The debate, which was attended by specialists from Poland, Bulgaria, Lithuania, and Slovakia, showed that the most valuable discussion on the system takes place at the international level.

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Initiative across borders

In order to make improvements, it is important to build the sustainability and resilience of the health care system not only in our country, but throughout the CEE region. The cooperation of countries in one region provides an opportunity to share good practices and methodologies for dealing with crisis situations. This is precisely what the CEEBA Health Policy Network initiative is designed to do, with the aim of enabling the exchange of experience among countries in the region. This is what the panellists discussed at the Economic Forum 2022 in Karpacz.

In 2020, the World Economic Forum, the London School of Economics along with support from AstraZeneca inaugurated the Partnership for Health System Sustainability and Resilience (PHSSR). As part of the initiative, research teams from eight countries, including Poland, conducted surveys on the countries’ health care systems.

During the debate in Karpacz, George Wharton of the London School of Economics stressed the importance of reliably identifying the strengths and weaknesses of the health care system in order to move forward. As part of the activities of the Partnership for Health System Sustainability and Resilience, a matrix was created to assess how health policies respond to the requirements of sustainability and resilience.

Act with forward thinking and planning

Piotr Najbuk, Director of External Relations at AstraZeneca, said that strengthening the health care system is necessary not only because of emergencies, such as a pandemic or war, but also because of upcoming threats, which could be severe diseases of civilisation or an aging population.

- The systems in the countries of the Central and Eastern European region have many points in common and similar problems, said Piotr Najbuk. - As a company, we are an entity that is committed to ensuring the resilience of systems at many levels, one example being the delivery of a non-profit vaccine against Covid-19. I hope that the results of the CEEBA Health Policy Network project, which was established after the success of the PHSSR researchers’ work, will help support decision makers and public policy makers. The system needs to be strengthened, P. Najbuk added, urging people to read the results of the study.

Professor Iwona Kowalska-Bobko from the Jagiellonian University, who co-led the study, briefly presented some of the PHSSR report’s conclusions for Poland. She stressed that the resilience of the health system lies in its ability to adapt to a new crisis situation, as exemplified by the pandemic. Bringing sustainability to the system, on the other hand, is about ensuring the continued performance of its key functions, including the provision of health services, equal access, and efficacy of treatment.

The system image

The report shows several areas, called domains, such as governance (also understood as support of patient organisations), financing, human resources, technology, and the processes of providing services, among others. In the countries that participated in the survey (including Italy, the UK, Germany, and Poland), post-Covid-19 strengthening in the domain of technology and the sharing of competencies within human resources was indicated.

However, every country is struggling with the problem of insufficient number of medical professionals. One solution to this problem in the pandemic crisis was to give professionals additional powers (such as the ability to perform vaccinations).

Is the Polish system sustainable and resilient? Prof. Iwona Kowalska-Bobko noted that in our country, we have the best results in technology. The development of Poland’s health policy points to the strengthening of the issues of digitalisation, innovative technological solutions, and e-health. The system is unfortunately underfunded, and we are weakest in the area of human resources.

- There is not a word about a pay strategy in the health care strategy documents. Nothing about migration policy. Nothing about building the physical and mental well-being of doctors. It’s amazing, because the pandemic is still here, says Iwona Kowalska-Bobko.

- We are not a lonely island in the system. There are countries that are struggling with similar problems. It is worthwhile for us to share experiences, commented Dr Łukasz Jankowski, President of Naczelna Rada Lekarska [Chief Council of Physicians and Dentists].

He pointed out that even good solutions subject to discussion can cause a desire to improve them.

Foto: Mariusz Szachowski, fototaxi.pl

- We introduced e-prescription very quickly, but let’s also talk about the shortcomings. Doctors still have to execute administrative function due to the duty of determining reimbursement, said Łukasz Jankowski. – I’m not surprised by the staffing problems, either. There is a shortage of doctors everywhere. The number of vocational schools looking to train new specialists is growing rapidly in Poland. However, a question immediately arises about the quality of this teaching..., Łukasz Jankowski added, pointing out several areas for improvement in the Polish system.

What is the situation in other countries? Dr Elena Marusakova pointed out two problems she sees in the Slovak system that are very similar to those in Poland, i.e. underfunding and staff shortages.

- In Europe, a minimum standard is needed to be provided to patients from each country. There are big differences between countries when it comes to the quality of services provided, added Elena Marusakova.

Dr Alexander Simidchiev, Member of the Bulgarian National Assembly, among many problems, indicated underfunding, lack of a long-term development plan, and a conservative system that blocks the development of digitalisation.

- During the pandemic, the only dialogue that took place between countries was comparing statistics on how many people died from Covid-19. Even in the distribution of vaccines, there were big discrepancies among countries, Alexander Simidchiev said, stressing the importance of sharing experiences between countries in one region for development.

- The pandemic showed that experts are also needed in politics. They have to be involved, constantly cooperating with the government, added Ramune Kalediene of the Lithuanian University of Health Sciences in Kaunas.

In Lithuania, there is no problem of shortage of personnel, but there are shortcomings in the forecasting and data analysis system, which causes the system to leak in emergency situations. - We also need to strengthen communication skills and educate patients, just as we do with vaccinations, Kalediene added.

Establishing international cooperation helps speed up some processes. Thanks to the exchange of experience, we can bet on many existing and proven solutions, but also notice the shortcomings of the system much earlier. For these reasons, international cooperation is of key importance in order to build the sustainability and resilience of health systems in the CEE region.

- We can look to the future with optimism, Łukasz Jankowski said. - There used to be more competition for data than cooperation. This project verifies how much we can cooperate today, concluded the President of Naczelna Rada Lekarska.

Partner: AstraZeneca Pharma Poland, CEEBA Health Policy Network

Foto: .