In the coming weeks, we would like to carry out the projects from the queue and oncology package through parliamentary work, Minister of Health Bartosz Arłukowicz told PAP. He added that after consultations, the projects consume some of the comments, but with the main line of changes.
On Tuesday, draft amendments to the acts on health services financed from public funds and on the profession of nurse and midwife are to be dealt with by the Council of Ministers, and then they will be submitted to the Sejm.
We are after the Standing Committee of the Council of Ministers, internal and external consultations, we have prepared materials that the government will look at, and then everything is in the hands of the parliament – said the Minister of Health in an interview with PAP.
When asked about the course of public consultations, he assured that the ministry was carefully reading all comments, because the changes are deep and systemic.
After the consultations, a project was created that consumes some of the proposals coming from various circles, but maintaining the whole line of sense of these changes, i.e. shortening the queues, facilitating procedures for patients and doctors, lifting limits in oncology and accelerating oncological therapy, but with a guarantee of timeliness and quality Arlukowicz said.
The projects do not differ significantly from the originally proposed solutions – he assessed. The projects themselves were created in cooperation with communities, so we did not introduce any fundamental and key changes – he added.
We will try to carry out these projects very efficiently – emphasized Arłukowicz.
We would like to take these bills through parliamentary work in the coming weeks. In order for the acts to enter into force from 2015, the ministry must also have time to prepare draft regulations, and the National Health Fund (NFZ) – financial products and draft ordinances of the President of the National Health Fund – emphasized the minister. He added that draft regulations and ordinances are already being prepared. The projects are important and quite deep, therefore they require a lot of attention when implementing them – he stressed.
He pointed out that the Fund has had a new president, Tadeusz Jędrzejczyk, for several days. We are also in the process of changes in the NFZ itself, we have a new president. He perfectly understands the need to introduce these changes and cooperates with the ministry – said Arłukowicz.
Arłukowicz, when asked about the emerging doubts regarding the financing of the announced changes, replied: Of course, you can always start with adding money, and I am a supporter of increasing financing only in the incentive system and with a tightly built system.
You have to reorganize the entire system. I have repeatedly said that additional financial resources are not excluded, but only when the system is closed and tight – he added.
Solutions from the queuing and oncology packages are to enter into force in January 2015.
Proposals aimed at reducing queues to specialists and better access to cancer therapy were presented in March by the Minister of Health. On April 7, the bills containing some of these solutions were submitted for consultation. Dozens of organizations and associations operating in the field of health protection, consultants, medical centers and societies submitted comments to the projects.
The medical community assesses some of the solutions positively, but emphasizes that others are impossible to implement, as the financing of services is not expected to increase. According to the Supreme Medical Council, the proposals of the Ministry of Health are imprecise and underfunded, and they will not make it possible to shorten the queues at medical facilities. The medical self-government generally supports most of the ideas announced by the minister, but after a detailed analysis of the legal acts, it should be noted that many projects lack specific solutions, and some contain erroneous assumptions, which may, in effect, infringe the patient’s rights – assessed the vice-president of the NRL, prof. Romuald Krajewski.
We evaluate some of these ideas positively, e.g. longer contracts or regional maps of health needs. These are the proposals that we look at with some optimism, but as always, the devil is in the details, so you have to wait and see what this project will look like after the work in the Sejm and whether it has any chance of being implemented – the head of the NSZZ health secretariat told PAP Solidarity Maria Ochman. However, according to her, shortening the queues requires deeper system changes and a clear definition of the role and tasks of primary health care, outpatient specialist care and hospitality.
In turn, oncologists’ doubts are raised by the mechanism of privileging patients with suspected or diagnosed cancer by equipping them with the so-called oncological treatment card. The draft amendment to the Act on benefits provides that a patient with a suspected cancer will receive a Cancer Patient Card, which will entitle him to quick diagnosis and visits to specialists without referral; it will also allow you to sign up for specialists on a separate waiting list, dedicated to patients waiting for oncological diagnostics. The card will be issued by a primary care physician or a specialist, e.g. a gynecologist, who finds a malignant neoplasm.
The queue package also includes solutions that are to improve access to specialists for all patients.
One of them is better monitoring of patient queues. According to the draft, service providers are to provide the National Health Fund with information about the first available date on which a given service may be provided. On this basis, the NHF department will inform you where the patient will be admitted the fastest. In addition, service providers will be obliged to keep waiting lists in electronic form, which is to increase the transparency of this procedure. The minister of health will indicate those specializations for which the longest wait – waiting lists will be kept centrally there. The patient will be required to deliver the original referral to the specialist within two weeks of entering the waiting list for an appointment. Failure to deliver it will result in deletion from the list. The draft also includes referrals to ophthalmologists and dermatologists.
One of the solutions that is to reduce queues is also the introduction of the so-called prescription advice; without examining the patient, the doctor will be able to issue a prescription necessary for the continuation of treatment. According to the ministry, currently many visits to specialists are made only to renew the prescription, which delays access to the doctor for new patients or those requiring a quick diagnosis.
The draft also provides for changes in health policy planning. In order to ensure proper provision of services, voivodes, with the participation of voivodship councils for health needs, on the basis of projects submitted to them by the National Institute of Public Health – National Institute of Hygiene, will prepare regional maps of health needs every five years. A nationwide map will also be developed on their basis.
According to the draft, there are also changes in the appointment of the president of the National Health Fund – he is to be appointed and dismissed by the minister of health after consulting the Fund Council, and not by the prime minister – as it is now.
Moreover, the Ministry of Health proposes to extend the periods for which service providers sign contracts with the National Health Fund. In the case of POZ, the contracts will be indefinite, while hospitals will conclude contracts for 10 years, and specialists – for 5 years.
The draft also includes new rules for health insurance for the unemployed without the right to unemployment benefit; this part of the package was prepared by the Ministry of Labor and Social Policy. The new provisions are intended to enable a jobless person to choose whether he only wants to obtain health insurance, or whether he actually wants to look for a job and take it. Therefore, a separate window will be created in labor offices, where it will be possible to submit a declaration on this matter and complete the formalities. Such changes will relieve some employees of labor offices, who will be able to deal more intensively with the activation of the unemployed. The new solution will also make the number of unemployed real.
As part of the queue package, the Ministry of Health also prepared a draft amendment to the Act on the Nursing and Midwife Professions. It assumes that from 2016, nurses and midwives with a master’s degree will have the right to prescribe certain medications and prescribe them. On the other hand, undergraduate nurses and midwives will be able to issue prescriptions for specific medications necessary for the continuation of treatment at the doctor’s request.
Beata Pieniążek-Osińska (PAP)