Can you imagine a system in Poland where hospitals would not have to go into debt?
Anna Łukasik, Director of the University Clinical Center of the Medical University of Warsaw: Yes, with the support of the Ministry of Health and the state in general, which would provide financial instruments that would allow restructuring. Everyone knows that most facilities are in debt and those that financially manage are a fraction of a percent. There is a lack of liquidity, after all, everyone has to pay for heating or electricity, drug supplies. So what do they do? They borrow, but this is difficult, because everyone demands a loan guarantee from the founding body. So we support ourselves with loans from financial institutions other than banks, but these institutions lend to hospitals at a higher interest rate than the government's Bank Gospodarki Krajowej. With BGK, on the other hand, the hospital's founding body must guarantee the loan, but often has nothing with which to do so. Well, unless with its assets. We managed to get a loan once, because the Rector of the Medical University of Warsaw supported us with such a guarantee. However, it was not an amount sufficient for restructuring. A second amount was needed, but the surety was "no longer enough".
Interest is killing hospital finances. At UCC MUW last year we spent PLN 108 million on interest on loans alone, and we could have spent half as much if all loans had such a privileged interest rate as those at BGK. Hospitals or institutes that are subordinate to the health minister are not able to take a loan from BGK at all, because the minister has no legal ability to guarantee it. District hospitals, on the other hand, can be supported by local government bodies. They, however, have much lower contracts than teaching hospitals. Too little revenue means much less opportunity for restructuring. This is a systemic problem: we have a lot of small hospitals with contracts in the range of 50-60 million. I've managed such hospitals, so I know what I'm talking about.
You can read the full interview in the pages of, among others, Rynek Zdrowia (link)