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Changes in
Economy and Healthcare Accompany Poland's Accession to the European Union
The European Union (EU) is in a
state of flux following the recent accession of several Central and Eastern
European countries. Their membership has further complicated the already complex
economic, social and cultural dynamics at work within the EU. With a population
of over 38 million, around 40 cities with more than 100,000 inhabitants and an
overall population growth rate of about 0.02 per cent, Poland (which joined the
EU in May 2004), is among the 'new' member states set to play a decisive role in
shaping the future of the EU.
In the sphere of international
trade, the main export partners for Poland are Germany, Italy, France, the
United Kingdom and the Netherlands. The import pattern, on the other hand, sees
some changes with Russia and China emerging as major players in addition to
Germany, Italy and France. Seen in the context of the medical sector, this is in
keeping with the phenomenon of cheaper but good quality medical disposables from
Asia and other Eastern European countries entering potential EU countries and,
on their accession, using them as an entry point to access the rest of Europe.
Since its entry into the EU, all medical devices sold in Poland need to bear the
CE mark. The registration of medical devices in Poland comes under the
jurisdiction of the medical devices section of the Bureau of Drug and Medical
Devices Registration in Warsaw.
The history of healthcare in
Poland is similar to many other countries in central and eastern Europe. The
first state healthcare system was put into place in the late 1940s. Democracy
was expected to trigger change in the Polish healthcare structure but real
reforms took effect only in 1999. This was in the form of separation of the
caregivers from the receivers in terms of payments while, at the same time,
maintaining freedom of access and a system of no payments at the point of
delivery. These reforms which revolutionised the way health services were
financed caused serious disruptions. It is estimated that one in twenty
hospitals in Poland were closed between 1998 and 2001. Efforts were subsequently
undertaken to progressively resolve these issues.
The Ministry of Health controls
the health system. This system has traditionally been centralised in its
approach, although constant efforts have been made to decentralise authority and
promote efficiency. The healthcare market as estimated by the Ministry of
Health, was 6.3 per cent of gross domestic product (GDP) in 2004. The total
market for corporate healthcare services was estimated at approximately US USD
150 million. This consisted of approximately USD 90 million dedicated to prepaid
benefits and the remaining USD 60 million representing statutory occupational
health checks.
Among the key issues currently
affecting the Polish healthcare system include the relatively small proportion
of GDP dedicated to healthcare and the lopsided allocation of resources. The
payment pattern in some cases also tends to be irregular.
At the infrastructure level,
inadequacies are reflected mainly in the lack of efficient healthcare delivery.
Local needs are not addressed effectively and primary care services as well as
referrals are poor. On the technology and supplies front, Polish care givers see
a need for better technology, newer equipment and wider drug availability.
Most governmental reform has been
targeted at supporting private contributions (currently accounting for about 35
per cent of the market) in order to implement a system of structural payments
that would include insurance premiums and employee benefit schemes. The Polish
Senate has recently voted for amendments to the law on health services sponsored
from public funds. Great interest has also been evinced in foreign investments
and in promoting collaborative endeavours in the Polish pharmaceutical and
biotechnology market.
The year 2004 saw the Polish
healthcare system suffer from unresolved issues related to the National Health
Fund Act. A shortage of resources, lack of service improvements, resultant high
levels of public dissatisfaction as well as strikes by medical personnel dotted
the rather tumultuous Polish healthcare landscape.
On a more positive note,
treatment patterns in Poland have been beneficially impacted by EU accession.
For instance, there is greater freedom to travel within the EU as well as
improved access to overseas treatment.
Poland is likely to experience
steady economic growth in 2005. Fund transfers from the EU could generate
additional capital flows into the country. This is supported by the fact that
the growth of foreign direct investment was USD 7.9 billion in 2004. This marked
an increase of 23 per cent when compared with 2003 and it also represented the
highest increase in the last four years.
The unemployment rate in Poland
is relatively high at around 18 per cent. But this is expected to decrease in
2005 due to investments in the economy. Amendments related to business
regulations in the Special Economic Zones (SEZ) in March 2005 have resulted in
permission to conduct services in the area of information technology, research
and development, accounting, technical research and analysis and call centres.
In spite of price increases, some
border control concerns as well as a few other teething troubles; Poland is
optimistic about its future as part of the EU. Boosts to agriculture, easier
travel, better trade conditions, improved access to the European market,
opportunities for training and greater financial support are some of the most
visible advantages of the country's membership of the EU.
In the latter half of 2005, the
focus will be on the parliamentary elections scheduled to be held in October.
Expected to change the governing coalition, the elections promise to bring more
change to Poland's constantly evolving landscape. What will remain unchanged,
however, will be Poland's ever strengthening presence within the EU.
( For more information, visit
http://www.frost.com.)
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