The regulation in question was issued by the Minister of Health a week ago. It concerns restrictions on the work of doctors and nurses dealing with patients infected, suspected of being infected, with coronavirus. In it, the minister orders that the directors of hospitals should compile a list of all medical workers who have direct contact with such patients. Employees on the list may not participate in the treatment of any other patients, unless it is a matter of advice over the telephone.
Hospital directors had to notify all employees on the "viral" list that they were not allowed to work anywhere else. They should have given the date until when the restriction was in force, but because it was impossible, the prohibition would remain until further notice, i.e. until the country's epidemic has ended. Nurses, doctors and other health care professionals will be able to return to work in other places two weeks after this time, unless they are released from work in a hospital or infectious ward. In response to the ordinance, some doctors are already considering it "They have not yet resigned from work, but have said they will." Among others, gynecologists are particularly susceptible to such thinking, since private practice is often their main source of income - says the director of one of the hospitals turned into an infectious hospital for anonymity.
Doctors who announced their departure do so for the purpose of being removed from the list of employees forbidden to work in other hospitals or from treating other patients. Such a list must be forwarded to the voivode and the National Health Fund as soon as possible. The list must contain all the data: next to the name and surname, PESEL number and the right to practice the profession. It will be updated once a month, which means that those who are now on the list, even if they quit their job at the infectious ward, for the next few weeks may have a problem finding work elsewhere.
However, there is also a potential way out: "in justified cases" the director of the NFZ department may, at the request of the hospital director, grant permission for the medical professional to work outside the hospital or infectious department. This has to be communicated to the voivode.
Not a word about financial compensation
The directors of hospitals and clinics, which are the second or third place of work of doctors and nurses dealing with coronavirus patients, are to grant them unpaid leave. The regulation is silent on compensation for lost earnings. - This is not in the regulation, because it will be an order issued by the minister to the head of the National Health Fund - explains Wojciech Andrusiewicz, spokesman for the Ministry of Health. However, this order is not the same as a provision in the Regulation, which has the rank of a binding legal provision.
- Lack of provision on compensation for lost earnings in the regulation is a flaw in this document. It undermines the ministry's credibility. More important, however, is the fact that through this regulation the minister admitted that a doctor should work in one place and earn PLN 20 thousand there. - said Krzysztof Bukiel, head of the Polish National Trade Union of Doctors.
The Supreme Medical Council was critical of the document. - This limits the access to a doctor for patients, which, especially during an epidemic, is not something that the Minister of Health, who is also a doctor, should be pushing for - says Andrzej Matyja, president of the Council. The problem is not only the limitation of patients' access to treatment, but also "far-reaching restrictions on civil liberties, which can only be imposed during the state of emergency, which the government has not officially announced." In addition, a doctor or nurse cannot appeal against a decision of a hospital director regarding being restricted to work in one place. According to the head of the Council, the ministry's claims that the regulation will not affect the activities of micro, small and medium-sized enterprises are also incorrect. It will, because doctors banned from working outside the hospital or infectious ward will not earn in their practices. Hospitals and clinics where they earned extra money will not earn. There will be chaos.
- During an epidemic, patients also suffer from diseases other than COVID-19 and also die because of them. Meanwhile, access to treatment weakened by the epidemic will worsen even more, "notes Matyja.
He addressed the Ombudsman last week.
AIDS, hepatitis, Lyme disease - these diseases cannot officially be treated during the epidemic
The restriction on access to treatment, however, lies not only in the fact that doctors from infectious hospitals cannot work outside them, but also in the fact that infectious wards cannot treat anyone who does not have coronavirus. These are people with AIDS, viral hepatitis (B or C), Lyme disease and all other infectious diseases that require long-term treatment, in many cases for the rest of their lives.
- It's a dangerous ban. These patients also require hospitalization, are given drugs as part of treatment, and this requires conducting the tests required by the National Health Fund. Should we send them back because of the virus? This is absurd. We do something else. We write to everyone that we suspect those patients have SARS-CoV-2 infection and we are ordering a test. We lie, but for the patient’s sake. It is not the first time that we have to try to bypass the rules, because someone has issued a stupid regulation - we hear in one of the infectious wards.
The Ministry of Health claims, however, that the provision is correct. - we have no signals from voivodes about possible dismissals due to a ban on working elsewhere. Instead, we have positive signals from some of the staff, because such a ban reduces the risk of spreading infections - says Wojciech Andrusiewicz.
The infectious diseases doctors disagree with him. - This regulation means stigmatization of doctors and all personnel of infectious wards and hospitals. It will be even harder for people who are willing to work - believes prof. Robert Flisiak, president of the Polish Society of Epidemiologists and Infectious Diseases Doctors. As head of the Infectious Diseases Clinic at the University Hospital in Bialystok, he has already applied to the NFZ for lifting the ban on doctors from his institution so that they can treat patients suffering from other diseases than just coronavirus.
The regulation was also criticized immediately after its entry into force by Andrzej Sośnierz, MP of the Agreement, former president of the National Health Fund. - This is not a well thought-out solution and will introduce more harm than good. We don't have enough doctors in the system. In addition, if we limit their work opportunities, the system will fall apart soon. We need to provide doctors with all protection measures and universal access to tests, and not limit them so much - he said.
Doctor infects more than a hospital cleaner?
Meanwhile, the Council of Ministers issued another document that outraged the doctors. It is a regulation that allows people working abroad to be exempt from quarantine. From May 4, all who cross the border "as part of their professional, business or paid activities in the Republic of Poland or in a neighboring country" are exempt from it. Exemption from quarantine, however, does not apply to persons in the medical profession, i.e. also doctors and nurses. "It is discrimination," says the president of the National Council of Doctors. - A cleaner working in a Czech hospital can also spread a virus. I don't understand why doctors and nurses are treated differently. This is a violation of the constitution. It is outrageous that in the eyes of the authorities we do not deserve equal treatment - says Dr. Justyna Krowicka, an ophthalmologist from Racibórz, who works at the Gemini clinic in Ostrava.
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