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The issue of the ownership form of hospitals frequently crops up in political discussions in Slovakia and surrounding countries. Health Minister Zajacs 2004 reform (Pažitný [30]) was strongly based on the assumption that private ownership is the best solution. The Law on Health Care Providers, Medical Staff and Professional Organizations in the Health Service Sector (Nr. 578/2004) decreed that all state providers should be transformed into private companies. The current Slovak government is trying to reverse this step, despite proposing a range of ownership forms in its programmatic statement. As it must respect the rule of law, its attempts are indirect, such as the decisions on the minimum network of providers, and promoting state-owned academic hospitals.

In the Czech Republic the differentiation of political interests is even more visible. The Social democrats have tried several times to stop any hospital privatisation. In 2005 they passed an amendment to the Law on Public Health (Nr. 5/2005) to stop privatisation. The Council of Regions successfully appealed this amendment at the Constitutional Court, and the privatisation continued, supported by the then prime minister Topolaneks government. The New Public Management theories from the end of the last century advocated privatisation. But more recent governance and public-private--civil sector mix and cooperation approaches suggest reasons for a range of ownership models (Pollit and Bouckaert,[31]). For example in the UK most hospitals are public, but in the Netherlands they are private.