“The burden on public finances could be reduced and access to healthcare improved by strengthening primary care” – this was the position expressed by the Council of the European Union back in 2014 as part of the European Semester, the annual process coordinating EU economic and social policy. However, a decade passed before these recommendations were transformed into support measures dedicated to primary healthcare (PHC) under the FEnIKS program, financed by the European Union’s cohesion policy.
2014 was a turning point for me personally, as I won a competition for expert support for the European Commission’s Directorate-General for Regional and Urban Policy (DG REGIO). My role concerned investments from the European Structural and Investment Funds in the healthcare sector in Poland. We worked on a strategy aimed at reducing the burden on public finances through the efficient use of EU funds. Strengthening primary healthcare was one of the top priorities at the time, especially in the face of an aging population and rising healthcare expenditure.
Therefore, it should come as no surprise that, like many of my colleagues, both in the Commission and in Poland, I am committed to working to reverse the benefits pyramid and strengthen primary healthcare. Ten years of working together is a long time – full of effort and hope for real change.
The disappointment at the beginning of this process was all the greater. Despite years of preparation, when the moment finally arrived, chaos ensued. Such an important undertaking should not have started with a false start, especially when everyone knew the project would attract enormous interest. Instead of proper planning, we faced systemic inefficiencies and errors that could have been predicted and avoided.
That’s why I’m surprised by the growing number of opinions from both sides of the aisle that everyone tried, that there’s no other way in public administration, and that the effort should be recognized. I have a different vision for public administration. But it requires not so much a change in people, but, above all, an organizational culture. After all, life isn’t just about trying. You also have to deliver. Especially when thousands of doctors spent those days not treating patients but dealing with the situation. Someone rightly asked what the health consequences were.
I also disagree with the view that the ministry assumed little interest in supporting primary healthcare investments under the FEnIKS program. On the contrary, everyone knew it was a project for several thousand entities and hundreds of thousands of złoty of assistance for each qualified applicant, without any contribution from the beneficiary. It was obvious it would generate enormous interest! This was evident even during its preparation years ago, and discussions on industry mailing lists months in advance only confirmed it. Better preparation was simply needed, support from those experienced in implementing such projects, listening to the community, analyzing the risks, and taking appropriate precautions.
Server performance, the architecture of the process itself, the quality of the forms – all of this could be discussed at length. The desperate recovery process and loss mitigation after the failed launch only underscore the scale of the problem. The crux of the whole situation is the fact that the National Health Fund (NFZ) didn’t even have the appropriate tools to handle webcasts of thousands.
To be clear, success will be announced in a month. The ministry has already launched a positive media campaign, emphasizing the value of the support. The allocation was exhausted at the outset. The ministry is meeting with the Zielona Góra Agreement to discuss “important systemic issues.” The protests seem to have subsided. The first funds will likely flow to primary healthcare systems in the fall. We managed it again.
We are masters of creating and managing chaos. But is this what an effective state aspiring to global leadership looks like?