There was supposed to be a CAP...

The Tripartite Team meets on December 2 and the atmosphere of the talks, assuming they begin, will not be light. Already the partners, primarily the employers' organizations, did not take well to Health Minister Jolanta Sobieranska-Grenda and Deputy Minister Katarzyna Kęcka's emphasis on the "social character" of the proposals lying on the table. It looked as if the ministry's leadership was contemplating changes - such as CAP, but also, for example, minimum working hours for contracted physicians - that it could not sign off on. - This is a field for dialogue, not dogma," Deputy Minister Katarzyna Kęcka explained in conversations with the media, even though a trace of these proposals can also be found in the work of the ministerial team for system changes (established by Izabela Leszczyn, already disbanded).

Well, and finally, it's also not the case that the Health Ministry put "strict" proposals from the social partners on the table. Because, of course, it is true that the abolition of "chimneys" and the introduction of CAPs were demanded by trade unionists, and such a solution was also proposed by some employers or local government officials, but this does not mean that the Health Ministry was asleep as pears in the dust on this issue. A month ago, during the Health Market Forum, Katarzyna Kęcka, commenting on the fact that "the possibility of introducing a maximum salary, or so-called CAP, has also appeared in the public space," added: - We are talking about it, it is being recalculated, prepared. "There is also the possibility of regulating contracts, because it has arisen in the public space whether we are going to give up a percentage on procedures in the case of contract salaries or wages. And contracts are prepared in different ways, taking into account the hourly rate - I'm talking about medical professionals, based on a percentage on procedures performed. But we also have contracts that are made on a lump sum basis - if the doctor in question works only in primary care. And so really at the moment we have to arrange ourselves, if there is talk of stacks - we have to have in the back of our minds and the lowest salaries, but also this CAP, which is expected by the social side."

The original sin of the "dialogue" on CAP, and contract changes in general, was that the Ministry of Health did not see fit to discuss the proposals that would be on the table during the talks (regardless of who put them on the table) with the representation of the environment affected by the proposals. What's more, the health ministry more or less passively looked at the whole setting, the outer circle of this "public space" in which the discussion was taking place - for months - in which doctors, as a professional group, were (and still are) presented as responsible for the meltdown of the NFZ finances. The Ministry explains that it has never claimed this, but there is such a thing as a sin of omission.