Black clouds over POZ

Staff shortages in the health care system have long been talked about, as well as the need to implement urgent solutions that will attract staff. Both hospital directors, AOS and POZ, today have to face challenges that have quickly fallen on their shoulders. Raging inflation and rapidly rising costs of living, the next wave of COVID-19 and the changes that entered primary care since July 1, imposing additional obligations on clinics and the influx of patients - these are just the challenges of the last weeks. Another one has just come - the valuation of benefits, which pushes POZ to the margin. Will clinics from small centers cease to exist?

The Minister of Health approved the recommendations of the Agency for Health Technology Assessment and Tariffs in the field of financing health care services. The adopted second variant of the valuation is associated with an increase in NHF expenditure by over PLN 18 billion, which is to constitute 22.4% of the value of contracts of the National Health Fund. Meanwhile, the medical community has no doubts: with the increasing costs and the need to search for and maintain personnel, the current valuations do not meet the real needs of the facilities. The representatives of POZ have the greatest concerns, because the services they provide were valued the lowest.

“In small facilities it is much more difficult to find qualified personnel, and it is worth noting that the problems and needs of patients are the same as in large cities. The lack of adequate motivation for medical personnel, with the current inflation and soaring costs, may no longer lead to a blockage, but a system collapse. For years, patient organizations have been calling for equal access to healthcare, because they feel that not all patients can count on the same rights. Therefore, I am surprised that there are still no systemic actions that would allow the development of medical care on an equal basis throughout Poland. And it is all the more surprising as it is a blow to patients from small centers, ”says Anna Osowska, president of the Warmia and Mazury Employers' Association of the Zielona Góra Agreement.

An increase of 6.26% is expected for POZ, which, according to environmental calculations, gives a gap of almost 20%. In order to be able to adjust to the increase in salaries of clinic staff, contracts should be increased by at least 24%, because only then will it be possible to guarantee the employees of POZ an increase in wages at the expected level. Otherwise, with the current costs of the clinic (almost 60% of the employees' salaries already), rising inflation and the cost of living, it is impossible to raise the minimum wages.

The representatives of the environment are wondering how to reconcile the entrusted budget management with a number of other everyday challenges. For several weeks, there has been an ongoing discussion about introducing changes to GPC, which may lead to a significant division of society and exclusion of patients from small towns, because clinics will not be able to guarantee care at an equal level for all under the currently adopted rules. The adopted AOTMiT recommendations in the field of financing benefits only aggravate the already serious problem.

“We represent both clinics from large cities and those from tiny towns, so we know what they deal with on a daily basis. And these little outposts now have legitimate fears that they will be excluded altogether. Though it's not really about us. It is about patients who will not be treated. After all, POZ is the foundation of the health care system and in the future it may become a relief for the budget, because we take over a significant part of the responsibility in order to take care of the sick as early as possible and protect them from chronic treatment or hospitalization, which generates enormous costs "- says Tomasz Zieliński, family doctor, vice-president of the Zielonogórskie Agreement Federation.

Representatives of medical institutions are waiting for annexes to the contracts that they will receive from the National Health Fund, although they will not be reliable, because only in a few months it will be possible to realistically assess the costs they have to bear, and with such rapidly growing inflation, they may be much higher than it seems today. “We have been sidelined, but again, this is not about us. It is patients, especially from small centers, who are pushed to the margins and excluded from the basic right to decent health care "- adds Tomasz Zieliński.

Source: Zielona Góra Agreement