Government Proposes Limits on Doctors Working Across Multiple Hospitals Simultaneously

The Polish Ministry of Health has drafted legislation to curb employment across multiple hospitals simultaneously, introducing strict caps on total working hours and new contracting rules for state-funded facilities.

New Employment Rules for Medical Professionals

A doctor working simultaneously in several hospitals, often on fractional employment contracts, may soon become a rarity. The Ministry of Health has prepared a draft amendment designed to restrict this employment model and introduce new working rules for medical professionals in facilities financed by the National Health Fund (NFZ).

Proposals for the draft bill amending the Act on Publicly Funded Healthcare Services and Certain Other Acts (UD439) respond to staffing and financial problems within public healthcare. The Ministry argues that shortages of doctors and nurses cause facilities to compete for the same specialists, leading to rising costs and compromised continuity of patient care.

The Multiple Hospital Model Under Scrutiny

Currently, many specialists provide services in several facilities simultaneously, such as a hospital, an outpatient clinic, and another provider, often through civil-law contracts and in small time dimensions. The Ministry of Health states this model causes hospitals to outbid each other for staff, increasing NFZ treatment costs and threatening personnel availability and patient safety. New regulations aim to tie medical staff closer to their primary workplace.

Total Working Hours Capped at Two Full-Time Equivalents

A key change introduces a total working time limit. A medical professional providing NFZ-financed services cannot work across all employing entities exceeding the equivalent of two full-time positions. This restriction applies to both employment contracts and civil-law agreements.

Mandatory Minimum Part-Time Engagement per Hospital

The draft sets special rules for hospital treatment and ambulatory specialist care. Medical professionals providing services in an NFZ-financed hospital generally must be employed by that entity for at least half of a full-time position or its equivalent.

Additional work in another NFZ-contracted hospital requires at least half-time employment there and prior consent from the primary employer. This prevents doctors from easily dividing time among multiple hospitals for just a few hours a week per facility.

Exceptions for Emergencies and Specialized Care

The draft does not entirely ban additional work. Restrictions do not apply to emergency services rendered during medical duty. The NFZ may also temporarily allow exemptions when specific fields face specialist shortages, require emergency coverage, or demand highly specialized services.

Eliminating Intermediaries in Medical Employment

The Ministry intends to eliminate situations where doctors provide services to hospitals via external entities, such as companies or cooperatives. New regulations require individuals providing NFZ-financed services to contract directly with the facility where they treat patients.

Detailed Contract Requirements and Penalties

Contracts for NFZ-financed services must precisely specify the type and number of tasks, gross hourly rates, working hours, and schedules for non-employment contracts. Facility managers will bear responsibility for violations and face potential fines.

Under transitional provisions, non-compliant medical contracts will expire by operation of law on December 31, 2026, giving hospitals and doctors time to adjust.

The draft is currently in the legislative process, with adoption by the Council of Ministers planned for the third quarter of 2026.