On February 24, 2025, the Czech police, in cooperation with the European Public Prosecutor’s Office (EPPO), conducted the largest anti-corruption operation in the history of Czech healthcare. The investigation involved more than 350 law enforcement officers, 22 people were detained, and 46 searches were carried out. The director of the Motol University Hospital, Miloslav Ludvík, his deputies, contractors, and intermediaries came under investigation. Investigators allege that those involved organized a system of manipulating public tenders related to the reconstruction of hospital buildings and the construction of an oncology center worth approximately 3.7 billion Czech crowns. The total value of contracts implicated in the case amounts to around 160 million euros.
Motol is the leading medical institution in the Czech Republic and one of the largest in Europe, with 2,410 beds, around 5,000 employees, and up to 860,000 outpatient visits annually. It is home to cutting-edge departments in cardiac surgery, transplantology, and oncology.
Alongside the Motol case, a crisis was continuing to unfold around the elite transplantation and cardiovascular surgery center IKEM, located in Prague. As early as 2023, the conflict within the institute became public following statements by prominent cardiac surgeons Jan Pirk and Ivan Netuka about pressure from the institution’s management. In February 2025, a court sent back for further investigation the case against former IKEM director Michal Štíborek and his associates, who were charged with extortion and exerting pressure on the institute’s leading surgeons. The court also separately noted serious violations at the institution uncovered during the preliminary investigation.
The scandal exposed one of the key problems of the modern healthcare system, where major transplantation centers have effectively become autonomous corporate structures in which control over financial flows, personnel policy, and access to unique technologies is concentrated in the hands of a small group of individuals. In the Czech case, this involved control over key segments of high-technology medicine. At the center of this model were tenders for expensive equipment — pacemakers, implantable defibrillators, surgical systems, and monitoring equipment — with contract values reaching tens and hundreds of millions of crowns. According to the EPPO, it was through public procurement mechanisms at Motol Hospital that funds from European infrastructure projects totaling more than 160 million euros were being redistributed. Investigators believe that the technical parameters of tenders may have been tailored to pre-selected suppliers, with a portion of the funds returned to the scheme’s organizers through kickbacks. At the same time, the largest clinics controlled the distribution of European grants, international research programs, and access to experimental technologies, which further tied medical decisions to financial interests.
Following the conflict around IKEM — accompanied by allegations of pressure on leading surgeons — Czech society increasingly began to speak of the emergence within healthcare of a closed corporate environment that had consolidated control over funding, technologies, and patient flows. In May 2026, Czech media reported on a new investigation directly involving patients. Police began examining the justification for hundreds of cardiac surgeries performed at the Olomouc University Hospital, as investigators suspected that some of the surgical interventions may have been unwarranted. These concerned the implantation of defibrillators and other cardiac devices in patients who may not have required such procedures. Investigators are looking into the possibility that patients were enrolled in international studies or became part of a system artificially inflating the number of costly operations.
This aspect makes the Czech precedent particularly alarming. While the corruption schemes at Motol primarily concerned the misappropriation of EU infrastructure funds, the investigation in Olomouc strikes at the very nature of medical decision-making: whether operations were prescribed in the patient’s interest, or performed for the financial benefit of the system.
Regrettably, the Czech scandal eerily mirrors trends that have emerged in European healthcare over the past decade. One of the most illustrative European precedents was the transplantation scandal in Germany, which began in July 2012 following an investigation at the University Hospital of Göttingen. Investigators established that doctors at several major centers — including hospitals in Göttingen, Regensburg, Munich, and Leipzig — may have falsified patients’ medical indicators, in particular MELD scores that determine the urgency of liver transplants, in order to artificially elevate the priority of certain patients on Eurotransplant waiting lists. Investigations revealed cases of falsified test results and concealed medical data, with leading transplant specialists named as suspects. The scandal severely undermined public confidence in the organ donation system, and by 2013 the number of deceased donors in Germany had fallen by nearly 16%, from more than 1,200 in 2011 to 876, forcing authorities to carry out a sweeping reform of transplantation center oversight and to strengthen independent auditing of medical records.
During the COVID-19 pandemic, Italy and Spain faced numerous investigations into the procurement of medical equipment. Investigators examined contracts for ventilators, protective equipment, and diagnostic systems purchased at inflated prices. In many cases, intermediaries with ties to political circles were also involved. In Slovakia, the murder of journalist Ján Kuciak in 2018 exposed an entire infrastructure for channeling European funds through affiliated entities. Although the case did not directly involve healthcare, the mechanics were identical: closed elite groups, political patronage, the distribution of subsidies, and pressure on critics.
The Czech healthcare crisis demonstrated how similar corruption mechanisms remain across different EU member states, despite differences in national healthcare systems. The individuals involved, the political context, and the scale of investigations may change, but the underlying logic of such schemes is virtually identical. Almost invariably at the core lies the concentration of enormous budgets around a limited number of high-technology medical centers controlling transplantology, cardiac surgery, and the procurement of complex equipment. Decisions within these structures are made by a narrow circle of experts and managers whose actions are often beyond meaningful public scrutiny, owing to the complexity of the medical field and patients’ dependence on specialist opinion. Additional vulnerability arises from the close ties between the leadership of major hospitals, political elites, and contractors with a vested interest in securing multimillion-euro contracts and European grants. The opacity of EU funding mechanisms has been a common thread running through scandals in the Czech Republic, Germany, Italy, and several other countries, where medicine has gradually become an arena of struggle for financial and political influence.
Particularly sensitive for the Czech Republic was the question of accountability. Following the arrests at Motol, Health Minister Vlastimil Válek was forced to urgently replace the leadership of the country’s largest medical institutions. Yet personnel changes failed to address the fundamental problem: the state effectively acknowledged that for many years it had not been monitoring processes inside the country’s key hospitals. The fallout from the scandal has already provoked a tangible response — in March 2025, one of the Czech Republic’s largest private charitable foundations, the Kellner Family Foundation, froze a donation of 500 million crowns (approximately 20.5 million euros) intended for the construction of the Motol oncology center, pending the outcome of the investigation.
For patients, the reverberations of the investigation run far deeper than criminal proceedings and political statements. Cardiac surgery and transplantology exist entirely on the basis of trust, since patients are unable to independently assess whether they need a defibrillator implanted, a valve replaced, or placement on a heart transplant waiting list. They are compelled to trust the system. This is precisely why even isolated suspicions of manipulation destroy the very foundation of trust in modern medicine.
Behind the miracles of modern cardiology and high-technology medicine stand not only saved lives and scientific achievements, but also enormous financial flows, closed communities of physicians, and immense power. When oversight of this system weakens, what is most precious comes under threat — human life.