Health care

Poland

Country Report: Health care Last updated: 26/05/22

Author

Independent

The right to healthcare is a constitutional right, applicable to third-country nationals as well. Recognised refugees and beneficiaries of subsidiary protection are considered “insurance holders’ under the Law on Healthcare Services financed from public funds and are thus entitled to exactly the same services as Poles under the condition of having a valid health insurance.[1] It means that in practice free health care is conditional on the payment of health care insurance with the National Health Fund (NFZ). Refugees and subsidiary protection holders, within their 12-month IPI, are obliged to register within regional job centre and are granted health insurance. After the IPI is completed, the obligation to pay insurance lies with: the employer (if a refugee has a work contract), a regional job centre of social assistance centre (if they are registered as unemployed) or the refugees themselves if they wish to cover the costs of insurance.[2] The required documentation is very hard to obtain and there are long administrative delays and waiting periods in obtaining entitlement to health care in Poland, according to the report from 2019.[3]

Importantly, in Poland, all children under 18 years old are entitled to free health care, even if they are not insured and the cost of their treatment is covered by the State Treasury. Children under 19 years old who attend school, regardless of their migration status, are covered by preventive healthcare which includes medical and dental examinations, rehabilitation programmes, health awareness education and health emergency education provided by school or district nurses.[4]

The health insurance with the NFZ covers all guaranteed health care services specified in the lists of the Ministry of Health. They include both basic and specialist medical services, vaccinations, diagnostic testing (laboratory or other), rehabilitation, hospital care and medical rescue services, emergency ambulance services and medical transport. The NFZ, however, does not cover some dentistry procedures, costs of purchasing medicines, auxiliary products or orthopaedic equipment.[5] Notably, nursing care for elderly persons is not provided in Poland.[6]

Although these provisions were in place for years, there are still cases where they are put in question. In 2021 SIP reported a case of a woman granted subsidiary protection 10 years earlier, who was charged with the costs of perinatal care provided in the hospital when she was delivering her child, on the basis of a decision of the President of the NFZ. The reasons of the decision mentioned that at that time the woman had not had social insurance. As a result of a complaint submitted by the woman, assisted by the NGO lawyer, the authority annulled its own decision admitting that the woman had a right to cost-free perinatal care.[7]

The main issue with regard to access to healthcare are linguistic and cultural barriers. Access to interpretation in the health care system is not available at all.[8] Other challenges are similar to the challenge Polish nationals are facing as well: long waiting time to see a specialist, costly private medical services and expensive medicines. The beneficiaries’ access to health care is jeopardised by difficulties in accessing legal forms of employment, which guarantee free health care.[9] That is why in 2020, when due to pandemic beneficiaries were left without work, in many cases the situation was critical – NGOs organized online fundraising for food or medical treatments.[10]

According to a report from 2020, the barriers in accessing healthcare were linguistic ones and linked with the stereotypical perception of persons coming from a specific part of the globe or belonging to a given ethnic or religious group. Similar to citizens of Poland, persons with international protection who cannot wait to see a specialist and have an adequate funding use the services of the private medical sector. One of the clear gaps in the medical services is the specialized treatment for victims of torture or traumatized refugees. There is a clear lack of the qualified psychologists and therapists specializing in treating trauma, in particular in an intercultural context.[11]

The COVID vaccination in Poland is voluntary and free of charge. Since 10 May 2021, everyone could register for the vaccination, including non-Polish citizens, regardless of their legal status. According to information from the Ministry of Health, in the case of migrants, a referral for vaccination could be issued on the basis of an ID and not the national identification number (PESEL).

 

 

 

[1] Article 3(1)(2) Law of 27 August 2004 on healthcare services financed from public funds.

[2] M. Szczepanik, Right to healthcare and access to medical services for asylum seekers and beneficiaries of international protection in Poland, May 2017, available at: http://bit.ly/2CxXokd.

[3] Alexander Wolffhardt, Carmine Conte, Thomas Huddleston, The European benchmark for refugee integration: A comparative analysis of the National Integration Evaluation Mechanism in 14 EU countries, 2019, available at: https://bit.ly/2SlshUh, 123.

[4] Article 27(1) and (3) Law on healthcare services financed from public funds.

[5] M. Szczepanik, Right to healthcare and access to medical services for asylum seekers and beneficiaries of international protection in Poland, May 2017, available at: http://bit.ly/2CxXokd.

[6] Alexander Wolffhardt, Carmine Conte, Thomas Huddleston, The European benchmark for refugee integration: A comparative analysis of the National Integration Evaluation Mechanism in 14 EU countries, 2019, available at: https://bit.ly/2SlshUh, 122.

[7] SIP, Opieka medyczna dla kobiet w okresie porodu i połogu oraz ich dzieci, 10 May 2021, https://bit.ly/3vuhsTH

[8] Alexander Wolffhardt, Carmine Conte, Thomas Huddleston, The European benchmark for refugee integration: A comparative analysis of the National Integration Evaluation Mechanism in 14 EU countries, 2019, available at: https://bit.ly/2SlshUh, 124. 

[9] Maryla Koss-Goryszewska ‘Służba zdrowia’ in A. Górska, M. Koss-Goryszewska, J. Kucharczyk (eds), W stronę krajowego machanizmu ewaluacji integracji: Diagnoza sytuacji beneficjentów ochrony międzynarodowej w Polsce (Instutut Spraw Publicznych 2019), 43.

[10] See e.g. information available on the website of Ocalenie NGO, about online fundraising for some particular medical treatments for beneficiaries: http://bit.ly/3s2qtP0.

[11] K. Sobczak-Szelc, M. Pachocka, K. Pędziwiatr, J. Szałańska, ‘Integration Policies, Practices and Responses. Poland – Country Report’, Multilevel Governance of Mass Migration in Europe and Beyond Project (#770564, Horizon2020), available at: http://bit.ly/3bfjTxL, 136.

Table of contents

  • Statistics
  • Overview of the legal framework
  • Overview of the main changes since the previous report update
  • Asylum Procedure
  • Reception Conditions
  • Detention of Asylum Seekers
  • Content of International Protection
  • ANNEX I – Transposition of the CEAS in national legislation