Strategic Social Report 2015

Transcription

1 Strategic Social Report 2015 Warsaw 2015

2 2

3 Table of contents Introduction... 4 Poland s socio-economic situation in Europe 2020: Goal of reducing poverty and social exclusion, as of Measures taken in Social inclusion and social investment... 9 Access to resources, rights and services preventing and eliminating social exclusion and averting all forms of discrimination... 9 Investment in children Supporting people entering the labour market Homelessness and ensuring access to housing Pensions Health Provision of health services Managing the healthcare system Investing in healthcare staff Increasing access to healthcare services Long-term care Support for de-institutionalization of care for dependent persons

4 Introduction On 17 June 2011, the Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) endorsed the position of the Social Protection Committee (SPC) on Renewed Social Open Method of Coordination (OMC) [10405/11] 1, under which Member States shall submit, from 2012 onwards, information about measures in the area of social security. It was decided that every two years, more extensive information would be presented in the form of National Social Reports (NSR); in years when these are not drawn up, synthetic Strategic Social Reports (SSR) would be published. NSRs and SSRs are to supplement the National Reform Programme (NRP) and refer to the Recommendations of the Council, presenting measures taken by Poland in the areas of: 1) social protection; 2) pensions; 3) health 4) longterm care. Thus, the NRP together with NSRs and SSRs provide a full picture of national activities in all areas of social OMC, including: combating poverty and social exclusion, adequate and sustainable pension systems, available and stable health care systems and long-term care. In 2015, Poland shall submit a Strategic Social Report covering activities and measures undertaken between 1 July 2014 and 30 June The document shall also be sent to social partners. Upon the approval of the Committee for European Affairs, the report shall be forwarded to the Director-General for Employment, Social Affairs and Inclusion (DG EMPL) and the President of the Social Protection Committee (SPC). Any comments of social partners shall be included. Results of public consultation on the draft of the National Reform Programme for the implementation of the "Europe 2020" Strategy /2016 Update (NRP 2015/2016), including opinions on the implementation of the national strategy "Europe 2020" by Poland in the area of fight against poverty and social exclusion have been presented in the form of an annex to the NRP 2015/2016. SSR shall be used by SPC to prepare information on social situation in Europe, presented to the EPSCO Council and to review progress in achieving the objectives of social OMC. 1 EPSCO 3099 th meeting, 17 June 2011 [11574/11] 4

5 Poland s socio-economic situation in 2014 Poland s socio-economic situation in 2014 was better than in the previous year. Gross Domestic Product increased in real terms by 3.4%, i.e. twice as much as in the previous year (1.6%). At the same time, EU s GDP increased by 1.3% after stagnating (0.1%) a year earlier. The situation on the Polish labour market also gradually improved. The employment rate in 2014 increased compared to the previous year by 1.7 percentage points and stood at 61.7%. 2 Data from the Labour Force Survey pertaining to the first quarter of 2015 confirm the continuation of this upward trend. The employment rate for persons aged was approx. 1.3 percentage points higher compared to the first quarter of The number of workers also increased. It was due almost entirely to the greatest growth in the number of employed persons in 5 years. After two years of decline, the number of employers and self-employed persons also rose. In 2014, the downward trend in agriculture employment was maintained (2.1 million in 2008, 1.8 million in 2013, 1.7 million in 2014). The share of this group in the structure of employment subsequently declined (13.3% in 2008, 11.7% in 2013 and 11.2% in 2014). An increase in demand for labour contributed to a marked decline in unemployment down to 9.0% (from 10.3% in 2013), as compared to the EU average of 10.2%. 3 Improved labour market situation, along with the stabilization of prices of goods and services (HICP 4 0.8% in 2013, 0.1% in 2014) had a positive impact on the growth of real disposable income of households and, consequently, accelerated the pace of consumption growth of households (from 1.2% a year earlier to 3.1%) 5. At the same time, consumption growth was also boosted by the improving consumer confidence index and a faster growth of consumer loans. Income inequality in Poland has decreased. The Gini coefficient 6 dropped from 32.2 in 2007 to 30.7 in 2013 (in the European Union, the Gini coefficient in 2013 was 30.5) 7. This is consistent with the Social Diagnosis 8 - a nationwide social survey on the conditions and quality of life of Poles according to which the economic stratification of Polish society has been declining. The Gini coefficient decreased over the last three editions of the survey: - from 31.3 in March 2009 and 30.1 in March 2011 to 29.9 in March Pursuant to the latest European Economic Forecast (Spring 2015) 10 Poland s GDP in 2016 will increase by 3.3% in year-on-year terms. The unemployment rate is expected to drop to 8.4% in 2015 and to 7.9% in 2016, while employment is to grow by 0.7% and 0.6% in yearon-year terms. In 2015, inflation is stable, close to 0%; it is likely to grow to approx. 1% in These factors should result in a further increase in real disposable income of households. The most important long-term challenges in the area of social protection, pensions, health and long-term care are associated with Poland s demographic situation, i.e. a greater average life expectancy, low fertility rates (1.26 in 2013) and the country s negative migration balance (the number of Poles living abroad is estimated at approx. 2.1 million). Polish population, although still relatively young (median age in 2014: 39.2 years, in UE-28: 42.2 years) will grow old at a fast pace. According to the Central Statistical Office (October 2014), Poland s 2 Employment rate among people aged 15-64, Labour Force Survey, Eurostat, [lfsi_emp_a] 3 Labour Force Survey, Eurostat, [une_rt_a] 4 Eurostat, [tec00118] 5 Annual macroeconomic indicators, Central Statistical Office 6 A measure of households' income gap in a given country 7 Income and living conditions of Poles (report from the EU-SILC 2013), Central Statistical Office 8 Sample of approx. 12,000 households, i.e. approx. 36,000 individual respondents. 9 P. 23, Diagnoza społeczna 2013 Warunki i jakość życia Polaków, ed. J. Czapiński, T. Panek

6 population will dwindle from 38.5 million in 2014 to 33.9 million in Consequently, the pressure on the pension system and health care system will amplify. In 2013, the percentage of working-age population (aged 18-59/64) stood at 64% (approx million people). The CSO estimates that the proportion of working age population in 2050 (taking into account the new retirement age, i.e for women and men) will stand at approx. 56%, while those in retirement age will make up 29% of total population, compared to 19% today. Since 1999, the pension system in Poland has been based on the defined contribution principle, with the exception of the farmers' social insurance system, which is based on the principle of defined benefits. Efforts are continually taken in order to extend the effective retirement age and improve employment opportunities for workers aged 50+. Steps are systematically taken to facilitate reconciliation of work and family life, inter alia through tailoring support schemes aimed at facilitating the process of adaptation to labour market changes and lifestyle changes for people of childbearing age. These actions are described in Poland s national development strategies: Long-term National Development Strategy - Poland 2030 and the medium-term National Development Strategy

7 Europe 2020: Goal of reducing poverty and social exclusion, as of 2014 The total number of people at risk of poverty or social exclusion in Poland in 2013 was 9.75 million (25.8%), i.e. approx. 1.7 million fewer than in 2008 (EU-SILC) 11. This means that Poland has achieved the national target of the Europe 2020 Strategy, namely reducing the number of people at risk of poverty or social exclusion by 1.5 million compared to Efforts continue in order to further reduce poverty levels. Figure 1. Percentage of people at risk of poverty or social exclusion in Poland in ,3 39,5 34,4 30,5 27,8 27,8 27,2 26,7 25, People at risk of poverty or social exclusion (AROPE) At-risk-of-poverty (AROP) Severe material deprivation (SMD) Low work intensity (LWI) Goal of reducing AROPE by 1.5 million people Source: own study based on Eurostat data. Between 2008 and 2011 and in 2013, the factor of greatest impact on the decline in the synthetic index of poverty 12 in Poland was the falling percentage of people suffering from severe material deprivation (SMD). In 2012, the decline of the synthetic index was also impacted by a decrease in the number of people at risk of poverty (AROP). Despite the systematic decline, the risk of poverty or social exclusion in Poland is still slightly higher than the average for the UE-28 (24.5% in 2013). The results of the national household budget survey of 2013 confirm the above trends observed in the EU-SILC survey. At-risk-of-relative-poverty rate 13 in 2013 stood at 16.2% and has been declining since (17.4% in 2010, 16.9% in 2011). At the same time, it should be noted that the proportion of people at risk of extreme poverty 15 increased from 5.8% in 2010 to 7.4% in The base year for the Europe 2020 Strategy in relation to reducing the risk of poverty or social exclusion 12 The synthetic poverty index encompasses people at risk of relative poverty, those affected by severe material deprivation and living in households with very low work intensity. 13 Calculated on the basis of 50% of average equivalent expenditure of all households. 14 Limit year for weight verification enabling full comparability of results. 15 In other words, it means the minimum subsistence income, i.e. the level of expenditure sufficient to meet basic food needs and maintaining a very small apartment. No expenditure related to occupation, communication, culture and recreation are taken into account, only spending necessary to meet the most basic existential needs. It estimated by the Institute of Labour and Social Affairs (ILSS). 7

8 A steady increase in the income of Polish households has been observed. In 2003, declared average monthly disposable income 16 per family member amounted to PLN 712, while average expenditure stood at PLN 678 per family member (95.2% of disposable income); in 2013, disposable income increased to PLN 1,299 and expenditure to PLN 1061 (82% of disposable income). In 2013, just as the year before, more than 50% of households assessed their material situation as average, while a quarter perceived it as good or very good. 20% of households assessed their financial situation as bad or very bad. However, questions about the overall evaluation of one s life, asked in a survey of the quality of life and social cohesion carried out in 2011 by the Central Statistical Office, as well as in the Social Diagnosis 2013 survey, indicate that only 5-6% of the population aged 16 years and over (or 18 years or more in the case of the Social Diagnosis) claim that their life is bad/very bad. Quality of life was also the subject of modular research conducted in the framework of the European Statistics on Income and Living Conditions (EU-SILC) It shows that - just as in the surveys referred to above - lowest satisfaction ratings among respondents were observed with respect to the financial situation of respondents own households. Approximately 43% of people aged 16 and more were satisfied with this aspect of their life; one person in five expressed their dissatisfaction. Despite this, the vast majority of Polish citizens aged 16 and over (approx. 71%) were satisfied with their life in general, while only one in twenty-five respondents (approx. 4%) expressed their dissatisfaction. It is also worth noting that preliminary analysis indicated that age is one of the aspects that have the greatest impact on the above assessments. As a rule, young people are more satisfied with both life in general and the majority of its aspects. A person s assessment of his/her material situation does not translate directly into the assessment of his/her quality of life. The increasing income of households results in a diminishing share of spending on basic needs, inter alia, food and housing in the disposable income. Over the past decade, the share of expenditure on food and non-alcoholic beverages in household expenditure steadily declined until 2009 (27.8% in 2003, 25.1% in 2009); it remained stable at around 25% in the following years. The share of expenditure on housing and energy declined slightly in (from 21.0% in 2003 to 18.4% in 2007), and increased to approx. 21% in The difference between the percentage share of these types of expenditure in 2013 stood at approx. 4 percentage points and was more than twice lower than in Gross income minus transfers on taxes and social contributions. 17 Polish residents about their quality of life, CSO

9 Measures taken in In , in areas of social inclusion and social investment, health and long-term care, Poland continued the implementation of measures initiated earlier and undertook new activities. In the below description of areas, new measures are outlined first, followed by actions implemented cyclically and those that have already been described in the NRP 2015/2016. Social inclusion and social investment Access to resources, rights and services preventing and eliminating social exclusion and averting all forms of discrimination Increased support for people with disabilities Since 1 January 2015, the amount of funding from the State Fund for Rehabilitation of Disabled Persons (PFRON) allocated to patients for their participation in rehabilitation treatments and the maximum amount of funding for rehabilitation equipment, elimination of architectural, communication and technical barriers has been increased. Legislative work is aimed at providing support in terms of personal assistance services for people with disabilities, as well as the purchase, training and maintenance of assistance dogs during training and after its completion. Increased support for families and people in difficult material situation In 2015, it is planned to increase the income criteria entitling to social assistance 18 and to family benefits. In the case of the latter, it is also planned to raise the amounts of family allowances and selected bonuses to the family allowance. Given that the permanent and periodic social assistance allowances are granted on the basis of the difference between the income criterion and the actual income of a particular household (they serve compensatory purposes), raising the income threshold qualifying for social assistance shall affect the amount of benefits received by families. Higher thresholds and allowance amounts shall apply from 1 October 2015 onwards. The new income criterion entitling to family benefits and increasing the benefits and certain bonuses to the family allowance are currently being developed. As opposed to social assistance benefits, the increase in the income criterion does not directly affect the amount of allowance received. Changes are to become effective as of 1 November Changes to income criteria and the amount of benefits combined with the proposed zloty per zloty mechanism (expected to enter into force on 1 January 2016) 19 will improve the situation of families with children and broaden the range of support. The implementation of several programmes is continued, namely Dayroom - Children - Work - supporting children and families within communes (implemented since 2011), Social support for persons with mental disorders (since 2006), Active Forms of Counteracting Social Exclusion edition, Integration of the Roma community in Poland in (since 2001). 18 This will engender a simultaneous increase in benefits. Social assistance benefits based on one s income are compensatory in nature, and thus are awarded on the basis of the difference between the amount set as the income criterion and the actual income of a household. 19 Zloty per zloty is a new mechanism of granting family benefits. It means that if the income of a family exceeds the set income criterion by PLN 1, the amount of benefits will be PLN 1 lower instead of being cancelled altogether. 9

10 Dayroom - Children - Work programme focuses on organizing socio-therapeutic support (based on day care centres - community centres, youth clubs, childcare centres) for children and adolescents. Support for the unemployed, including the parents or guardians of children, as well as social welfare charges is also provided. A total of EUR 0.8 million is allocated to the programme annually. In , the Minister of Labour and Social Policy subsidized in this manner 60 initiatives. Social support for persons with mental disorders is a programme directed especially to patients with chronic mental disorders and intellectually disabled. Its aim is not only to help them meet basic needs and ensure decent living conditions, but also to support people with mental disorders in their efforts to live independently or in finding employment. In 2014, 56 projects for a total amount of PLN 3 million were financed. In 2015, the budget of the programme also amounted to PLN 3 million. Active Forms of Counteracting Social Exclusion is a programme in the framework of which competitions for local authorities and non-governmental organizations are held relating to partnerships projects for organizing social integration centres and clubs, as well as a more efficient use of local labour market programmes, such as socially useful work or public works; strengthening the role of social employment entities in the process of assisting people in returning to their social and professional roles; promoting good practices, in particular with respect to organizing local cooperation between organizational units of welfare and public employment services using the potential of NGOs. A total sum of EUR 3.5 million is spent annually on the implementation of the programme. Under the programme Integration of the Roma community in Poland in , financial support in the areas of education and cultural education is provided, including the protection and preservation of the cultural identity of the Roma community, housing, healthcare and participation in the labour market. In , a total of PLN 65 million has been earmarked for the programme (PLN 5 million in 2014 and PLN 10 million in subsequent years). The government is also implementing the Programme Promoting Social Activity of Seniors (since 2012), described in detail in the NRP 2015/2016. The NRP 2015/2016 also outlines successive measures aimed at families with children, whose implementation is planned from 1 January 2016, i.e. the introduction of the zloty per zloty rule 20 to the family benefits system, and a new allowance - the so-called parental benefit 21. Investment in children Material support for families with three or more children through the Large Family Card was introduced in Large families receive discounts for cultural events, educational, recreational and transport services from public and private organisations throughout the country. The Card is described in detail in the NRP 2015/ Under the Zloty for Zloty rule, which will come into force on January 1, 2016, family benefits will be decreased by the exact amount of zlotys (the national currency) by which family income exceeds the family benefit eligibility threshold, i.e., when a family income exceeds that threshold by, e.g., 1 zloty or 25 zlotys the family benefits will be reduced likewise. Under the current rule, eceeding the threshold by any amount results in the loss of eligibility for the whole family benefit. 21 Parental benefit in the amount of PLN per month will be paid to persons not entitled to the maternity benefit (eg.: unemployed, students, people working under civil law contracts) or whose maternity benefit is lower than PLN (then the person will receive the top-up). Parental benefit will be paid for a period of 52 weeks from the date of birth for one child or of up to 71 weeks in case of multiple births. 10

11 The Ministerial programme of development of care institutions for children under the age of 3 ( Maluch ) has also been provided for in the NRP 2015/2016 as a measure implemented in 2014 and continued in Supporting people entering the labour market The NRP 2015/2016 describes in detail numerous measures taken in this area. These include: implementing new activation/support instruments aimed at people entering or returning to the labour market provided for in the amended Act on employment promotion and labour market institutions, continued implementation of the Youth Guarantee and the implementation of the Human Capital Operational Programme (HC OP), Measure 1.5: Supporting solutions for reconciling career and family life.. Homelessness and ensuring access to housing Reactivation of social housing On 9 June 2015, the Council of Ministers adopted a bill (prepared by the Minister of Infrastructure and Development) amending the Act on certain forms of support for housing construction. Its aim was to reactivate social housing construction, carried out so far by social housing associations and housing cooperatives. Beneficiaries are people whose income is too high to allow them to qualify for a council flat, yet insufficient to satisfy their housing needs on the housing market. Refundable funding provided by Bank Gospodarstwa Krajowego, in the form of preferential loans and guarantees for the purchase of bonds is expected to be an instrument of social support for social rental housing. Within 10 years, it is planned to finance the construction of 30,000 new social rental apartments. The amount of funding from the state budget is expected to total approximately PLN 750 million, while the amount of credit is estimated at PLN 4.5 billion over the 10-year period. The amended act is to enter into force in the third or fourth quarter of The Programme supporting the rehabilitation of the homeless (implemented since April 2010) and the Programme of support for local authorities and public benefit organizations in the construction of social housing, municipal housing, sheltered accommodation, shelters and houses for the homeless (since 2007) are continued. Their beneficiaries are people in a difficult economic situation, including the homeless. The first is targeted at NGOs. It supports prevention measures, integration and social and professional activation of the homeless within local communities and improving accommodation standards, as well as - since 2011 reducing the scale of homelessness at railway and bus stations and in their immediate environment. A total of EUR 5 million is allocated annually to the implementation of the programme. The latter of the above programmes allows the co-financing of investments from the Subsidy Fund amounting to 30-50% of the total cost. In the second half of 2014, the budgetary grant for the Subsidy Fund amounted to PLN 40 million and could be increased with funds unspent in previous editions, totalling approx. PLN 21.4 million. In the first half of 2015, the budgetary grant for the Subsidy Fund amounted to PLN 40 million and was increased by the amount of funds unspent in previous editions, i.e. approx. PLN 23.4 million. 11

12 Pensions Given the horizontal nature of the area of pensions, all major measures have been presented in the NRP 2015/2016, while the National Social Report provides detailed information on selected aspects thereof. Consequently, the layout of this section differs from the remaining parts of the document. The process of gradually extending and equalizing retirement age for women and men began on 1 January Changes observed in this area in the period between July 2014 and June 2015 stemmed directly from the Act of 11 May 2012 amending the Act on pensions from the Social Insurance Fund and certain other acts. Detailed information on the pension system: Universal pension system (under the Social Insurance Institution) Current situation: Early retirement: In , no changes regarding the right to early retirement were introduced. Legal provisions on partial retirement pension apply. 22 Retirement age: Contribution period: Amount of pension benefits: Pension adjustment: Since January 2013, the statutory retirement age is increasing at a rate of 3 months per year. This process shall be completed in 2020 for men and in for women. The target retirement age for both sexes is 67 years. In the reformed pension system, the sufficient pensionable service requirement does not apply. By virtue of the law adopted by the Parliament on 23 October 2014, since 1 January 2016, a mechanism of insurance title accumulation shall apply to contracts for mandate if, in a given month, the basis of payment of social security contributions is lower than the minimum wage. The purpose of the mechanism is to ensure that persons working on the basis of contracts for mandate acquire the right to minimum pension benefits. The average amount of newly granted pension benefits set pursuant to the new rules amounted in 2014 to PLN 1,975.53, i.e. PLN than in In 2015, a single change of the currently applicable indexation rules was introduced. It is assumed that in 2015, indexation of benefits would not be less than PLN 36. This means that pension benefits were increased as a result of percentage indexation carried out in March 2015 or by a minimum amount of PLN 36. Indexation at the level of the guaranteed minimum increase was granted to all beneficiaries whose pension benefits did not exceed PLN 5, Farmers pension system (under Farmers Social Security Fund, KRUS) - Current situation: Early retirement: Early retirement in the Farmers Social Security Fund is being phased out. It shall be granted to insured farmers who are entitled to it through their compliance with the set requirements until the end of The limitation entered into force on 1 January In , no 22 Since 2013, women are entitled to a partial pension at the minimum age of 62 years, with a minimum social insurance period of 35 years; in the case of men, it is 65 and 40 years respectively. Partial pension benefits amount to 50% of the full amount of pension from the Social Insurance Fund calculated on the date of determining entitlement to partial retirement pension, i.e. at the age of 62 years for women and 65 years for men and it is not increased to the level of minimum pension. Upon reaching the age entitling a person to full pension benefits, the basis for calculating its amount shall be reduced by the amount paid out as the partial pension. The longer the period of receiving partial pension benefits, the lower the amount of pension benefit paid once the person becomes entitled to full pension. The payment shall not depend on the termination of employment or on the amount of revenue generated through employment. 12

13 Retirement age: Contribution period: Amount of pension benefits: Pension adjustment: changes regarding the right to early retirement were introduced. Since January 2013, the statutory retirement age has been increasing at a rate of 3 months per year. This process shall be completed in 2020 for men and in for women. The target retirement age for both sexes is 67 years. There is a gap in the level of benefits for women and men provided under farmers' social insurance system. The period of raising children while running a household is covered by insurance (with contributions). On 1 September 2013, amendments to the Act according to which a 3- year period of care with respect to a child under the age of 5 (or a 6-year period in the case of a child with a disability up to 18 years of age) by a farmer, a farmer s spouse or another household member were introduced; pension insurance contribution are financed from the state budget. The statutory period of pension insurance entitling a farmer to a pension is 25 years. In order to benefit from early retirement, a 30-year insurance period is necessary. In 2014, the actual period of insurance was estimated at years for women and for men. The average amount of pension benefits had increased as compared to 2013 from PLN to PLN in In 2015 (1 March 2015), pension indexation was carried out on the basis of principles other than those specified in the Act on social insurance for farmers. It combined percentage indexation with indexation by a fixed amount and was conducted on the basis of the Act of 23 October 2014 amending the Act on pensions from the Social Insurance Fund and certain other acts (Dz. U. of 2014, item 1682). It guaranteed a percentage indexation of pension benefits with a minimum amount of PLN 36. In the case of farmers pensions, all benefits were increased by the same amount. 23 KRUS data 13

14 Health The main measures essential for the improvement of protection and access to health care services are described in detail in the NRP 2015/2016. They include improving oncology care standards, the management of waiting lists for health services and the process of concluding contracts for the provision of health care services, as well as enhancing the functioning of the National Health Fund. Provision of health services The implementation of the following was continued: National Programme for Combating Cancer , National Programme for the Development of Transplantation Medicine , Ensuring Poland s self-sufficiency in terms of the supply of blood, its components and blood products , PL13 Programme of reducing social inequalities in terms of health in the framework of the Norwegian Financial Mechanism. Tasks in the area of health prevention implemented in the framework of the aforementioned programmes were aimed, inter alia, at increasing public awareness of healthy lifestyle, promoting prevention of oncological diseases, unpaid donations of cells, tissues and organs, encouraging participation in screenings with the view to preventing breast cancer and cervical cancer. In the framework of the National Programme for Combating Cancer measures were taken in order to familiarize the public with the provisions of the European Code Against Cancer. Nationwide intervention campaigns were carried out to promote healthy lifestyles: events linked to the World No Tobacco Day or the World Obesity. In 2014, numerous training courses and workshops were organized in the form of conferences. Informational and educational activities were conducted, as well as media campaigns in the field of cancer prevention. Funds allocated to the above tasks in 2014 amounted to PLN 9.8 million. In the framework of the National Programme for the Development of Transplantation Medicine promotional and educational actions were carried out in the field of transplantation, with particular emphasis on the donation of cells, tissues and organs. A total sum of PLN 1.7 million was allocated to the programme. Under the programme entitled Ensuring Poland s self-sufficiency in terms of the supply of blood, its components and blood products , nationwide campaigns promoting blood donation were carried out. As a result, the number of new blood donors increased. The amount allocated to the programme totalled PLN 2.7 million. PL13 Programme of reducing social inequalities in terms of health in the framework of the Norwegian Financial Mechanism is implemented in partnership with the Norwegian Directorate for Health and Social Affairs. It consists of a predefined project aimed at creating a policy for reducing health inequalities and at least 23 pilot projects in the field of public health in local communities. The total allocation for measures planned for amounts to PLN 79.1 million. The area of e-health services encompasses such measures such as the Electronic Platform for Collection, Analysis and Sharing of Digital Resources on Medical Events - P1 Project and a draft act amending the Act on the information system in health care and certain other acts, further described in the NRP 2015/

15 Managing the healthcare system Improving the quality of healthcare system management From March 2014 to 30 September 2015, a project is implemented with the view to improving the quality of healthcare system management in terms of rights and obligations arising from cross-border healthcare. Actions undertaken are focused primarily on improving information policy conducted by the National Health Fund in relation to patients and providers of medical services. The project encompasses a wide range of educational and information activities, including training, conferences and two information publications. Training is organised for the employees of the insurance contribution payers and service providers who - thanks to the newly acquired knowledge - will be prepared to provide patients with comprehensive information pertaining to the terms and conditions of use of cross-border healthcare. Thus far, 360 people have been trained and the amount of funds allocated to the project has totalled PLN 1.4 million. Another project, which has been implemented since June 2013 and is expected to be completed it in November 2015, is known as Safe Hospital Safe Patient. Its aim is to improve the quality of hospital management and the number of accredited hospitals. The project encompasses inter alia training and advisory support pertaining to accreditation standards and provided to hospital staff, training in patient safety, identification and analysis of adverse events, legal issues and communication with patients, preparation of a study on the safety of healthcare. Thus far, 2,905 people have been trained in the framework of the project, training support in preparing for accreditation procedures was provided to 78 hospitals, 28 accreditation inspections have been carried out and 12 hospitals have been certified under the project. The amount of funds amounted to the programme totalled PLN 8 million. Investing in healthcare staff Measures provided for in the National Programme for Combating Cancer , National Programme for the Development of Transplantation Medicine , National Programme for haemophilia and related disorders and Ensuring Poland s self-sufficiency in terms of the supply of blood, its components and blood products were continued. They include inter alia raising the awareness of medical staff involved in the implementation of services in the area of oncology, transplantation and treatment of haemophilia, optimizing the use of blood and blood components in treatment. Total expenditure on training for medical personnel within the above programmes amounted to PLN 1 million in In 2015, the allocation earmarked for the implementation of specialized training for health professionals in the framework of the above programmes amounted to nearly PLN 5 million, i.e. five times more than the amount spent on these issues in From 2012 until the end of June 2015, Nationwide training in the health care system as well as communication skills, cooperation and building relationships with patients for young doctors was implemented. Training is addressed to doctors under 35 years of age; thus far, 2,312 people have participated in training. The amount of allocation for project implementation totalled PLN 8.1 million. 15

16 Increasing access to healthcare services Increasing the number of places in medical residency programmes Every year, the Minister of Health provides approx. 3,000 residencies. In 2015, this number will be increased by approx. 3,500. Thus, the number of resident doctors will increase from 12,000 to 18,500 in It is anticipated that total funding for residencies in 2015 will amount to approx. PLN 703 million. This area encompasses also health policy programmes initiated in previous years, namely National Programme for Combating Cancer , National Programme for the Development of Transplantation Medicine , Antiretroviral treatment of people living with HIV in Poland - purchase of anti-retroviral drugs for AIDS patients in Poland, National Programme for haemophilia and bleeding diathesis - the purchase of blood clotting agents to treat haemophilia patients, National program of equalizing access to prevention and treatment of cardiovascular diseases, Programme of newborn screenings in Poland, Program of comprehensive diagnostics and intrauterine therapy in the prevention of consequences and complications of malformations and diseases of the foetus. In the framework of the above programmes aimed at improving the availability of health services, a number of measures have been carried out, inter alia, the purchase of medicinal products and medical devices, specialized treatment and disease prevention services, oncology, cardiology and transplantation equipment, renovation and construction works in transplantation centres, tissue and cell banks and diagnostic laboratories operating within the transplantation medicine system. Expenditure on the implementation of the above measures aimed at improving the availability of services amounted to PLN million and was comparable to the expenditure incurred in The amount of 2015 allocation was comparable to the 2014 allocation. 16

17 Long-term care Support for de-institutionalization of care for dependent persons In the framework of the Operational Programme Knowledge, Education and Development, (OP KED), a number of projects will be implemented in the area of support for the deinstitutionalization of care for dependent persons, including the elderly, through the development of alternative forms of care for dependent persons (Axis V, Measure 5.2 Measures improving service quality and organizational solutions in the healthcare system facilitating access to affordable, sustainable and high quality healthcare services). They comply with the Policy Paper on Healthcare in the National Strategic Framework. The European Commission adopted OP KED on 17 December On 30 March 2015, the Monitoring Committee of OP KED approved the Action Plan for Axis V Support for the area of health within OP KED. Thus, access criteria, eligibility criteria and the amount of allocation earmarked for activities related to the deinstitutionalization of healthcare were approved. A competition aimed at pilot implementation of solutions is to be announced in the second quarter of 2015 and the amount of financial resources allocated for this purpose totals PLN 40 million. The pilot programme provides for projects aimed at the creation of day care centres for dependent persons, in particular those over 65 years of age, for whom a combination of basic healthcare and outpatient specialist care is insufficient, but who do not required 24/7 hospitalisation. In , instruments of care deinstitutionalisation are to be applied with respect to a total of 40 medical units, within which places for 400 patients shall be deinstitutionalised. 17