A visit to the doctor is possible without the queue, but not for all patients. We asked an expert, Rafał Janiszewski, the owner of a Consulting Office providing services in the field of he althcare organization for he althcare entities and patients' rights, who has the right to use he althcare services out of sequence.
Anna Tłustochowicz: Who is en titled to skip-the-line he althcare services and on what terms?
Rafał Janiszewski:At the beginning, we must say that there are queues for he althcare services, of course, and Poland is no exception in this respect. There are waiting lists in all countries.In some cases, the waiting time for the provision of he alth services is shorter, in others - longer , however, queues are a certain standard. In some countries there are also priority services and the catalog of these services is longer than in Poland, and in most systems there are privileged groups of patients who - regardless of the type of service - are treated differently in the queues.
To put it bluntly: there are en titlements to get benefits without the queue.
Yes. In general, patients from privileged groups should receive benefits on the same day they report to the he althcare facility.
Queuing means both the receipt of benefits and the pending registration.
I don't understand?
Well, when we come to the clinic, we first wait in the queue to be able to register at all, right? And patients who are particularly en titled to benefits have the right not to wait in this line as well.
Sure.
And above all, as we have already said, they are en titled to receive the benefit on the day of reporting:this person comes to the hospital or clinic today and has an appointment today.Theoretically! This is - one could say - an ideal situation. Because, of course, it may happen that it is not possible to provide this service today, because when the person came to the clinic, all patients "for today" have already been called and there is simply not enough time for them to receive the benefit. And it would be difficultget someone out of the waiting room, right? Therefore, the provision says that if it is impossible to provide the benefit on the date of notification, it must be providedno later than within 7 working days from the date of submission.
This has already been done for a week and a half.
But it is undoubtedly a great privilege with many months of queues.
It's true. So: who is en titled to use this privilege?
The queue does not have to be registeredsoldiers, military employees and veteranswho are to receive benefits related to injuries or diseases acquired while performing tasks outside the country.
Privileged aremeritorious, honorary blood and transplant donors, war and military invalids, as well as combatants . These persons are en titled to use the services out of sequence, upon presentation of an appropriate ID. Another privileged group ispregnant women.
From the very beginning of pregnancy?
Yes.
Even when it is invisible?
Yes, and therefore the regulator indicated that a pregnant woman receives a skip-the-line benefit on the basis of a medical certificate. The next group isminors, i.e. patients up to 18 years of agewith severe and irreversible disability or an incurable disease that arose in the prenatal, developmental or childbirth period.
These are the patients from the "for life" package, right?
That's right. Thesechildren are en titled to benefits out of sequence on the basis of a certificate from a GPor a he alth insurance doctor who has a second degree specialization, or who is a specialist in the field of obstetrics and gynecology, perinatology, neonatology or paediatrics. The next group - which appeared in the privileged catalog quite recently, in 2022 - areactivists of the anti-communist opposition.
Everyone?
Everyone who has an ID. The list of privileged persons is closed by those repressed for political reasons.
It is worth adding that all these people have the right not only to receive he althcare services without queuing, but alsoto be served out of sequence in pharmacies .
The list of eligible persons is quite extensive.
And we haven't told you yet thatevery patient - even those who do not have such special rights - has the right to receive benefits out of sequence in a life-threatening condition!I often meetwith comments that this is a dead law, because someone was in a life-threatening condition, and yet waited for the emergency department.
What do you say then?
That, first of all, not all people reporting to the HED are in a life-threatening condition. That is why the local personnel makes the so-calledtriage, which meanspriorities. And sometimes we actually wait for the service to be provided, even when we are in a life-threatening condition, because medics prioritize who needs to be de alt with in the first place. However, I would like to point out that the very fact that we have been admitted to the HED is the provision of a service! We are waiting for the next steps, it is true, but they have started, so it does not violate the obligation to provide the patient in a life-threatening condition.
And what exactly does a life-threatening state mean?
Of course, a situation where we have a disturbance in some of the basic life activities, such as circulation or breathing, but also if the disease or symptom with which we agree to this ED, may lead to disturbance of these activities in a short time. High fever, runny nose and abdominal pain usually do not necessarily have to be life-threatening, but people report these diseases to the Emergency Department and thus involve local staff who are required to verify each patient. Therefore, the service time for those who are actually in a life-threatening condition is often delayed.
I really urge you to think seriously each time before engaging the resources of hospital emergency departments! Remember that we have at least a night and holiday help.
We also talked about this. Finally, please tell me whether - to your knowledge - people from privileged groups actually receive benefits out of sequence?
Generally, this system works, although the number of patients in the facilities is certainly very large and it is often difficult for a medical entity to organize the provision of services beyond the sequence of services for privileged groups. Often, there are many such eligible patients - so as to ensure a smooth provision of current services to those who do not have these privileges.However, what often hurts me and what is sad for me are situations when I see patients from privileged groups, but waiting in the queue for registration.Often they do not have dare or feel uncomfortable with others waiting at the counter to say that they have a disabled child or are a veteran, and therefore humbly wait. I believe counseling offices shouldcreate separate windows that would interrupt current work when a privileged person approached, and where privacy conditions would also be provided for these patients, so that other waiting people would not necessarily hear that they belonged to a privileged group for one reason or another.
Expert
Rafał Janiszewski, owner of the Advisory Office providing services in the field of he althcare organization to he althcare entities
Speaker, organizer of many trainings and conferences on he alth protection and patient rights. In the years 1998-1999 an employee of the Office of the Government Plenipotentiary for the Implementation of the General He alth Insurance. Author of over 20 books on he althcare organization and he alth care financing standards. In 2005-2007, he was an expert of the Presidium of the Parliamentary He alth Committee, as an advisor on he alth services. Co-author of the general study as part of the Pharmaceutical Pricing and Reimbursement project for the European He alth Commission.
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