District hospitals sign annexes with NHF and await further decisions

District hospitals will sign annexes, based on which the National Health Fund will transfer funds to implement the AOTMiT recommendation related to increased labor costs as of July 1. Hospitals had strong objections to the recommendation, but after a meeting with the Health Minister, there is no longer any talk of protests or boycotting the annexes.

Hospitals are counting on dialogue with the Health Ministry on the financing of services in the coming months (or rather, on the fact that the dialogue will result in an acceleration of the settlement of liabilities, for example, due to overdrafts in non-limited services), and stress that Jolanta Sobierańska-Grenda, who also has experience in managing county facilities, will approach their problems with understanding. Until Thursday, the National Health Service reported that annexes had been signed by more than 70 percent of hospitals - all indications are that this process will accelerate further at the moment and be completed in the next few days.

The objections of the district hospitals were mainly related to the failure to include in the recommendation the cost of increasing the amount of physician contracts. However, these - as the previous Health Minister Izabela Leszczyna still stressed - are not linked to the Minimum Wages Law and must be adjusted to the financial capacity of hospitals. At the moment, the health ministry, within the framework of the Trilateral Team for Health Care, is holding talks aimed at introducing restrictions to contractual agreements, although as of today it is difficult to predict what solutions will ultimately find the support of the social partners (and political consensus within the government).

There is an ongoing discussion as to whether it would be possible (and beneficial from the point of view of the system and patients) to eliminate the possibility of signing contractual agreements in which remuneration is defined as a percentage of the value of procedures performed. In its latest proposal, the ministry suggested that contracts could be based solely on an hourly rate. In turn, on Thursday, the Federation of Polish Entrepreneurs (which advocates radical changes and "taking the area of civil law contracts under its thumb") proposed that a closed catalog of services that could be billed "on a percentage" be created. The reason? The idea - most likely - is not to throw the baby out with the bathwater and drastically reduce patients' access to services. Because this is precisely the scenario that policymakers are being warned against by, among others, the Medical Council.

The proposals that FPP presented at Thursday's meeting of the Team, however, are not limited to the issue of contracts or salaries alone. The organization points to the need to talk about extending the prospect of an increase in funding for the public health system to 8 percent of GDP (by 2030) and introducing more effective control over the purposes for which growing health expenditures are used.