"Human resources are the greatest asset, not a crutch for the health care system. The task of health care managers in Poland, following the example of other EU countries, is to focus on systemic solutions, not to search for cases that result from current organizational and legal restrictions," Marcin Karolewski stresses.
Below is the full statement:
The Polish Society of Physician Managers, looking at the public narrative blaming medics, and doctors in particular, with the disastrous state of the National Health Fund's finances, unequivocally states that the current burdening of physicians with the NFZ situation is a harmful action that can have very negative consequences for the quality of the system and the treatment of the public patient. Human resources are the greatest capital, not a crutch for the health care system. It is the task of health care managers in Poland, following the example of other EU countries, to focus on systemic solutions, and not to search for cases that result from current organizational and legal restrictions.
At the root of the information about the alleged "overeating" by health care workers of the increasing outlays for it, stands the initial very low level of wages in health care, which, as recently as 2016, oscillated for most employees below or around the minimum wage, which was then PLN 1850 gross. Until recently, so-called compensatory allowances were the order of the day in hospitals, which were supposed to adjust salaries to the level of the minimum wage.
The law of June 8, 2017 on how to determine the lowest basic salaries of some employees working in medical entities has gradually begun to equalize the disparity between earnings in health care and the average salary in other sectors. However, we would like to remind you that the aforementioned law sets the salaries of employees of health care entities at 65% to 145% of the amount of the average monthly gross salary in the national economy in the preceding year, and these amounts were reached over five years. As of 2017, funds to ensure salaries at this level were transferred to hospitals from the NHF budget in appropriate, well-defined tranches, and then included in the amount of the lump sum of the PES or contract with the NHF. Thus, this was not an irresponsible financial policy of hospital managers, but the implementation of statutory obligations. It should also be recalled that in 2022, many financial burdens, previously financed from the state budget, were included in the bloated NFZ budget, including drug programs or tasks related to the state emergency medical service system.
In the case of doctors, the salaries guaranteed by the law are far from the amounts reported in recent days, and in deficit specialties, the salaries of specialists are lower than those of resident doctors. It should not be overlooked here that currently hospital working conditions are so difficult that most doctors in the course of their specialization declare their intention to leave the hospital system upon completion. Hospitals (except for the largest teaching hospitals) continue to be understaffed at all levels - both doctors, nurses and other medical staff. Staffing levels and workloads in the hospital system are inadequate to meet demand and provide quality care. The appropriate staff, providing services 24 hours a day, 7 days a week, is responsible for treating the patient and the quality of that treatment. It is the people, through making diagnoses, performing treatments, issuing orders, nursing and caring care, who are responsible for saving people's health and lives. Pills and treatments will not order, administer and carry out themselves. Therefore, the words that the health premium "overwhelmingly" goes to pay employees, "and this premium is also to treat people, there is also the problem of reimbursement, hospitals need to be maintained," are hurtful to all health care workers.
The drawn out, and so eagerly recalled in recent times, individual irregularities in public health care are part of the pathosystem created over the last twenty-plus years by politicians, not health care workers. This is the aftermath of the creation of many makeshift solutions to cover up the system's mistakes, and result in the appearance of more. Such a solution was, for example, the criticized civil-law contracts, which doctors were urged to use as an ad hoc prescription for staff shortages, giving the public permission to work beyond their means. There are many such pseudo-solutions, both in primary care, AOS and hospitality. In such a shaped system, it is natural that there are units that do better, worse, but also those that will parasitize on it. This begs the question - who does this system serve, and is there a public will to fix it, or is it just politically safe to dismiss responsibility for the quality of the system?
With the above in mind, one cannot help but feel that the campaign's vilification of health care workers is only meant to cover up years of negligence in reforming the overall health care system, as well as irresponsible financial policies and shifting excessive burdens to the budget of the National Health Fund without providing adequate resources. Staff, especially highly qualified staff, are often used inefficiently and overburdened with reporting, bureaucratic and administrative duties. Health care managers have their hands tied and little influence in shaping personnel and payroll policies. We call once again for a calm, balanced and substantive discussion of health care reform, based primarily on well-defined population health goals and pro-efficiency system changes, removal of bottlenecks in the availability of services, cooperation of primary care, AOS and hospitality with each other, and proper use of personnel potential.
