6 major changes in healthcare from Brzoska's team. Submitted for implementation

• Since February, the deregulation team has been operating, headed by entrepreneur Rafał Brzoska
• Since the beginning of the "SprawdzaMY" initiative, citizens and entrepreneurs have submitted over 14,000 proposals for changes to the law
• In the "healthcare" category, 11 projects were submitted. We checked what stage of implementation they are at

On February 10, Prime Minister Donald Tusk proposed that Rafał Brzoska, CEO of InPost, lead a team that would deal with deregulation of the Polish economy. Since the beginning of the "SprawdzaMY" initiative, citizens and entrepreneurs have submitted over 14 thousand proposals for changes to the law, 70 percent of which come from citizens.

From among hundreds of identified barriers, seven priority areas were selected, the so-called Big Seven of deregulation, including health. One of the sub-sectors is health care. In this category, 11 projects were reported on the wiadomoMY.com website. We check at what stage of implementation they are.

Emergency room full? Check the app before you go

The authors of this report propose enabling visibility of data on emergency departments in the mojeIKP application, which will show their occupancy in real time. This will allow the patient to go to the place where they will get help the fastest, and the system will work more efficiently.

The initiators of the idea argue that having online data on the occupancy of emergency departments, as well as their map, it will be possible to modify the time of reporting to the emergency department in a mobile application on a smartphone, but above all to choose the one with the shortest queue from the surrounding ones, i.e. to obtain health care services faster.

The project has development status.

e-Leave faster and easier – the doctor no longer has to check everything

When issuing a sick leave (eZLA), the doctor must determine and enter whether the patient is insured with ZUS, KRUS or another institution in Poland or abroad and send this to ZUS as an element of eZLA. This requires asking the patient each time and entering it appropriately in IT systems.

Meanwhile, ZUS has data on where the patient is registered for insurance. The initiators believe that the obligation for the doctor to enter this information is unnecessary, generates errors and unnecessarily engages the time of doctors and patients. Mistakes lead to the need to correct sick leave certificates and delays in the payment of benefits.

The idea requires a change to the act on cash benefits from social insurance in the event of illness and maternity. OPZZ does not see a need for a change in this regard. At the moment, the initiative has been suspended because it requires clarification. Explanations are ongoing with the team of experts and further work is planned by the Wiadomomy team.

Medicines more easily accessible – clear rules for distribution

The proposal assumes the clarification of the regulations concerning the distribution of medicinal products, which - in the intention of the originator - will streamline the operations of pharmaceutical wholesalers and pharmacies, reducing administrative barriers and improving access to health services. It requires an amendment to the Pharmaceutical Law Act.

The authors want to introduce a clear definition of "distribution of medicinal products manufactured or imported", because its absence is said to cause inconsistent interpretation of the regulations and practical difficulties for entrepreneurs. In particular, the possibility of distributing exempt medicinal products between manufacturers on the basis of agreements concluded in accordance with Article 50 of the PF is questioned.

No more chaos when registering with a doctor – one convenient online queue

Today, patients have to call many medical facilities to find a free appointment date on the National Health Fund, which causes chaos, frustration and huge queues. The authors of the idea propose creating a central e-registration system that will ensure quick and convenient appointment scheduling throughout Poland.

They want to add automatic reminders and simple cancellation of visits via text message or e-mail. As they justify, this will shorten the queues, patients will get to see doctors faster, and doctors will avoid "empty runs" and wasting time. Because the lack of a common e-registration system and consequences for uncancelled visits causes artificially longer queues for doctors.

They argue that the introduction of a mandatory central registration system and facilitating the cancellation of visits will increase the availability of medical services and improve the efficiency of National Health Fund facilities.

The idea requires a change in the Act on Health Care Benefits financed from public funds.

It is worth adding that the government has previously prepared its own project on this matter and it is currently in consultation.

No unnecessary printing – medical examiners with access to IKP

Today, patients applying for health certificates must collect paper medical documentation, although everything is already digitally available in IKP. The authors of the solution propose to provide medical examiners with access to digital documentation, which will make life easier for patients, save doctors time and reduce costs and unnecessary printing of documents.

The idea turned out to be a hit, because the government deregulation team in cooperation with the Ministry accepted the initiative for implementation. Further work is being carried out on the presented documentation in order to submit it to the Chancellery of the Prime Minister.

Less bureaucracy, more treatment – ​​no more withholding of payments to hospitals

According to the authors of the idea, instead of focusing on treating patients, medical facilities are drowning in bureaucracy, reporting data that often has no real impact on improving healthcare. The National Health Fund has the right to withhold payments for services if the documentation is not delivered on time, which leads to financial problems for hospitals and longer queues.

The proposed change will align reporting obligations with actual needs, eliminating unnecessary bureaucracy and ensuring the financial stability of facilities. Thanks to this, doctors will be able to focus on treating patients, and the healthcare system will become more effective and less burdened with unnecessary formalities.

In this case, the regulation of the Minister of Health on general terms and conditions of contracts for the provision of health care services requires a change.

The proposal was opposed by OPZZ, which believed that the proposal to remove the provision that obliges service providers to submit settlement documents is unacceptable. "Irregularities in the implementation of contracts still constitute a large percentage, the adoption of this change will further deepen the misuse of money in health care," it was written in the commentary.

Despite the opposition, the proposal was accepted and forwarded for further work to the Chancellery of the Prime Minister.

Digital occupational medicine reports – faster, more convenient and without unnecessary bureaucracy

Currently, occupational health certificates are issued in paper form. Usually, the employee must personally deliver them to the employer, which often involves delays and additional administrative burden. In the event of a change of employer - without changing the specifics of the position - it is necessary to obtain the certificate again.

That is why the initiators propose their full digitalization, which will speed up the transfer of documents, improve data protection and reduce formalities. Additionally, the abolition of the obligation to obtain a new decision when changing employers (for the same position) will relieve employees and doctors.

This requires a change in the regulation of the Minister of Health and Social Welfare on conducting medical examinations of employees, the scope of preventive health care for employees and medical certificates issued for the purposes provided for in the Labour Code.

Also in this case OPZZ had reservations: "Each job position requires an assessment of suitability for work, due to the hazards involved, hence one certificate cannot be used for several types of work. Hence the obligation to use a medical stamp and the patient's signature is particularly important, as it enables contact with the certifying physician in special situations."

Nevertheless, the proposal was accepted.

Transparent treatment costs - better quality of medical services

The idea is to ensure reliable pricing of healthcare services by rationalizing the number of healthcare entities participating in the process, providing them with IT tools, and ensuring appropriate remuneration for performing additional work.

However, in the opinion of OPZZ, which has familiarized itself with the details of the proposal, the solution assumes limiting the cost calculation to selected (implicitly: large medical entities). "This is controversial and introduces inequality between medical entities. In practice, this means that some medical entities will be exempt from the obligation to apply certain regulations, while others will be obliged to comply with them," noted OPZZ.

The idea was rejected by the government's deregulation team and will not be taken further.

Disabled parking card - apply online without leaving home

A person with a recognized disability must apply in person for a parking card. The application is signed by the applicant in the presence of the chairman of the district disability assessment team.

In the opinion of the initiators, it should be possible to submit an application for a parking card signed digitally online. Change the provision on only submitting an application for a parking card in person to the chairman of the district team for disability assessment and the requirement to sign the presence of the chairman of the team or a person authorized by him - in order to add the possibility of submitting an application online through available communication channels together with an electronic signature in a selected form, e.g. qualified signature, trusted profile, mObywatel, etc.

The idea requires a change in the regulation of the Minister of Labor and Social Policy on the model and procedure for issuing and returning parking cards. It was recognized by members of the government deregulation and is being further processed.

Access to research results in the mObywatel application

Currently, the results of auxiliary tests are not made available to patients within their Individual Patient Accounts, just as there is currently no connection between IKP and the mObywatel application. This makes it difficult for the patient to access test results. Reporting of laboratory test results should be done separately for each test (service) in accordance with the principle of "one test - one result". Only such a method of reporting allows for quick and reliable analysis of changing patient test results. Unfortunately, such a method of reporting is not currently possible due to the lack of a universally applicable system of coding (naming) of laboratory tests in Poland.

Therefore, in the opinion of the authors of the solution, all diagnostic test results should be available in the IkP and/or mObywatel application, which will allow patients to quickly and conveniently check and store their medical records. Thanks to this, there will be no need to log into different systems or store copies of tests - everything will be in one place, ready to be made available to the doctor or to the patient at any time.

The proposal was accepted.

Abolition of the obligation of periodic examinations for people with permanent disabilities

The provisions of the Act on Vocational and Social Rehabilitation and Employment of Disabled Persons state that a decision may be issued for a specified period or permanently, depending on the expected duration of the disability and the possibility of improving the health condition. The provisions do not regulate the period for which the decision may be issued (apart from the general statement, decisions on disability or degree of disability may be issued for a specified period or permanently, depending on the expected duration of the disability and the possibility of improving the health condition).

Therefore, it is desirable to remove the requirement to periodically renew disability certificates for people whose health condition does not show any signs of improvement. Currently, people with Down Syndrome, autism, and other permanent incurable conditions that prevent them from working and functioning normally must regularly prove that their condition has not changed. The introduction of indefinite certificates will reduce stress and bureaucracy, improving the quality of life of people with disabilities.

It is advisable to ensure automatic issuing of permanent disability decisions in cases of permanent disabilities, as well as to introduce a mechanism to limit the discretion of the commission. Reforms should include clear criteria for the duration of decisions and more effective control of the decisions of adjudicating panels to prevent unnecessary burdens on people with disabilities.

The government deregulation team in cooperation with the Ministry accepted the initiative for implementation. The project was submitted to the government side 36 days ago.

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