Healthcare spending has historically been comparatively low, although it is now rising. Despite recent improvements, health outcomes have been poor. Any additional spending should focus on better treatment and more prevention and be linked to efficiency gains. A sustainable framework of long-term care for an ageing population is needed.
Despite significant improvements in health outcomes over the past two decades, life expectancy is still among the lowest in the OECD (Figure 2). Men live shorter than women, while the number of healthy life years lags behind most OECD countries. More than half of all deaths are due to diseases of the circulatory system and cancer. Healthcare services are widely available, but healthcare costs for patients are not fully covered by the public system, which puts poorer households at risk. Public spending on healthcare has been rising and is planned to reach 7% of GDP in 2027, up from an estimated 5.8% in 2023.
Efficiency in the healthcare sector can be improved by strengthening prevention and care coordination through making more use of incentives within primary care. A shift towards integrated care is under way, but many primary care practices experience difficulties in finding specialist clinics to cooperate with, while incentives for better performance are too low. Despite higher spending, the removal of limits on visits to specialists has not shortened waiting times.
The hospital system is large, complex and poorly coordinated. The number of hospital beds is relatively high. Hospitals are persistently indebted and management quality is variable. Rationalising the system while ensuring that services reflect adequately regional health needs would reduce costs and improve outcomes. Executive education and training and higher accountability for hospital performance could raise the overall managerial quality. Further investment is also needed.
Poland has experienced a persistent shortage of health workers due to an insufficient number of medical and nursing graduates, an ageing workforce, and migration. This has contributed to long waiting times and reduced access to healthcare. Following recent increases, salaries have now become competitive, but working conditions need to be improved. Staff shortages are hampering access to healthcare, particularly in rural areas. The authorities should continue to raise the number of training places for nurses and develop a comprehensive workforce strategy.
Preventable mortality is relatively high. Low participation in cancer screening should be raised to increase chances of successful treatment. More emphasis on prevention can reduce behavioural health risks and reduce healthcare costs. Excise duties on tobacco and alcohol should be raised further while opening hours and the number of shops selling alcohol should be restricted.
Currently, most long-term care is provided informally by households. An expansion of residential care and formal home-based care, which can improve wellbeing and increase the participation of carers in the formal labour market, is needed. This requires development of the care sector and an approach to funding based on needs and linked to both income and wealth.