On the footsteps of a Boxer horse

The defeat, which is the struggle of the Ministry of Health with the coronavirus epidemic, is not yet complete, and our disaster specialists are already planning the next enlightened undertakings. For several months now and there, salons have been talking about another initiative of the ministry aimed at further centralization of our health care system, consisting in the liquidation of the already significantly limited independence of the branches of the National Health Fund.

After the achievements of Minister Radziwiłł, it seemed to me that we had already reached the pinnacle of centralization activities, and yet I underestimated the inventiveness of our creators of successive disasters and failures. Another change is to involve the fact that individual branches of the National Health Fund will become organizational units of one company, i.e. the National Health Fund, and these local branches will not be managed by directors, but by the president's proxies.

There is no end to the fight against the epidemic in Poland. The course of the infections shows that we are dealing with the epidemic of the worst among the European Union countries. Belarus and Moldova are coping as ineptly in Europe as we are - so far. Ukraine and Russia, who handled the epidemic just as badly, seem to have mastered the situation and are slowly moving towards reducing the number of infections. However, our model of the course of the epidemic is deceptively similar to the course of Covid-19 in Sweden.

The problem is that Sweden made a conscious choice in this regard and seems to have made a mistake. We, on the other hand, reportedly flattened the course of infections with the result that the highest daily incidence occurred in Poland after almost three months of the epidemic and the end of this "spectacle" is not in sight. Looking at the disease course curve, one gets the impression that the epidemic is taking place in our country as if the government is doing nothing in this regard.

The fact that we have fewer infections and that the mortality rate is several times lower than in Italy, Spain, France and other countries of Western Europe is not due to the ministry, but it results from the fact that this is how these phenomena proceed in all countries Central and Eastern Europe.

Some people associate this with the obligation to vaccinate against tuberculosis in these countries. For now, the mortality rate in Poland is 30 deaths per 1 million inhabitants, and in Western Europe it is approaching 400 deaths per 1 million. We can only compare ourselves with other countries within these blocs of states. The mortality rate is similar to us, for example, in the Czechs, but in Slovakia it is 5 deaths per 1 million. Thus, comparing the situation in Poland and in Italy results either from ignorance or from the will to manipulate data.

In the struggle with the epidemic, the inability of the Ministry of Health to manage large-scale undertakings was made manifest in full force. The ministry was unable to mobilize and improve the functioning of the sanitary and epidemiological services. The fact that they functioned well here and there was due to the managerial skills of each individual. The Ministry was unable to organize an efficient swab collection system, failed to organize an adequately efficient network of isolation units and finally, it has not yet organized an efficient and adequate network of laboratories.

It would seem that after all these disasters the ministry would wind up with ideas of further centralization of a system that it cannot manage anyway. Meanwhile no, they really want to centralize the system even more.

It is like in the example of the horse Boxer from Orwell's Animal Farm, which I have repeatedly recalled, who reacted to every failure with the postulate that we need to work even more until he finally died of overwork. The ministry's response to the successive failures in managing the healthcare system unfortunately resembles that of Boxer.

Unless it is all about better management, but about having a more direct influence, for example, on the way money is distributed to individual service providers, because the powerlessness in this respect irritated many previous ministers. And if so, everything becomes clear already.

Source: "Healthcare" 6/2020