Doctors' salaries are draining hospital budgets. Changes will allow for reductions.

• The Association of Polish Counties argues that the issue of doctors' remuneration has gotten out of control.
• The average salary on which medical professionals' salaries are calculated is overstated, with median earnings being as much as 20 percent lower.
• District hospitals pay rates significantly higher than the local labor market, often under pressure to lose entire medical teams.
• The Ministry of Health is planning changes to the law and medical contracts, including the obligation to report earnings and the abolition of contracts with intermediary companies.

The Association of Polish Counties wants to reform the rules for determining healthcare salaries. According to the union, "those practicing medical professions should be fairly compensated, but this does not mean that their remuneration levels should be set in isolation from the economic realities of our country, which is currently the case."

Current regulations define the minimum wage in healthcare based on the average wage in the economy, which – according to the Union of Polish Employers – is artificially inflated by the very high salaries of a select few. The median salary is as much as 20 percent lower . Furthermore, the average salary includes not only the base salary but also, for example, the thirteenth month, which artificially inflates the amount, which then serves as the basis for calculating the entire remuneration of medical workers.

The system constructed in this way means that already now - before the July increase - medical entities, including district hospitals , are forced to pay salaries that are much higher than the accepted salary rates on local labor markets.

- ZPP points out.

Trade unionists argue that due to staff shortages, healthcare entities are forced to pay any rate to retain doctors.

Hospital directors are often threatened with the departure of entire teams if exorbitant salary demands are not met. We recognize that the medical profession requires the completion of demanding studies and several years of specialization. However, this does not justify tolerating a situation in which monthly salaries of PLN 70,000-80,000 or more are paid from public funds.

- we read in the ZPP position.

The Ministry of Health acknowledges that remuneration is a regular agenda item for the Tripartite Group for Healthcare. Currently, three points have been developed that could be included in the amended regulations:

• maintaining the indexation of the lowest basic salaries in healthcare entities based on a changed index, e.g. the salary growth index in the state budget sector or the indexation index of pensions and disability pensions;
• reducing the disproportion between the lowest basic salary for groups 2 and 5 and 6 from the annex to the Act;
• adapting the dates of increases in the lowest wages to the calendar of preparation of the state budget, the National Health Fund, and healthcare entities.

The Ministry also presented preliminary proposals for regulating contracts that hospitals conclude with doctors , which may indirectly affect their remuneration:

• the service provider may only conclude a contract with a person exercising a medical profession - departure from contracts concluded with collective entities (companies/medical entities),
• employment based on a contract under the normal ordination (performing surgical procedures) provided that the employment time is at least the equivalent of ½ full-time employment,
• within the scope of employment in the duty schedule (outside the normal schedule) it is permissible to perform life-saving procedures ,
• defining the essential provisions in the contract,
• the obligation for service providers to report to the Agency for Health Technology Assessment and Tariff System expenditure on B2B contracts in the hospital's financial report together with the numbers of the right to practice the profession.

- The new regulations will improve the quality of patient care and will not lead to a deterioration in the availability of services - the ministry argues.