1. Patients’ Rights in Poland Magda Bojarska Institute for Patient‘s Rights & Health Education Workshop on patients‘ rights in cross-border health care Budapest, February 2009 Magda Bojarska Institute for Patient‘s Rights & Health Education Workshop on patients‘ rights in cross-border health care Budapest, February 2009

2. Institute for Patient‘s Rights & Health Education Founded in 2004 by Father Arkadiusz Nowak Mission – promote patiens’ rights, - integrate patient movement Activities: -Webportal directed to patients – www.prawapacjenta.eu www.prawapacjenta.eu -Legal advise for patients -Conferences, public debates, advocacy of patients’ rights -Public actions & campaigns -Project „Patients’ Academy” – 2-years educational programme for 120 leaders of patient associations (sponsored by EFPIA & PhRMA) Founded in 2004 by Father Arkadiusz Nowak Mission – promote patiens’ rights, - integrate patient movement Activities: -Webportal directed to patients – www.prawapacjenta.eu www.prawapacjenta.eu -Legal advise for patients -Conferences, public debates, advocacy of patients’ rights -Public actions & campaigns -Project „Patients’ Academy” – 2-years educational programme for 120 leaders of patient associations (sponsored by EFPIA & PhRMA)

3. Patients’ Rights in Poland Polish Constitution: Art. 68 - Everyone has a right to protection of health and a right of equal access to health services financed from public sources; Art. 38 – Life of a person is protected by law; Art. 18 and art. 40 – Privacy and dignity of a person is protected by law; Art. 51 – Personal data of a person are protected by law; Polish Constitution: Art. 68 - Everyone has a right to protection of health and a right of equal access to health services financed from public sources; Art. 38 – Life of a person is protected by law; Art. 18 and art. 40 – Privacy and dignity of a person is protected by law; Art. 51 – Personal data of a person are protected by law;

4. Polish legislation related to Patients’ Rights Act on Health Care establishments Act on Health Care services refunded with public funds Acts on Doctor’s and Nurse’s profession Laws on Doctors’ and Nurses’ Chambers Act on Health Care establishments Act on Health Care services refunded with public funds Acts on Doctor’s and Nurse’s profession Laws on Doctors’ and Nurses’ Chambers

5. Charter of Patients’ Rights Adopted by the government in 1998 Based on international and Polish legislation Does not have legal power of a law, it is only a cathalogue of patients’ rights Contains 11 articles. Adopted by the government in 1998 Based on international and Polish legislation Does not have legal power of a law, it is only a cathalogue of patients’ rights Contains 11 articles.

6. Charter of Patients’ Rights A patient is explicitly entitled to: - equal access to the health services financed from public sources; - proper and clear information on own health status, necessary diagnostic and treatment procedures, health risks and prognosis - consent or refuse treatment - access to own medical record & documentation - respect of physical and mental integrity - confidentiality of all health data and personal data - contact and care of close / relatives - religious support / pastoral care - die in peace and respect - complaint and compensation A patient is explicitly entitled to: - equal access to the health services financed from public sources; - proper and clear information on own health status, necessary diagnostic and treatment procedures, health risks and prognosis - consent or refuse treatment - access to own medical record & documentation - respect of physical and mental integrity - confidentiality of all health data and personal data - contact and care of close / relatives - religious support / pastoral care - die in peace and respect - complaint and compensation

7. Problems The right to equal access to the health services financed with public funds - granted The right to receive inmediate treatment in situation of serious life or health thread - granted The right to choice among available treatment methods – limited by the State budget The right to free choice of service provider – formally granted The right to choose more expensive treatment or diagnostic method and cover the difference – not granted Maximum waiting time for health services „guaranteed” – „lists of patients waiting” depending on local capacities The right of second opinion – conditioned by doctor’s assent The right to equal access to the health services financed with public funds - granted The right to receive inmediate treatment in situation of serious life or health thread - granted The right to choice among available treatment methods – limited by the State budget The right to free choice of service provider – formally granted The right to choose more expensive treatment or diagnostic method and cover the difference – not granted Maximum waiting time for health services „guaranteed” – „lists of patients waiting” depending on local capacities The right of second opinion – conditioned by doctor’s assent

8. Medical documentation Access have: - Doctors, nurses and other medical professionals (including administrative staff) - Patient & the person authorised In case of death – a proxy - a person authorised by a patient / close ones/ relatives – not formally regulated New law on patient rights & patients’ rights ombudsman – limits the right of access to medical documentation in case of death of a patient only to persons formally authorised by a patient (not yet in force) Medical documentation should be translated to Polish – the law on the Polish language Access have: - Doctors, nurses and other medical professionals (including administrative staff) - Patient & the person authorised In case of death – a proxy - a person authorised by a patient / close ones/ relatives – not formally regulated New law on patient rights & patients’ rights ombudsman – limits the right of access to medical documentation in case of death of a patient only to persons formally authorised by a patient (not yet in force) Medical documentation should be translated to Polish – the law on the Polish language

9. Enforcement of patients’ rights The law on patients’ rights & patients’ rights ombudsman – enacted by the Parliament in 2008 - vetoed by the President (together with the whole bunch of health care-related acts proposed by the government) -will hopefully be voted again in 2009 and enforced in 2010 -Institute for Patient’s Rights actively participated in legislative process The law: Enforces patients’ rights and introduces new body responsible for patients’ rights implementation and observation – the Patients’ Rights Ombudsman. At present – PR advocates in hospitals – paid by NFZ - PR Office at the Ministry The law on patients’ rights & patients’ rights ombudsman – enacted by the Parliament in 2008 - vetoed by the President (together with the whole bunch of health care-related acts proposed by the government) -will hopefully be voted again in 2009 and enforced in 2010 -Institute for Patient’s Rights actively participated in legislative process The law: Enforces patients’ rights and introduces new body responsible for patients’ rights implementation and observation – the Patients’ Rights Ombudsman. At present – PR advocates in hospitals – paid by NFZ - PR Office at the Ministry

10. Quality standards in HC Quality standards are regulated only in anestesiology Internal system of quality management in HC – TQM External system – ISO 9000 Acreditation by the Centre for Monitoring of HC Quality Quality standards are regulated only in anestesiology Internal system of quality management in HC – TQM External system – ISO 9000 Acreditation by the Centre for Monitoring of HC Quality

11. Cross border HC National HC Fund (NFZ) refunds cost of medical services for Polish citizens only in case of emergency. The cost of planned procedures or diagnostics is covered by NFZ only if these procedures are not available in Poland. The Supreme Administrative court issued a ruling that an excessive pending time for treatment can be treated as „unavailability” of this treatment in Poland. National HC Fund (NFZ) refunds cost of medical services for Polish citizens only in case of emergency. The cost of planned procedures or diagnostics is covered by NFZ only if these procedures are not available in Poland. The Supreme Administrative court issued a ruling that an excessive pending time for treatment can be treated as „unavailability” of this treatment in Poland.

12. THANK YOU!