ZK OZZL on the draft act on the modernization and improvement of the efficiency of hospitality

The fundamental flaw of the act is the assumption that the main reason for the poor financial situation of hospitals in Poland is bad management by bad (unqualified) management. For this reason, in the opinion of the authors of the bill, hospitals will not be able to independently improve their financial situation and their efficiency, which will prevent their development. Hence - the proposal contained in the act - to create permanent, governmental supervision over hospitals in the form of the Hospital Development Agency and to change (at least in part) the management of hospitals according to the principles included in the act.

In the opinion of HRM, the adopted assumption is incorrect and - consequently - incorrect are also the actions proposed in the act. The main reason for the poor financial situation of hospitals is the poor external conditions in which hospitals must operate, in particular the underestimated and often irrational pricing of services provided by hospitals. This makes it impossible to balance hospitals if they want to maintain an appropriate quality of services, an appropriate level of employment (safe for patients and staff) and an appropriate level of wages. It also often forces hospitals to take unreasonable measures (e.g. extending hospitalization, applying unnecessary tests, etc.). Other conditions also prevent reasonable - especially in the long term - action. These include, for example, changing conditions for the settlement of services provided by hospitals or previously unplanned loading hospitals with new tasks.

In the opinion of HRM, the way to improve the financial situation of hospitals, which will also enable them to operate effectively and rationally, improve the quality of services provided, and modernize and develop, is the correct valuation of medical services provided by hospitals. It must take into account the (average) costs that must be incurred in their implementation, also taking into account the appropriate valuation of the work of medical personnel. Contrary to the authors of the act, HRM believes that competition between hospitals is a necessary supplement to the proper valuation of services - for patients, and thus for funds from the National Health Fund (in accordance with the principle that "money follows the patient). This competition will force the improvement of the quality of services, a better response to the needs of patients (e.g. comprehensiveness of services), and at the same time the effectiveness of their functioning. Competition for medical personnel is also necessary, because the quality of health services is primarily related to the right people who provide these services. In the opinion of HRM, the authors of the act make a mistake in considering that it is possible to improve the quality of services offered by hospitals and compete in this quality (competing for whom?) In a situation where - at the same time - competition for patients, for funds from the National Health Fund and medical personnel. For the proper functioning of hospitals, it is also necessary to liquidate other, non-substantive influences on hospitals and management (e.g. by local or central politicians). It is also obvious that some hospitals - due to their "naturally" monopolistic position - will not be subject to competitive pressure. Administrative central regulation may become necessary in these hospitals.

In the opinion of HRM, the enactment of the draft act should be abandoned and the actions aimed at repairing hospitality in Poland should be rethought, taking into account the comments presented in this position.

The National Board of OZZL,
Krzysztof Bukiel - Chairman of the Board

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