Bad medicine
An elderly man is deposited outside a hospital complex in Częstochowa in the middle of winter. He dies, as the centrally heated medical bureaucrats inside debate about what to do with him. Their subsequent explanations are inexplicable. The public prosecutor suspects that hundreds of people may have been murdered in Łód, in a grim nationwide trade to feed undertakers with cadavers. Hospitals all over the country run out of money to pay for medicines, staff and other essentials. This country spends less on the national health service than the one provided for 11 million Greeks. The late health minister Mariusz Łapiński presided like Nero over this extraordinary spectacle, partying away with expensive limousines and ego-boosting personal CD speeches. Had these bizarre events overtaken any other country in Europe, his head would have long before greeted the block.
Instead he went on enjoying the personal confidence of the prime minister, because he was the fall guy to press on with the purely political agenda of restoring a centralised structure to the health service, setting aside the despised decentralisation of the previous AWS administration. Unquestionably, he would have felt the touch of cold steel applied to his neck, as soon as this was achieved. But Łapiński's clowning, in the end, made his position untenable. And despite the sentence read out on the scaffold, that of exceeding his powers, he was in reality sacrificed to the government incompetence.
A blind eye is being turned to abortion laws which, irrespective of individual opinions, are treated with contempt by badly paid doctors and anaesthetists. A maverick SLD MP recently popped up to suggest modest reforms, only to be crushed by president and prime minister. Not the time to discuss such a silly idea. Of course not, with the European referendum in sight and all tricky priests making up their minds what to preach. Abortion is available on demand in Poland, so long as you have the money.
The black market saves the government embarrassing calls upon the state budget. Of course, good and decent people are giving their professional lives to the service, but there are also legions of medical barons exploiting the system as their own personal fiefdom. The last thing they want are power-sapping reforms. They would represent a welcome reverse of intrusive local scrutiny and transparency.
Ministers and politicians have, so far, no experience of a bruising encounter with people power outraged by the absence of a functioning health system. Yet, in every other EU state, health care is the one which ranks alongside taxes as the greatest issue of voter concern. Why is it different here? Partially, the answer lies in the absence of collective trust in anything to do with the government. Then there is the cultural inheritance of putting up with what is shoved to you. And then comes the entrenched cadres in the health service who are opposed to change because it will undermine their control over the system. It means that people die in the car park.
There was a hope, if only a modest one, that decentralisation and local purse-holding would embolden the more enlightened to seize the initiative. Silesia supplied some impressive evidence this might happen. If the misnamed "reforms" guided over by the unfortunate Łapiński do proceed, then prospects for any meaningful improvement in the delivery of quality health services by the private sector will evaporate. In the meantime, Łapiński epitaph is his boast that the health sector is as good as any in Europe because his glittering personal limousine passes muster with other health ministers.
There is another malign factor at work, and that is the disinterest of politicians of all persuasions in the people they entice to vote for them. It is also reflected by the debt-laden public finances which will remain utterly unreformed so long as Grzegorz Kołodko, who maintains a Trappist silence on the oft-promised statements to that effect, remains in charge.
Poland has no health service worth the name because there is no money in the budget to pay for it. Here is a tragic legacy with which to enter the European Union. When the EU starts to subsidise the budget next year, thanks to the accord reached in Copenhagen, the money will be employed as it is now. To pay off debts.
Instead he went on enjoying the personal confidence of the prime minister, because he was the fall guy to press on with the purely political agenda of restoring a centralised structure to the health service, setting aside the despised decentralisation of the previous AWS administration. Unquestionably, he would have felt the touch of cold steel applied to his neck, as soon as this was achieved. But Łapiński's clowning, in the end, made his position untenable. And despite the sentence read out on the scaffold, that of exceeding his powers, he was in reality sacrificed to the government incompetence.
A blind eye is being turned to abortion laws which, irrespective of individual opinions, are treated with contempt by badly paid doctors and anaesthetists. A maverick SLD MP recently popped up to suggest modest reforms, only to be crushed by president and prime minister. Not the time to discuss such a silly idea. Of course not, with the European referendum in sight and all tricky priests making up their minds what to preach. Abortion is available on demand in Poland, so long as you have the money.
The black market saves the government embarrassing calls upon the state budget. Of course, good and decent people are giving their professional lives to the service, but there are also legions of medical barons exploiting the system as their own personal fiefdom. The last thing they want are power-sapping reforms. They would represent a welcome reverse of intrusive local scrutiny and transparency.
Ministers and politicians have, so far, no experience of a bruising encounter with people power outraged by the absence of a functioning health system. Yet, in every other EU state, health care is the one which ranks alongside taxes as the greatest issue of voter concern. Why is it different here? Partially, the answer lies in the absence of collective trust in anything to do with the government. Then there is the cultural inheritance of putting up with what is shoved to you. And then comes the entrenched cadres in the health service who are opposed to change because it will undermine their control over the system. It means that people die in the car park.
There was a hope, if only a modest one, that decentralisation and local purse-holding would embolden the more enlightened to seize the initiative. Silesia supplied some impressive evidence this might happen. If the misnamed "reforms" guided over by the unfortunate Łapiński do proceed, then prospects for any meaningful improvement in the delivery of quality health services by the private sector will evaporate. In the meantime, Łapiński epitaph is his boast that the health sector is as good as any in Europe because his glittering personal limousine passes muster with other health ministers.
There is another malign factor at work, and that is the disinterest of politicians of all persuasions in the people they entice to vote for them. It is also reflected by the debt-laden public finances which will remain utterly unreformed so long as Grzegorz Kołodko, who maintains a Trappist silence on the oft-promised statements to that effect, remains in charge.
Poland has no health service worth the name because there is no money in the budget to pay for it. Here is a tragic legacy with which to enter the European Union. When the EU starts to subsidise the budget next year, thanks to the accord reached in Copenhagen, the money will be employed as it is now. To pay off debts.
