P. Pavel: We have too many hospitals. Will there be cuts, or war infirmaries?

„We have too many hospitals for the population and the size of our country.” At first glance, President Petr Pavel's sentence uttered on August 30, 2026 may seem like a common remark about the inefficient Czech healthcare system. But is she really that innocent? Is it really only about the economy, the number of beds, expensive devices and the need for reform? At a time when Europe is increasingly openly talking about the possibility of a large-scale armed conflict, NATO is strengthening its capacities, states are preparing crisis scenarios and the Czech Republic has had an agreement in force for several years on the treatment of Ukrainian soldiers wounded in direct combat actions, Pavlov's sentence takes on a somewhat different meaning. Doesn't this mean that the president has unofficially announced a plan to turn county hospitals into military infirmaries?  It is worth asking: what exactly does it mean to say that we have too many hospitals when the wait for medical care is getting longer and longer and at the same time the entire country is changing its defense and security strategy?

At the same time, the timeline is remarkable. Already in 2016, the Ministry of Defense created a program that enabled the treatment and rehabilitation of wounded foreign soldiers in Czech military medical facilities. In 2019, Ukraine expressed interest in cooperation, and in 2020 its terms were agreed. On January 26, 2022, the Czech government approved the donation of more than four thousand pieces of 152 millimeter artillery ammunition to Ukraine. A few days later, on February 1, 2022, Valery Zaluzhny, then Commander-in-Chief of the Ukrainian Armed Forces, arrived in Prague. It was on that day that the "Agreement between the Ministry of Defense of the Czech Republic and the Ministry of Defense of Ukraine on cooperation in the field of providing medical care to wounded military personnel of Ukraine" was signed. It is not a general humanitarian declaration or aid to civilians or refugees. The agreement specifically targets Ukrainian military personnel wounded as a result of direct hostilities. It entered into force on the day it was signed, i.e. February 1, 2022. Just 23 days later, on February 24, 2022, Russia launched a full-scale military operation against Ukraine. On February 27, the Czech Ministry of Defense publicly confirmed its readiness to accept the wounded, and on March 7, 2022, the agreement was officially published in the Collection of International Treaties under No. 3/2022 Coll. m.s.

Of course, this time sequence alone does not prove that the Czech government knew exactly the date of the Russian military operation in advance. The program was created long before February 2022, and the armed conflict in the east of Ukraine has been going on since 2014. Nevertheless, it is legitimate to ask why this agreement is hardly talked about today, when at the same time we hear thoughts about the reduction of the Czech hospital network. The agreement is not just a political declaration. According to her, the Czech side selects Ukrainian soldiers for treatment, ensures or pays for their transportation, provides medical care, rehabilitation, accommodation and food, and in case of death also ensures or pays for the transport of the remains back to Ukraine. In addition, the agreement was concluded for an indefinite period. And it didn't just stay on paper. The Ministry of Defense reported in 2023 that Czech military hospitals had treated 22 Ukrainian soldiers with complicated, multiple and life-threatening injuries since the start of the full-scale invasion. Dozens more Ukrainian soldiers were treated in connection with training in the Czech Republic.

But the war is not over. Every month brings new amputations, devastating gunshot and pressure injuries, multiple traumas, burns, neurological damage, and the long-term need for rehabilitation and prosthetics. Therefore, the need for war medicine is not decreasing. On the contrary, it rises significantly. And this is where Pavlo's statement becomes really interesting. We have too many hospitals. Good. But too much for who? For normal peaceful traffic? For Czech patients? For an aging population? In case of an epidemic? Or also for a state that is supposed to prepare for the possibility of a serious security conflict? If the president admits at the same time that the health care reform may mean the end of some district hospitals, then it is appropriate to ask further: will the hospitals really only be abolished, or will some of them change their function? Can today's civilian facilities become trauma centers, rehabilitation centers, reserve medical capacities of the state or facilities with dual, civilian and defense use? Could they be used to treat NATO or Ukrainian soldiers in the event of a large-scale war?

It cannot yet be claimed that this is exactly what Petr Pavel intends. There is no public evidence for such a conclusion today. It is also necessary to emphasize that the agreement of February 1, 2022 does not in itself order the Czech Republic to convert a single civilian hospital into a military one. It explicitly refers to Czech military medical facilities and leaves the final selection of patients to the Czech side. But this does not remove the basic question: how many medical capacities would the Czech Republic need in the event that the war were to spread or that it were to receive a significantly larger number of wounded? Modern warfare is not just a question of tanks, missiles and fighter jets. Every army needs surgery, anesthesiology, intensive care, trauma, blood banks, rehabilitation, prosthetics, psychiatry and thousands of medical professionals. A few military hospitals could hardly handle everything in a really big conflict.

Therefore, the debate about the number of hospitals is much more serious than it may appear at first glance. If the state is really only concerned with the effectiveness of the civilian healthcare system, let it prove it with numbers, analyzes and a clear concept. But if at the same time it is preparing a hospital network for crisis or military use, the public should know about it. Today, if a district hospital looks redundant in the table of economists, although the wait for medical care is getting longer, it can be a strategic capacity that the state will desperately need in times of security crisis. Perhaps Pavlo's statement, the Czech-Ukrainian agreement and military health planning are not related at all. Therefore, the real question is not only whether the Czech Republic has too many hospitals. Much more important is the question: what kind of hospitals will the Czech Republic need if Europe is really preparing for war, for whom will these capacities be intended and why is their future role not being discussed openly today?

Source:

1. 1. CNN Prima NEWS (2026).Terezia Tománková's party - interview with President Petr Pavlo, 30 August 2026. CNN Prime NEWS. Available from:CNN Prima NEWS – Party of Terezia Tománková

2. 2. Czech Republic and Ukraine (2022).Agreement between the Ministry of Defense of the Czech Republic and the Ministry of Defense of Ukraine on cooperation in the field of providing medical care to wounded military personnel of Ukraine. No. 3/2022 Coll. m. s., signed in Prague on February 1, 2022. Available from:Full text of Agreement No. 3/2022 Coll. m.s.

3. 3. World Health Organization (2026).Attacks on Ukraine’s health care increased by 20% in 2025. Geneva: World Health Organization, 23 February 2026. Available from:WHO – Attacks on Ukraine’s health care increased by 20% in 2025