In brief

• The Sejm adopted an amendment allowing the President of the National Health Fund (NFZ) to ban a doctor from providing publicly funded services for providing false information in settlements.
• The ban is to last from one month to eight years, and in case of a repeated violation, permanent exclusion is possible.
• The amendment will go to the Senate, which has submitted nine amendments; the health committee will consider them on 3 November.

The Sejm passed rules that are not yet in force

Deputies supported an amendment giving the President of the National Health Fund the right to ban a doctor from providing publicly funded services. The amendment also covers the pay and working time of medical staff. From November, facilities are to provide the fund with data on the working hours of their staff, and failure to comply with this obligation carries penalties (Spór o zarobki lekarzy odsłania głębszy problem polskiej ochrony zdrowia – deon.pl). The package also provides for a maximum hourly rate for doctors, calculated at about PLN 240 gross, as well as public disclosure of contracts and a percentage limit on the share of wages in a hospital's budget (240 zł za godzinę i dwa etaty. Senat szykuje poprawki do ustawy – abczdrowie.pl). The Senate will consider the package of changes to health care, to which nine amendments have been submitted (Co najmniej ćwierć zamiast pół etatu dla medyków? Senatorowie przygotowali 9 poprawek do pakietu zmian w ochronie zdrowia - rp.pl – rp.pl).

Length of the ban and the possibility of appeal

The ban is to last from one month to eight years. In case of a repeated violation of the rules, a doctor may be excluded permanently (Gorące dni w Senacie. 3 listopada Komisja Zdrowia zdecyduje o zasadach zatrudniania medyków – rynekzdrowia.pl). It will be possible to appeal the NFZ president's decision to a court. The provisions may still change during the legislative work, so the date on which the sanctions take effect remains unclear.

Objections from the medical self-government

The National Medical Chamber (NRL) assesses that the act will not improve the availability and quality of services, and that restrictions on employment and pay may lengthen waiting lists for treatment (NRL: Proponowana reforma ochrony zdrowia wydłuży kolejki do leczenia – prawo.pl). The self-government stresses that most of the doubts it raised have not been taken into account. Sebastian Goncerz, chairman of the Resident Doctors' Agreement OZZL, said during the discussion in the Senate that the project is harmful to the health care system (Senat pracuje nad zarobkami lekarzy. "Ręki nikt nie podniósł, również MZ. Kurtyna" – Medonet).

Pay and time limits

The amendment introduces a monthly pay limit of PLN 76,900 gross. Total working time may not exceed the equivalent of two full-time jobs. Senators have submitted amendments, including one reducing the minimum working time of doctors to a quarter of a full-time job. The Senate health committee will consider them on 3 November.

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