Tag Archives: healthcare

English patients dying for treatment in Poland

This might come as a shock to most people in Poland, but apparently Poland has a BETTER healthcare system than Britain.

Poles do complain a lot, and healthcare is one of their favourite subjects to moan about. Quite rightly so, as there is a need for massive improvements and updates. Healthcare financing badly needs to be reformed too. I don’t know whether this makes Poles feel better – but there are places in this world where healthcare is actually worse. One of those places is wealthy Britain. Believe it or not but the British Health Minister visited Poland recently to study and learn from the healthcare system management in this country.

Britain sports a system where general practitioners (Polish: internista) are responsible for the majority of diagnosis and treatment. Extreme cases qualify for hospital. And there is nothing in between. British GPs have to deal with a multitude of conditions, although they cannot possibly have advanced knowledge in all fields of medicine. Many people, therefore, reach specialist treatment only when their condition worsens.

The Polish system is opposite to the British. GPs are often referred to as ‘doctors of first contact’, and wont treat anything more serious than flu on their own. Their main task is to refer their patient to specialists (such as: cardiologists, opthalmologists, neurologists, rheumatologisst, endocrinologists, alergologists, pulmunologists etc.) who work at one of thousands of “Poradnia specjalistyczna” and to gather a patient’s whole medical history. These are the middle link between a GP and the hospital. They diagnose and treat conditions that do not require hospitalisation, and support the further treatment of patients who have left hospital.

What is more, in Britain, patients have to wait up to three days for an appointment with a GP, while in Poland they will be received the same day, or on the spot. Queing for appointments to specialist doctors and for operations in Britain could take years. Although there are some waiting times in Poland, it’s never been that drastic.

Another issue with which the British healthcare has been struggling for years is a problem with staff commitment and discipline. Hygene is poor, which results in severe hospital infections, such as MRSA superbug epidemic. Carers frequently neglect their duties regarding washing and taking care of immobile patients. Inspection bodies have reportedly been ineffective at identifying the wards and staff that have failed. Polish nurses working in the UK have told horror stories. (Disregard for hygene (and other) standards, cases of head lice and scabies left right and centre, staff ignoring patients diet requirements – sometimes with serious consequences, state inspections saying everything is fine, management getting rid of the Polish troublemakers.)

Problems with staff in Poland concentrate around the issues of bribery – either by patients, in order to skip the waiting list, or by pharmaceutical companies and their “incentives” to use particular medications. Doctors and nurses are however usually regarded as well trained, and resourceful – not least becasue they often have to work without the newest equipment available to their Western colleagues.

No wonder Polish people who have relocated to the British Isles are opening clinics for themselves (and for the autochtones). “To provide the level of service that we were accustomed to in our country” – as Jarosław Leszczyszyn, Professor of Medicine at EMC Medical Centre Dublin, puts it.

Not everything is perfect with the Polish healthcare system of course. NFZ, a state agency that signs contracts with hospitals and provides state-funded services to the general public, is being criticised for various policies. In many cases cheaper and older procedures are preferred to be covered, by the NFZ, over more advanced and expensive treatment. For many hospitals the NFZ funding is not enough, and they are deep in debt. But they say no healthcare system in the world is perfect.

Do you agree? Have you been diagnosed/treated in Poland, Britain, Ireland or elsewhere? What are your experiences?

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Why Polish people don’t smile – explanation 1


Many foreigners asked about their first impressions of life in Poland note the fact that people in the street don’t smile. I even read that American English teachers are warned before coming to this country, that “people don’t show emotions”.

Even though I was born in Poland, and therefore I am supposed to know this country inside-out, I could never actually get to the bottom of this.

That might be due to the fact I never had to deal with state institutions.

Until two weeks ago, that is. During that time I was given the chance to embrace on a new set of feelings: helplessness, confusion, humiliation and despair. Smiling in the street would be the very last thing on my mind. And most people have to deal with bureaucracy on a regular basis. This experience made me realise the whole system, the whole working of things is in a desperate need of a major reform.

I should also add, I cannot describe here all aspects of the matter, however reading this you should get the general idea.

This is the story:

My grandmother got very ill and was taken to a hospital. (As she was alone at her house at that time, and could barely talk in the moment when she called 112, it was a miracle the ambulance arrived on time). These things can happen suddenly, especially when you’re 85, and you have a list of diseases covering a whole page of fancy latin text.

It turned out, among many other things, that she won’t walk, and that the urinary tract won’t work properly, any more. You would think hospital would have adult nappies for their patients – but no. The procedure for obtaining nappies includes
1. Visit at her health centre to which she is registered, in the hours 7am – 3pm, and waiting 20 minutes at the registration desk
2. Going to a doctor, who needs to write a piece of paper, put his stamp on it (1 hour waiting time)
3. Taking the piece of paper to the state health insurer (NFZ) where they need to put their stamp proving that she indeed is insured (although as a pensioner she automatically is!)
4. Going to the pharmacy and buying the nappies for 30% of the price for the uninsured
5. Bringing them to the hospital

Completing this takes 2-3 days, and if you have any commitments connected with work, studying, family, relationships, or, let’s say fitness, you better forget about them. And this, of course is just one of the things you need to do.
You are also, for instance, required to pick the sick person’s shirt(s) everyday for washing, which you are expected to do at home. The fact that you have your own life to run as well, is of no importance, and no one will ever spare a silly thought that the hospital could actually deal with this.

Washing patients, or changing their nappies, is a delicate matter. But it is something that has to be done. Generally hospital staff will wait for patient’s family to perform these tasks. And only do it when having absolutely no other option. My grandmother, however, didn’t want my mum or any other family member to do it. She has always been a little reserved, courteous, and she’s just probably desperate to hold to the last piece of dignity by the skin of her teeth. Nurses would wash her only before the doctors examination in the morning. Which means patients could just lie out there in their own excrement without anyone to bother. And you can’t even complain, because (1) you’re expected to do it by yourself, and (2) complaining at the hospital is not the best thing to do.
Since, as it was recognised, grandmother’s state will not get any better, she decided she wanted to go to a care home, where she would have assistance at all times and medical help whenever needed. She asked us to arrange for that.

Getting a comprehensive and reliable information on the procedure for making such an arrangement has proven almost impossible. Each institution gave us contradicting and confusing advice. The doctor, who’s available at the hospital in the early hours only, sent us to the chief nurse. The chief nurse sent us to hospital’s social nurse. Who said hospital cannot help in this situation, as they participate in finding care homes only for those who are in a coma, have a cancer or have no family. It’s not like they cared or anything. And she sent us to the health centre where grandma was registered.

On the next morning, getting another day off work, my mum was told at grandma’s health centre that they don’t have the proper forms, but she will find them at a care home. At the care home, they said it wasn’t them, and that she should go to the social services.
One thing they told us. The price. It turns out regulations changed and a person is no longer admitted to a communal care home in exchange for their pension, like it used to be. Now there’s a fixed price of 2000 zł per month. Grandma’s pension is 800. She’s a homeowner and pays monthly bills of 400. Someone would have to take another full time job to cover for it, when you add medications and other stuff. A cheaper option is a private care home run by grumpy Catholic nuns. 1100 zł. Fair enough.

Another day passes, and I go to the social services (Miejski Ośrodek Pomocy Rodzinie – literally ‘communal institution for helping families’) which surprisingly happens to be placed in the city outskirts (how convenient for the poor!). Walking there I felt like going back in time to a communist relic. As there was no receptionist, or reception for that matter, I wondered where to turn with my inquiry as all departments listed on the wall had very similar names. Inside it quickly turned out it was not them who are to help me, but it is me who is supposed to know exactly what, where and how I was supposed to do. I met the officer who was extremely rude, gave me no information whatsoever, and referred me to the hospital’s social nurse “who will arrange everything for you”. I couldn’t believe this was actually happening and that my taxes go for this. Did they ever help a family here? It was obvious he had no interest in talking with me, so I left promising myself I’ll file a complaint or talk about this on city mayor’s next public meeting (which of course I didn’t).

A hint from a friend suggested that care home could be arranged by health centre’s social nurse. But not the health centre grndma used. The health centre in the catchment area of which she lived. It couldn’t surprise anyone that the social nurse there is available only from 8 a.m. to 9 a.m.

Finally we obtained the forms. The forms however needed to be filled by her GP and few other people so it’s the merry-go-round again. Her GP however – you see – has no record of her hospital treatment. The doctor at the hospital refused to produce a paper for the GP. And by then I almost exploded.

The doctor at the hospital was certain we wouldn’t be able to find a place at a care home and was ready to release grandma home after a week and a half. In a terrible hurry we bought a special bed, set of medical blankets, etc. as it seemed we’d be taking care of her for at least some time.

However we managed to secure a place in a superb hospice nearby using an “unofficial” way (please let me keep the details to myself).

The hospital doctor didn’t expect that. With a very surprised face he asked “how did you do that” and hurried to do some additional tests, blood transfusions, and stuff, and kept her few days longer in the hospital. Which made everyone wonder: how come she was “ready” to be signed off home – and not ready to be signed off to a place where other doctors work… Was he signing her so that she died home and not ruin hospital statistics?

When you’re in bad health you might want to settle your earthy matters. Write a testament, transfer property ownership etc. In Poland to do that you need a notary public, called notariusz. I thought there will be no problem: you pay and they serve. Oh how was I wrong! I can’t find one, who would be ready to come to the hospice and perform their duties. Notariusz is a strictly licensed profession, numbers of new people getting access to this profession is very limited. Imagine: a guarantee of monopoly and massive income. Each property sale needs to be done before a notary public who receives somewhat 2% of the transaction. They have many clients, and don’t give a damn. Most of the ones I talked to weren’t even trying to be polite. That was yet another surprise for me. They are educated lawyers, they should be the leaders of a positive change. Yet their power corrupted them.

This whole story really made me think… Is there is absolutely no one who will help you in Poland when you really have a problem? How many people face things like that daily, and why doesn’t anything change? Is it because most of them are powerless and have no idea about their rights, like most of the social services clients? Or are they simply used to it?

Why do state institutions care only about having papers fine when another state institution comes to control; about appearing to be doing work, not about really doing it?

Is this only me thinking that it can’t be like that anymore? Is this only me thinking the state is for helping citizens, not for obstructing their daily business with endless paperwork, and “necessary” things, signatures, stamps… to obtain from a number of offices. Is this IMPOSSIBLE to keep the country running without the tsarist-like administration?

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