Coordinated care impossible to implement

During the session of the Poviat Council and PPOZ Board, regional and poviat representatives gave a negative opinion on the regulation of the Minister of Health, extending the package of guaranteed benefits in POZ with coordinated care and unanimously indicate that they do not see the possibility of starting this task, in the current situation and on the terms presented by the Ministry of Health and the National Health Fund.

The proceedings took place on September 18 at the headquarters of PPOZ in Konin. It was attended by regional and poviat representatives, the PPOZ Board, an audit committee, a PPOZ lawyer and invited guests.

The main topic of discussion (apart from current and legal matters) was coordinated care in Primary Healthcare. During a thorough analysis of the ordinance of the Ministry of Health and the ordinance of the President of the National Health Fund, the participants pointed out that it was not possible to start a new task. For many reasons. The most important are: staff shortages, shortages of premises, additional administrative and reporting obligations (unknown in details), staffing capacity of specialists (dietitians), underestimated valuations in the field of diagnostics required for coordination, valuation of services, as well as crediting the performed tests and consultations (for possible further billing by the National Health Fund).

- In practice, coordinated care would mean that family doctors, not the minister of health or the president of the National Health Fund, are to guarantee unrestricted, free access to the most important specialists (cardiologist, pulmonologist, diabetologist, endocrinologist, allergist) and to some diagnostic tests , e.g., Holter scans, echocardiography, and even fine needle biopsy of the thyroid gland. Nay! GPs are to pay for advice from specialists and for tests ordered from their own resources! The National Health Fund, only after they have submitted detailed reports (including IT reports), would reimburse them for the costs incurred, but only up to the amounts specified in the ordinance. These amounts differ significantly from market prices, e.g. for a consultation with a specialist doctor, the National Health Fund is to pay a family doctor only PLN 81.65, and for echocardiography PLN 106.26. Anyone who has had to consult a cardiologist or have an echocardiographic examination at least once knows well that such examinations are at least twice as expensive - emphasizes Bożena Janicka, president of the PPOZ.

The Agreement of Healthcare Employers, which brings together family doctors from all over Wielkopolska, warned the minister of health in correspondence addressed to him that at present it is not possible to organize coordinated care.

- And not because of the bad will of family doctors, but because of the increasing absenteeism of specialist doctors in the public health system. In many poviats of Wielkopolska, none of the practicing specialist doctors has a contract with the National Health Fund. These doctors have moved to the private sector and are not interested in coordinated care, because patients wait in queues lasting several weeks to visit their private clinics. The same applies to the availability of dietitians or other required for the implementation of diagnostic tests. Perhaps, looking from behind an office desk in Warsaw at the shoulders of primary health care, many new tasks can be imposed, because there are vast reserves of reserves in it, but in fact… reality screeches. None of the primary health care units in Greater Poland will provide coordinated care. The Ministry of Health will not be able to beat the political success! - PPOZ doctors emphasize.

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