A speech therapist soon only in medical facilities?

The draft law adopted by the government last week regulating the conditions and rules for the practice of 17 medical professions has provoked a violent protest from the speech therapist community. They point out that the speech therapy profession should be regulated by a separate law, as only about 15 percent of speech therapists in Poland work in the health service. Meanwhile, the effects of the proposed legislation will affect all speech therapists, most of whom work in educational institutions and private offices. The new law will cause them to suddenly lose the right to use their title unless they comply with the new law, which entails a number of costly obligations. As a result, this could lead to private practices closing down, leaving the profession, and thus reducing the availability of speech therapy.

According to estimates from the Polish Association of Speech Therapists (PZL), out of 100 speech therapists employed - 12 work for the health ministry, 76 for the education ministry, and 12 run private practices, as part of their business activities. Thus, after the new law is implemented, suddenly 88 speech therapists out of 100 will lose the right to use their title, and this regardless of their previous length of service and qualifications, as well as the right to use the title of speech therapist based on the education they have received. In order to retain their title, they will have to submit to the provisions of the new law, which means, among other things, that they will have to register in the appropriate registry and meet the dual continuing education requirements required of both education and the health ministry. Private speech therapy offices, on the other hand, will have to transform themselves into medical entities with the same requirements as all medical facilities.

"The draft law also contains provisions that presuppose a hindered return to the speech therapy profession because a person who has not practiced a medical profession for more than 5 years in the past 6 years, and intends to take up the profession, is obliged to practice it under supervision for 6 months from the date of taking up the profession. In this regard, there are unclarified doubts by the Ministry of Health as to whether practicing as a speech therapist will be considered as practicing as a speech therapist teacher and, in general, practicing as a speech therapist in non-medical institutions," says Milena Stasiak, President of the Polish Association of Speech Therapists.

Ministry mostly deaf to speech therapists' arguments

The doubts and concerns of the speech therapy community have been articulated repeatedly toward the Health Ministry during the course of work on the Law on Certain Health Professions. The Ministry first refused to meet on the issue in early February last year. Then in January of this year - after receiving more than 700 comments on the draft from 168 entities - the Health Ministry decided to reject most of them. The adopted amendments to the law on the speech therapy profession were mostly cosmetic in nature, which did not address the main concerns articulated by the community.

It was not until February of this year that representatives of the Ministry of Health met directly with the Polish Association of Speech-Language Therapists and the Polish Speech-Language Therapy Association. The Ministry accepted minor substantive comments on the draft. However, the meeting did not lead to a change in the fundamental position of the Health Ministry, which on March 29 adopted a draft law regulating the functioning of certain medical professions, including not only speech therapists employed in medical institutions, but all speech therapists, despite the information provided on the specifics of this profession and doubts about the provisions relating to the speech therapy profession contained in the law, according to data posted on www.logopeda.org.pl (see calendar: https://logopeda.org.pl/new.php?id=1386, note of meeting at the Health Ministry on 01.02. 2023).

Why are speech therapists treated differently from physiotherapists or psychologists?

In the opinion of the PZL General Board, denying speech therapists the right to a separate law, by which the professions of doctors, nurses, paramedics, for example, are regulated, and psychologists and psychotherapists are also to be, is not only out of order, but additionally violates Articles 2, 17 and 32(1) of the Polish Constitution, which speak, among other things, of the right to self-government of individual professional groups and the right to equal treatment by public authorities.

"We find it difficult to understand why speech therapists are denied the right to a separate law, but no longer, for example, psychologists or psychotherapists, despite the comparable nature and forms of work of these professions. Speech therapy is an interdisciplinary science that combines linguistic, medical, pedagogical, psychological and knowledge of language and communication disorders in the broadest sense. This results in the specific nature and selection of methods of work by graduates of speech therapy studies - both in the educational and health ministries, as well as within other non-public entities, including business. The role of the speech therapist in the broader rehabilitation process is invaluable and underestimated," says Milena Stasiak.

In the opinion of speech therapists applying to the PZL, the new law will contribute to the elimination of the use of the full range of the aforementioned methods and educational aids necessary for the effectiveness of speech therapy diagnosis and therapy, as a result of the limitations in the typical medical standards extended to multi-specialty offices/outpatient clinics operating outside the health department. This will also limit the availability of professional speech therapy due to the mass closure of micro-enterprises operating in the speech therapy field (due to financial costs and the stress of change), and will expand the gray area where individual specialists who ignore the requirements of the new law will continue to operate.

What's next for the law on certain medical professions?

According to the Health Ministry, the purpose of the adopted draft law on certain medical professions is to regulate the conditions and rules for the practice of these professions, which have not been covered by statutory regulations to date, as well as issues relating to professional development, the registry and the professional liability of these individuals.

The law applies to the following health professions: dental assistant, dietician, electroradiologist, dental hygienist, speech therapist, massage therapist, medical caregiver, optometrist, orthoptist, podiatrist, prophylactician, audiologist, dental technician, pharmacy technician, orthopedic technician, medical sterilization technician and occupational therapist.

The approved bill will now go to the Sejm, and after approval in that chamber, it will go to the Senate, which, within 30 days, can accept it without change, pass amendments, or reject it in its entirety. The final vote, however, belongs to the Sejm, which may or may not accept the Senate's amendments. The law will enter into force after the President of Poland signs it.

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