Poland. National Social Report 2013/2014

Transcription

1 Poland National Social Report 2013/2014 Warsaw 2014

2 Table of contents Introduction... 3 Socio-economic situation of Poland in Activities in the area of social inclusion and social investment... 7 Activities towards high-quality healthcare and long-term care Activities to support the young unemployed

3 Introduction On June 17, 2011 The Employment, Social Policy, Health and Consumer Protection Council (EPSCO) endorsed the opinion of the Social Protection Committee (SPC) on "Reinvigorating the Social Open Method of Coordination (OMC) [10405/11] 1, under which since 2012 Member States submit information on activities in the area of social protection. It has been decided that every two years the countries will provide more comprehensive information within the framework of National Social Report (NSR), and in years when there will be no NSRs they shall account the taken actions in Strategic Social Report (SSR). Both documents (NSR and SSR) are presumed to be complementary in relation to the National Reform Programme (NRP) and the Council's Recommendations (CSR) and present actions undertaken by Poland in three areas: 1) social integration; 2) pensions; 3) health. In this way, the NRP and NSR/SSR represent all activities involving the areas of social OMC consisting of: the fight against poverty and social exclusion, adequate and sustainable pension schemes, as well as accessible and sustainable healthcare systems and long-term care. NSR 2013/2014 has been extended further with information on support measures for the unemployed up to 30 years of age. National Social Report is submitted to the SPC President and the Director-General of the Directorate- General for Employment, Social Affairs and Social Inclusion (DG EMPL). NSR is used to prepare (by SPC) information on social situation in Europe, submitted to the EPSCO Council, or a review of progress in the attainment of objectives of social OMC. 1 EPSCO 3099th meeting, June 17, 2011 [11574/11] 3

4 Socio-economic situation of Poland in 2013 Gross Domestic Product (GDP) in Poland grew by 1.6% in Although its growth rate was lower than in previous years (2.0% in 2012, 4.5% in 2011 and 3.9% in 2010) when compared to the situation in the EU, the increase of this indicator was well above the average of 0.1%. Lower economic growth compared to previous years, is largely the effect of persistent poor economic activity in other EU countries, especially those belonging to the euro zone, as well as low (in the 1st half of 2013) domestic demand. Certain slowdown of economic growth in Poland in 2013 resulted in stagnation in employment growth. Therefore, the pace of employment growth was still low. The number of employers and self-employed persons also declined. In terms of sectors, the increase in the number of workers in services sector and in the widely understood industry sector (including industry and construction) couldn't offset the decrease in the number of workers in agricultural sector. As a result, unemployment rate has increased slightly from 10.1% in 2012 to 10.3% in 2013 (10.8% EU average). The stagnation in the number of employed was accompanied by a limited upward pressure on wages. At the same time, according to the latest European Economic Forecasts (spring 2014) it is expected that the Polish situation in 2014 will improve - GDP growth will reach 3.2%, unemployment rate will fall to 9.9%, inflation will be low at 1.1% whereas employment will grow. These factors should lead to growth of real disposable income of households. At the same time, in 2014 spring forecast the Commission points out that the rate of household savings 2 will rise from 6.1% in 2013 to 6.2% in The total number of people at risk of poverty or social exclusion in Poland in 2013 was 9.75 million people (25.8%) i.e. about 1.7 million less than in 2008 (EU-SILC) 3. From 2008 to 2011, and in 2013 the factor having the strongest influence on the decline in synthetic poverty rate 4 was the decline in the percentage of people affected by severe material deprivation. In 2012, the decline in synthetic indicator was also influenced by reduction in number of people at risk of relative poverty. Despite the systematic decline, the risk of poverty and social exclusion in Poland is still a bit higher than the average in the UE 28 (24, 8% in 2012). National research on household budgets from 2012 confirms the above trends observed in EU-SILC study. Relative poverty risk indicator 5 in 2013 amounted to 16.2% and since shows a downward trend (17.4% in 2010, 16.9% in 2011). The percentage of people at risk of extreme poverty has increased slightly from 5.8% in 2010 to 7.4% in In Poland, takes place a systematic improvement in the area of household income. This has a positive impact on the quality of life. In 2003, the declared average monthly disposable income 7 per person in the family was PLN 712 whereas the expenditure was PLN 678 per person in the family (expenditure accounted for 95.2% of disposable income); in 2013, disposable income has risen to the level of PLN 1299 whereas expenditure to PLN 1061 EUR (expenditure accounted for 82% of disposable income). In similar to the previous year - more than half of the households when asked the question on subjective assessment of the financial situation indicate that their situation is "average", while the 2 Calculated as the sum of the savings divided by gross disposable income. 3 The reference year for the Europe 2020 strategy in case of aim of reduction of the risk of poverty or social exclusion. 4 A synthetic poverty indicator includes persons at risk of relative poverty, people affected by deepened material deprivation and people living in households characterised with very low work intensity. 5 Calculated on the basis of 50% of the average equivalent expenditures. 6 Limit year of weights verification allowing full comparability of results. 7 Gross income less social security premiums and income tax. 4

5 quarter of respondents sees it as good or very good. 20% of households indicate that their financial situation is bad or very bad. However, questions about the overall assessment of life, asked in the study on quality of life and social cohesion carried out in 2011 by the Central Statistical Office (GUS), as well as in the Social Diagnosis 2013 study of suggest that only 5-6% of the population of persons aged 16 years and over (or 18 years or more in the case of Social Diagnosis) declare that their life is bad/very bad. Therefore the assessment of the financial situation does not translate directly to the assessment of the quality of life. Together with the increase in income of the population, the share of expenditure to meet the basic needs of the households which include among others: food and house maintenance falls. Over the last decade the share of expenditure on food and non-alcoholic beverages in overall expenditure of households declined consistently up to the year 2009 (27.8% in 2003, 25.1% in 2009), whereas in the following years it remained at similar level i.e. at approx. 25%. While the share of expenditure on the house maintenance, and energy carriers decreased slightly between 2003 and 2007 (from 21% in 2003 to 18.4% in 2007), whereas in the years rose to approx. 21%. The difference between the shares of these expenditure groups amounted to 4 percentage points in 2013, and was more than two fold lower than in The most important long-term challenges for the social security scheme in Poland are resulting from the extending of average life expectancy, low fertility rate (1.26 in 2013) and still negative migration balance (it is estimated that outside Poland there are 2.1 million temporary migrants). The population of Poland will be ageing rapidly and its size will decrease. According to the most recent Eurostat demographic projections (March 2014) it is anticipated that the population in Poland will drop from 38.5 million in 2013 to 34,8 million people in At the same time, due to the low birth rate compared to the baby boom from the turn of the 1970s and 80s of the 20th century, the pressure on the social security scheme associated with the area of pensions and medical services will increase. By 2013 the proportion of working-age population (ages 18-59/64) accounted for 64%. This group consisted of approx million people. Eurostat projections indicate that the percentage of people in working age in 2050 (after taking into account the new retirement age, i.e for men and women) will amount to approx. 59%, and the people in the retirement age will constitute 28% of the total population against 18,2% observed today. In 1999, Poland introduced pension reform, which the social security scheme of defined benefit changed into a defined-premium social security scheme. This reform is being continued in the direction of the extension of the effective age of retirement and to improve employment opportunities for people in the 50+ age group. There are also actions undertaken to facilitate combining of family and professional responsibilities, better adapting support systems to changes in the labour market and changes in lifestyle models of people of child-bearing age. The prospects of these activities are indicated by the country development strategies adopted by Poland: Long-term National Development Strategy - Poland 2030, and medium-term National Development Strategy Social protection area belongs to the competence of a number of government departments: activities in the field of social integration are carried out by the Ministry of Labour and Social Policy (social assistance, family policy, politics towards the elderly), the Ministry of Infrastructure and Development (social housing), the Ministry of Administration and Digitisation (programme for the Roma community), 5

6 activities in the area of pensions are implemented by the Ministry of Labour and Social Policy (social security scheme) and the Ministry of Agriculture and Rural Development (social security of farmers), activities in the field of health largely belong to the Ministry of Health, although some solutions in the field of care services for single people or requiring 24-hour care because of age, illness or disability are carried out by the Ministry of Labour and Social Policy (within the framework of social assistance - social assistance homes, family homes of social assistance, care services, specialised care services). 6

7 Activities in the area of social inclusion and social investment From July 2013 to June 2014, Poland's actions have focused on the 4 priorities 8 : 1. increasing access to resources, rights and services to prevent and eliminate social exclusion, as well as to prevent all forms of discrimination, 2. supporting people entering the labour market, 3. investing in children, 4. solving the problem of homelessness and providing access to housing. Many of the activities undertaken within the framework of these priorities had already been presented in the National Reform Programme (NRP). Reports on implementation of recommendations of the Council (CSR) have been also presented to the relevant advisory councils. Presented in the NRP and in responses to CSR, activities included: implementation of the Government's Programme of Social Activity for the Elderly for the years (ASOS) (priority 1), the creation of the draft law amending the law on social assistance (priority 1), promotion of the equalization of opportunities for women and men on the labour market within the framework of the Human Capital Operational Programme aiming to support building of childcare institutions (measure 1.5) (priorities 2 and 3), change of the law on childcare up to the age of 3 and some other acts (dated May 10, 2013), implementation of the Departmental programme for the development of childcare up to the age of 3 - "TODDLER" (priorities 2 and 3), the amendment to the Labour Code introducing parental leave (priorities 1 and 2). Presented below are the other activities that have been presented within the framework of NRP, and CSR implementation reports. Social housing support programme (priority 4) The date of entry into force: January 13, 2007 The budget for the financing: The Act of December 8, 2006, on financial support for the creation of social housing, protected flats, night shelters and homes for the homeless. The budgetary grant for SF in 2012 PLN million. The budgetary grant for SF in PLN 90.0 million + resulting from the settlement of previously completed projects in the amount of PLN 6.2 million The budgetary grant for SF in the first half of PLN 40.0 million + resulting from the settlement of previously implemented projects in the amount of PLN 16.9 million. Social housing support programme started in 2007, was continued within the priority 4. It is a multiannual programme of support of local governments and non-profit organisations for improvement in the availability of social housing, protected flats, night shelters and homes for the homeless. Depending on the nature of the enterprise being implemented, investor may receive financial support from the Subsidy Fund (SF) up to a maximum of 30-50% of his costs. Eligible entities shall 8 Later parts of NRP include references to this list of priorities. 7

8 have the right to apply for support twice in a calendar year. The authority responsible for the implementation of the programme is the Ministry of Infrastructure and Development. Program supporting the return of homeless people to the society (priority 4) The date of entry into force : April 2010 The budget for the financing: the program is being implemented on the basis of article 23, para. 1, item 7a of the Act of March 12, 2004 on social assistance 2013 PLN 5.0 million, 2014 PLN 5.0 million Started in 2010 Programme supporting the return of homeless people to the society was continued. Within the programme, there is a contest held annually targeted at non-governmental organisations acting on behalf of homeless people who organise projects in the area of short-term, protective help, social integration and professional activation as well as prevention of homelessness. In addition, there was a nationwide goal implemented "Reduction of the scale of homelessness at railway stations and in their vicinity". In 2013, 41 bodies received financial support, 39 in Active Forms of Prevention Against Social Exclusion Programme (priority 1 and 4) The date of entry into force : January 1, 2011 The budget for the financing: November 9, the acceptance of the Programme rules by the Minister of Labour and Social Policy programme is being implemented on the basis of article 23 and article 25 and Act of March 12, 2004 on social assistance 2014 PLN 3.0 million The Programme of the Minister of Labour and Social Policy - Active Forms of Prevention Against Social Exclusion Programme is being implemented via four goals: Goal No. 1 Strengthening the trend towards the creation of local partnerships in the municipalities for implementation of the partner projects realising professional and social activation is realised through a contest called: "Municipal programmes for the social and professional activation for social housing. Goal No. 2 Strengthening cooperation between the social assistance centres, Poviat (county) labour offices and entities providing social - professional reintegration services and the entrepreneurs is realised through a contest called: "The social employment entity is a partner of social assistance centre and a Poviat employment office in the implementation of social contracts. Goal No. 3 The creation of a nationwide platform for cooperation and consultations between the Ministry of Labour and Social Policy, and a entities realising the tasks arising from the law on social employment - is being realised through the contest: "the Convention of Centres and Social Integration Clubs. Goal No. 4 The creation of a nationwide platform for presenting and promoting good practices of active forms of assistance is implemented through a contest: Active Forms of Assistance Fairs. 8

9 The Programme "Day room - Children - Work" to support the child and the family in the years (priority 1 and 3) The date of entry into force: from 2011 The budget for the financing: The Programme "Day room - Children - Work" to support the child and the family in the years was approved in 2010 by the Minister of Labour and Social Policy Each year to subsidise the tasks in the programme the Ministry of Labour and Social Policy designates the funds in the amount of PLN 0.8 million Within the programme primarily a support of social therapeutic nature is being organised (on the basis of daily support facilities day rooms, youth clubs, educational day centres) for children and youth, coming mainly from dysfunctional families with problems resulting from alcohol abuse. Programme offers also a support for the unemployed, including parents or guardians of children, as well as people under the care of social assistance services. Funding from the grant may be used for: equipping day rooms, youth clubs, educational day centres in order to enrich the educational/entertainment offer, e.g. computer hardware, games, sports equipment, musical instruments and other items necessary to organise the activities; organising summer/winter leisure time during the summer/winter holidays, including educational/leisure trips in the form of so-called "green schools" with the participation of parents and other family members of children benefiting from the activities; organising educational-cultural events for children and parents, including trips to museum, cinema, theatre or cultural-sports events; organising additional meals for children participating in the activities. In , the Minister of Labour and Social Policy co-funded 60 initiatives in this way. Programme for the Roma community (priority 1) The date of entry into force: January 1, 2004 The budget for the financing: Resolution of the Council of Ministers of August 19, 2003 on the establishment of a multiannual programme for the Roma community in Poland In a total of PLN 85.0 million from the special-purpose reserve, including PLN 10.0 million in 2013 Roma community in Poland includes 17 thousand people (Census 2011). Under priority 1 the programme for the Roma community started in 2004 was continued, including in the areas of education, civil society, labour market, health, living situation, security and crimes perpetrated on ethnic grounds, culture and preservation of Roma ethnicity, knowledge of the Roma community. About 600 projects were realised primarily in the areas of: education - school starter kit for pupils, funding for kindergartens, holiday trips of pupils, funding integrating day rooms, additional educational classes and compensatory classes for 9

10 students, training for teachers and assistants of Roma education, student insurance, scholarships; civil society free legal and administrative advice offices, training for leaders, broadcasts in the media on Roma; labour market - professional courses, subsidised job positions, vocational guidance; health the functioning of the public health nurse, preventive vaccinations, medical examination, preventive medicine; household situation - housing repairs; culture and preservation of Roma ethnicity, cultural festivals, exhibitions, publishing activity; knowledge about the Roma community, conferences, broadcasts in the media, publishing activity. The authority responsible for the implementation of the programme is the Ministry of Administration and Digitalisation. The continuation of the process of social integration of the Roma has found its expression in the draft of the social integration of Roma in Poland for Programme. This document was sent in July 2014 to the Standing Committee of the Council of Ministers for consideration. Its adoption is scheduled for 3rd quarter of this year. Integrative activities include 4 areas: education, housing, health and the labour market. In 2014, the minister responsible for religious and ethnic minorities has allocated the amount of PLN 4.4 million for activities in the field of education, as the primary tool for social integration and about PLN 1 million in the area of housing intended for the implementation of the investment. After the approval of the social integration of Roma in Poland for Programme this expenditure as well as implemented activities shall be included in the integration Programme. Nationwide Large Family Card (priority 3) The date of entry into force: June 16, 2014 The budget for the financing: Resolution N o 85 of the Council of Ministers of May 27, 2014 on the establishment of a Government-run program for large families N/A During the period covered by the NSR, the work on Nationwide Large Family Card was continued. The card is designed to provide large families with discounts for, e.g.: cultural, educational, recreational, and transport services. Currently 101 entities participate in the programme, providing large families with discounts (as of August 13, 2014). There is great interest in the programme among large families; within months since the launch of the programme approx. 235 thousand applications were submitted to issue a card. The authority responsible for the implementation of the programme is the Ministry of Labour and Social Policy. 10

11 Activities towards sustainable pension schemes Due to the horizontal nature of the area of pensions, the main activities have been presented in the National Reform Programme, while the National Social Report contains details of selected aspects. For this reason, this section has different layout than the other parts of the document. The Act reforming the capital part of the general pension scheme The date of entry into force: February 1, 2014 December 6, 2013 adoption of the Act by the Parliament; In December 2013 the Act reforming capital part of the general pension scheme was adopted. The main changes include: relocation of the part of the pension rights insured expressed in obligative commitments of the State Treasury from the open pension funds (OFE) to the Social Insurance Institution (ZUS); identification of the principles of pension payments from the funds collected in the OFE and the method of relocating of the pension rights from the OFE to ZUS; determining the premium transferred to OFE at 2.92% (2,8% in 2013); enabling insured persons to choose whether they want to continue to transfer part of the premium to the open pension funds (in regard to the future premiums); elimination of a minimum rate of return and the introduction of market rules for OFE investments; review of fees and remunerations in pension funds. In the it remains necessary to prepare the implementing acts to the aforementioned law and the implementation of other relevant tasks in the area of social security, i.e. amendment of the provisions of the law amending the law on cash social insurance benefits from the social insurance in case of sickness and maternity, aiming at - inter alia - rationalising the rules on the calculation of sickness benefits of people engaged in non-agricultural activities, and amending the provisions of the Act on the social security scheme and some other acts. In addition, as of January 1, 2013 a gradual extension and levelling of the retirement age for men and women has begun. Observed changes in this respect during the period of July June 2014 are resulting from the Act of May 11, 2012 introduced in 2012, on amending the Act on pensions and the disability pensions from the Social Security Fund and certain other laws. 11

12 Detailed information about the pension scheme: General Pension Scheme (under ZUS) - Current status: Taking early retirement: Retirement age: The premium period: The amount of pension benefits: Valorisation of benefits: In the period of no changes were introduced in terms of the right to early retirement. The provisions on partial pensions are in force. 9 As of January 2013, the statutory retirement age is growing at the rate of 3 months per year. This process will end in the case of men in 2020 and, in the case of women in 2040 Target level of the statutory retirement age for both sexes is 67 years. This process is a consequence of the statutory change of In the reformed pension scheme, the condition of appropriately long pension seniority does not apply. In 2013, the average amount of the newly granted pension benefit was PLN , i.e. about 8% more than in In the period of July June 2014 no changes were made or are planned in the system of valorisation of benefits. Pension scheme of farmers (under KRUS) - Current status: Taking early retirement: Retirement age: Early retirement in the social security scheme of farmers is an expiring benefit. The right to it have the insured farmers who meet the conditions for its awarding by the end of Limitation shall have effect from January 1, 2013 In the period no changes were made in terms of rights to early retirement. As of January 2013, the statutory retirement age is growing at the rate of 3 months per year. This process will end in the case of men in 2020 and, in the case of women in 2040 Target level of the statutory retirement age for both sexes is 67 years. This process is a consequence of the statutory change of 2012 coming into force as of January 1, 2013 In the social insurance scheme of farmers there is no gap in the level of benefits for men and women. A period of parenting during the running a household is the period subjected to insurance (with imposed premiums). As of September 1, 2013 an amendment of the Act entered into force, according to which for the period of 3 years of exercised personal care for the child under the age of 5 (or 6 year period in the case of a disabled child up to the age of 18 years of age) by the farmer, his or her spouse or 9 As of 2013, women aged minimum 62, with a minimum of 35 years of insurance seniority, and men aged minimum 65, with a minimum of 40 years of insurance seniority are entitled to partial retirement. The amount of the retirement pension is 50% of the amount of retirement pension from FUS calculated on the day of the determination of the rights to this partial retirement, i.e. for the age of 62 in case of women and 65 in case of men, and it will not be increased to the amount of the lowest pension. After reaching the age of entitlement to a full pension, the basis for calculation of its amount will be reduced by the amount paid partial retirement. The longer the period of collecting of partial retirement benefits, the greater reduction in provision of benefits will be in full retirement age. Partial retirement can be combined with income derived from work. 12

13 a household member, a pension scheme premium is financed from the State budget. The premium period: The amount of pension benefits: Valorisation of benefits: Statutory period of obligatory participation in pension / disability pension scheme, which entitles to receive a retirement pension, is 25 years. The actual period of participation in the scheme - according to estimates by the Ministry of Agriculture and Rural Development - is years for women and years for men. Has increased compared to 2012 from PLN to PLN in 2013 In the period of July June 2014 no changes were made or are planned in the system of valorisation of benefits. 13

14 Activities towards high-quality healthcare and long-term care Poland has taken a series of actions intended to ensure high quality healthcare. Some of them were reported in the National Reform Programme 2014/2015 or within the report on the implementation of the Recommendations of the Council: introduction of "Electronic Platform for Collection, Analysis and Sharing of digital resources on Medical Events", so called P1 system (area: provision of health services, section: e- services), implementation of programmes: o National Programme of Levelling of the Availability of Prevention and Treatment of Cardiovascular System Diseases POLKARD for , o National Cancer Eradication Programme for the period and o National Programme for the Development of Transplantation medicine for (area: provision of health services, sections: prevention of health, provided services). Introduction of changes (November 2013) in the Act of August 27, 2004 on healthcare benefits financed from public funds, which - when choosing benefits providers - will take into account the complexity of the benefits they offer. Presented below are the information on the complementary actions included in NRP under the Strategic actions to increase cost savings and effectiveness of spending on health prevention section, and actions that were not presented in the NRP and implementation reports (CSR). The draft law amending the law on healthcare benefits financed from public funds and certain other laws (area: increasing access to services and improving their selection by the patient, section: access to services) The date of entry into force: January 1, 2015 The budget for the financing: The project has been mentioned in the NRP. It includes changes in several areas of healthcare system, and contains solutions designed to improve the efficiency of the allocation of public resources in short and long term. The project provides for the introduction of, inter alia: regional maps of health needs, which will set priorities for contracting health benefits; regulation of the supply of health benefits 10 in the given area, to adjust development of medical infrastructure to the health needs; tarification of healthcare benefits. Work on the project began in the second half of 2013, in February 2014 draft was sent to the Standing Committee of the Council of Ministers, on August 12, 2014 the bill was signature by the President of the Republic of Poland. The change of the management system will not cause additional public expenditure. 10 Voivode would issue an opinion on advisability of investments healthcare entities in the area of inpatient treatment and outpatient specialist care; having favourable opinion by the Voivode by the given entity would constitute condition of signing healthcare contract by NFZ with a given entity within a given scope. 14

15 In addition, the project aims to improve the keeping of waiting lists for healthcare services, and to improve the availability of healthcare services among cancer patients. In particular, the project foresees: introduction of electronic waiting lists;weekly update of the waiting lists; elimination of multiple entries on waiting lists of various benefit providers; provision of priority medical benefits to cancer patients; introduction of oncology treatment card in order to improve the availability of data about the previous course of treatment of a patient. The bill was signed by the President of the Republic of Poland on August 12, 2014). The change of the management system will not result in an increase in public expenditure. The institution responsible for the implementation of the Act is the Ministry of Health. The draft law amending the law on the refund of medicines, foodstuffs of special nutritional use, as well as medicinal products and certain other laws (area: reduction of costs and sharing of costs, section: optimisation of expenditure on drugs). The date of entry into force: The budget for the financing: Work on the project began in the first half of 2013, in August 2013, the project was sent to the Standing Committee of the Council of Ministers. Currently project is still in the external consultations phase. It is anticipated that the project will enter into force in the 2nd half of State budget: - the costs of Integrated System for Monitoring of the Marketing of Medicinal Products in : PLN 4.4 million - the costs of Monitoring the Availability of the Marketing of Medicinal Products: PLN 20.5 million National Health Fund: - the costs of establishing new coordination teams for drug programs and verification committee: PLN 3.5 million within one year from the date when the bill come into force. In subsequent years forseen cost is about PLN million anually. The goal of this project, described in brief in the NRP, is to ensure better availability of drugs for patients, more effective monitoring of their availability and limiting opportunities to export them from the country in a situation of limited access to drugs for the citizens. In particular, the project foresees: further increase in the availability of medicines, foodstuffs of special nutritional use and medicinal products for the patient; enabling effective monitoring of the availability of medicines, foodstuffs of special nutritional use and medicinal products and limiting opportunities to export them from the territory of Poland in a situation of lack or limited access for the citizens; limitation of the scope of information submitted in applications for reduction of the official selling price, and shortening the period of validity of refund decision; 15

16 introduction of the possibility of making changes in refund decisions at the request of a party; the amendment of the provisions related to descriptions of drug programmes in a way to facilitate the incorporation of new drugs into these programmes; elimination of reported interpretative doubts as to the provisions of the refund Act. E-prescription (area: provision of health services, section: e-services) The date of entry into force: N/A N/A, E-prescription is currently the subject of a preliminary legislative work. The budget for the financing: The project is in the initial phase of the work. In this respect, the budget has not yet been precisely evaluated. Implementation of the e-prescription, to allow the issuance of prescriptions in the electronic form will aim at: improving the quality and readability of the information included in the prescription; elimination of partial prescription filling in terms of the number of medicinal products; providing doctors with reliable and complete information on medicinal products authorised in the country; allowing the doctor an access to previously issued prescriptions, thereby improving the quality and safety of applied therapy; providing the doctor and pharmacist with information about withdrawn batches of medicinal products; allowing the patient to manage access to the electronic prescriptions issued; enabling acceleration of the refund of prescriptions for refunded drugs and easier control of settlements transferred to the payer; enabling analysis concerning marketing of medicinal products available on prescription, regardless of the refund level (from 0% to 100%). It is assumed that the issuance of prescriptions in the electronic form will be carried out in two ways. The first relies on sharing adequate functionality in the Service Providers and Pharmacies Application (AUiA) constituting part of the P1 system with qualified medical workers. This solution will primarily be used by service providers, who do not have their own solutions adapted to cooperate with P1 system. Second solution is dedicated to those service providers who have adjusted their solutions to work with P1 system in the area of electronic prescriptions. It is assumed that this cooperation will be implemented using Web services. 16

17 An Integrated System for Monitoring of the Marketing of Medicinal Products (area: provision of health services, section: e-services) The date of entry into force: N/A N/A, project is currently the subject of a preliminary legislative work. The budget for the financing: The project is in the initial phase of the work. In this respect, the budget has not yet been precisely evaluated. The aim of the project to build an Integrated System for Monitoring of the Marketing of Medicinal Products is to support the public administration authorities, including the Minister responsible for health affairs, the Main Pharmaceutical Inspector, and the President of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products in the conduct of State's drug policy. In particular, implemented system shall: give the opportunity to analyse the amount of turnover of medicinal products, together with the structure of this turnover on the basis of the data received from pharmaceutical wholesalers and pharmacies; allow for the regular supervision over the quantity, location and availability of medicinal products in the country; prevent a market shortage of medicinal products and foodstuffs of special nutritional use and medicinal products covered by refund decision; detect and prevent unwanted phenomena, including, in particular, restrict the export of medicinal products from the territory of the Republic of Poland, in the absence of, or limited availability posing a threat to the health or life of the patients. In addition, within the framework of Human Capital Operational Programme sub-action, Raising the quality of management in healthcare, the following projects are implemented: Support for the accreditation process of healthcare and "Safe Hospital Safe Patient" (area: healthcare system management, section: changes in the overall management of the system) The date of entry into force: June 2008 Project Implementation Period: The budget for the financing: PLN 8.2 million - Support for the accreditation process of healthcare institutions PLN 8.0 million - Safe Hospital Safe Patient The aim of the projects is to raise the quality of management in healthcare by supporting the process of accreditation, and to increase the number of accredited hospitals. They were presented together as they are mutually complementary. The improvement in the efficiency of the functioning of today's health systems through the dissemination of quality accreditation system relies on the identification of issues that most affect 17

18 the level of benefits and safety of the patients. In these areas a measurable criteria for the evaluation of an institution of specific type of healthcare are being created, e.g. for hospitals, long-term care facilities, primary healthcare. Within the project "Support for the accreditation of healthcare process" in 2013, 42 healthcare units have obtained the accreditation of the Centre for Monitoring the Quality of Healthcare. In the first half of 2014, within the project 20 medicinal entities have been granted accreditation. In addition, since August 2013 the project called: "Safe Hospital Safe Patient" is being implemented which supports hospitals in preparations for accreditation procedures, mainly through consultancy and training support in the area of meeting requirements necessary to receive accreditation. Since the beginning of the project s implementation, study visits have taken place in 38 hospitals, training workshops on accreditation standards were carried out in 33 hospitals. The total number of persons covered by the training support amounted to 1261 people. Project: NFZ Academy (area: investing in healthcare system staff, section: professional development) The date of entry into force: 2011 Project implementation period: The budget for the financing: PLN 5.0 million The main objective of the project is to improve the quality of management in the healthcare system by improving the information policy conducted by the NFZ (National Health Fund) in relation to healthcare providers and patients through educational and information activities. So far under the project, classroom training was completed by representatives of medicinal entities. In addition almost people benefited from the individual e-learning training, while the portal was visited by over 800 thousand people. Classroom training and e-learning include subjects, such as: the rules for the provision of information about the healthcare benefits executed by the healthcare providers and patients rights, the rules for the functioning of the health system in Poland, the rules for contracting healthcare benefits in Poland, the rules for accounting and reporting on the implementation of medical services financed from public funds, the rules for the proper preparation of tenders under the competitions for provision of healthcare benefits financed from public funds, patient's rights. NFZ Academy project is being implemented in within the framework of the Human Capital Operational Programme. 18

19 Project: National training on the functioning of the healthcare system and the skills in the area of communication, collaboration and relationship building with the patient for doctors commencing their career" (area: investing in the national healthcare system staff, section: professional development). The date of the official decision Project implementation period: to The date of entry into force : 2012 (project is being implemented till June 2015) The budget for the financing : PLN 8,1 million Within the framework of the project: "National training on the functioning of the healthcare system and the skills in the area of communication, collaboration and relationship building with the patient for doctors commencing their career", a comprehensive training program was prepared (both classroom - including the possibility of consulting - as well as e-learning), which supplement the knowledge and skills of doctors in the field of interpersonal communication, and functioning of the healthcare system doctors commencing their career benefited from classroom training (ultimately people), whereas e-learning training was completed by 724 young doctors. 126 doctors benefited from expert consultations. 19

20 Activities to support the young unemployed General information: In Poland the number of population at the age of years is 1.3 million, and at the age of years 3.6 million 11. The number of secondary school graduates amounts to 500 thousand young people in total, of which in the school year 2012/2013: approx. 69 thousand are basic vocational schools graduates; approx. 253 thousand are general high school graduates; approx. 9 thousand are profiled high school graduates; approx. 127 thousand are technical school graduates; approx. 88 thousand are postsecondary school graduates. In 2013, the unemployment rate for the age group years amounted to 24.2%. In the same period the NEET indicator 12 for people aged years amounted to 12.2%, and was approx. 0.8% lower than the UE28 average. Activities: The main legal act under which help for the unemployed is being provided is the Act of April 20, 2004 on promotion of employment and labour market institutions (Journal of laws of item 674, as amended). The Act specifies, among other things forms of aid and so-called groups in the specific situation on the labour market. On May 27, 2014, its last amendment entered into force 13. The document will present solutions already in force and those introduced through the amendment. Unemployed persons up to 30 years of age 14 represent one of the groups identified as eligible for special assistance. Therefore, can benefit from a wide range of opportunities to support them on the labour market, and in view of their allocation to a group of the unemployed in the specific situation on the labour market, they are entitled to get a priority for participation in a special programme 15. In addition, for people up to 25 years of age, in a period of 4 months from the date of registration, Poviat employment office should present employment proposal, other gainful employment or a proposal to participate in the active labour market programme in order to increase the chances for finding employment 16. This solution represents implementation of Youth Guarantee initiative. In the case of the unemployed up to 30 years of age, particularly important are those services and labour market instruments that will enable them to acquire qualifications or professional experience, i.e. 11 As at December 31, GUS. 12 NEET (Not in Employment, Education and Training) persons not employed, not in education or in training. 13 The Act of March 14, 2014, amending the law on employment promotion and labour market institutions and certain other laws. 14 Prior to the amendment it concerned people up to 25 years of age. 15 Besides the unemployed up to 30 years of age, the group of the unemployed in the specific situation on the labour market also includes long-term unemployed (remaining in the Poviat employment office registry for a total period of over 12 months during the last 2 years), unemployed persons over 50 years of age, unemployed persons benefiting from social assistance benefits, unemployed persons with at least one child under 6 years of age, or at least one child with disabilities under the age of 18 and unemployed persons with disabilities. 16 In the earlier provisions it was 6 months. 20

21 internships, training, the professional preparation of adults, postgraduate study funding, funding of the costs of exams and costs to obtain a license, training loan, a scholarship for continuation of education. In addition, unemployed persons - including up to 30 years of age - can count on covering the costs of the necessary tests to determine their ability to perform the work selected by them, the costs of travel, accommodation and food associated, among others with the training or the taking of the proposed work. At the same time, all training participants designated by the employment office can count on covering the costs of insurance against accidents arising from participation in training. Unemployed parents are entitled to the refund the cost of care for each child up to the age of 7 in the amount not exceeding half of the allowance, if they take job or any other gainful employment or will be sent on internship, professional preparation of adults or training and the monthly income from such do not exceed the minimum remuneration for work. An additional form of support, addressed in particular to persons with entrepreneurial characteristics, of which can enjoy also the young unemployed, are funds to start economic activity, or to establish or join the social cooperatives. The amount of subsidy to start the economic activity does not exceed 6 times the average wage 17. These funds can also be used to finance the costs of legal assistance, consultation and advice related to the activities to be undertaken. In the case of starting the activity under the conditions laid down for social cooperatives, the amount of subsidy must not exceed 4 times the average wage per one founding member of the cooperative, and 3 times the average wage per one member joining the social cooperatives after its foundation. Other important changes which were introduced through the law of March 14, 2014, on amending the law on employment promotion and labour market institutions and certain other laws, addressed to young unemployed people are the following: individual advisory support of unemployed client 18, confirmation of activation of young unemployed up to 30 years of age, including: o training voucher, under which the sum in the amount of 100% of the average wage is at the disposal of the unemployed person to cover up-skilling in the forms of workshops / training, where unemployed himself searches for training and decides at which training institution, and at what date the training will take place. Within the voucher there is a chance to finance more than one training, costs of travel to and from the place of training as well as accommodation costs (training takes place based on referral of unemployed persons by Poviat employment office); o internship voucher constitutes a promise on the part of Starost to grant scholarship for internship if unemployed finds an employer who will arrange for a 6 month internship, and at the same time undertakes to employ unemployed person for a period of at least 6 months after the end of the internship. As part of this voucher there is an additional premium foreseen for the employer in the amount of PLN 1 500, paid after 6 months of 17 The average salary is the average gross monthly salary in national economy in the previous quarter, announced by the President of the Central Statistical Office in the Official Journal of the Republic of Poland "Monitor Polski", on the basis of article 20. Act of December 17, 1998 on pensions and disability pensions from the Social Security Fund. In the second quarter of 2014 the salary amounted to PLN Client Advisor, however, is not intended for young unemployed only. 21

22 employment of a young person after the internship (internship being carried out on the basis of referrals of unemployed persons by Poviat employment office); o employment voucher, under which Starost concludes an agreement with the employer, and as a result of which the refund will be made of the part of the costs paid by employer i.e. salaries and social premiums for employment of unemployed person in the amount of the allowance, whereas employer must undertake to continue to employ the unemployed over the next 6 months following immediately after the 12 month period of the refund. The introduction of this instrument will allow young unemployed person up to 30 years of age active functioning on the labour market for at least 18 months; o inhabitation voucher, under which Starost may grant unemployed person financial means up to 200% of the average remuneration for work, to cover the costs associated with housing resulting from taking up employment, other gainful employment or business in a new location, in particular to cover the cost of renting a flat. facilitations allowing to gain professional experience: o refund of social insurance premiums due from the employer for the unemployed up to 30 year of age taking up employment for the first time covering the period up to 12 months and its amount must not exceed ½ per month the minimum remuneration for work based on separate regulations. The employer using this solution has the obligation to continue the employment of the referred person after the refund period for a period of 6 under the pain of returning the refund. o voucher for telework - benefit, which the Starost may - on the basis of concluded contract - grant to the employer or entrepreneur to create job positions in the form of telework for the referred unemployed parent returning to the labour market, having at least one child up to the age of 6 years, or unemployed having custody over statutory dependent, which in a period of 3 years before registration in the employment office resigned from employment or other paid work due to the need to raise the child or take care of statutory dependent. Employer or entrepreneur receives from the Labour Fund a grant of up to 6 times the minimum remuneration for work, and at the same time undertakes to employ unemployed for 12 months in full-time or for a period of 18 months in ½ FTE. o activating benefits - paid to employer for 12 (at the rate of 1/2 minimum wage) or 18 months (at the rate of 1/3 of the minimum wage) for a full-time employment of referred unemployed parent returning to the labour market, after the break in employment due to raising a child, or unemployed having custody over statutory dependent, which in a period of 3 years before registration in the employment office resigned from employment or other paid work due to the need to raise the child or take care of statutory dependent. The employer undertakes to employ referred unemployed over the next 6 or 9 months after the expiry of a period of eligibility and activating benefits 19. The possibility to apply for a loan to take up economic activities was also created, which, in particular young people can benefit from, because this instrument is aimed at the following groups: 19 Instruments are foreseen not only for the unemployed up to 30 years of age. 22