The government has adopted a series of health acts which will change the healthcare system organization, lead to the implementation of new personnel solutions, and regulate the medications policy. Hospitals will be able to employ more doctors, and it will become possible for the patients to arrange medical visits on-line. Hospital restructuring, limitation of patient surcharges on reimbursed medications (through rigid margins), and quick indemnification for doctor errors are also stipulated in the health acts series. The parliament is already working on the government proposals. Meanwhile, the government has increased public spending on healthcare. In 2006 it amounted to PLN 42.9 billion, while in 2010 to PLN 62.7 billion.
Hospital restructuring option
There will be an option for hospitals to restructure into companies with share capital. If a hospital generates loss at year end, the competent local government may choose to cover such loss within the next three months. Otherwise, such hospital will have to be transformed into a company with share capital.
Electronic medical records
A system of electronic medical records is to be implemented. Patients will be able to make appointments online and they will be notified by email of the date and time of their appointment. There will be e-prescriptions, e-referrals and e-orders, so that patients will not have to remember about taking the right documents with them. Dispensing assistants will have access to e-prescriptions and specialist physicians – to e-referrals.
Quick recovery of compensation for medical errors
There will be an administrative (non-judicial) procedure to enable quick recovery of compensation for medical errors. Maximum waiting time for the award of compensation will be 6 months. Patient Ombudsman will make sure that the new law is observed.
More physicians in hospitals and outpatient clinics
The government has been gradually cutting down the period needed by young doctors to start their professional practice. In accordance with the regulation passed by the Minister of Health, since Autumn 2008 doctors have been able to begin their specialization right after the diploma internship, and to pass the Doctors’ State Exam before the internship is over. On 12 October 2010, the government adopted an act by force of which the diploma internship is replaced with practical classes in the 6th year. Thus, doctors will start their professional careers sooner, becoming more available to patients in hospitals and clinics. There are plans for doing away with the so-called State Exams for doctors and dentists. During the specialization training, it will be possible for young doctors to obtain additional qualifications. For instance, a person specializing in surgery will be capable of acquiring qualifications allowing them to run ultrasound tests and analyze their outcomes.
Uniform prices of pharmaceutical products in every pharmacy
A system of fixed retail and wholesale margins will be implemented. As a result, the prices of refunded pharmaceutical products will be the same in every pharmacy.
Limited application of bailiff enforcement
The new set of health laws is the next stage of the health reform process. Numerous measures aimed at supporting the health sector have already been implemented, such as limited application of bailiff enforcement. To help hospitals out of financial difficulties, the Bailiff and Enforcement Law has been amended to include provisions which enable hospitals to challenge the amount of bailiff’s fees before a court. This way, hospitals which are already in debt will not fall into another debt spiral. Moreover, the amount of enforceable debt has been limited to 25 percent of the value of a hospital’s contract with the National Health Fund (NFZ, Narodowy Fundusz Zdrowia). This means that hospitals in debt will have some funds left to treat their patients.
Basket law
Since August 2009, the amended Public Health Service Law has been in force (the so-called Basket Law), on the basis of which the Minister of Health has issued the so-called Basket Regulations. Those Regulations set out, for the first time since the introduction of the general health insurance system in Poland, a list of guaranteed free of charge medical services and the conditions (standards) of their provision. The terms and procedures of verifying the eligibility of health services determined in the Basket Law, with due consideration of the recommendations of the Polish Agency for Health Technology Assessment (Agencja Oceny Technologii Medycznych), will make it possible for the Government to guarantee and finance only those health services which are efficient and effective.
Patient’s Rights Law
The Patient’s Rights and Patient Ombudsman Law entered into force in June 2009. All the rights that patients are entitled to are now listed in a single act of law. Patients may seek enforcement of their rights with the assistance of the Patient Ombudsman, who is independent of the Minister of Health and whose duties include, apart from the normal duties of an ombudsman, to prepare and evaluate draft laws on patient’s rights. Since the new Law acknowledges a vast majority of patient’s rights to be personal rights, patients have now more possibilities to seek redress for their breach in court. There are also provisions that enable patients to object against the decision or opinion of a physician.
More money for medical rescue service
The Ministry of Health has changed the so-called algorithm of funds division between individual provinces, earmarked for financing tasks performed by medical rescue teams. In December 2008, the act on the National Medical Rescue was amended. A new algorithm of funds division, taking into account the number of medical rescue teams and costs of their 24 hour maintenance, was introduced. Pursuant to the act on the National Medical Rescue, the amount earmarked for financing tasks performed by medical rescue teams was increased in 2008 by PLN 130 million, up to PLN 1.47 billion. PLN 1.73 billion was allocated for such tasks in 2009, and PLN 1.78 billion in 2011.
Higher salaries
The basic salaries of interns and residents increased significantly for the first time in many years. Between 2007 and 2009, basic internship salary went up from PLN 1,403 to PLN 2,007. Residents now receive a basic salary ranging between PLN 3,170 and 3,890 (depending on what they specialise in), compared to PLN 1,757 in 2007 and PLN 2,473 in 2008. To encourage young physicians to specialise in certain specific fields of medicine (paediatrics, anaesthesiology, neonatology), residents specialising in priority fields are offered higher salaries: during the first two years of residency, the basic salary is PLN 3,602, then it goes up to PLN 3,890. In non-priority fields, resident salary is PLN 3,170 during the first two years of residency and then PLN 3,458. In 2010, the average full-time hospital salary of a 2nd degree specialist was PLN 7,420, compared to PLN 5,435 in 2007. The salaries of nurses and midwives went up, too. The average full-time hospital salary of a specialist nurse or midwife went up from PLN 2,995 in 2007 to PLN 3,564 in 2010. In the case of senior nurses and midwives, average salaries increased from PLN 2,564 in 2007 to PLN 3,134 in 2010.
Hospital restructuring option
There will be an option for hospitals to restructure into companies with share capital. If a hospital generates loss at year end, the competent local government may choose to cover such loss within the next three months. Otherwise, such hospital will have to be transformed into a company with share capital.
Electronic medical records
A system of electronic medical records is to be implemented. Patients will be able to make appointments online and they will be notified by email of the date and time of their appointment. There will be e-prescriptions, e-referrals and e-orders, so that patients will not have to remember about taking the right documents with them. Dispensing assistants will have access to e-prescriptions and specialist physicians – to e-referrals.
Quick recovery of compensation for medical errors
There will be an administrative (non-judicial) procedure to enable quick recovery of compensation for medical errors. Maximum waiting time for the award of compensation will be 6 months. Patient Ombudsman will make sure that the new law is observed.
More physicians in hospitals and outpatient clinics
The government has been gradually cutting down the period needed by young doctors to start their professional practice. In accordance with the regulation passed by the Minister of Health, since Autumn 2008 doctors have been able to begin their specialization right after the diploma internship, and to pass the Doctors’ State Exam before the internship is over. On 12 October 2010, the government adopted an act by force of which the diploma internship is replaced with practical classes in the 6th year. Thus, doctors will start their professional careers sooner, becoming more available to patients in hospitals and clinics. There are plans for doing away with the so-called State Exams for doctors and dentists. During the specialization training, it will be possible for young doctors to obtain additional qualifications. For instance, a person specializing in surgery will be capable of acquiring qualifications allowing them to run ultrasound tests and analyze their outcomes.
Uniform prices of pharmaceutical products in every pharmacy
A system of fixed retail and wholesale margins will be implemented. As a result, the prices of refunded pharmaceutical products will be the same in every pharmacy.
Limited application of bailiff enforcement
The new set of health laws is the next stage of the health reform process. Numerous measures aimed at supporting the health sector have already been implemented, such as limited application of bailiff enforcement. To help hospitals out of financial difficulties, the Bailiff and Enforcement Law has been amended to include provisions which enable hospitals to challenge the amount of bailiff’s fees before a court. This way, hospitals which are already in debt will not fall into another debt spiral. Moreover, the amount of enforceable debt has been limited to 25 percent of the value of a hospital’s contract with the National Health Fund (NFZ, Narodowy Fundusz Zdrowia). This means that hospitals in debt will have some funds left to treat their patients.
Basket law
Since August 2009, the amended Public Health Service Law has been in force (the so-called Basket Law), on the basis of which the Minister of Health has issued the so-called Basket Regulations. Those Regulations set out, for the first time since the introduction of the general health insurance system in Poland, a list of guaranteed free of charge medical services and the conditions (standards) of their provision. The terms and procedures of verifying the eligibility of health services determined in the Basket Law, with due consideration of the recommendations of the Polish Agency for Health Technology Assessment (Agencja Oceny Technologii Medycznych), will make it possible for the Government to guarantee and finance only those health services which are efficient and effective.
Patient’s Rights Law
The Patient’s Rights and Patient Ombudsman Law entered into force in June 2009. All the rights that patients are entitled to are now listed in a single act of law. Patients may seek enforcement of their rights with the assistance of the Patient Ombudsman, who is independent of the Minister of Health and whose duties include, apart from the normal duties of an ombudsman, to prepare and evaluate draft laws on patient’s rights. Since the new Law acknowledges a vast majority of patient’s rights to be personal rights, patients have now more possibilities to seek redress for their breach in court. There are also provisions that enable patients to object against the decision or opinion of a physician.
More money for medical rescue service
The Ministry of Health has changed the so-called algorithm of funds division between individual provinces, earmarked for financing tasks performed by medical rescue teams. In December 2008, the act on the National Medical Rescue was amended. A new algorithm of funds division, taking into account the number of medical rescue teams and costs of their 24 hour maintenance, was introduced. Pursuant to the act on the National Medical Rescue, the amount earmarked for financing tasks performed by medical rescue teams was increased in 2008 by PLN 130 million, up to PLN 1.47 billion. PLN 1.73 billion was allocated for such tasks in 2009, and PLN 1.78 billion in 2011.
Higher salaries
The basic salaries of interns and residents increased significantly for the first time in many years. Between 2007 and 2009, basic internship salary went up from PLN 1,403 to PLN 2,007. Residents now receive a basic salary ranging between PLN 3,170 and 3,890 (depending on what they specialise in), compared to PLN 1,757 in 2007 and PLN 2,473 in 2008. To encourage young physicians to specialise in certain specific fields of medicine (paediatrics, anaesthesiology, neonatology), residents specialising in priority fields are offered higher salaries: during the first two years of residency, the basic salary is PLN 3,602, then it goes up to PLN 3,890. In non-priority fields, resident salary is PLN 3,170 during the first two years of residency and then PLN 3,458. In 2010, the average full-time hospital salary of a 2nd degree specialist was PLN 7,420, compared to PLN 5,435 in 2007. The salaries of nurses and midwives went up, too. The average full-time hospital salary of a specialist nurse or midwife went up from PLN 2,995 in 2007 to PLN 3,564 in 2010. In the case of senior nurses and midwives, average salaries increased from PLN 2,564 in 2007 to PLN 3,134 in 2010.