One doctor, one hospital, one contract - this is how the health minister would model the staffing structure of the public health system. In an ideal world, of course. Because realistically, listening to Izabela Leszczyna develop the idea she put forward earlier this week in an interview, it turns out that this is simply impossible, at least at the moment, and the specter of at least "two-hospitalism" is already looming on the horizon, to travesty a principle familiar for years in higher education. First, we don't have cannons. First, we don't have (that many) doctors. Of course, one can assume that the structure of hospitals will undergo rapid restructuring - perhaps as a result of the planned reform or lack thereof - and the demand for doctors' work will fall so much that the one-hospital rule will become the norm, but this is not a topic for sci-fi musings.
Feature
Małgorzata Solecka
What we talk about, what we should
Published July 3, 2025 08:22
The health care system is too big to fail (the reference to the financial crisis in the US is completely deliberate and not coincidental) and the complexity of the processes that take place in it (and which, after all, make up the system de facto) too complicated for simple prescriptions to have an impact. There is nothing wrong with simple prescriptions, as long as they are accompanied not only by the reflection "it can't go on like this", "we have to change something", but also by an analysis - what can be changed, what effects this change will have, how the change should be designed and the legal framework for its implementation should be prepared. In fact, a much wider range of questions arise, the answers to which are neither simple nor, even worse, certain.
The situation is complicated by the fact that politicians - even those who are aware of how badly the health care system needs a "good change" - most in the world would like to implement it in such a way that no one feels it and certainly - does not notice. The change itself, of course, because the positive effects - those, of course, should be noticed and (preferably) appreciated by the public. Except that the world doesn't work that way. You can't have your cake and eat your cake. You can't maintain a base of acute hospitals that is swollen beyond need (and capacity) and an efficient, effective, health care system that doesn't regularly run into staffing and financial turbulence.
Last but not least - you can't spend 5 percent of GDP on health with public funds and claim that you can, with that money, create and maintain a well-functioning system that offers accessible and quality health services to patients. The world does not work that way, and in highly developed countries, European countries at a similar stage of economic development to Poland, well-functioning systems that offer stable working conditions for medical professionals and a satisfactory level of services for patients cost (as of today) about 8% of GDP. At the same time, the club of highly developed countries knows that costs will only increase - due to the development of technology and, above all, the aging of the population - and the mainstream debate is about how to slow down the dynamics of cost growth.
There is no doubt that in terms of the organization and financing of health care, Poland, yesterday, today and unfortunately tomorrow, is rather an outsider in this club.
