The Polish health protection system is currently poorly prepared for crisis situations, such as further pandemics or natural disasters. Essentially, every element needs improvement: from personnel policy and funding of services to legal solutions – as reported in a study discussed by experts during the “2024 Changes in Health Care” conference. They point out that we have not learned the lessons of the COVID-19 pandemic.
“Decision makers need to be aware that crises will recur, that COVID-19, war, floods, and other environmental or economic crises which may affect us, will require flexibility, resilience, and proper reaction to ensure access to health services,” says Dr. Iwona Kowalska-Bobko, Professor at the Jagiellonian University and Director of the Institute of Public Health, Faculty of Health Sciences, Collegium Medicum of the Jagiellonian University.
The COVID-19 pandemic was an unprecedented challenge for health systems worldwide, including Poland. Many of them were pushed to their limits trying to manage the spread of the virus and provide immediate care while also maintaining basic services and ensuring patient and medical personnel safety. Despite existing crisis response plans, the initial responses were chaotic and uncoordinated, exacerbating the effects of the pandemic. COVID-19 highlighted the issue of our health protection system’s resilience and its readiness to handle future crises – this springs from a report “Matrix of health protection sustainability and resilience assessment” prepared by, among others, Prof. Iwona Kowalska-Bobko and Dr. Małgorzata Gałązka-Sobotka, Director of the Institute of Management in Health Care at Łazarski University. The publication, which was created as part of the PHSSR – Partnership for a Sustainable and Resilient Health System (a joint initiative of the World Economic Forum, the London School of Economics, and AstraZeneca), shows that the Polish health protection system is currently poorly prepared for crisis situations like future pandemics or natural disasters. Basically, every element needs improvement: from personnel policy, funding of services, to unclear and imprecise legal solutions.
“As it seems, we haven’t learned the lessons from the COVID-19 pandemic, as the previous version of the matrix that we created to measure the resilience of the system recorded better indicators than now. This suggests that COVID-19 probably mobilized us initially to secure certain actions for potential crises. However, memory is unfortunately short – not only in the health care system but generally regarding the COVID-19 crisis and the restrictions that were required of us all, including hand washing, mask wearing, and caution in infection transfer. This has been forgotten. So I’m afraid – as the results of our research also indicate – that this lesson hasn’t been learned and much is still ahead of us. Our resilience to crises is at a medium-low level,” says Prof. Iwona Kowalska-Bobko.
As she points out, one of the priority areas in which the resilience of the health protection system needs to be strengthened is financing of services.
“This is a very important issue because we simply lack money in the system and we should show particular caution in spending it, especially the funds reserved for crisis situations,” says the expert from the Collegium Medicum of the Jagiellonian University. “We need to focus on accumulating financial resources and, of course, not only financial ones, to deal with a crisis.”
According to the report, the Polish health system also scores poorly in terms of sustainable development and green transformation, partially due to the fact that the average age of Polish hospitals is about 50 years. The outdated infrastructure requires significant investment which hampers the implementation of reforms.
“It’s not that health care unit directors and managers do not see the importance of these phenomena. However, due to infrastructure and financing, we have a problem implementing good environmental practices in the health care system, identified in countries that have moved more towards implementing green transformation and sustainable environmental practices,” says Prof. Iwona Kowalska-Bobko.
The report “Matrix of sustainability and healthcare system resilience assessment” shows that the Polish system is relatively good at implementing digitization. The development of digital services was accelerated – or even forced – by the COVID-19 pandemic. Experts argue, however, that preparing the Polish health care system for further crises requires, among others, extensive cross-sector cooperation and the development of an appropriate strategy in this direction.
“We will be building a Sustainable Health Care System Resilience Index. We will primarily use quantitative indicators that will show us where we are. Every year we would like to present such an index version so you can see how this system quantitively balances and ensures resilience, or unfortunately does not,” says the Director of the Institute of Public Health at the Collegium Medicum of Jagiellonian University.
As she points out, such indicators are so important because they focus not only on health matters, but also on environmental issues.
“In public health, we have been using easily defined indicators for years. These are the average life expectancy at birth, healthy life expectancy, and other indicators regarding the number of doctors, nurses, number of beds in the system. However, it is more difficult to define indicators that touch several sectors – health and environment, health and education, health and social assistance, health and labor market,” says Prof. Iwona Kowalska-Bobko. “Building cross-sector cooperation is very important and it would be good if we started communicating using the same measures, which could be such indicators.”
