Tuesday, 14 July 2026
Poland’s hospital system came under intense scrutiny in June 2026 after journalists reported alleged irregularities at several publicly financed facilities. The reports raised questions about medical contracts, implausible work schedules, recruitment decisions and preferential access to treatment.
The controversy placed Health Minister Jolanta Sobierańska-Grenda under pressure to demonstrate that the government could prevent similar cases. On July 8, she presented a package intended to strengthen supervision of hospital spending and employment.
The proposals include a maximum individual rate of PLN 240 gross per hour, aimed primarily at medical professionals working under independent contracts. Hospitals would also face limits on the proportion of their NFZ funding allocated to wages.
Other measures would require hospitals to publish the results of recruitment procedures, disclose the terms of contracts with external medical providers and report actual staff schedules to the National Health Fund. Agreements concluded through medical companies would face tighter restrictions.
Doctors would be expected to work at least half-time for one principal employer. Additional work at another medical facility would require that employer’s approval. The government also intends to introduce a national electronic waiting list for planned hospital treatment.
These measures remain proposals. The individual pay ceiling will require legislation, and the government has not announced a date on which it would take effect. The final scope of the restriction, including possible exceptions, has yet to be negotiated.
Some elements deserve support. A hospital financed with public money should be able to prove who worked, for how long, under what agreement and for what payment. Recruitment decisions and contracts should be open to scrutiny. Central reporting could make it harder for one person to claim overlapping working hours at several facilities.
Nevertheless, additional reporting will not by itself resolve Poland’s hospital difficulties.
The proposed half-time rule could create immediate operational problems. Smaller hospitals often depend on doctors whose principal employment is elsewhere but who provide occasional consultations or cover a limited number of shifts. If every doctor must accept a substantial position at one hospital before working at another, some facilities may lose access to specialists they cannot employ on a larger basis.
The Polish Chamber of Physicians raised this concern after meeting the health minister on July 9. Its representatives warned that county hospitals could find it more difficult to complete their duty rosters. They also argued that a rigid pay ceiling could encourage some specialists to choose private work, where the restriction would not apply.
These consequences are not certain, but the government should examine them before turning a politically attractive number into national policy.
The same problem applies to the hourly ceiling. A single national rate does not reflect differences between regions, hospitals or medical specialties. A payment that appears excessive in a large city may be the only way for a smaller hospital to secure a specialist needed to keep a ward operating.
The government therefore needs a mechanism for distinguishing abuse from genuine scarcity. Hospitals should have to justify exceptional rates, demonstrate that they conducted an open search and show that the contracted work was actually performed. Total working hours and payments across several publicly financed institutions should be visible to the relevant supervisory authorities.
This would be more precise than assuming that every payment above one national figure is improper.
Financial pressure is clearly influencing the debate. In July 2026, the health minister said the National Health Fund still faced a funding gap of approximately PLN 14 billion, despite receiving more than PLN 33 billion from the central budget in addition to income from health contributions. She maintained that the proposed changes were intended to improve care rather than simply reduce expenditure.
Yet the package concentrates heavily on what hospitals pay their workers. It says much less about how treatment is priced, how hospital responsibilities should be divided or who must answer when a facility repeatedly accumulates debt.
The central question is one of accountability. The NFZ finances treatment, while hospitals operate under different public owners and supervisory bodies. When responsibility is spread among the payer, hospital management and political authorities, each side can blame another for financial or organizational failure.
A serious reform should give hospital managers clear objectives and connect authority with responsibility. Management appointments should be competitive, professional and publicly documented. Those making strategic decisions should be answerable for access to treatment, quality of care, staffing and financial performance.
Poland could also test private or nonprofit management at selected publicly financed hospitals. This would not require patients to pay for guaranteed treatment or the state to sell hospital property. An outside operator could manage a facility under a time-limited public contract.
Such an arrangement would need strict protections. The operator would have to maintain emergency services and essential wards, including those that are not commercially attractive. It could not reject expensive or medically complicated patients. Its performance would have to be assessed through waiting times, treatment results, patient safety and independently audited accounts.
Private management is not automatically better management. Without carefully designed contracts and strong supervision, it could reproduce the same problems in a different legal form. It should therefore be tested against well-run public and nonprofit alternatives rather than treated as a universal answer.
The government’s 2026 package may improve transparency and make certain abuses harder to conceal. But an hourly pay ceiling cannot replace workforce planning, clearer management responsibility or a coherent hospital structure.
Poland needs rules that expose improper contracts. It also needs institutions capable of making difficult decisions and accepting responsibility for their consequences. The minister has addressed the first problem. The second remains largely untouched.
Source: WEI
