The government has announced the liquidation of the National Health Fund and an increase in spending on national health care. Crucially it’s a move from insurance-only to universal, including foreign residents.
Liquidation of the National Health Fund and a return to financing it from the country’s budget, an increase in expenditure on health care and the right to treatment in public health care facilities for all – these are the main objectives of the reform presented by the Minister of Health Konstanty Radziwiłł.
On Tuesday, Minister Konstanty Radziwiłł has presented the government’s “strategy to change the national health care system.” According to the new assumptions, from the year 2018 health care in Poland will be provided by the National Health Service. Other significant changes are as follows:
Liquidation of the National Health Fund
Starting from January 2018, the National Health Fund will be replaced by a system administered by the Minister of Health and the Provincial (Polish: wojewódzkie) Health Offices. The latter will be organised in a voivodship system depending on the Minister of Health.
The Minister of Health will supervise the work of the entire system of health care services, manage the reimbursement of drugs, contract the high specialty services, as well as supervise the Provincial Offices of Health, – Radziwiłł has explained.
The Minister of Health will also control the general conditions of servicing. Radziwiłł has pointed out that the Provincial Health Offices will handle a number of tasks related to direct contracting of health care services and they will operate on completely different principles than the provincial branches of the National Health Fund.
Insurance for all
Access to health services in the public health care system according to the Ministry’s plan “will be civic, or even more – residential entitlement”. What does it mean? Any person who needs medical assistance will get free help. They won’t have to have valid insurance, as it is today. Healthcare will therefore be available for people working on civil contracts and not paying premiums.
More money for health care from the budget
The Minister has also introduced a change in the method of financing health care. Funds for its functioning will be secured on a special account of the State Fund for Special Purpose called “Health”. It will be part of the state budget managed by the Minister of Health. Radziwiłł has explained that this solution will ensure that funds allocated to health care will be safe.
The Minister has announced a systematic increase in spending on health care, starting from early 2018. As pointed out by the Ministry, in 2025 they will reach 6 percent of Poland’s GDP.
The new system of financing hospitals
The new way of financing will also concern hospitals, some of which will be “budgeted” – instead of previous individual financing of hospitalisations and procedures they will receive a lump sum for treatments in specified ranges.
Hospitals will be divided into three levels of activity, creating a network of institutions on different levels of performed services. The first degree hospitals will resemble regular hospitals with just a few wards, while clinics and specialist hospitals will constitute the third level.
Radziwiłł has pointed out that nearly 30 billion zloty will be allocated to current health care services – approximately 78 percent of it will be transferred to units’ lump sums and only 22 percent will be disposed through contests.
The Minister has stressed that hospitals will have to provide reports of their activities: Each hospital will have to prove that it does what it was doing in previous years. If it turns out that it provides more of some services and it is justified, the budget for the next year will be adjusted, increased.
The new office
One of the reform’s parts will be the establishment of the Office of Public Health, aimed at integrating the management of public health. It includes, among others, the State Sanitary Inspection, the State Agency for the Prevention of Alcohol-Related Problems and the National Bureau for Drug Prevention. The Office of Public Health will also be responsible for the implementation of the National Health Programme.
Changes in primary health care
The changes will also affect primary health care. Special groups consisting of a GP, nurse, midwife, school nurse and a dietician will be created. They will collect and coordinate all information about treatment of patients who have received assistance in hospitals or specialist care practices.
On top of that, the Minister has announced a turn-back from the current pay system. Capitation rate (for each patient) will be modified by the addition of the incentive grant for a service in the field of prevention and health promotion, as well as for taking care of chronically ill patients. Hospitals will be granted a budget for diagnostics and outpatient specialist care. Additionally, performance bonuses for health care workers are also planned.
The Minister informed that provisions concerning primary health care will come into force as soon as mid-2017: We hope we will be able to introduce new contracting rules by 1 July 2017.