FELCSUT, Hungary — The Pancho Arena stands about 20 yards from the country home of Viktor Orban, Hungary’s prime minister. The professional soccer stadium has a heated pitch, a museum, a spotless medical clinic and 3,814 seats, double the population of the surrounding village.
In the same county, the biggest public hospital, the St. George, is flagging. On a recent night in the emergency ward, the women’s bathroom had no soap and the men’s room had no functioning urinals. Two doctors struggled to treat an overflow of patients, with 30 still waiting past midnight.
Gleaming soccer stadiums. Decaying hospitals. The contrast reflects the priorities of Mr. Orban, who has become one of Europe’s most powerful far-right leaders by presenting himself as a nationalist champion of ordinary Hungarians and a scourge of European elites.
Yet ordinary Hungarians have suffered most as the country has plunged in European health ratings and many doctors have departed since Mr. Orban took office in 2010. Health care was badly managed by prior administrations, but Mr. Orban has overseen a drop in government health care funding as a proportion of national economic output.
At the same time, Mr. Orban pushed through a program that has allowed businesses to divert at least $1.5 billion in corporate taxes directly to sports institutions. The biggest recipient is the professional soccer team that Mr. Orban co-founded. He uses the stadium’s V.I.P. section to entertain state officials and wealthy business leaders — raising questions about conflicts of interest, and corruption.
Hungary’s chief prosecutor, who decides which politicians to investigate over corruption, has sometimes joined Mr. Orban for matches at Pancho Arena. So have several of Hungary’s richest men, including Lorinc Meszaros and Sandor Csanyi, who wield significant influence across broad sections of the economy.
At another stadium, Mr. Orban sat with a constitutional court judge, Istvan Stumpf, who at the time was reviewing Mr. Orban’s legislation.
“Anyone who wants to get close to Orban tries to do that through football,” said Attila Juhasz, an analyst with Political Capital, a research group in Budapest. A stadium construction boom fueled by the tax change, he said, was rife with corruption.
“There are massive amounts of money that can be stolen,” he said.
While Hungary’s health care ratings have dropped, the flood of money into sports has not improved its ranking in European soccer.
And in both health care and tax revenue, Mr. Orban’s government has weakened accountability and transparency, much in the way he has curbed the media, the courts and other democratic institutions in creating what critics call a semi-autocracy inside the European Union.
“In the last eight years, across the government, the system of checks and balances has been dismantled,” said Ferenc Falus, a former chief medical officer dismissed weeks after Mr. Orban took power in 2010. “And that has also happened in the health care system.”
A Health System in Turmoil
Today, Hungarians die of preventable diseases at the fifth-worst rate in the European Union. The cancer death rate is tied for worst. And the government has refused to release the number of infections contracted in state hospitals for fear of, in its words, “spreading panic.”
Senior clinicians estimate that more than one-tenth of Hungarian doctors — an estimated 5,000 — have emigrated because of low wages and poor working conditions.
Though Mr. Orban has raised doctor’s wages, the average Hungarian general practitioner earns less than twice as much as the average Hungarian, one of the worst ratios in Europe.
Many clinics are understaffed, lengthening waits and causing patients to visit emergency wards in desperation. As the head of a major state-run emergency department in Budapest, Dr. Gabor Zacher said his ward had 25 doctors instead of the 50 needed and 14 beds in intensive care instead of 40.
Dr. Zacher, who resigned in protest last summer from Honved Hospital in Budapest, said his department was underfunded by $1.8 million, leaving no money for new equipment or staff. Several doctors work up to 300 hours a month, he said, while some patients waited more than 10 hours to be treated.
“It was too much for us,” Dr. Zacher said. “I couldn’t look at myself in the mirror.”
Miklos Szocska, the junior minister who was in charge of health care from 2010 to 2014, defended the Orban administration, saying that new hospitals had been built, hospital management had become more centralized, and some general practices had been combined to create a more organized primary care system in some parts of the country.
Smoking has been banned in all public places, and taxes on sugary foods have risen. Spending dropped only as a proportion of national economic output, he said, and only because of the 2008 financial crisis.
“You can’t talk about these things without understanding what was happening to the Hungarian economy,” Mr. Szocska said.
Critics say Mr. Orban’s government has never prioritized health care, even as Hungarian opinion polls show it is a critical problem.
In fact, Mr. Orban has de-emphasized health care in his government. He eliminated the Health Ministry, which was subsumed into a “super ministry,” depriving the sector of a cabinet-level representative.
He also has weakened oversight. The chief medical officer, an independent state ombudsman, has lost resources. The Health Insurance Supervisory Board, an independent body with a mandate to inspect hospitals, has been disbanded.
State doctors and hospital directors have been barred from speaking out about problems. They are instructed to publish weekly examples of positive developments.
Mr. Orban’s party, Fidesz, has siphoned state health care funds toward private companies with links to the government, just as it has done in nearly every sector of the economy.
And at least one of the private companies receiving health care contracts has diverted tax money to Mr. Orban’s own soccer team.
A Soccer Scheme
An ardent soccer fan, Mr. Orban helped start the foundation that owns the Pancho Arena and the team that plays there, Puskas Akademia FC.
Even though his home is a one-minute walk away, he has a designated parking spot steps from the entrance and routinely uses the V.I.P. section as a salon where his closest allies can meet and show their fealty.
In 2011, Mr. Orban’s government approved a program that allows corporations to divert part of their pretax profits to sports federations and clubs. Government officials said the policy was intended to encourage spectator sports and healthy living.
But government watchdogs say the program has diverted $1.5 billion that could have been used on public services, including health, and that the program is vulnerable to corruption.
Transparency International Hungary, an anticorruption monitor, estimates that from 2011 to 2017, roughly 13.5 percent of all corporate tax revenue was redirected to sports. Of the six spectator sports federations eligible for the program, five are led by current and former Fidesz party officials.
The biggest beneficiary is soccer — and Mr. Orban’s team has received the most money, about $83 million, according to official records.
“The basic architecture of this scheme is to divert substantial public revenues to sports organizations with political ties for the purpose of spending without any public oversight,” said Miklos Ligeti, the legal director for Transparency International Hungary.
And just as Mr. Orban’s policies have enabled private companies to divert profits on public contracts to sports, so have some companies with ties to Fidesz amassed health care contracts.
Emails sent to Csolnoky Ferenc Hospital in western Hungary, just months after Mr. Orban entered office in 2010, offer a glimpse of this process.
That September, the management at this provincial hospital, owned by a Fidesz-run council, was instructed to establish a secret email account hosted outside the hospital servers.
Anonymous messages sent to that account, recently seen by The New York Times, instructed the hospital leadership to invite a pair of related consulting companies to manage a multimillion dollar renovation project.
The two firms — Vital Management and Value Added Solutions Consulting — are both jointly owned by a business partner of one of Mr. Orban’s oldest friends. They won the renovation contract.
Although the two consulting companies had rarely worked for the government, for the next four years they won more than 30 project management contracts at 18 state hospitals and health agencies, mostly funded by the European Union, according to data collated from the Hungarian government’s public procurement database.
This work paid them the equivalent of nearly $5 million, and gave them oversight over construction budgets worth at least $200 million.
In a statement, Vital Management, which now owns Value Added, said it had won these contracts fairly and denied any irregular practices.
Gabriella Nagy, who oversees investigations into public procurement at Transparency International Hungary, said the awarding process reflected “a well-known method to funnel E.U. money to business entities close to the governing party.”
Once in control, the winning companies can exert significant control over which construction firms and equipment suppliers get work funded by the project budget.
“They do so by shaping the financial and technical requirements for the bidders in a way that only the favored company is able to meet them,” Ms. Nagy said.
Swietelsky, a joint winner in 2013 of a hospital renovation project worth $3.7 million, was part of a conglomerate that would, less than two years later, transfer 300,000 euros, about $334,000, to Mr. Orban’s favorite soccer team.
Mr. Orban has defended the “special attention” he gives to sports.
“I am convinced,” he said in January, “that for raising children, caring for families and their unity, and for health, sports is the most important area in Hungary today.”