NInvestment in health without results: more money, longer queues

The Supreme Audit Office has examined the effectiveness of projects financed by the Regional Operational Program of the Podlaskie Voivodeship in 2014-2023. Despite the goal of increasing the availability of medical services, investments have had the opposite effect - waiting times for services have increased, and the number of waiting patients has increased.

NIK identifies key problems:

• Low-quality projects - projects evaluated below the 50% threshold were eligible for funding.
• Lack of relevant data - no reliable analysis of the need for equipment and health services was available.
• Ineffective indicators - outcome indicators did not reflect real improvements in service availability.

Major investments included:

• Purchase of medical equipment,
• Expansion of hospital infrastructure,
• Support for long-term care, psychiatric care and rehabilitation.

However, improvements in infrastructure have not translated into an increase in the number of services contracted by the National Health Fund or the availability of medical personnel. As a result, investments worth hundreds of millions of zlotys have not resulted in real improvements for patients.

Availability data:

• Waiting times for cardiology, orthopedics and pediatric oncology services increased between 2017 and 2023.
• Access to gynecological care, obstetrical care, neurological rehabilitation and many other key services has not improved.

According to the Supreme Audit Office, the lack of effectiveness of the projects was due to, among other things, unreliable preparation of competitions, ineffective monitoring tools and lack of proper planning. Grants went to entities in poor financial condition, which limited their ability to achieve their goals.

The Supreme Audit Institution requests the Marshal of the Podlaskie Voivodeship to:

• Monitoring the investment needs of medical entities, in conjunction with the National Health Fund's ability to contract the services provided using the subsidized infrastructure;
• The introduction in the current financial perspective of criteria for evaluating applications for funding, allowing a reliable assessment of the effectiveness of planned investment projects;
• Enforcing from the beneficiaries a strict connection between the indicators of the results of the subsidized projects and the objectives set in them, so that the indicators allow measuring the degree of achievement of the planned objectives and efficiency of project implementation;
• Elimination of irregularities identified as a result of the inspections carried out;
• Enforcing from the beneficiaries the implementation of obligations arising from the regulations of competitions and application documentation, including the launch of the operation of infrastructure produced under the projects, including with their own funds, when the assumptions of the competition provided for this.

Source: NIK