Gynecologists in Poland are raising the alarm about new amendments that will be introduced to the 2004 Act on health care services financed by public funds. The Ministry of Health is presenting new threatening plans on limiting protection for women and children within the existing healthcare system in Poland. The anticipated changes will result in the deterioration of the standards of protection provided for women giving birth. The new amendments are to be adopted in the near future, and would delete the provisions that finance an adequate level of medical care granted to pregnant women and children. Advocates, pediatricans and gynecologists say that the new law will not guarantee that basic medical examinations of pregnant women and necessary vaccinations for children will be financed by the state.
Current standards of medical care for pregnant women in Poland are already inadequate and unsatisfactory, as already mentioned in a few articles posted last year (see for example: Poland Says No to Pain-Free Childbirth). And the Act, currently being debated within the Parliamentary Health Commission, may result in making the existing situation even worse. It is commonly acknowledged that women giving birth are not provided with sufficient level of medical care. The issue of anaesthetization could serve as an example here - the state budget cannot afford to ensure free anesthetization during childbirth to all Polish women. And furthermore, changes to be soon adopted by the Ministry of Health indicate that the above standards may deteriorate. For example, what will happen with prenatal examinations, asks Professor Mirosław Wielgoś, Gynecology Consultant in the Mazovia region.
Similar concerns are expressed by pediatricians, who call upon the Ministry not to change the previously binding provisions. They claim that the new regulations adopted by the Ministry of Health will create a loophole in law with regard to the vaccination process. "It would mainly concern those vaccinations that are now financed from public funds and therefore are automatically guaranteed," said Teresa Jackowska, vice-president of the Polish Pediatric Association.
The Ministry of Health defends itself, stating that all the existing regulations previously included in the 2004 Act, will be moved into new ordinances drawn up by the Ministry. However, the Polish doctors question the practicality of adopting such a solution. They rightly point out that ordinances, as acts located lower in the hierarchy of legislative acts, could be subject to amendments or modifications in much easier way. "Regulations adopted in a form of ordinances do not guarantee their adequate and effective implementation. Such regulations could also create an interpretation chaos," highlights Marek Michalak, the Ombudsman for Children's Rights, who also prepared a special petition on that issue submitted to the Parliamentary Health Commission.
In its response, the Ministry of Health points out that such a possibility to introduce changes to the ordinances will facilitate the process of adoption of modern methods of medical treatment or preventative treatment. Moreover, as stated by the Ministry officials, there is no need to specifically differentiate women and children in the law, because they will have access to medical examinations exactly to the same extent as provided for the rest of society.
But the above explanations are difficult to accept, even by members of the Polish parliament. They say it is guaranteed in the Polish Constitution that women and children should enjoy a special protection with regard to needed medical treatment. Article 68 (3) of the Constitution states that public authorities shall ensure special health care to children, pregnant women, handicapped people and persons of advanced age. So why then does a guaranteed protection disappear from the Act? By deleting the provisions that specifically refer to mothers and children, the Ministry presents evident proof for its negligence in observing the fundamental rules of law.
The entire situation, as described above, seems to be even more interesting, or strange, because of the fact that for a few months now the Ministry of Health has been working on establishing a new Department on Mother and Child, which was to initiate its operations in January 2009. Its major task shall be in particular to provide all necessary care to children as well as women during pregnancy and delivery. But what it will be doing in practice still remains to be seen.
