County hospitals appeal to the government: The situation is critical

In a position adopted Wednesday, local government officials assess that the situation in health care has reached a critical level. - The situation in health care today is extremely difficult. Local governments running hospitals have been facing for months growing financial, personnel and organizational problems, which are not the result of local decisions, but a consequence of systemic solutions," stresses ZPP President Andrzej Płonka.

ZPP points out that despite ongoing discussions with the Ministry of Health and the National Health Fund, real corrective measures have not yet been implemented, and the burden of maintaining the system in practice falls on local governments.

The counties on the situation in health care have been sounding the alarm for quite some time: in early January, the ZPP sent a letter to policymakers on, among other things, the necessary changes to the Raise Law, noting the huge burden it generates on the finances of the National Health Fund. At the same time, local government officials - as they are doing now - objected to the search for savings in hospital budgets, including by reducing the valuation of some services or changes regarding the financing of the standard of patient nutrition. Although the Health Ministry has announced far-reaching changes to the law on raising salaries (which, nota bene, the trade unions do not want to agree to), the local governments see savings on valuations being made here and now, while the fate of the increase law is not, in their view, certain.

Tension on the part of hospitals and their founding bodies is increasing, which was also evident during Wednesday's meeting of the Parliamentary Group on Local Government Hospitals, which was attended by local government officials from both the district and provincial levels. Among other things, they talked about the prospect of settling excess payments, with the Ministry of Health and the National Health Fund saying nothing new: it is known that unlimited services will be financed in full (at the moment the first two quarters of 2025 are closed, not yet all departments have settled with hospitals for the third quarter, payments for the last one will be calculated by mid-February, and paid - in the following weeks or months, already from the plan for 2026). It is unclear to what extent the payer will be able to settle the limited overdrafts, which, according to the regulations, it does not have to finance. It is tentatively known that hospitals are waiting for about PLN 4.5 billion. That's not all, however, as hospitals point out that this year's contracts with the NFZ are lower by up to 10 percent than last year's, which means that in some ranges of services - for example, in drug programs - the entities will fall into the trap of overexecution faster.

Local government officials are also counting on support for restructuring measures - in April it will be known how many hospitals must prepare repair programs, as their net loss will exceed 1% of the budget. It is still unclear if, when and under what conditions the support program from the state budget (BGK) will be launched, and it is also unclear when the MZ will release funds from the Medical Fund (about a billion zlotys) to support hospitals undergoing restructuring.