- We present the assumptions of the PHC reform, which we have developed based on the expectations of patients and the way offices function - said Minister of Health Adam Niedzielski on Monday.

A revolution, or a huge change, in primary care is set to begin on July 1. But family doctors warn against reassuring patients that from that date the availability of health care services will rapidly improve.

A change in the method of financing, more diagnostic tests, the focus shifted to prevention ("proactive care", as Minister Niedzielski said) and coordinated care in the most common civilization diseases - these are the most important assumptions of the primary health care reform presented by Minister Adam Niedzielski and dr hab. Agnieszka Mastalerz-Migas, national consultant in the field of family medicine.

The press conference took place immediately after the meeting of the representatives of the Ministry of Health with representatives of organizations associating primary health care physicians. Our information shows that at this meeting the doctors presented their reservations not so much, because the direction of changes has been accepted by the health care community for years, but doubts related to the lack of specific solutions - perhaps this week the answers will be given by the order of the President of the National Health Fund, changing annexes to contracts.

What is known? First, there will be a change in the philosophy of POZ financing, i.e. a shift of emphasis from capitalization financing to paying for specific services (entrusted budget). - The capitalization rate remains, but the next elements that will be added will be financed in accordance with the fee for service principle - the minister explained. - These new payments also appear at the preventive level. We will try to reward the institutions that will be the most active in promoting prevention. For example, for every hundred people who benefit from research under the
program Prophylaxis 40 Plus, a bonus of 2.2 thousand will be paid. PLN - he said.

Adam Niedzielski confirmed that from October POZ will face further changes related to coordinated care. - We are introducing coordination of the entire treatment process. There will be a much larger pool of tests in coordinated care. As many problems as possible are to be solved at the basic level, he stressed.

The details of the POZ reform were also discussed by Dr. hab. Agnieszka Mastalerz-Migas, a national consultant in the field of family medicine, who led the work of a team of experts preparing a proposal for changes in primary health care (doctors associated with the College of Family Physicians in Poland and the Federation of Zielona Góra Agreement withdrew from this team in February).

- We covered a few areas in our work that we know need improvement. This includes prophylaxis - said Mastalerz-Migas. - We are introducing activities that are to contribute to this. We are increasing the target group in the cardiovascular disease prevention program. A very important change is also enabling nurses to implement the program - said the national consultant. She added that every zloty spent on prophylaxis is a few times smaller amount spent on diagnostics and treatment.

- The changes are to come into force at the beginning of July. This is an introduction to the implementation of coordinated care, planned for autumn this year. Coordinated care will cover cardiological, pulmonary, endocrine and diabetic diseases. The GP will be provided with diagnostic tools and the support of the coordinator, the national consultant explained.

What was not mentioned during the conference was addressed directly after the conference by the GPs. - The introduction of coordinated health care within primary health care is essential. However, the current shape of the project bears the hallmarks of an experiment rather than a well-thought-out and discussed with many environments idea to improve functioning. Let's not create a two-speed POZ - wrote on Twitter Jacek Krajewski, president of FPZ. Doctors point out that while in large cities POZ clinics will have, at least potentially, the possibility of providing patients with access to specialists, in smaller centers it will be a purely theoretical option.