Hospitality bill. Comments of the Supreme Medical Council on the proposed changes

The Supreme Medical Council has presented its position on the draft law amending the law on health care services financed from public funds and certain other laws. The draft, which has been sent for consultation by the Ministry of Health, is intended to put the Polish health care system in order. However, according to the NRL, many of its provisions need improvement, and its assumptions raise serious doubts.

Public consultation as a step in the right direction

The NRL welcomed the decision to send the draft back for public consultation. The numerous comments made on earlier versions and the significant changes introduced as a result of the consultations made another round of public dialogue necessary.

Lack of precision and vagueness of records

The bill, although another attempt to reform the health care system, in the opinion of the NRL still does not implement all the demands. First of all, it was pointed out:

• Lack of clear decision-making criteria,
• Difficulties related to the operationalization of the law's provisions,
• imprecise definition of time horizons for action.

The NRL stresses that the timeliness of key strategic documents, such as health needs maps and transformation plans, should be ensured prior to the introduction of new regulations.

Problem with funding and qualification for hospital network

Particular attention was paid to the problem of opening new departments in hospitals just to qualify them for the so-called hospital network. The NRL welcomed the removal of this requirement in the new version of the draft. It was noted, however, that issues of financing wards created "out of necessity" remain problematic.

Similarly, the abandonment of the qualification of hospitals in the field of gynecology and obstetrics solely on the basis of the number of deliveries was viewed positively. However, among the objections were the repeated names of qualification profiles in the bill and the lack of precise eligibility criteria for the health security system.

Disadvantages of the qualification system

The NRL pointed out that the lack of unambiguous qualification criteria introduces the risk of excessive discretion for governors. Meanwhile, qualification standards should be the same in all provinces. It also stressed that setting up numerous teams for each qualification profile could generate significant costs and unnecessary administrative burdens.

Repair programs and their evaluation

The draft law stipulates that recovery programs for SPZOZs must be drawn up, but the NRL points to the lack of a key regulation specifying criteria and methods for their evaluation. Equally problematic is the admission of an assessment of the alignment of SPZOZ activities with one of the strategic documents, instead of all of them at the same time.

The NRL called for the introduction of clearly defined indicators of health care quality, as well as the appointment of a person responsible for implementing the repair program. It also stressed the need for more frequent evaluation of the implementation of repair programs versus updating them.

The role of system institutions

The NRL noted that institutions responsible for the health care system, such as the Ministry of Health, provincial governors, the National Health Fund and the Agency for Health Technology Assessment and Tarification, should play a key role in the process of implementing recovery programs. Their task should be to assess the interdependence of the recovery plans and prevent conflicts that could negatively affect the functioning of the system.

Source: NIL