Łapiński sacks second Patients Fund director

Health Minister Mariusz Łapiński last week dismissed the head of the Małopolska Patients Fund (MRKCh), bringing to two the number of fund directors the minister has fired this month after they openly criticized his policies. Łapiński, under the recently amended healthcare law has the power to appoint the majority of council members of Poland's 17 regional Patients Funds. The council of the MRKCh, nominated last week, terminated Jacek Kukurba's contract as director of that fund, explaining that the term of the management had expired due to the appointment of the new council. "Building a state (of Poland) with a real public spirit has always been my task," Kukurba told journalists last week after he was given termination notice. Kukurba has criticized the health minister for his idea to abolish all the Patient Funds and replace them with one central fund. According to MRKCh's press office, four new members appointed by Łapiński on the seven-member council voted to terminate the contracts of the fund's management. The council said a replacement would be named this week. Kukurba's dismissal is similar to that of Andrzej Sośnierz, who was fired earlier this month as director of the Silesian Patients Fund (ŚRKCh). Sośnierz also had criticized Łapiński's plans to dump the regional Patients Funds system, which was established by the previous government in 1999 as part of the healthcare system reform. The minister envisions reintroducing a Warsaw-based system, even though a handful of the regional funds, such as the ŚRKCh, have been successful.

"I'm only curious how (the Health Ministry) is going to deal with those funds that are in terrible debt," Sośnierz told the WBJ. "In many cases it's the management of the funds that has to be blamed for the financial crisis. But so far the ministry is focused on us, the three Patient Funds that have maintained liquidity and have no debts." Unlike most of the funds, ŚRKCh, MRKCh and the Podkarpacka Patient Fund (PRKCh), whose director is rumored to be next on the minister's hit list, have no debts and pay for their contracted services on time. According to Liliana Leniart, the spokeswoman for PRKCh, her fund posted a zł. 90 million ($22 million) surplus in 2001. The Health Ministry refused to comment on the dismissals. "The minister's role ends after he appoints the members of a Patient Fund's council," said Agnieszka Włodarczyk, the director of the Health Ministry's press and promotion office. Jan Kopczyk, the deputy health minister, told journalists that the firings had nothing to do with politics and could be legally justified. "UNUZ (the Patients Fund watchdog) had no serious charges for sacking Sośnierz or Kukurba since the Supreme Administration Court (NSA) dismissed all of them last year," said a source close to the MRKCh, who asked not to be named. "MRKCh's previous council twice rejected demands to dismiss Kukurba, and the local government, which appointed the former council, can be changed only after the October elections. So, changing the law that allows the minister to nominate the majority of the Patient Funds' council members was the only way to take control of the funds."

When sacking Sośnierz earlier this month, the UNUZ accused him of having paid cash advances to three hospitals, a breach of the public-money spending law. In fact, Sośnierz did pay such advances to the hospitals. "All Patient Funds paid such advances to hospitals, and it was UNUZ's instruction to do so," Sośnierz said. "Otherwise, at the beginning of every year hospitals would have had no money while waiting until February for our payments. The whole system would have collapsed without the advances. When the UNUZ banned us from paying advancements last year, I stopped, but I came up with the idea to pay the contracted hospitals every two weeks to make their lives easier. So, I treat all those charges only as an excuse to sack me." Michał Żemojda, the president of UNUZ, was unavailable for comment at press time. Market insiders said last week that the Health Ministry would use the same scenario to get rid of another critic, Anna Szubart-Lelek, the director of the Rzeszów-based PRKCh. Her dismissal, they said, was postponed last week when the Health Ministry canceled a meeting of the PRKCh's new council. "What's going to happen?" said PRKCh's Leniart. "We really don't know. We don't even know the names of the minister's nominees for the new council. The meeting was canceled, but it's clear that the new council has the power to dismiss the fund's director."