Hospital reform approved. "Concerns about commercialization are fanciful."
On Tuesday, the Sejm passed the government-drafted hospital reform bill. The provisions allow local governments to flexibly reorganize departments and merge facilities.
- I hope this is not the only proposal that will appear, Skóbel said.
She added that the reform must include financial resources to support hospital restructuring processes. She emphasized that regulations are also necessary to facilitate a broader shift in hospital operations. She added that currently, there is no guarantee of a contract with the National Health Fund (NFZ), even if the hospital completes a restructuring program and receives a positive opinion from the voivode and the National Health Fund.
Skóbel emphasized that the government's hospital reform does not introduce any loopholes for commercialization or privatization.
“The fear of commercialization is far-fetched,” she said.
During the draft bill's discussion at the parliamentary Health Committee, MP Marcelina Zawisza (Razem) said it left a loophole open to the commercialization of hospitals . Zawisza referred to a provision that allows associations of local governments to establish commercial companies. The Health Committee rejected Zawisza's amendment, which stipulated that hospitals established by associations of local governments would only be able to operate "in a non-commercial formula," meaning as independent public healthcare facilities (SPZOZ).
The ZPP expert noted that currently the local government can run a healthcare entity in the form of a commercial company.
"If the authority to run healthcare facilities is granted to an association of local government units, the association should be able to operate according to precisely those principles. If neighboring counties wanted to join forces, with one operating a hospital as a company and the other as an independent public health care center (SPZOZ), this wouldn't be possible without the association taking over both hospitals, " she added.
Skóbel emphasized that there is no prohibition against a SPZOZ operating a commercial department for which the hospital does not have a contract with the National Health Fund. She added that if a hospital does not have a contract, for example, for urology, there is no formal prohibition against opening a department providing paid services if there is a local need.
She said that SPZOZ hospitals do something different.
"For example, a public healthcare facility (SPZOZ) has a signed agreement with a private entity that subleases part of its space from the hospital. The hospital receives a ground rent for the floor, and a healthcare entity other than the SPZOZ operates in this designated area. Such situations do occur. When asked if the reform will lead to more such occurrences, I would answer that it does not change the actual situation," she emphasized.
She noted that during the creation of the National Cardiology Network, it turned out that due to functional, organizational, and ownership issues, the hospital specializing in cardiology services was not placed at the appropriate level within the network. It turned out that the hospital did not formally have one of the required departments, but that department operated within the hospital and was financed by the National Health Fund, albeit within the organizational structure of a different healthcare provider.
Work on the reform, which amends the Act on Healthcare Services Financed from Public Funds and the Act on Medical Activity, lasted for several months. The project was the flagship proposal of Minister of Health Izabela Leszczyna, who never saw its adoption in her position. At the end of July, Prime Minister Donald Tusk decided that Jolanta Sobierańska-Grenda would assume leadership of the Ministry of Health.
From the outset, the Ministry of Health's proposal lacked full consensus among coalition partners (including concerns from the Left about the risk of hospital privatization), and the bill was withdrawn from the Council of Ministers' deliberations several times . After numerous changes to the proposed regulations, Leszczyna admitted that the final version was a "soft" version compared to the original proposal.
The hospital reform is a milestone in the National Recovery Plan (KPO). These changes will adapt hospital services to local needs, including demographic changes: declining birth rates and an aging population. Medical staff, equipment, and infrastructure will be utilized more efficiently.
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