conditions for healthcare professionals. There has also been major progress in digitization. Projects have been launched that will soon bring tangible results: shared medical records in the form of the so-called EZ Card, a three-way request form that makes it easier to book examinations and share results, and more. Digitization also has huge potential for the future, for example in the use of artificial intelligence in diagnostics. On the other hand, serious challenges remain. The biggest problem is the shortage of healthcare staff – doctors, nurses, physiotherapists, or speech therapists. The aging of both healthcare workers and patients creates double pressure.

 

How has Czech healthcare been affected by the arrival of hundreds of thousands of refugees from Ukraine? Did it bring more of a burden, or also new opportunities – for example in the form of doctors and nurses who want to work here?
As chairman of the board of VZP I can say that at the peak of the influx we registered about 260,000 people from Ukraine. Of these, around 80,000 were children under 18, 117,000 were women, and 63,000 were men over 18. The arrival of such a number of refugees was a huge challenge not only for Czech society, but also for healthcare, VZP, and medical professionals themselves. The strain on general practitioners and pediatricians was very significant in the first months. But the scare stories that Ukrainians would be sicker or bring serious diseases into the country proved false. That was unpleasant propaganda from some opposition politicians. The opposite was true: they were mostly young and healthy people, usually from good socio-economic backgrounds. I also have personal experience – for over a year, my home was shared by three Ukrainian refugees – two university-educated women and a young girl. Most refugees were insured by VZP, and I can say with certainty that their treatment costs were significantly lower than those of a comparable group of Czech people. Today it is clear that refugees are gradually integrating and participating. In 2025, nearly 170,000 are employed in the Czech labor market. Thanks to this, their dependence on benefits is decreasing while their contributions to health insurance and the tax system are increasing. Healthcare has not only gained new patients, but also new colleagues. A number of Ukrainian doctors and nurses have come here and are working. The qualification recognition process is not simple – we must protect quality of care and patient safety – but their integration is gradually happening. In some hospitals or senior homes, Ukrainian healthcare workers are already a major reinforcement.



 

Why does Czechia still lack doctors and nurses when interest in studying medicine and healthcare fields is huge? And what has been done to increase the number of graduates?
The shortage of doctors and nurses is a long-standing problem not only in the Czech Republic, but across Europe. It cannot be solved overnight – training a doctor takes at least six years, and further years are needed for specialization. That is why a simple solution like “taking in twice as many students and having enough doctors in a few years” does not work. We need enough quality teachers, trainers, and practical placements in teaching and regional hospitals. When I was deputy minister of health, we prepared a project with Professor Ladislav Dušek to increase the number of medical students by 200 per year. The project was launched in subsequent years, and this year the first expanded class of doctors is graduating. That means in the coming years we will be able to replace most of the doctors who are retiring. Simply increasing the number of graduates, however, is not enough. To make care truly more accessible, we also need to organize work better. Some competencies can be taken over by university-educated non-physicians, freeing doctors’ hands for complex medical tasks. I also see great potential in modern technologies – artificial intelligence is already helping with diagnostics and its importance will grow. Under this government, a similar project has also been launched for non-physician health professions, especially nurses.

 

How should the Czech Republic prepare for population aging? Is importing workers into social and healthcare services from abroad the answer?
Population aging is the biggest challenge facing Czech healthcare and social services. The share of seniors is rising rapidly – according to the Czech Statistical Office, by 2050 they will make up around 29 percent of the population, roughly 3.1 million people. We can already see that nursing homes and home care are at the limit of their capacities. The positive news is that the government is aware of this problem and is deliberately strengthening the very segments that will be key as the number of seniors grows. Between 2018 and 2023, reimbursements for home care rose by 236 percent, compared with an average increase of 150 percent. In the 2025 reimbursement framework, payments for long-term inpatient care are increasing by 10 percent, while most other fields will grow by only 3–5 percent. This is a clear signal that the state and health insurers are supporting the segments that will be most needed in the coming decades. As for caregivers, it is clear that simply importing labor from abroad will not solve the situation. Some countries tried, for example hiring workers from the Philippines or other distant regions. But in the Czech environment, the language and cultural barriers would be too great. Caring for an elderly, often ill person is not only about basic assistance – it is about communication, empathy, and understanding. And that works much better when the caregiver is culturally and linguistically close. That is why I believe it is much more effective to focus on supporting workers from neighboring countries – Ukraine, Slovakia, or other Slavic nations – where cultural and language closeness allows easier integration. But the main thing is to motivate Czech people to want to work in social and healthcare services.

 

The author is a European editor of Deník

 

 


CV BOX
Tom Philipp (born December 26, 1968, in Prague) is the head of the Rheumatology and Rehabilitation Clinic of the Third Faculty of Medicine at the Charles University and the Thomayer University Hospital, MP, chairman of the Board of Directors of the General Health Insurance Company (VZP), member of the Prague 12 Municipal Assembly, and former vice-chair of the KDU-ČSL.
Following his graduation from the Second Faculty of Medicine at Charles University in 1993, he started working as a physician at the rheumatology ward in the Thomayer Hospital, later becoming the deputy director (2005–2014). From 2014, he worked as deputy minister of health for four years. From late November 2018, he worked at Agel, a.s., as the first vice-chairman of the board and director of the Jeseník Hospital. He never fully severed ties with Thomayer Hospital and eventually returned there full-time. 
He has been a KDU-ČSL member since 2002 and an MP since 2021. After eight years of serving as a member of the VZP board of directors, he became its chair in February 2022.
Philipp lives in Prague. He is married and has five children. He enjoys hiking, cycling, cynology, and fishing. Politics remains his primary hobby, however.

ad

Keep reading

More articles