Patients have reason to worry. The reform will improve hospital finances, but not the patients.

• The new hospital reform law still lacks many provisions that would enable effective restructuring of facilities, says Marta Nowacka, president of the Association of District Hospitals of the Silesian Voivodeship (ZSPWŚ).
• He adds that there are no defined plans in the voivodeships that would enable many health needs to be met.
• - It may happen that the restructuring of facilities will be based only on the possibility of minimizing financial losses, and not on meeting the many needs of patients - warns the president of ZSPWŚ.

On September 17th of this year, a law came into force aimed at reforming the functioning of hospitals, preventing their debt and adapting facilities to the needs of an aging society.

The provisions of the amended Act on Healthcare Services Financed from Public Funds also provide for the possibility of merging hospitals by associations/consortia of local government units and define the principles for creating and implementing programs in hospitals struggling with significant financial problems.

In the opinion of the Association of District Hospitals of the Silesian Voivodeship (ZSPWŚ), these regulations have many "positive aspects".

It's certainly important and positive that this law has finally been passed. We've been eagerly awaiting it. However, in our opinion, it doesn't address the issues, but it is a first step that will enable the transformation of departments and hospital mergers, as well as the creation of new entities, such as associations of local government units.

- said Marta Nowacka, president of the Association of District Hospitals of the Silesian Voivodeship, on Thursday, October 30, on Radio Katowice.

She added that the law still lacks many provisions that would enable effective hospital restructuring . She further noted that the new regulations are unlikely to encourage expansion of hospital operations, but rather a reduction, including the creation of day-case or elective wards.

- We do not see this act as an opportunity to develop and supplement services and diagnostics - admitted Nowacka.

She was also asked on Radio Katowice whether patients should have reason to worry that some hospitals may be closed as part of the merger.

Currently, there's a lack of maps of healthcare needs, so these concerns may indeed arise. There are no regional plans in place to address many healthcare needs. It's possible that facility restructuring will be based solely on minimizing financial losses.

- pointed out the president of ZSPWŚ.

- This should also be the goal of restructuring, of course, but above all we should meet the health needs that are still undefined today - said Marta Nowacka.

In early October, the Minister of Health announced forecasts for the National Health Fund (NFZ)'s finances. These estimates indicate the Fund will face a shortfall of PLN 14 billion this year. The president of the District Hospital Association admitted on Radio Katowice that she views this situation with concern. "This is especially true in Silesia. Our contract with the National Health Fund for Silesian hospitals expires in a few days. We've only received amendments to the contracts through the end of October," Marta Nowacka reported.

The government has announced funding for the National Health Fund (NFZ) through the release of budget reserves. The exact amount is being discussed between the health and finance ministries.

"This is an exceptional situation, one that has never occurred in Silesia before. We hope that the funding mentioned by the Ministry of Finance will allow us to continue treating patients in November and December, and that we will also be compensated for the services we have already provided. We have not yet been paid for services provided since April of this year ," said President Nowacka.

She admitted that the problem is, among other things, the so-called unlimited overperformance.

These are actually patients, meaning services provided to them, which are not subject to any restrictions on their funding. They are encouraged to reduce and shorten waiting times. Hospitals do this, but they are not paid on an ongoing basis.

- notes the president of the Association of District Hospitals of the Silesian Voivodeship.

In her opinion, the entire healthcare system in Poland requires profound reform. "We have such a financial crisis, especially in the hospital sector, that it may already be threatening patient safety," warned Marta Nowacka.

"As patients, we need new doctors. Without them—with the current workforce—we won't be able to maintain patient services," Nowacka said when asked about staffing shortages in hospitals.

The President of the Association of District Hospitals of the Silesian Voivodeship places his hopes in private universities.

There's hope in new fields of study, especially those being created at private universities. The media is making mixed claims about this, but there seems to be no other option. As patients, we need new doctors.

- she admitted on Radio Katowice.

"We have a large number of staff who are nearing retirement or are already in the process of retirement. There are also significant problems in internal medicine departments (internal medicine wards - ed.), which should now be the main departments due to the aging population. Doctors don't want to work in these departments due to the enormous workload," admitted Marta Nowacka.

She added that staffing shortages are particularly acute at the Municipal Hospital in Ruda Śląska, among other locations. In mid-October, the facility announced the temporary suspension of operations of its cardiology department, including the intensive care unit. The decision was related to insufficient medical staffing.