"We were deceived by those in power." The President of the Supreme Medical Council speaks harshly about unfulfilled promises.

• The President of the Supreme Medical Council, Łukasz Jankowski, criticized the government for failing to keep its promises to doctors and patients.
• He accused decision-makers of faking actions and creating narratives that attack medical professionals.
• Doctors feel cheated - talks on key reforms have stalled and the implemented solutions significantly differ from the original assumptions
• Expanding the no-fault system, increasing protection against violence, and ensuring education standards are just some of the demands that have not been implemented.
• According to doctors, instead of reform, we are dealing with political PR and maintaining the tradition of creative calculation of healthcare expenditures.

"We will not accept sham actions that do not serve patients or doctors. This concerns discussions regarding the shape of contracts not only for us, but also for nurses," said Łukasz Jankowski, president of the Supreme Medical Council, during a press briefing on Tuesday (July 29).

He also included among the sham actions the narrative of a supra-political Ministry of Health, composed of experts. He emphasized that healthcare management should be an area discussed beyond political divisions. To Jankowski, a "Ministry of Experts" sounds like a ministry potentially lacking political support.

The President of the National Medical Council (NRL) declared his willingness to cooperate with the new leadership of the Ministry of Health. However, he admitted that after Prime Minister Donald Tusk's words that the healthcare system should serve patients, not doctors , Minister Jolanta Sobierańska-Grenda might have an "uphill battle" from the start. According to Jankowski, narratives that antagonize doctors and patients are a clear signal that those in power are increasingly willing to blame medical personnel for the system's ills and incompetence in implementing reforms.

During a media briefing, Łukasz Jankowski listed a long list of promises that decision-makers failed to keep. This criticism was leveled not only at Prime Minister Donald Tusk and former Health Minister Izabela Leszczyna, but also at former Justice Minister Adam Bodnar.

- Today we are speaking with great emotion, with resentment, with a feeling of being cheated by those in power - said the president of the NRL.

He added that public discourse is still dominated by stories about the now legendary earnings of a handful of doctors who earn over 100,000 złoty per contract. The local government leader wants to counter such government narratives, which are intended to turn public opinion against doctors. He wants to discuss the specific promises that decision-makers made but failed to deliver.

Among the unfulfilled promises he mentioned, among others:

• no no-fault system extension,
• failure to implement an automatic reimbursement marking system,
• failure to launch a universal electronic appointment scheduling system (Central e-Registration),
• failure to establish a strategy for health care system reform,
• no additional legal protection for medical personnel,
• tolerating low quality standards of medical education
• ineffective fight against medical disinformation and "quacks",
• no clear ban on performing invasive aesthetic medicine treatments by beauticians and cosmetologists,
• failure to implement appropriate control of so-called prescription machines and failure to create a standard for teleconsultation
• lack of adequate financing for preventive and dental services
• continued use of "creative accounting" to show the increase in financial outlays on the healthcare system.

During the meeting, it was clear that Łukasz Jankowski was deeply disappointed with the actions of former Justice Minister Adam Bodnar, who had long collaborated with the local government on expanding the no-fault system. The frustration could have been greater, as this was one of Jankowski's main demands, promised to doctors during his term.

The idea was to limit doctors' criminal liability solely to situations involving gross medical error. In other cases, patients would be "cared for" by the Medical Event Compensation Fund (run by the Patient Ombudsman from September 2023).

According to Jankowski, both the Ministry of Justice and the Ministry of Health have been dragging their feet on this issue. This spring, a new team was established to address the issue from scratch. Medical experts fear that the new Minister of Justice, Waldemar Żurek, may be completely uninterested in continuing the talks.

Despite the Ministry of Health's grandiose announcements, the system designed to help doctors correctly determine reimbursement rates has also stalled . Currently, physicians determine reimbursement levels independently and must pay for any errors out of pocket. The Supreme Medical Chamber received a massive Excel file from the Ministry of Health requesting refinement of the algorithms—questions doctors would have to answer before the system determines the appropriate reimbursement level for the patient. The government was dissatisfied with the proposals presented by the National Institute of Health (NIL), and the system remains in place.

Doctors also criticized the operation of the Central e-Registration System. Although former Minister of Health Izabela Leszczyna declared that implementing this solution would be simple, when she left office, she found it difficult to demonstrate success in this area. Currently, only a pilot of the central registration system is in operation, and only in three areas: first-time cardiology appointments and mammography and cytology screening appointments. From 2026, implementation of the Central e-Registration System will be mandatory for facilities providing services in these areas, which, according to Łukasz Jankowski, is difficult to describe as a widely used electronic appointment scheduling system.

The NRL President also noted that the government had announced the lifting of National Health Fund (NHF) limits on hospital services. Meanwhile, we are seeing a growing number of hospitals failing to receive payments for overpayments from last year, indicating that they were already experiencing serious liquidity problems in July. In this context, Łukasz Jankowski is not surprised that other promises, such as expanding geriatric care and a real increase in healthcare spending, have also failed to be kept. Jankowski pointed out that the government continues to employ "creative accounting" when it comes to calculating expenditures relative to GDP.

Three months after the tragedy in Krakow, where a patient killed a doctor, medical professionals also expected legislation to increase legal protection for physicians regardless of their medical practice. Furthermore, it also anticipated the prosecution of violence against doctors ex officio, and the creation of a register of aggressive patients (controversial according to some experts).

- Apart from the guidelines of the Prosecutor General regarding cases of aggression against medics, we have not received any specific information - complained Łukasz Jankowski.

Discussions about the quality of education at the new medical schools also proved disappointing. "The matter ended in a bitter end with the Ministry of Education issuing a recommendation to the Ministry of Health, according to which even universities with negative assessments from the Polish Accreditation Commission can continue to educate future doctors," pointed out Łukasz Jankowski. The President of the National Medical Council also criticizes the toleration of simplified procedures for obtaining medical licenses for foreigners.

Moreover, the much-publicized "Lex Quack" law, intended to combat medical disinformation and quacks, is—according to the medical self-government—a "hoax." This is because the proposed regulations may prove difficult to enforce in the context of the adoption of new Polish Classification of Activities codes, which standardize businesses such as crystal healing or bioresonance.

The government has also decided not to introduce a clear ban on performing invasive aesthetic medicine procedures (e.g. Botox injections) by beauticians and cosmetologists, who may not have sufficient technical resources and knowledge to deal with complications following such procedures.

"We will be relentless. We have been pushing for these demands for several years, and we will not pursue them. In line with the direction adopted by the government and the Prime Minister, we can expect the healthcare sector to continue to lag behind, for example, the beauty industry and other sectors," concluded Łukasz Jankowski.

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