Debates on the healthcare system during the Eastern Economic Congress in Białystok
Białystok/Katowice, 18 September 2014 - The Podlaskie Voivodeship lacks good coordination of actions within the scope of healthcare. Mapping healthcare needs may improve this situation, but the question remains open as to who is supposed to implement such works – these are the voices resulting from debates on healthcare, which were held during the Eastern Economic Congress in Białystok.
During the Eastern Economic Congress, a two-day debate on the economy of Eastern Poland, special sessions on various aspects of the healthcare system functioning were also held – with particular emphasis on the current state of affairs, the potential, prospects and problems of broadly defined healthcare in the voivodeships of Eastern Poland.
‘The experience related to the forming of special bodies, the aim of which is to determine the shape of health mapping, has not proven well so far,’ said the participants of the session entitled “Main problems and the health policy strategy in eastern voivodeships”, which was held during the Eastern Economic Congress in Białystok.
‘Several months ago we made an attempt, using funds from the Regional Operational Programme, to form a group that would bring together representatives of Narodowy Fundusz Zdrowia (National Health Fund), the Marshal’s Office and the Voivodeship Office, as well as other institutions that manage healthcare. We were thinking of a group of 8-10 experts. Unfortunately, we were unable to form such a group; it can be concluded that we met some difficulties on our way, which resulted from disparate visions of health policy,’ stated Karol Pilecki, Member of the Board of the Podlaskie Voivodeship, who is responsible for such areas as healthcare in the region.
In his opinion, it is Narodowy Fundusz Zdrowia (National Health Fund) that health policy coordination could concentrate around, but it currently has too little qualifications to be able to assess the actual needs of hospitals. However, he expressed his hope that the health need maps being created today will prove immune to political moods in particular regions.
‘We need an automatically operating body, which would make independent decisions concerning the distribution of funds for contracts,’ emphasised Karol Pilecki.
On the other hand, according to Magdalena Borkowska, Deputy Director for Uniformed Services in the Podlasie Regional Branch of Narodowy Fundusz Zdrowia (National Health Fund) in Białystok, it is precisely Narodowy Fundusz Zdrowia (National Health Fund) that is an institution which has reliable information concerning actual health needs, based on current reporting. ‘Except for the Fund, no one is able to make available such detailed data which allow pursuing appropriate health policy in the region,’ she argued.
Another person to say that the region lacks coordination in health policy was Prof. Zenon Mariak, Deputy Rector for Clinical Affairs and Postgraduate Education of the Medical University of Białystok.
‘There are data being gathered, which are used by voivodeship consultants to express opinions concerning health needs within the scope of medicine they are responsible for, but these opinions do not translate into any particular actions,’ believes the Deputy Rector.
In his opinion, the Fund, although it wants to be a partner for healthcare units, is a bureaucratic institution at the same time, which mainly implements regulations. Therefore, some solutions cannot be introduced at a regional level.
As a matter of an example, the Deputy Rector specified some problems which the implementation of postgraduate education poses to university research and teaching hospitals in the area of contracting medical services. ‘The introduction of residents to medical service offers makes us being pushed towards the end of the queue when it comes to our efforts in attempting to win contracts, and our offers are becoming less competitive and receive lower numbers of points,’ he explained.
Cezary Rzemek, Undersecretary of State in the Ministry of Health – who was present during the session “Main problems and the health policy strategy in eastern voivodeships” – reminded the participants that from January 2015 onwards the Agency for Health Technology Assessment in Poland (AOTM) will take the responsibility for measuring the benefits, based on average data being reported from medical facilities.
According to the Deputy Minister of Health, Narodowy Fundusz Zdrowia (National Health Fund) currently has the most comprehensive information, but it lacks cost data. ‘I am in favour of a solution, in which AOTM would conclude contracts with hospitals and collect appropriate data, but on condition that it would have the right to demand quality control of such data. Therefore, the only possible step is to create a bill of costs, which would allow a realistic valuation,’ argued Cezary Rzemek.
In his opinion, profit is to be predicted for every single procedure, so that medical facilities would be able to allocate their profit margin to investments, for instance. At present, however, directors of medical facilities make investments with the expectation that Narodowy Fundusz Zdrowia (National Health Fund) will contract their offer.
It is important, however, that investments be coordinated. ‘We would like all new undertakings to be consulted with us,’ emphasised Director Magdalena Borkowska.
‘At present, every new entity can make investments and has the right to apply for a contract. In this way, the stream of funds breaks down into an increasing number of smaller ones,’ indicated Prof. Zenon Mariak, Deputy Rector for Clinical Affairs and Postgraduate Education of the Medical University of Białystok.
‘None of the items of the financial plan of the Podlasie Regional Branch of Narodowy Fundusz Zdrowia (National Health Fund) for 2015 assumes reductions in expenditure. We have about 2 per cent growth in total. First of all, there will be annexing and some extra time as far as competitions are concerned,’ explained Magdalena Borkowska.
Participants in the session “Innovations, research and development in the medical sector” held during the Eastern Economic Congress emphasised that in order to create innovative products in medicine, it is necessary to resort to fundamental research and accept solutions that would increase the attractiveness of making investments in science for business partners.
According to Prof. Zbigniew Gaciong, Member of the Steering Committee of the BASTION Project (From Basic to Translational Research in Oncology) and Chairman of the Department of Internal Medicine, Hypertension and Vascular Diseases of the Medical University of Warsaw, the research financing system rests on a false assumption that it is possible to obtain scientific success, so to say, on demand, by “closing the scientists in a laboratory with a decent remuneration, in anticipation of a breakthrough”.
‘It does not work like that anywhere else in the world. Inventing scientific discoveries is pointless,’ argued Prof. Gaciong. According to his explanation, if we take a look on actual histories of innovative discoveries that have been made in medicine in recent years, we would see that the approach to the so-called application research is affected by error. An example of this may be the medicine used for treatment of hepatitis type C, which has recently been invented in the USA. This mega-product, which is likely to gain a record-breaking amount of USD 12 billion in revenue from sales this year, has been created because of the fact of conducting fundamental research.
‘The history of this medicine has begun at a university, where two virologists-biochemists conducted a research on substances that suppress replication of various viruses. At one of the stages of their research, they came across a nucleoside derivative which suppresses replication of hepatitis C virus,’ said Prof. Gaciong, arguing that increased financing of science should work towards fundamental research, for that is what the experience gained in other countries teaches us.
Prof. Jacek Nikliński, Rector of the Medical University of Białystok, admitted that increased financing of scientific research is visible because it has been raised to the level of 0.9 per cent of the GDP. However, this is still less than the European average, which amounts to approx. 2 per cent of the GDP.
As Prof. Nikliński noted, the condition for participation in projects financed by Narodowe Centrum Badań i Rozwoju (The National Centre for Research and Development) is for scientists to enter into partnership with business. So far, however, the contribution of Polish entrepreneurs towards innovative implementations has placed Poland almost at the bottom of the list, giving it 24th place among 27 countries of the EU, which have been assessed in this respect.
‘Entrepreneurs do not get involved in scientific research because they expect a very fast financial result,’ said the Rector. However, he also admitted that scientists meet with remarks that they work too slowly: ‘We must be patient in waiting for the results of scientific research, but the pace of it should indeed be rather rational,’ he emphasised.
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The idea behind the Eastern Economic Congress in Białystok is twofold: to present the economic potential of voivodeships of Eastern Poland and show the eastern regions as valuable intermediaries in the relations between the East and the West of Europe. During the two-day debate in Białystok, important issues will be raised, which are important from the point of view of both Polish and European economy and which have remained outside the mainstream debate so far.
The Eastern Economic Congress in Białystok – a debate on economic and trade relations between the European Union and the East of Europe – provides a logical follow-up to, and a completion of, the subject matter of the previous editions of the European Economic Congress in Katowice held so far. Both business conferences are organised by PTWP Group, the publisher of the “Rynek Zdrowia” monthly and portal, to name but a few.
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