Jolanta Sobierańska-Grenda: Behind the hospital doors, when illness strikes, politics ends

• One of the priorities of Minister Jolanta Sobierańska-Grenda is the digitalization of the system, including the implementation of universal e-registration to facilitate patients' access to services.
• The head of the ministry announces the consolidation of hospitals and a regional cooperation model as a way to strengthen public health protection.
• He emphasizes that the system is currently confused and chaotic, and the patient is lost in it, which is why coordination and ordering of activities is necessary
• He wants to pursue health policy in a spirit of apoliticality, focusing on prevention, education and long-term reforms above party divisions.

Jolanta Sobierańska-Grenda, a manager and lawyer from Pomerania, replaced Izabela Leszczyna in her position at the end of July. Announcing the change, Prime Minister Donald Tusk emphasized the resulting depoliticization of the ministry. "In the coming days, the ministry will be exclusively in the hands of specialists in managing the entire healthcare system," he announced.

The Polish Press Agency (PAP) is the first news outlet to receive an interview with Jolanta Sobierańska-Grenda since taking office as Minister of Health. The Minister of Health answers questions such as what effects her work will have on the government by the end of its term and how the apolitical minister will convince the Sejm to support her projects.

PAP: What's the current situation in healthcare? Is it going bankrupt, as the opposition is making it out to be?

Jolanta Sobierańska-Grenda, Minister of Health: Let's not exaggerate, let's give it a chance, although of course there's much to be done. The Minister of Finance increased healthcare funding by almost PLN 26 billion in next year's budget, but if we want to implement the bill increasing salaries for healthcare workers at the current level, we'll need even more money.

PAP: You've been heading the Ministry of Health for over a month. What will the changes in health policy entail after the personnel change?

I believe in regions.

PAP: What does that mean?

The healthcare system would benefit if all its participants sat down and tried to organize it, taking into account maps of healthcare services, i.e., what patients actually need at the local level. This is precisely what we achieved in Pomerania.

PAP: What did this consensus in the region require?

A few years ago, we sat down with all hospital owners, local governments and trade unions, the National Health Fund (NFZ), and the voivode to establish priorities that are important to patients in our region. Because, in the healthcare debate, we rarely seriously discuss patients.

I came to the ministry with the idea of ​​launching a similar model of cooperation.

From the perspective of these past few weeks at the Ministry of Health, I see that people here are doing a lot of incredibly cool things. But we still can't talk about it; we commonly suffer from a condition that leads us to complain about how hopeless this sector is, that nothing can be changed.

PAP: So what is your plan for health care?

I want to properly coordinate the cooperation between the individual participants, get them out of silos, that is, get out of the mindset that we only see our own task and do not see that someone else could benefit from our actions.

I hope that my colleagues and I will be able to create a platform for open conversations about health, while also addressing issues. The system is confusing and chaotic, and patients are lost within it. This was my first reflection.

PAP: The government's term ends in autumn 2027. What effects of your actions would patients feel by then?

The Prime Minister and the Council of Ministers have identified the priorities we would like to work on.

One of these is digitization in healthcare. Much has already been achieved in this area, but there's still much more to come. A draft law on e-registration is currently being considered in the Sejm, which, in two years, should make it practically and universally easier for patients to quickly schedule appointments.

However, I'd like to think about health not just from the perspective of how long I'll be here, but also from the perspective of choices. This approach makes it difficult to make difficult decisions.

In addition to this project, numerous digitalization initiatives are underway at the e-Health Center. Hence the appointment of Tomasz Maciejewski as Deputy Minister of Health, who will be responsible for this entire area.

The next priority is continuing the hospital reform, which is why I'm pleased that President Karol Nawrocki signed the bill. This is my understanding of apoliticality – let's try to do something about this system together.

I also made no secret of my delight that Professor Piotr Czauderna, whom I've known for many years, is an advisor to the president. We worked in Pomerania and showed together that something can be done for the healthcare system across divisions.

PAP: What will this reform change and how?

The law gives hospitals the option—not the obligation—to consolidate based on regional needs. We will strive to encourage such changes. A program from the Medical Fund will soon be released—we will allocate one billion złoty to adapt hospital infrastructure to demographic needs, including reprofiling beds.

My meetings with both the Association of Polish Counties and the Association of Polish Provinces indicate that they are interested in reform. This is especially true given the concrete examples in various parts of the country that demonstrate that consolidation is improving the situation of facilities, and consequently, patients. This includes Pomerania, where we have indeed implemented the most consolidation.

We want to use these good examples in the "Healthy hospital, safe patient" project to show what and how can be done as part of the reform.

PAP: When will we see the effects of the reform?

Within three to five years, hospitals will begin to gain financial stability after consolidation and will be able to offer services that are actually needed by patients in a given region.

PAP: And what are your other priorities?

We are continuing work on amendments to the Public Health Act and the implementation of the National Health Programme (NPZ), to which we want to add the "Healthy Heart, Healthy Brain" project, which will focus on the prevention of cardiovascular and neurological diseases.

We are also working on organizing preventive and educational programs that will extend beyond the hospital walls. We will implement them close to people, for example, in shopping centers.

Deputy Minister Katarzyna Kęcka, who has an excellent understanding of public health issues, will be responsible for the National Health Fund.

PAP: You mentioned the apolitical nature of your cabinet, something the Prime Minister emphasized during the government reshuffle. Freeing healthcare from party affiliation may sound appealing to patients, but without a political base, how will you find support in the Sejm for more challenging projects?

European examples, such as Denmark and the Netherlands, show that apolitical approach to health and long-term strategies bring the best results.

Being apolitical was actually a condition for me to undertake this mission, because I am not a politician and I wanted to have permission to build health based on various options, without politics.

This approach guarantees openness to discussing good ideas with anyone who has them. Politicians sometimes hesitate to engage with diverse parties. I have no such hesitation today.

Politics doesn't foster effective management. And, above all, patients have diverse political views. Beyond the hospital doors, when illness strikes, a health- or life-threatening situation strikes, politics ends.

Moreover, I know of many examples from various regions where governments have managed to forge a coalition for health that transcends political divisions. My approach, therefore, is not detached from what is already happening in many places.

I'd like healthcare in Poland to be treated like defense, treated as a priority and removed from the most heated political debates. I'm glad my colleagues also believe in apolitical healthcare and have entered this building with me. I admire the team that's with me—these people want to take real action. Let's give them a chance.

PAP: And will you be able to convince the Minister of Finance to subsidize the system more? Experts have no doubt that the National Health Fund will increasingly need budget subsidies.

I believe that if I demonstrate how I intend to spend this money wisely and rationally, the Minister of Finance and members of parliament will agree. However, I prefer to discuss specific situations and figures rather than consider what-ifs.

I'm not here to make promises, but to do as much as possible. In our first conversation, the Prime Minister told me: let's do as much as we can in terms of health for the good of Poles. And that's exactly what I've undertaken.

PAP: Prime Minister Tusk recently said that your task is to prepare the healthcare system for the difficult coming months. What do you intend to prepare the system for and how?

The events of the night of September 10th compel us all to review what we can improve and to continually assess our preparedness. The Ministry of Health has developed programs related to efficient evacuation and patient protection.

However, let's remember that, according to the 2023 regulation, the main defense-related tasks rest with the voivodes and are based on cooperation with local governments and healthcare providers. However, the Ministry of Health is working closely with the Ministry of National Defense to prepare healthcare providers. Tuesday night motivates us to further intensify our efforts, in ongoing cooperation with the Ministry of National Defense.

It's also a challenge related to healthcare financing; we can't avoid this topic. And I don't intend to. My experience managing large hospitals and large companies gives me the confidence to be prepared for crisis situations and manage in dynamically changing circumstances.

It will also be important to me to calm the situation in healthcare, reconciling the interests of all parties. I think we're over-absorbing patients today, causing them concern.

PAP: Managing healthcare means choosing specific directions and solutions, for example, should we raise or lower health insurance premiums? Should we privatize hospitals or protect the system from them?

I won't comment on health insurance premiums now; there's far too much politics involved. Although, of course, we'd like to have more resources available in the system.

But I'm glad you asked about privatization. I haven't privatized a single hospital so far. And it's not my mission or my job to privatize hospitals in Poland. The better the public healthcare sector functions, the fewer tasks private hospitals have to perform. These can be, and sometimes are, a good complement to the public system.

If you look at what's happening in the Pomeranian Voivodeship, we have virtually no private hospitals. However, I understand that some people's concerns stem from the conceptual confusion surrounding the transformation of public healthcare centers (SPZOZs) into companies, which is widely considered privatization in our country.

This is unfair, because all these commercial companies are 100% owned by local governments, so they are still public companies. And patients don't care about the legal form of the hospital they're dealing with. They simply want good service, financed by the National Health Fund.

We cannot reduce the pending hospital reform to a discussion about ownership transformations, because the law does not make obtaining restructuring support conditional on changes in legal form.

PAP: But the appeal to privatization always affects part of society and as Minister of Health you will probably have to, like your predecessors, disarm such fears of patients.

I've spent my entire professional life disarming such fears, and I know they're natural. Every change is accompanied by resistance, shock, and the need to emotionally accept the change.

I've also been a change management trainer for a long time and teach this topic at universities. Therefore, I understand why people react the way they do and why this change is so difficult for us. Reliable communication is key.

It's aimed not only at patients but also at hospital employees, as they fear that consolidation will mean job losses, job redesign, and organizational changes. Unnecessarily, as few sectors need workers as much as healthcare – we need doctors, nurses, and qualified hospital administrators.

PAP: When announcing your appointment, the Prime Minister also said that the goal of your work would be to improve the situation of patients, not doctors. Is this a sign of changes to the healthcare salary increase system?

It's best to ask the Prime Minister what he meant. However, the examples of salaries that appeared in public certainly stirred emotions in society.

Most representatives of various professional groups who come to the Ministry of Health for discussions say that the minimum wage law in healthcare requires changes. The challenge is establishing a common denominator for these changes. And that's precisely what needs to be addressed.

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