Health Promotion for Older People Performed in Health Sector

Background Health sector plays important role in health promotion for older population (HP4OP). The institutions involved constitute a very differentiated sphere: variety of models, structures, financing methods, different forms of providers and payers. HP4OP requires engagement of health sector and medical/public health professionals. Methods Literature review was used: systematic reviews for English-language papers on HP4OP and sectorial institutions activities (incl.PubMed and the healthPROelderly database). Questionnaires, individual interviews and templates were provided for collecting information from country experts. Due to the low feedback for template distribution personal interviews and desk research methods were used. Results Health sector institutions have been indicated and analysed proving the importance of primary care role, institutional and inter-sectorial cooperation, specifically with local governments and NGOs. The important results showed that the medical professional’s approach has to be changed. Moreover, innovations, new technologies used by professionals and patients may significantly improve activities of health sector oriented on effective and long lasting HP4OP. Conclusions: The research performed provided a set of information for the description of the sectorial role in HP4OP, including barriers and limitations, the prerequisites for the cooperation, good practices regarding health promotion projects/  programs focused on old population. The paper, based on EU project, presents the overall picture of health sector involvement in HP4OP and the statement that various institutional arrangements in EU do not contravene the idea of good practices applicability and importance for the effective implementation of HP4OP programs

The 2015 emergency care reform in Poland: some improvements, some unmet demands and some looming conflicts

Between 2006 and 2015, the Act on the State Emergency Medical System was the key act governing the organization, financing and provision of emergency care in Poland. From the moment it entered into force, it had been heavily criticized. The critique focused, among others, on the lack of provisions allowing for emergency medical services (EMS) to be performed outside the EMS units, the lack of a separate Act regulating the profession of a medical rescuer and the lack of a separate professional organization representing medical rescuers. As early as 2008 a team of specialists was set up to work on amending the Act and these works resulted in the draft Act on the State Emergency Medical System that was submitted to public consultations on 19 August, 2014. This draft was further reworked in 2015 and was signed by the President on 25 September of the same year. The Act addressed some of the shortcomings of the EMS legislation that was previously in place. However, the new Act did not meet the key demands of medical rescuers; namely, it did not introduce a separate legal act regulating this profession nor established a professional organisation representing their interests. An analysis of the vested interests of various groups of medical professionals indicates that these interests are likely to have influenced the final legislative outcome. The Act, as well as its implementing executive regulation from April 2016, may reduce support of certain medical professional groups during the Act’s implementation as well as create tensions between these groups, especially between medical rescuers and nurses

The first attempt to create a national strategy for reducing waiting times in Poland : will it succeed?

The waiting lists package, proposed in March 2014, is the first attempt to create a national strategy to reduce waiting times for specialist care in Poland. The policy proposes a number of measures directed at primary, specialist ambulatory and hospital care with the goal of shifting patients to the lowest possible level of care. Initially, it has been welcomed by the patients and there has been, so far, no strong opposition against the reform from other stakeholders. However, this may be because there is some disbelief that the policy would actually be implemented (due to limited funding available for its implementation) and because some of the proposed changes are vague and have yet to be clarified. One stakeholder group that may obstruct the implementation of the reform, if they are not satisfied with the final shape of the proposed measures, is the primary care doctors. They are directly affected by the reform and enjoy a relatively strong bargaining position compared to other groups of medical professionals. Thus, the future of the reform remains uncertain

„Przedsiębiorstwo lecznicze”. Innowacyjne rozwiązanie legislacyjno-systemowe czy manowce reformy?

„Healing Company”. The Innovative Legislative and Systemic Solution or the Reform Quibble?The necessity of the hospitals status change in Poland was the hot issue for quite a long time. The problems of hospitals debts, local governments role, state (public) ownership problems, management weaknesses, resources lack, humans resources problems and many others have been stressed in public debates, often by different sides and political parties. The present Ministry of Health from the very beginning proposed the formal status change concerning ownership of health care units, mainly hospitals, as a first step for the system transformation in this respect. The proposal of the new legislation called the Health package included such approach. One of the most important laws in the package was the “Hospitals privatisation”, subsequently vetoed by the President representing the political opposition. The next step toward the transformation was the governmental Plan B, proposed also by Ministry of Health, criticized for the improper legal instruments and infectivity of the proposed strategy. The new legislation, described in this paper, is a consequence of the process and the main issue of the analysis undertaken hereby

Komunikat z Seminarium „Polityka zdrowia publicznego Unii Europejskiej. Konflikty jako siła sprawcza ewolucji”. Jubileusz pracy zawodowej Prof. dra hab. W. Cezarego Włodarczyka

W bieżącym roku upływa 40 lat od momentu rozpoczęcia przez Prof. Cezarego W. Włodarczyka pracy zawodowej. Pomimo iż pierwsze stanowisko pracy Profesora jako referenta prawnego w zakładzie produkcyjnym nie było związane z dziedziną, która obecnie zdominowała jego naukowe dociekania – czyli z polityką zdrowotną, to jednak do dzisiaj coś z tych prawniczych zainteresowań mu pozostało

The 2014 primary health care reform in Poland: Short-term fixes instead of a long-term strategy

AbstractAt the end of 2013, the Minister of Health started legislative changes directly and indirectly affecting primary health care (PHC). The reforms were widely criticised among certain groups of medical professionals, including family medicine physicians. The latter mainly criticised the formal inclusion of specialists in internal diseases and paediatrics into PHC within the statutory health care system, which in practice meant that these two groups of specialists were no longer required to specialize in family medicine from 2017 in order to enter into contracts with the public payer and would be able to set up solo PHC practices—something over which family medicine physicians used to have a monopoly. They argued that paediatricians and internists did not have the necessary professional competencies to work as PHC physicians and thus assure provision of a comprehensive and coordinated PHC. The government’s stance was that the proposed measure was necessary to assure the future provision of PHC, given the shortage of specialists in family medicine. Certain groups of medical professionals were also supportive of the proposed change. The key argument in favour was that it could improve access to PHC, especially for children. However, while this was not the subject of the critique or even a policy debate, the proposal ignored the increasing health care needs of older patients—the key recipients of PHC services. The policy was passed in the Parliament in March–April 2014 without a dialogue with the key stakeholders, which is typical of health care (and other) reforms in Poland. The strong opposition against the reform from the family medicine specialists, represented by two strong organisations, may jeopardise the policy implementation in the future

Międzynarodowe koncepcje podstawowych funkcji/świadczeń zdrowia publicznego ze szczególnym uwzględnieniem funkcji środowiskowych i ich wpływ na identyfikację priorytetów zdrowia publicznego w Polsce

International concepts, ideas and theories concerning the fundamental functions/services in the sphere of public health and their influence on the public health priorities identificationThe article focuses on the international concepts, ideas and theories concerning the fundamental functions/services in the sphere of public health. Particularly it concerns the environmental problems, the influence of this functions on the public health priorities identification. The main goals of the work are the international approaches identification and description of the observed frequency of the environmental actions inclusion on the lists of public health functions. The nature and specifics of the analyzed issue as well as the Polish approach are presented in the context of the National Health Program for 2007–2015. The main theme of the paper relates to the basic questions: how and in which way the internationally identified and listed public health functions influence the priorities established in Poland and if the environmental actions are being included