Slovakia’s largest-ever ambulance service tender, worth an estimated €2 billion and launched in December 2024 to award six-year licences for 351 emergency stations, has spiralled into a political and legal crisis, drawing allegations of corruption, breaches of European Union procurement law, and deepening fractures within the governing coalition. The Ministry of Health, led by Kamil Šaško of the Hlas–Social Democracy party, delegated the process to the National Emergency Medical Service Operations Centre under rules allowing companies without current staff or equipment to bid, while keeping the selection committee’s identities secret until after the competition. Opposition parties, professional medical bodies, and coalition partner Slovak National Party have condemned the process as opaque and potentially pre-arranged, pointing to the emergence of new firms shortly before bidding, early branding of ambulances, and leaked results favouring two dominant groups, one alleged to have political ties. The Public Procurement Office has confirmed that the tender contravenes EU rules Slovakia was ordered to implement in 2020, a warning it says was ignored by the minister; major operator Penta Hospitals has withdrawn over transparency concerns; and the General Prosecutor’s Office has opened an investigation, leaving the future of the tender — and potentially the minister’s position — in question.
In December 2024, Slovakia’s Ministry of Health announced a major public tender to award six-year licences for the operation of the country’s emergency medical services (EMS). The competition covered 344 ground ambulance stations and seven air ambulance stations, replacing licences due to expire between August 2025 and June 2026. It was the largest EMS tender in Slovak history, valued at roughly €2 billion. New rules limited each bidder to a maximum of 25 per cent of all stations, equivalent to 86 sites. At the same time, a reform of urgent healthcare added 23 new stations to shorten ambulance response times.
From the outset, concerns emerged about the tender’s design. The National Emergency Medical Service Operations Centre (Operačné stredisko záchrannej zdravotnej služby – OS ZZS), an operational body without full regulatory powers, was appointed as organiser. Applicants were required only to declare that they would have the necessary staff and equipment once awarded a licence, with no verification during the bidding process. Critics warned that this opened the door for newly formed companies without operational capacity to compete. The selection committee, appointed by acting OS ZZS director Marian Povolný—himself installed by Minister of Health Kamil Šaško—would remain anonymous until after the tender closed.
By mid-2025, opposition parties and professional organisations began to question the process. The Slovak Chamber of Nurses and Midwives, the Slovak Chamber of Paramedics, and the paramedics’ trade union denounced undisclosed evaluation criteria and the inclusion of companies created shortly before the tender. They argued these practices could damage the quality and accessibility of emergency care.
In early August 2025, tensions escalated within the governing coalition. The Slovak National Party (Slovenská národná strana – SNS), a coalition partner, publicly called for the tender’s cancellation, describing the system—introduced by a previous reform—as inefficient and speculative, and claiming private operators could realise profit margins of up to 40 per cent. SNS leader Andrej Danko urged President Peter Pellegrini to intervene. Hlas–Social Democracy (Hlas-SD), Minister Šaško’s party, rejected the claims and accused SNS of political opportunism.
The dispute quickly became a political crisis. On 4 August, opposition parties including Progressive Slovakia (Progresívne Slovensko – PS), Freedom and Solidarity (Sloboda a Solidarita – SaS), and the movement Slovakia (Hnutie Slovensko, led by Igor Matovič) jointly demanded an extraordinary parliamentary session to dismiss Minister Šaško. They alleged that the tender was corrupt and predetermined, citing evidence that some bidders had already purchased and branded ambulances. Matovič described the process as “state extortion” and called for the General Prosecutor’s Office to investigate.
The government responded on 5 August. The Ministry of Health denied wrongdoing, insisting the process complied with laws unchanged under previous administrations. Prime Minister Robert Fico acknowledged “unanswered questions” and warned that if Minister Šaško could not dispel doubts, the tender should be cancelled and repeated. President Pellegrini also pressed the minister to ensure full legal compliance and transparency.
On 6 August, SNS renewed its appeal for cancellation, threatening to seek Šaško’s dismissal. That afternoon, Agel, one of Slovakia’s largest private healthcare groups, issued a statement rejecting allegations of tender manipulation, insisting its ambulance purchases in 2024 were unrelated to insider knowledge. The Slovak Chamber of Nurses repeated its demand for transparency, highlighting late disclosure of committee members’ names, unclear scoring criteria, and the suspiciously early branding of ambulances.
The turning point came on 7 August, when the daily newspaper SME published leaked, unofficial results of the tender. According to these reports, the state-run Bratislava EMS would receive the maximum 86 stations, Agel Merea approximately 70–76 stations, and a newcomer, Emergency Medical Solutions (EMS), over 60 stations. Penta Hospitals, a major private operator seeking 29 stations, would receive only four. The leaks indicated a dramatic reshaping of the EMS landscape, favouring two dominant players, one of which was alleged to have political ties.
That same day, the Public Procurement Office (Úrad pre verejné obstarávanie – ÚVO), led by Peter Kubovič, entered the dispute. Kubovič announced that the tender violated EU law because Slovakia had failed to implement a 2020 European Commission requirement for ambulance services to be procured as public contracts by health insurers. The Commission had already found Slovakia’s model non-compliant, and the ÚVO had ruled against the legality of a previous 2019 tender—a case still unresolved on appeal. Kubovič confirmed he had warned Minister Šaško in March 2025 that the new tender still breached EU law, but the government had not amended the legislation.
The crisis deepened on 8 August when Penta Hospitals withdrew its application, citing a “non-transparent process.” Minister Šaško hinted he might refer the matter to the General Prosecutor and the courts, while continuing to reject allegations of misconduct. The General Prosecutor’s Office, led by Maroš Žilinka, subsequently opened an investigation.
Public scrutiny intensified when opposition parties alleged that Emergency Medical Solutions, one of the apparent big winners, had ties to a donor of Hlas-SD. Minister Šaško denied any wrongdoing, accusing opponents of political attacks. However, pressure mounted from across the political spectrum, with some members of Hlas-SD itself reportedly calling for the tender’s cancellation.
By mid-August 2025, the tender had become both a legal and political test for the government. It combined allegations of corruption, transparency failures, and breach of EU procurement law with a destabilising coalition conflict. The outcome remained unresolved, with the possibility of annulment, legal challenge, or ministerial dismissal still open.
