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.