Health care in Poland: from crisis to crisis

During its first twenty years the Polish health service represented a neglected sector of government activity, as the development of heavy industry remained the predominant economic goal, with social policy regarded as a "nonproductive" sphere. When Edward Gierek came to power in 1970, the promise of reform extended throughout society to include health. However, despite a fundamental organizational reform, the health service has remained in a state of crisis, currently worsening as a result of mounting economic dislocation and political tension. Inadequate access to treatment, lack of continuity of care, poor quality of care, profound shortages of drugs and supplies, and the absence of preventive medicine are some of the manifestations of this crisis. Its main causes lie in the political weakness of the Ministry of Health, with consequent underfunding and the nonfulfillment of its plans. This situation is exacerbated by continuing organizational fragmentation, the neglect of primary care, the existence of conflicting aims in health policy, and the dominance of an ideology of clinical specialism.