The health minister’s toughest week

Dark clouds are gathering over the Ministry of Health. Jolanta Sobierańska-Grenda as head of the ministry had to come up with ideas that PM Donald Tusk would accept.

Following media reports exposing irregularities in Poland’s public healthcare system, Sobierańska-Grenda’s ministry has come under intense pressure.

“The task facing the National Health Fund (NFZ) and the Ministry of Health is straightforward. This practice must end – in accordance with the law, the Constitution, and basic standards of decency. Access to medical services in the public healthcare system should be equal and depend solely on when a patient joined the waiting list, not on personal connections. This has to stop. If I do not receive satisfactory, precise recommendations by Tuesday, I will make the appropriate decisions on Wednesday, including personnel decisions,” Prime Minister Donald Tusk said on Friday.

The Prime Minister’s ultimatum

The prime minister identified three issues that the recommendations from the health minister and the head of the National Health Fund (NFZ) must address: VIP treatment in public hospitals, patients bypassing waiting lists for medical services, and the exceptionally high earnings of some physicians. These issues have been widely covered by the media in recent weeks.

The debate began after the news outlet Zero published a report about a young Warsaw city councilor from the Civic Coalition (KO). According to the report, despite being a physician without a specialist qualification, he served as the coordinator of a hospital emergency department (SOR). The outlet alleged that he earned more than PLN 1.6 million (approximately EUR 375,000) a year in the role and arranged priority treatment for fellow party members, allowing them to bypass waiting lists.

Jolanta Sobierańska-Grenda joined the government at the end of July last year. She replaced Izabela Leszczyna, deputy leader of the Civic Coalition (KO), as health minister. Unlike her predecessor, she entered the cabinet from outside party politics. Before taking office, she managed healthcare institutions in the Pomeranian region in the north of the country. For eight years, she headed Szpitale Pomorskie, the company overseeing hospitals owned by the regional government. The region has long been led by Marshal Mieczysław Struk, who also heads the Civic Coalition’s Pomeranian branch.

Is her dismissal all but certain?

Politicians from the governing coalition have, to varying degrees, acknowledged that the health minister’s dismissal is a real possibility. Anna Maria Żukowska, leader of the Left’s parliamentary caucus, wrote on X that giving such a short deadline to prepare recommendations could indicate that the prime minister has already made up his mind.

Wioleta Tomczak, deputy chair of the parliamentary Health Committee and a lawmaker from Poland 2050, believes the current crisis could become an opportunity for meaningful reform.

“That is how I interpret the prime minister’s recent remarks, in which he points to the health minister and the president of the National Health Fund. Perhaps he expects the entire political class to finally support experts’ recommendations on politically difficult decisions. During both Donald Tusk’s previous government and the Law and Justice (PiS) administrations, the healthcare system was managed simply to keep it functioning, rather than to develop it. We have seen a dramatic rise in lifestyle-related diseases, which are dragging the system down. Had certain reforms – particularly in preventive healthcare and politically courageous decisions concerning the lifestyles of Polish women and men – been introduced earlier, what we are now proposing for the healthcare system, including its financing, might well have been sufficient,” Wioleta Tomczak said.

An excuse for the Prime Minister?

The Poland 2050 lawmaker points out that changes were introduced under the previous Law and Justice (PiS) government without securing the necessary funding in the state budget. One example was the decision to increase wages in the healthcare sector without identifying sources of financing for subsequent years.

The politician hopes that Jolanta Sobierańska-Grenda will present the recommendations needed to reform the system. In her view, the minister has had a plan for a long time. This assessment is also frequently heard in unofficial conversations with people who have experience managing public healthcare.

“The question is whether Prime Minister Tusk will be bold enough to follow the path proposed by a practitioner with experience in managing the healthcare system. I am not certain that he will. Perhaps Prime Minister Tusk’s remarks, delivered with such a short deadline for a response, were intended to create an opportunity for a possible ‘termination of the contract’ he had agreed with Minister Sobierańska-Grenda. Prime Minister Tusk is not my political leader, so I have not had the opportunity to get to know him personally well enough to understand what he means. Either he will take bold political decisions, or he will want to have an excuse to replace the government’s representative at the ministry,” Wioleta Tomczak said.

Three priorities for the health ministry

Following last year’s government reshuffle, Maciej Berek, the minister responsible for overseeing the implementation of government policy, announced the tasks that each ministry is expected to complete by the end of 2026. Three priorities were assigned to the Health Ministry.

One of them is a joint project with the Ministry of Digital Affairs: reforms to the e-health system, with the introduction of an electronic booking system (e-rejestracja) as the central element. Prime Minister Donald Tusk said on Friday that he had instructed officials to accelerate the work as much as possible.

The other two priorities for the Health Ministry are improving cardiac and neurological care and implementing a systemic reform of the management of healthcare providers. Although the year is already halfway through, much remains to be done. Friday’s statement by the prime minister is further evidence of that.

The greatest optimism surrounds the electronic booking system. The legislation establishing the system came into force at the beginning of this year, and in August it will be expanded to cover additional medical clinics. Joanna Wicha, deputy chair of the parliamentary Health Committee from the Left and a former nurse, hopes that the development of the system will put an end to artificially inflated waiting lists. In 2024, the number of missed appointments that patients failed to cancel exceeded 1.3 million.

“I remember from my own professional experience that when waiting lists were not coordinated, patients would register at several different places. They would not cancel their appointments, while other patients had to wait for months,” Joanna Wicha said.

Surpluses and shortages

When it comes to neurological and cardiac care, our interviewees are less optimistic. Joanna Wicha points primarily to a shortage of specialists in neurology. In her view, young doctors increasingly choose less demanding fields of specialization. The Left’s lawmaker believes there should be oversight of the specializations selected by graduates of publicly funded medical universities.

“I am not talking about forcing people into specific specialties, because thankfully those days are behind us. But we do need a systemic solution to the problem of having too many doctors in some specialties and too few in others,” Joanna Wicha argues.

According to Wioleta Tomczak, the healthcare system also lacks mechanisms for registering patients and sending reminders, including through the Internet Patient Account application. This issue extends beyond cardiology and neurology. The Poland 2050 lawmaker points to services such as mammograms and cervical cancer screenings, where electronic booking is already available but many appointment slots remain open. The same applies to publicly funded vaccinations, including HPV vaccinations for children.

“I know of cases where parents remembered about it a year later and were told that they could now do it for PLN 500 (around EUR 115). I am concerned that people will become discouraged from using the system. We expect patients to take responsibility for their own health. However, I believe the healthcare system should also take the initiative in engaging with patients. It is worth encouraging people to get tested, vaccinated and take care of their health,” the Poland 2050 lawmaker said.

A change in the management system

Following the latest high-profile media reports – in which Civic Coalition (KO) politicians were featured – Marta Golbik, chair of the parliamentary Health Committee from KO, points to two priorities for the healthcare sector. The first is a systemic reform of hospital management. The second is the introduction of a system for recording doctors’ working hours.

The reform of healthcare facility management includes, among other measures, streamlining the operation of the hospital network. One of the key proposals is the consolidation of hospitals and hospital departments by local governments. Our interviewees believe that public healthcare should be coordinated at the regional level.

“A regional marshal or a voivode – both solutions have their advantages and disadvantages – should have a clear map of the region’s needs and then, in consultation with county heads and mayors, determine where and which departments should operate to ensure that all medical needs are properly covered,” Joanna Wicha said.

“At present, a county head does not want to give up a loss-making hospital department because residents would perceive it negatively. This creates competition for doctors, who are already relatively scarce in highly specialized fields. At Poland 2050, we believe there are too many of these specialties. Medical services are also not priced rationally. Cardiology procedures are reimbursed above reasonable levels. Internal medicine and pediatrics face shortages, and these are among the departments contributing to hospitals’ growing debt,” Wioleta Tomczak added.

A new situation. Will patients support the government’s plans?

Marta Golbik from the Civic Coalition (KO), meanwhile, expects that on some issues the government may enjoy broad public support from patients. One example is transparency around the salaries of doctors working in public hospitals. Reports about millionaire physicians have sparked public outrage. The Supreme Medical Chamber (Naczelna Izba Lekarska) is opposing the government’s proposed legislation on pay transparency.

“Patients expect changes, even if they will be difficult. Had we announced adjustments to doctors’ salaries before these recent events, public sympathy would have been with doctors rather than the government. After the latest media reports, we are in a position where we can introduce changes. However, we must clearly explain to the public what the situation looks like and what abuses are taking place. Today I read about a case of a doctor earning PLN 26,000 (around EUR 6,000) per hour. It is unbelievable. With information like this, everyone can understand that the government must intervene. Sometimes unpopular but necessary decisions have to be made to ensure that the system functions,” Marta Golbik said.

“Had we announced adjustments to doctors’ salaries before these recent events, public sympathy would have been with doctors rather than the government.”

The chair of the Health Committee does not rule out changes to next year’s budget that would reduce spending on doctors’ salaries compared with current levels.

“I would start by changing the pay increase law introduced by the previous government, which imposed an obligation on hospital directors to raise salaries regardless of the quality of work performed. This year, it costs PLN 70 billion (around EUR 16.1 billion). This money could be spent more effectively,” Marta Golbik said.

Judgment day

Anna Choszcz-Sendrowska, the Health Ministry’s press spokeswoman, confirmed in an interview with the Polish Press Agency (PAP) that the prime minister will receive the recommendations on Tuesday. They are expected to address three areas: the electronic registration system, excessive pay disparities, and doctors’ working hours.

During a Monday press conference held by medical unions, Sebastian Goncerz, head of the Residents’ Alliance (Porozumienie Rezydentów), said that dismissals at the Health Ministry were necessary. He added, however, that personnel changes alone would not resolve the situation.

The Law and Justice (PiS) party is calling for Jolanta Sobierańska-Grenda’s dismissal. PiS politicians argue that the minister has no real control over the ministry and that responsibility for the healthcare sector effectively lies with the prime minister.

When announcing the ultimatum for Jolanta Sobierańska-Grenda, Prime Minister Donald Tusk recalled that appointing a minister from outside politics had been described as an “experiment”. Critics had also argued that her lack of a political support base would become a source of weakness. On Friday, Tusk acknowledged that Sobierańska-Grenda’s professional qualifications were beyond question.

“The question is whether she has enough strength, determination and the kind of drive needed to push things through. The coming days will show,” the prime minister added.

Key Takeaways

1. Health Minister Jolanta Sobierańska-Grenda is under political pressure. The prime minister has demanded that she and the head of the National Health Fund (NFZ) present recommendations addressing problems with access to medical services, patients bypassing waiting lists, and the high salaries of some doctors. Her future in the government depends on how these proposals are assessed.
2. Within the governing coalition, there is growing recognition that the priority for healthcare reform should be improving the organization of the system and the management of healthcare facilities. Discussions also focus on shortages of specialists in fields such as neurology, as well as the lack of coordination in the delivery of medical services.
3. Work is underway on legislation requiring greater transparency around doctors’ salaries in public healthcare facilities. The government is considering limiting spending on remuneration from the NFZ budget. The medical community opposes the disclosure of doctors’ earnings.