During the summer months of 2026, public debate was dominated by reports concerning the remuneration received by certain doctors working in public hospitals. This alert focuses on the legal aspects of the matter, leaving aside its reputational and political dimensions. Nevertheless, the reasons behind the recent legislative activity in this area cannot be disregarded entirely. Political circles have opted for a regulatory response which, inevitably, will affect the medical profession. Overall, the rules governing the criteria for determining the remuneration of doctors working in public healthcare institutions are set to change.
Direction of the proposed changes
The Ministry of Health is working on a regulation amending the Regulation of the Minister of Health of 8 September 2015 on the General Terms and Conditions of Contracts for the Provision of Healthcare Services. The proposed regulation is intended to introduce new healthcare quality criteria, or indicators. All three concern the staffing resources of healthcare providers.
In broad terms, the purpose is to determine what proportion of the funds transferred to healthcare providers by the National Health Fund (NFZ) is allocated to the remuneration of, among others, doctors providing services at those institutions. In other words, the indicators are intended to show what proportion of healthcare providers’ publicly funded revenue is spent on medical and non-medical personnel. The draft regulation will be subject to public consultation. The proposed changes are ultimately expected to enter into force at the beginning of 2027.
Separately, the Ministry of Health intends to amend the Regulation of the Minister of Health of 8 September 2015 on the General Terms and Conditions of Contracts for the Provision of Healthcare Services in another respect. A Regulation of 27 August 2026 amending the Regulation on the General Terms and Conditions of Contracts for the Provision of Healthcare Services has been published in the Journal of Laws under item 1137. Under this regulation, healthcare providers offering inpatient treatment will be required to submit monthly records of the attendance of healthcare professionals at the institutions in which the services are provided, using dedicated online platforms or IT services. These changes are due to enter into force on 1 November 2026.
Stated purpose of the changes
The healthcare quality indicators are currently laid down in the ministerial regulation of 8 September 2015, which undoubtedly justifies the need for them to be updated. According to the Ministry of Health, the first indicator is to measure the proportion of total staffing costs relative to the revenue earned by healthcare providers from services delivered under contracts concluded with the NFZ. The second is to measure the costs associated with persons employed under contracts of employment within the meaning of the Labour Code as a proportion of total staffing costs. The third indicator will measure the proportion of staffing costs attributable to healthcare professionals relative to total staffing costs.
Put simply, the Ministry wishes to determine how much of the funding transferred by the NFZ to healthcare providers is allocated to the remuneration of persons employed by those providers. Officially, the proposed regulation is intended to ensure that due regard is had to ‘the interests of beneficiaries and the need to ensure the proper performance of contracts’.
The second regulation will, de facto, introduce a system for recording the working hours of healthcare professionals. The explanatory memorandum states that its adoption is intended, among other things, to ‘increase the transparency of the performance of contracts for the provision of healthcare services’, ‘strengthen mechanisms for monitoring the proper provision of publicly funded services’, facilitate the ‘earlier detection of irregularities’, ‘reduce the risk of improper performance of contracts for the provision of healthcare services’ and ‘ensure that publicly funded services are provided by healthcare personnel at the place and during the times stipulated in the relevant contract’.
The records are to include ‘information concerning the dates and times at which attendance at the place where services are provided commenced and ended’. The Ministry maintains that the regulation does not impose an obligation to create any new documentation and that information relating to the organisation of healthcare providers’ personnel is sufficient to achieve its objectives.
Implications for healthcare providers
The first regulation is intended to enable an assessment of the cost structure incurred by healthcare providers in securing the human resources necessary to deliver publicly funded healthcare services.
According to the Ministry of Health, the second regulation is intended to achieve the numerous objectives identified in its explanatory memorandum. In reality, however, this measure is also concerned with monitoring the actual times and locations at which healthcare services are provided by institutions using public funds. It may reasonably be expected that the regulation will quickly acquire the informal title ‘lex Kacprzyk’.
Assessment of the changes
From a legal perspective, I do not consider either of the two measures to contain provisions warranting a critical assessment. The introduction of three new healthcare quality criteria is justified, if only because the ministerial regulation establishing the existing criteria has been in force for more than 11 years. It undoubtedly requires updating.
Moreover, having regard to the principles governing the management and scrutiny of public finances, the regulation that has already been published is also consistent with those principles. Public authorities responsible for financing healthcare providers should have both adequate information about, and oversight of, the expenditure of public funds, including expenditure on remuneration.
Social expectations regarding more extensive intervention by the legislature and greater scrutiny by the competent authorities over the financing of services provided by publicly funded healthcare institutions fall outside the scope of this alert.
Nevertheless, the pace of developments, the need for regulation and public expectations concerning transparency in the expenditure of public funds provide reasonable grounds to expect that the remuneration of persons engaged by healthcare providers will be subject to increased scrutiny.
Jabłoński Koźmiński & Partners advises healthcare providers on healthcare law, contracting with the National Health Fund and medical personnel engagement structures.
Should you have any questions regarding these matters, please do not hesitate to contact us.
Sources:
- New quality indicators to measure healthcare employment costs — Prawo.pl — https://www.prawo.pl/zdrowie/nowe-wskazniki-jakosci-mierzace-koszty-zatrudnienia-w-ochronie-zdrowia,1551229.html
- Three new indicators: Ministry of Health outlines proposed changes from January 2027 — politykazdrowotna.com — https://politykazdrowotna.com/artykul/trzy-nowe-wskazniki-n2458469
- Regulation of the Minister of Health of 8 September 2015 on the General Terms and Conditions of Contracts for the Provision of Healthcare Services (consolidated text, 2023) — ISAP — https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20230001194
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