Hospitals not likely to see renovations anytime soon
A lack of funds is expected to delay much-needed renovation and construction of new hospitals for the next few years, construction industry sources said.
Polish hospitals are typically outdated multi-story buildings accommodating a wide range of hospital wards. Western style, single-floor hospitals located close to residential areas are scarce, sources said. Despite the need for modern medical facilities, neither the ailing public health-care sector nor private medical services are likely to start building modern hospitals in the foreseeable future.
"There's no chance at all," said Andrzej Piasecki, chairman of the PIA Piasecki construction company, which specializes in building hospitals.
In addition, Poland has more than enough hospitals to serve its 38-million population, according to data collected by international health-care research organizations, said Jerzy Piskorski, director of the board for construction firm Pomorze, which also focuses on hospital construction. In 1998, 746 hospitals were operating in Poland, according to the government's Health Care Economic Center. However, bed utilization is low at 55% in intensive care wards and 53% in pediatric wards. In comparison, Hungary's population of 10 million has 148 hospitals. Moreover, Polish hospitals are large and contain more than 200,000 beds, or 727 beds per 10,000 Poles. This is greater than in the U.K., which has 448 beds per 10,000 inhabitants, according to Health Ministry figures.
The Health Ministry's review of the country's public in-patient health-care system estimated that by 2002 the figure for short-term bed occupancy would have to be reduced. As a result, some hospitals will have to be closed down, as they still don't comply with market economy requirements. The move was supposed to be part of the health-care reform introduced in 1999.
Not surprisingly, few new hospitals are being built in Poland. The projects currently underway typically started several years ago and are still under construction due to a lack of funds, construction industry sources said.
"There are too many unfinished construction projects from the old days that make no economic sense," said Zbigniewa Nowodworska, spokeswoman for Anna Knysok, the government's health-care reform coordinator. "And the lack of funds for renovation of the existing hospitals was one of the main reasons why the reform had to be introduced."
As a result of last year's reform, self-sufficient hospitals, county and provincial authorities help pay for the costs of their own renovations as opposed to waiting for funding from the central budget. "Costs of potential renovations are now calculated into the price of medical services," Nowodworska said. Under the old system, money from the state budget was poorly distributed and often transferred to hospitals that didn't need it. While the reform was intended to make money available on a per patient basis, finding the necessary funding still seems to be the main problem at hospitals.
"It (the health-care sector) always had little money," said Piasecki, whose firm has for years been building a hospital in Grodzisk Mazowiecki, 40 kilometers west of Warsaw. Piasecki said companies building hospitals in Poland suffer from "budget sickness," meaning that the inflow of money for investment is irregular. Because of that, the hospital "is being built at an archaic pace," Piasecki said.
Pomorze's Piskorski said his company has been building a cardiac hospital in Warsaw's Anin district for four year. The project has taken so long because funding is routinely cut off. "It starts, then it stops, over and over again," he said.
When those lingering projects are at last completed, few new ones are likely to emerge. "Right now there is a break (in new projects)" Piskorski said. "I haven't heard about any new tenders."
Instead, construction companies see the hospital sector as attractive because of its substantial renovation needs, according to Piskorski. The majority of hospitals in the country are in very bad shape, and many will likely be closed, he added.
The closing of outmoded hospitals could increase pressure to start building small modern hospitals close to residential areas. "There is a need for a hospital in Ursynow (district)," Piskorski said. He added that the country lacks single-floor hotel-type hospital facilities in densely populated areas.
But no one is going to finance those developments soon, construction sources said. Public health-care will be allocating all available funds to finance urgent needs and not new investment, according to Pisecki.
Private health care, which is in its infancy, is rather likely to rent space in existing facilities and not build new projects, Piasecki said. "As far as construction is concerned, that (private health care) is a marginal market," he said.
Medicover Development, a private health-care provider, doesn't plan to build its own hospitals for four or five years, spokesman Slawomir Kaleta said.
And the American Medical Center (AMC), another private medical service provider, has been renting two locations for outpatient services but may soon build its own facility for inpatient services, said Gregory Eaton, managing director of AMC.
But even if AMC goes ahead and builds its own hospital, it's not likely to be followed by many other firms soon. "Currently big investors aren't coming here," said Piskorski. Private investors are staying away simply because health-care profit in Poland is 20% of that in the West, while the costs of health-care services are the same, he said.
