Draft changes to hospitality in consultation

The draft was published on the afternoon of August 9, the ministry gave 21 days for consultations, justifying their shortening by the need to proceed quickly with the law. The time pressure is justified by the short deadline for disbursement of KPO money, the release of which is contingent on the implementation of regulatory changes agreed with the European Commission. The goal of the changes is to have a well-functioning system of hospital treatment "primarily by adjusting this system to the demographic structure and actual health needs of the population, and by concentrating services and profiling hospitals, as well as networking them in terms of the profiles of services provided."

In its justification, the Ministry also stresses the need to strengthen the hospital system by consolidating resources and rationalizing costs on the part of medical entities when there is an overlap or inefficient dispersion of personnel and infrastructure potential in relation to identified health needs in a given area, and to strengthen the supervision of creating entities over restructuring programs.

Such positive changes, the document reads, were not brought about by the 2017 reform of the system of contracting health care services implemented in hospitals - either in terms of improving access to health care services, concentration of these services, rationalization of costs on the part of medical entities and rationalization of expenses on the part of the National Health Fund. - The separation, within the framework of the introduced system of basic hospital provision of health care services (PSZ, i.e. the so-called hospital network), of 6 levels of hospital provision was based on complicated and non-transparent criteria, with no significant added value, the ministry states. Health Minister Izabela Leszczyna has reiterated for several months that one of the main problems of the health care system is the inefficient use of personnel and equipment and infrastructure resources, as well as the maintenance by some hospitals of increased readiness under full hospitalization contracts, which generates excess costs, not justified by actual needs.

The structure and rules of qualification for the network are to be changed (one of the key proposals is to abandon qualification for individual levels of security in favor of qualifying all providers having at least one so-called qualifying profile - i.e. any profile in full hospitalization treatment covered by an existing healthcare contract for at least two years. Additional criteria will apply to surgical and gynecology and obstetrics wards, which has already caused an uproar, because according to the adopted criterion of a minimum of 400 deliveries per year, more than a hundred delivery rooms will not qualify for the network, although eventually this list will probably shorten significantly (Izabela Leszczyna announced that the NFZ will also take into account the geographical criterion and those delivery rooms that secure areas distant from other hospitals will be able to count on the contract).

The Ministry also envisages simplifying and relaxing the rules governing the coverage of selected additional types of services under the PES contract, as well as, among other things, allowing providers to switch from providing services within a hospital emergency department to providing services within an emergency room, and making the rules for providing night and holiday health care services within the PES more flexible and rationalized.

The draft provides for the possibility of creating and operating independent public health care facilities by unions of local government units, as creating entities. With this solution, local government units will be able to merge stand-alone public health care facilities, thus creating more efficient, larger treatment entities.

There is also a block of regulations for the creation and approval of recovery programs created by independent public health care facilities with a net loss.