This is the view of the union side of the Trilateral Team for Health Care. Thursday's meeting was adjourned, and talks are expected to continue, but there is no indication that they will result in a convergence of positions.
Is the government looking to save money on full-time employees?
Published July 18, 2025 16:51
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The reason? In fact, even before the substantive talks began, the Health Ministry truncated its initial proposals for restrictions on contractual agreements. Thursday's announcements by the Health Ministry depleted, compared to those of a week ago, two important points:
- obligation to structure contractual agreements solely on an hourly rate,
- the obligation to obtain permission from the director of the hospital with which the doctor is contracted to sign a contract with another facility.
From the system's point of view, the abandonment of the provisions on the transition to an hourly rate in particular may cause astonishment - since the Ministry assumed (and apparently this has not changed) that the contracts would specify the minimum number of procedures necessary to be performed on an elective basis, within the framework of the usual (off-call) order. These stipulations were supposed to exclude practices in which doctors drive around (mostly county) hospitals to perform favorably priced procedures. This, in turn, was supposed to lead to actual consolidation of specialized services at higher levels of hospital security. Will the effect be achieved if the contract package comes into force only partially?
The social partners have doubts, and the trade union side after Thursday's meeting does not hide its disappointment, because the health ministry maintains all the proposals for changes in the law on minimum salaries (they would mean that in 2026 medical salaries would not increase at all, and from 2027 salaries would be indexed, such as pensions), meanwhile, according to the trade unionists, there is no will to limit the highest salaries in health care.
However, this is not entirely true: also on Thursday, the National Association of Employers of County Hospitals issued a position on the latest AOTMiT recommendation. A negative position, the hospital directors pointed out that the recommendation does not cover contractual agreements this time (as opposed to 2022-2024), which means that hospitals will have to finance any contractual salary increases on their own, which, especially for county hospitals, where the percentage of doctors working on contracts is exceptionally high, could mean massive financial problems (or rather - a deepening of already existing massive financial problems). Experts have been pointing out for more than a year now that the NFZ's finances are burdened not so much by the Minimum Wages Act, but by the way it is implemented - if it were implemented to the letter (and applied only to minimum wages), its annual impact would be not PLN 17-18 billion, but about PLN 9 billion.
