Chaos in local government hospitals – Health Manager – Termedia

Association of Polish Poviats

Source: Association of Polish Poviats, Andrzej Płonka

Editor: Krystian Lurka
Date: June 9, 2022

– The hospital reform imposed by the Ministry of Health will cause chaos in local government hospitals without solving the real problems of the health care system and as such must be immediately abandoned – writes Andrzej Płonka in the post of the XXVIII General Assembly of the Association of Polish Poviats.

The position of the XXVIII General Assembly of the Association of Polish Poviats on the planned changes in the way hospitals are managed – signed by the chairman of the assembly, Andrzej Płonka:

The Association of Polish Poviats has long expressed the need to make changes to rationalize the functioning of the health care system in Poland. Unfortunately, like the voice of practitioners, our voice is ignored and solutions are enforced that have nothing to do with real problems. The best example of this is the bill to modernize and improve the efficiency of hospitality, which – contrary to its title – will lead to the degradation of local hospitals. For this reason, the Association of Polish Poviats categorically opposes the further procedure of this project.

Among the disadvantages, we list five main ones.

First, the project is not a systemic solution. It focuses only on hospital treatment, ignoring what is one of the main sources of problems in the Polish health care system – the scope of treatment of patients under primary care prior to the transition to the AOS level, and then to hospital treatment. Second, the project is limited to public hospitals only, leaving private hospitals contracted with the National Health Fund outside the scope of the regulation. Meanwhile, the hospital’s ownership structure is irrelevant from the point of view of providing health services.

Second, the project focuses on financial efficiency, forgetting that there is no point in considering effectively managing poverty. This is particularly a major drawback in the context of continuously increasing costs of medical activities in the hospital sector. It is worth noting that the real expenditure on hospital treatment in Poland is one of the lowest in Europe. Compared to other developed European countries, it can also be seen that the potential of hospitals as providers of non-hospital health services in Poland is not being exploited.

Third, the project centralizes management while dividing responsibilities. The newly created entity is to have a direct impact on the operation of hospitals – the Hospital Development Agency which operates alongside the Ministry of Health, the National Health Fund, the Agency for Health Technology Assessment and Tariffs which is already responsible for the functioning of the system . It is worth emphasizing that the Hospital Development Agency is not responsible for the consequences of its actions – hospitals and their owners will be responsible.

Fourthly, the jurisdiction of the Hospital Development Agency will not be limited to entities subject to restructuring procedures. The concept of the project assumes the possibility of authoritative interference by the Hospital Development Agency under the contract concluded between the medical entity and the National Health Fund. The draft does not contain any clear rules by which such decisions will be made, does not provide for an obligation to justify such decisions, or for an appeal or judicial process in which a health care institution could question such agency action. Here too, the consequences of the agency’s actions do not fall on him, but on the hospitals and their owners.

Fifth – the draft contains many sentences that conflict with other legal acts already in force. The project – especially in the first part – lists many unspecified obligations that are imposed on the managers of medical entities without specifying the tools by which these obligations would be fulfilled. Of course, this does not alter the fact that there is a possible liability for non-compliance with these obligations.

Given the above, there is no doubt that the forced hospitality reform is just introducing chaos into local government hospitals without solving the real problems of the health care system and as such should be abandoned immediately.

Also read: “The minister’s meeting with the directors – a comment from President Fedorowski”‘Hospital reform law is unnecessary’‘Money for hospital debt relief, not for ARS’“Director Control”“Project without hope”

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