Small maternity wards to be liquidated

These are the most important conclusions from the Thursday meeting of the Health Committee, which dealt with the minister's information on the situation of pediatric and gynecological-obstetric wards. In both areas, wards are decreasing, one of the key factors is, of course, demographics, but the recipes for this situation are different: in the case of pediatrics, it is a challenge to find such a model of contracting and financing pediatric services that even in small hospitals, especially in infectious seasons, treatment of patients. In the case of maternity wards - obtaining a consensus that in the current conditions maintaining them in every hospital is pointless.

– Keeping two gynecology and obstetrics wards 15 km apart is unreasonable if each performs 150-200 deliveries per year. Directors of NHF branches suggested solutions for consolidating such branches, bearing in mind the interests of managers, the system and patients. (…) A certain number of small branches can still be identified on the map of Poland. The only thing to consider are the geographically excluded regions. In the case of dynamic childbirth, if the travel time to the facility is long, the patient may simply not make it on time - said Michał Dzięgielewski, director of the Department of Healthcare at the Ministry of Health.

The process of liquidation of small birthing centers is progressing, but slower than the ministry and experts would like. In 2015, there were 424 gynecology and obstetrics wards in Poland, and at the end of 2022 - 364. There are voivodeships - e.g. Podlaskie - where the number of wards has not changed in 2015-2023, but there are also those where it has significantly decreased. This is the trend I was talking about. The Podlaskie Voivodeship is a vast region with large distances between towns where geographical exclusion could occur, hence the policy towards gynecology and obstetrics wards there was different than, for example, in the Lower Silesian Voivodeship, where the distances between hospitals are small - added director Dzięgielewski.

During the discussion, however, there were also reservations. According to Marcelina Zawisza (Lewica), gynecological and obstetric wards are disappearing from the map of Poland "blindly", and - what's worse - their liquidation is not accompanied by strengthening those maternity wards that take over deliveries. As a result, the quality of care and the conditions in which Polish women give birth are deteriorating instead of improving. The safety of birthing children is also deteriorating. Which, according to the MP, translates, on the one hand, into the reluctance of Polish women to give birth to children, and, on the other hand, into the increasing percentage of caesarean sections. Women consider this - contrary to medical knowledge - a safer and more comfortable way of giving birth than natural childbirth. Especially since a large part of hospitals do not guarantee anesthesia for laboring women (lack and poor availability of anesthesiologists).

– There are no clear standards as to which branches and where they should operate. For years, the number of four hundred deliveries per year has been circulating in the public space as a criterion for the operation of the gynecology and obstetrics ward, which is not respected anyway. Local governments should be encouraged to do so where it is justified - pointed out Marek Wójcik from the Association of Polish Cities.