As we have already reported, after the first two quarters of 2019, the debt of public health care institutions exceeded PLN 13.8bn. For entities cooperating with hospitals, such data were a kind of secret of the policy. The whole year 2019 was marked by growing payment bottlenecks, increasing level of payable liabilities, and finally a court battle to recover money for supplies of medical equipment or services, says Pawel Ossowski, Managing Director of Zarys International Group, in an interview with PMR.
Wage pressure from medical staff
This picture is influenced by many factors, the most important being the salary pressure from the medical staff, as well as shortages in the medical staff. – At present, many hospitals are forced to close their wards due to the shortage of professional medical staff. Other facilities wanting to maintain full functionality of the facilities increase the level of salaries. Hospital managers are more and more often saying that the cost of salaries in many cases exceeds 90% of the hospital’s budget – stresses Pawel Ossowski in an interview with PMR.
The small possibilities of action in this area cause hospital directors to try to look for savings in other areas of hospital functioning. An important, albeit proportionately smaller budget line, is spending on services, equipment or energy, given the rising wage costs. So how to look for cost optimisation in this area?
Purchasing groups not very popular
With very uniform and universal products (such as electricity, medicines or cleaning services and medical waste disposal), purchasing groups are an interesting, but still not fully exploited solution. – At the moment, there are several purchasing groups on the hospital market in Poland, but their scale of operation is small. There is also little interest in this solution on the part of the hospital management – emphasises director of Zarys International.
Pawel Ossowski recalls that in January 2018, the need to create hospital purchasing groups was already pointed out by the Minister of Health, Lukasz Szumowski. He rightly noted the resistance of the environment, especially when it comes to purchasing strictly medical products. – The issue is so delicate that in fact, in the field of medical equipment, there may be different needs of hospitals and the idea of group purchasing will not always work. A good example is one of the purchasing groups preparing the procedure for medical gloves. The result of this procedure was actually to collect the needs of hospitals, without unifying products, which did not allow to obtain favourable prices, and subsequent hospitals withdrew from the project over time – explains Ossowski.
Only a thorough reform of the system will help debt?
Zarys International’s director notes that the optimisation of operating costs of medical facilities, especially hospitals, should definitely start with the most uniform and uncontroversial product groups. These may include office supplies, media, cleaning products, cleaning services, etc. – If the purchasing process is carried out optimally, savings may even reach several percent. However, it should be remembered that purchases of public health care institutions are regulated by the public procurement law and in order to achieve the greatest benefits, group purchases would need to be legally sanctioned in the act – he adds.
Undoubtedly, the current financial situation of Polish hospitals is very difficult and every potential search for savings and cost optimisation is needed. – However, the key question remains: is it possible to recover from the current crisis with the current legal regulations and financing system for health care, or is a thorough reform of the Polish hospital sector awaiting us? – concludes Pawel Ossowski.