They were supposed to get raises, they got new responsibilities. Those that previously belonged to doctors. Physiotherapists feel cheated by the minister, hesitate what to do. It’s scary to think what will happen if they really rebel. Already today, people after accidents and strokes are waiting months for rehabilitation.
- – You have a PLN 150 raise and be happy that I give you a job at all, because I can always close the ward – said physiotherapists at the Independent Public Healthcare Center in Radzyń Podlaski from the director. They earn an average of PLN 1650 per hand
- From March 1, the valuation of health services in rehabilitation was to be increased, and the money obtained in this way, thanks to the regulation of the President of the National Health Fund, was to go to physiotherapists, diagnosticians, psychologists and electroradiologists.
- – Nothing like that happened, but on March 4, in the backstage talks at the Ministry of Health, we learned that the money will appear in hospitals, but … in April – says Dr. Tomasz Dybek, chairman of the National Board of the National Trade Union of Physiotherapy Employees and vice-chairman of the OPZZ Industry Council “Usługi” Public”
- – We listened to Minister Łukasz Szumowski, who on January 21, during a meeting with us, said that the role of trade unions is to call for pay rises and “put pressure” on employers. And we are starting to enter into collective disputes with our employers all over Poland, says Dr. Tomasz Dybek
Physiotherapists in Poland receive PLN 1600-1800 a month for their work. This is the lowest salary in the country.
Physiotherapists take over the duties of doctors
They have had difficult studies behind them, most of them are constantly training in Poland and abroad. In medicine, new discoveries, techniques and methods of rehabilitation appear almost every day. And there is more and more specialization. A few years ago it happened that when a patient after an injury came to the attending physician in a rehabilitation clinic, he received, for example, a referral for a massage, but there were no detailed guidelines. The doctor was aware that the progress in physiotherapy was so rapid that the masseur, who specializes in a given section of the spine and is fresh after the next course, has a greater understanding of how to best rehabilitate the patient than the orthopedist referring to the treatment. Now this situation has been officially sanctioned. The family doctor may refer the patient to the so-called a physiotherapeutic visit, bypassing the doctor. And it is the physiotherapist who will establish the patient improvement plan that he considers to be the most beneficial for him. He will carry out the treatments and finally assess the effect, be it as part of outpatient care or home physiotherapy.
Home visits for PLN 11
This has been happening since January 1, 2019. There has been more work and responsibility, but money has not followed the new duties and increasing competences.
In addition, the regulation, whose aim was to increase the availability of physiotherapy for patients, also at home, did not take into account the increased costs of the test incurred by entities implementing these contracts.
– A visit by a physiotherapist (at the National Health Fund) is covered at the ridiculous amount of … PLN 11,70. As part of this, a master in physiotherapy with three years of experience or a physiotherapy specialist (after a 4-year specialization) will examine the patient and establish a physiotherapy plan, as well as order specific treatments – says Dr. Tomasz Dybek.
– We are against the unequal treatment of our professional group compared to other hospital employees. For years we have been ignored, forgotten, disregarded – say Hanna Kowalewska, vice-president of OT OZZPF at the Provincial Hospital in Łomża and Maciek Bogdan, member of the National Board of the National Trade Union of Physiotherapy Workers, chairman of OT OZZPF from the same hospital. And they add: We, therapists, care about raising our qualifications, which translates into the quality of services provided by the hospital. And our salaries have become equal, and sometimes they are lower than the salaries of post-vocational workers. Only the salaries of doctors and nurses are “promoted” – the latter earn much more from the very beginning than a physiotherapist with 30 years of experience. We do not mention doctors, because they are already a “caste” whose earnings are achieved by “pay chimneys”.
Physiotherapists leave the profession
The state pays for educating physiotherapists (every year fewer and fewer students are willing to study), and then condemns them to vegetation. 30 percent of them leave Poland for other EU countries, because their profession is prestigious and well-paid there. Many of them stay in Poland after their studies, but sometimes they do not start working in the profession at all. And those who take it for PLN 1600, going to the clinic or hospital every day, will miss an advertisement in which a network of popular hypermarkets will lure them with twice as much salary.
– Our clinic visits 200 people a day, and each has several procedures (e.g. massage, laser, solux, etc.), and there are only 12 physiotherapists – says Hanna Kowalewska from the Provincial Hospital in Łomża.
It is similar all over Poland, and in many places even worse. And even so, the lines for physiotherapy are so long that it happens that when, after many months of waiting, the patient finally gets to the physiotherapist, who glances at the referral, says: “Your spine hurts in the lumbar region” and hears: “The lumbar pain hurt, how the doctor wrote this referral. Now it’s the cervical that hurts me more ”.
Those who wanted to stay in Poland and in their profession try to fight for themselves and their patients. However, they are disregarded by the Ministry of Health and their immediate superiors – directors of hospitals and clinics. When asking for money (often about PLN 100-200, which representatives of other professions would consider to be alms), they hear humiliating comments or are met with heartlessness. “We are of the opinion that the hospital cannot afford to raise the salary” – this was the mediation in one of the hospitals (it was about 250 zlotys), “41 thousand. PLN per year is a big cost for the hospital »- echoed the president. – The translation is always and everywhere the same: “The Ministry of Health does not give” meaningful “money for you, the National Health Fund pays us little for appraisals. There are no system solutions, no unanimity in what are proposed by the Ministry of Health, the Ministry of Finance and the National Health Fund, say physiotherapists. – The act, which was to guarantee a gradual increase in health care expenditure to 6 percent of GDP, as it now has, due to the new calculation methodology, will lead to the fact that in 2024 we will probably be the country that spends the least in Europe on health protection health. We have sad news for patients: if the statutory interpretation does not change, next year we will break the record from 2018 and expenses will be even lower – 4,3%. GDP, instead of the statutory 4,85 percent. – announces Dr. Tomasz Dybek.
Physiotherapists enter into a collective dispute
EHCI is an annual report devoted to the assessment of health systems in European countries. In the last one, only Albania, Romania and Hungary came out worse than Poland. We were overtaken by Cyprus, Bulgaria, Lithuania and Greece.
All over Poland, physiotherapists are beginning to enter into collective disputes with their employers. – We listened to Minister Łukasz Szumowski, who on January 21, at a meeting with us, said that the role of trade unions is to stand up for pay rises and “put pressure” on employers – says Dr. Tomasz Dybek. And she adds: “We are desperate. The situation in the community of physiotherapists is dramatic, to say the least, and the Ministry of Health is “inflating” the balloon with its promises. When will it break? We’ll see”.
On March 29, a convention of OZZPF delegates will take place. It is here that the physiotherapists will decide how they will fight. About myself and about patients.