Polish county hospitals face crisis as National Health Fund’s deficit forces unpaid bills and service cuts.
NFZ Deficit Sparks Hospital Cuts
The National Health Fund (NFZ), facing a multi-billion deficit this year, seeks budget cuts, targeting county hospitals first. Unpaid bills for 2024 “overperformances” are overdue, with arrears reaching over six months in some regions.
New 2026 contracts for flat-rate hospitals are set at significantly lower rates than 2024 actual service outputs. Hospital directors also fear the planned elimination of correction factors used in valuing services for small facilities, which could worsen financial strain.
Cost-Shifting Threatens Services
Costs like patient nutrition, previously funded by a separate “Good Meal in Hospital” program, will likely be shifted to hospitals by the payer. The Ministry of Health discontinued this program for 2025. Proposed austerity measures alarm local officials.
Union Warns of Closures
The Union of Polish Counties (ZPP) issued a statement on January 21st, stressing the critical state of many county hospitals and warning that proposed solutions could lead to widespread facility closures. They demand immediate government corrective action.
Systemic Issues Blamed
ZPP attributes hospitals’ problems not to mismanagement but to systemic failures, including inefficient primary care (straining emergency and specialist services), a flawed hospital network structure, and incorrect methodology for valuing services.
Debt Crisis Looms
ZPP states that fulfilling the obligation to provide healthcare services under current legal, organizational, and financial conditions inevitably leads to uncontrollable debt accumulation, risking local system paralysis. They argue that repair programs cannot ensure stable, long-term health security.
Parliamentary Debate Underway
The financial situation of county hospitals was discussed at a January 21st parliamentary committee meeting. NFZ economic director Dariusz Jarnutowski reported 58.88 million zł transferred to county hospitals by Q3 2025, including 43.39 million zł for limited services and 15.48 billion zł for unlimited services. “Overperformances” for Q1-Q3 totaled 2.71 million zł.
Jarnutowski assured the NFZ aims to settle all unlimited services and unfunded Q4 services (totaling 2.488 billion zł) by mid-February 2026. Unpaid unlimited services for Q1-Q3 stand at 450 million zł, and limited services at 1.62 billion zł. Q4 unpaid amounts are 1.124 billion zł (unlimited) and 1.364 billion zł (limited).
