The Ministry of Health wants to enable the collection of PESEL-linked data on doctors' remuneration to have more complete knowledge of how much they earn. According to the ministry, this will help shape the wage policy. Experts point out the risk of misuse of this information.
Deputy Minister of Health Katarzyna Kęcka announced in an interview with PAP that next week the Ministry of Health will send a request to include in the agenda of the Standing Committee of the Council of Ministers a solution that will enable the collection of information on the remuneration of doctors assigned to the PESEL number and the number of the license to practice the profession. Kęcka emphasized that the data will be the basis for possible solutions and mechanisms for shaping remuneration. – Medics can work in several entities, and we want to know what earnings are like – she said.
The salaries of doctors in public health care vary greatly – from several thousand zlotys for interns and full-time doctors without specialization to over PLN 100,000. PLN per month for some specialists working under contracts. The latter may be based on settlements for procedures performed.
Remuneration in health care is financed in the valuation of services, and the Agency for Health Technology Assessment and Tariff is responsible for the valuation. This agency annually collects data on the remuneration of people employed in medical entities that have contracts with the National Health Fund. According to AOTMiT data from September 2024, the median specialist contract is approx. PLN 24.6 thousand. PLN, although the highest 1 percent reaches 100-300 thousand PLN, and the actual income is difficult to estimate due to the lack of working time records and the possibility of combining several contracts. AOTMiT is currently unable to assign contracts to one person. It cannot also process identifying data in the form of PESEL and the number of the right to practice a profession. This means that it is not possible to determine the total amount of remuneration for a specific person.
Attorney, Ph.D. Radosław Tymiński told PAP that he does not see a justified purpose for processing data on doctors' contracts in connection with the PESEL number and the right to practice the profession. According to him, the challenge is rather the discrepancies in the amount of wages and the possibility of shaping them almost freely.
– The problem is not how much someone earns. This is a matter of a system that allows a doctor to earn earnings depending on the number of procedures performed. Contracts can be constructed in such a way that one doctor will receive PLN 10,000 for the same procedures. PLN, and the second one PLN 200,000. zloty. The hospital receives money for procedures performed, so the director is willing to pay a lot to a doctor who is authorized to perform them, the source told PAP. In his opinion, such a system may lead to patients not receiving the procedure that is best for them, but the most profitable for the doctor.
According to Tymiński, available tools currently allow the Ministry of Health to collect data from medical facilities and determine the remuneration of doctors in a specific specialization, including collecting data on contracts. At the same time, the lawyer expressed concern that anonymization of data may not sufficiently protect against the disclosure of data about a specific doctor's earnings.
In turn, according to Dr. Jerzy Gryglewicz from the Institute of Health Care Management at Lazarski University in Warsaw, data on contracts and agreements of doctors may be an argument for the Ministry of Health during talks on regulating remuneration and shaping tariffs. Especially since over 60 percent the costs of benefits financed by the National Health Fund are salaries. – The increase in the cost of salaries affects the profitability of benefits, which translates into the profitability of facilities – Gryglewicz noted.
Data on doctors' earnings, according to the expert, are also needed to shape the map of health needs. They allow us to estimate which medical specializations should be preferred by the Ministry of Health in the long run.
– Doctors who are missing on the labor market have the highest salaries – noted Gryglewicz. He pointed out that 10-15 years ago, pediatricians and internists earned relatively little. – Since the number of doctors in these specializations has decreased in recent years, hospital directors must offer them attractive hourly rates to maintain the functioning of the hospital – said Gryglewicz.
According to the expert, aggregating data on agreements and contracts in connection with the PESEL number and the number of the license to practice the medical profession would be justified provided that the data does not allow the identification of a specific doctor. Moreover, salary data must be anonymized, and the Ministry of Health should justify in detail the purpose of collecting it.
In an interview with PAP, member of the presidium of the Supreme Medical Council, Damian Patecki, recalled the disclosure of medical data of one of the doctors by the then Minister of Health, Adam Niedzielski. In his opinion, this shows that they are not properly protected. – I am sure that doctors' personal data will be leaked – he said, commenting on the plans of the Ministry of Health.
In 2023, Adam Niedzielski on Twitter (currently platform In September last year, the District Court in Warsaw upheld a three-month prison sentence suspended for two years for the former Minister of Health, who was accused by the prosecutor of exceeding his powers in connection with the disclosure of official secrets, i.e. sensitive data of a doctor. (PAP)
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