Minimal spending, growing needs, and patients waiting longer....

According to Lukasz Kozlowski, chief economist of the Federation of Polish Entrepreneurs, which has been preparing quarterly editions of the Monitor for the past four years, one of the reasons for the decline in accessibility is that for years health care spending has been settling at the minimum required by law, although the system's needs are much higher, if only because health needs are growing. - So we see the regularity that expenditures for a given year are planned at the statutory level, and then during the year adjustments are made to the NFZ financial plan," he explained.

According to experts' calculations, the estimated total of health spending in 2024 will close at PLN 211.8 billion. The plans for 2025 assume spending of PLN 222.7 billion, which means an increase of just under PLN 11 billion, although actual execution will (probably) be higher. - This amount is clearly lower than that appearing during the discussion of the work on the state budget for 2025, when an increase in spending of more than PLN 30 billion was presented, Kozlowski pointed out.

How does keeping health spending to a minimum affect patients? - We looked at outpatient specialty care and patient waiting in urgent cases. If we take the year-on-year third quarters, the number of waiters increased by 37.3 percent, while the median waiting time increased by 38.6 percent. In contrast, the number of waiters for urgent cases in AOS increased by 98.9 percent over two years, Kozlowski said. - Kozlowski said. During the same period, nominal spending on AOS increased by almost two-thirds.

The largest number of patients are queuing for neurological outpatient clinics (nearly 70,000), trauma and orthopedic surgery (more than 62,000) and a day rehabilitation facility (nearly 57,000).

In contrast, the longest median waiting time is for the otolaryngology clinic (150 days). More than 90 days are waited for appointments at the hematology and gastroenterology outpatient clinics for children, among others.

The information on debt is also important: already in the previous Monitor, experts pointed out the dynamic growth of maturing liabilities. After the third quarter of 2024, total liabilities of public hospitals reached more than PLN 23.8 billion, and maturing liabilities exceeded PLN 3 billion for the first time in years. - If this trend continues in the coming quarters, we will be facing a situation of serious concern, Kozlowski said.

The financial situation of hospitals will undoubtedly be complicated by the next round of increases from July 1. FPP estimates that the cost of the maximum variant of raises (i.e., the one implemented in 2022-2024) will exceed PLN 17 billion per year. - The National Health Fund simply does not have such money," the expert said.