Spa in Rabka has free NHS slots but few patients, as children's stays fall and adult care takes over

In brief

• A Rabka-Zdrój sanatorium is seeing fewer child patients as its contract shifts toward adult care.
• The regional NFZ office asked the resort to convert children's referrals into adult treatment slots, citing a risk of unfulfilled contract terms.
• The adult contract is used at about 97 percent, while a separate report says the overall NFZ contract is used at about half.

Children's places going unused

The Rabka-Zdrój sanatorium, long a destination for children needing recovery treatment, has seen its patient mix shift sharply toward adults. The Małopolska regional branch of the National Health Fund (NFZ) reported that it has no children waiting for a place or treatment date anywhere in Poland (Rabka - dziś sanatorium bardziej dla dorosłych niż dzieci – Urząd Marszałkowski Województwa Śląskiego) (Coraz mniej dzieci leczonych w sanatorium w Rabce. 97 proc. to dorośli – RMF24). Because of that, the fund warned there is a real risk it could not carry out its contract for spa inpatient treatment of children aged 3 to 18.

The fund's regional director asked the resort to consider converting children's referrals into adult sanatorium treatment slots. The resort's president, Tomasz Kajor, responded that the stays themselves are carried out by the sanatorium, but that the arrival of child patients depends entirely on the NFZ. He also said interest in spa treatment for children has steadily declined, with many parents choosing other forms of care for their children.

Adults fill the calendar

The adult programme is now the resort's core business. Its year-round contract for adult treatment is being used at about 97 percent. Patients include people after joint replacement surgery, those recovering from serious injuries, people with neurological conditions, and cardiac patients, including those in a programme after a heart attack. The facility also runs the Gorce Long-Term Rehabilitation Centre, which provides round-the-clock care.

Contract gap

A separate report on the same dispute says the resort uses only about half of its NFZ contract, and that the shortfall is driving the pressure to repurpose children's slots (Sanatorium zmaga się z brakiem chętnych. Kontrakt z NFZ wykorzystuje tylko w połowie – Portal Samorządowy). The 97 percent figure refers only to the adult contract, while the half-used figure refers to the NFZ contract as a whole, so the two numbers measure different things.

What comes next

The NFZ has framed the request as a way to rationalise resources and avoid breaching the contract. Whether the resort accepts the swap, and how many children's referrals it would convert, has not been settled in the reports available.