Due to the lack of coordination of purchases and poor planning, one-third of the hospitals inspected did not effectively use new equipment purchased thanks to EU funds, according to a report by the Supreme Audit Office, which was received by PAP on Wednesday.
NIK emphasizes that one third of the audited hospitals which purchased specialized equipment did not use it as planned in the applications for funding, which means that the number of actually provided services was lower than expected.
The Chamber assessed that the currently used purchasing procedures mean that some localities lack specialist equipment, while others have too much of it. The audit showed that in many institutions, EU projects were prepared carelessly: there was a shortage of, for example, qualified staff authorized to service the ordered devices, as well as adequately adapted offices and laboratories, although the funding could also be used to adapt the rooms.
NIK indicates that this delayed the delivery, installation and commissioning of the purchased equipment. As a consequence, modern and specialized devices remained unused for many months, and instead of the expected improvement, the financial situation of some hospitals even worsened, because they had to bear the costs of e.g. equipment depreciation.
In six clinics, the inspectors also questioned the use of devices: fees for diagnostic tests were charged there, although the equipment financed from EU funds could only be used to provide services under a contract with the National Health Fund.
In the opinion of the Supreme Audit Office, the applicable legal regulations are not conducive to the pursuit of a coordinated policy on equipping clinics with medical equipment and apparatus. Voivodship self-governments cannot, for example, monitor the number and type of tests carried out in private institutions or in public institutions, subject to e.g. communes. This makes it difficult to assess the needs of the population living in a given voivodeship.
The audit of the Supreme Audit Office confirmed that local governments did not carry out reliable analyzes of health needs in their area and did not have up-to-date data on the distribution of medical equipment. Data on the distribution of specialist equipment collected by the Center for Healthcare Information Systems for the Ministry of Health differed from the data obtained by inspectors directly from voivodes.
According to the Supreme Audit Office, an effective solution could be the constant cooperation of units implementing EU-financed investments in a specific area, including joint investment planning based on an analysis of health needs. This is particularly important in connection with the acquisition of funds by Poland in the new EU budget perspective for 2014–2020.
NIK audited 46 units, including Ministry of Health and 30 medical entities.
Health Minister Bartosz Arłukowicz, who was a guest of TOK FM radio in the afternoon, emphasized that there is currently no coordinated regional health policy, and the purchase of medical equipment for small hospitals often becomes a political ambition.
He added that currently the dispersion of the hospital ownership structure is enormous and each of the owners runs their own health policy, which is not coordinated with the partner who operates in the same area, e.g. the staroste who runs the hospital invests in the purchase of equipment without consulting it with the voivodship marshal who runs his office.
Arłukowicz reminded that in the draft assumptions of the act on the institutions of the health insurance system prepared by the ministry, the ministry proposes to create regional maps of health demand, which will describe, for example, what new equipment is needed in the region, what departments should operate, and which there are too many. He stressed that these maps will form the basis of a coordinated regional policy. According to the minister, the act would enter into force in 2014.
The spokesman for the Ministry of Health, Krzysztof Bąk, emphasized in an interview with PAP that the NIK report concerns the purchase and use of medical equipment co-financed by regional operational programs. He emphasized that the Minister of Health did not participate in the creation or implementation of these programs and was not responsible for the correct spending of these funds. Individual voivodship marshals are responsible for regional operational programs with the coordinating support of the Ministry of Regional Development.
Bąk emphasized that the Ministry of Health proposes to introduce solutions that will contribute to a better assessment of health needs in individual voivodeships and will improve the planning of medical investments and the correct diagnosis of the needs in the field of health care infrastructure.
The Ministry of Health proposed to the Ministry of Regional Development to apply to all interventions related to investments in healthcare infrastructure (both at the central and regional level) the mechanism included in the draft assumptions for the draft act on health insurance system institutions, on which the ministry is working, emphasized Bąk.
They are designed in it, inter alia, changes in the organization of the health insurance system regarding the planning and assessment of health needs and medical investments – he added. Bąk informed that the project envisages the creation of a support instrument in the field of planning health care services in the form of voivodeship maps of health needs assessment, which will be taken into account, inter alia, when preparing an opinion on the advisability of making new investments in medical infrastructure.
The proposals of the minister of health meet the expectations of the European Commission in terms of strengthening the coordination of the regional and central level and mapping the needs in the health sector under the next financial perspective for 2014-2020 – said Bąk. (PAP)
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