The draft amendment of the laws on the social security, benefits and pensions system, prepared by the Ministry of Family, Labour and Social Policy (MRPiPS), inspires tremendous emotions. The changes concern, among others, the rules for issuing medical exemptions (L4) and the anticipation of travelling abroad during the illness. Will the fresh rules make life easier for patients, or will they open the door to abuse? We're looking into what the Ministry of Labour is proposing and why the Minister of Finance is going after his head.
Physiotherapy alternatively of a doctor? Controversy around the case law
One of the most controversial points of the task is the proposal that physiotherapists and nurses should be able to issue judgments on medical rehabilitation and inability to live independently. According to Prof. Anna Wilmowska-Pietruszynska, president of the Polish Society of Medical Laws (PTOL), only the doctor has the appropriate competence to measure the wellness of patients, especially those with multi-sickness.
The Ministry of wellness points out the deficiency of precision in the project. "The concept of independent medical professions besides includes midwives, pharmacists, laboratory diagnosticians and paramedics. Without specifying precisely who can issue the rulings, there will be explanation doubts," the Ministry emphasises.
End of medical board? Single-person case law raises concerns
The next point is the plan to liquidate medical committees, which presently consist of 3 specialists in various fields of medicine. They would be replaced by 1 doctor appointed by the Chief Medical Officer of the Social safety Office. The president of the medical committees of the Social Insurance Institution warns that specified a change violates the rule of impartiality. “The subordinate will measure the decisions of his superior, who decides on wages and bonuses,” says their position.
According to experts, a single doctor is incapable to holistically measure the condition of a patient with many diseases. In practice, two-instance legal proceedings will become fiction.
Tourism on L4? Ministry of Finance warns against fraud
One of the most controversial ideas is to let people on sick leave to go to any EU country. All you request to do is give a abroad location so you can legally leave. The Ministry of Finance warns that this is “a consecutive way to abuse”.
"The ability to control short-term medical dismissals spent abroad is illusory" – MF thunders. The hotel recommends withdrawing from this proposal or limiting it to circumstantial situations, specified as treatment in a circumstantial clinic or staying in the recommended climate.
The Chief Medical Council besides criticises this idea. "The doctor's task is to find the patient's inability to work, not to consider the anticipation of controlling the Social safety Office outside the country," stressed the physicians.
Sick leave and wage at the same time? fresh responsibilities for doctors
The task besides provides for the anticipation of performing "incidental activities" during medical release, specified as signing papers or sending an email. However, the deficiency of precise criteria raises concerns from ZUS. “It will be hard to separate between the incidents and the forbidden work,” writes the Ministry of Finance.
Another problem is the proposal that the doctor may state in the certificate that the patient may work in another establishment. According to ZUS, the doctor is not able to objectively verify whether the patient is capable of doing a second job. "This is simply a step in the incorrect direction, expanding the bureaucratic burden on doctors," says the Warden of the Medical Chamber.
The full basket package? Medical environments and trade unionists criticise the project
The MRPiPS task met with harsh criticism from medical and union communities. PTOL considers that the changes pose a hazard to the quality of medical jurisprudence and may increase the cost of benefits. Solidarity warns that it will be hard to accomplish the nonsubjective of speeding up the case law.
The Ministry of Labour defends its idea, stressing that the task has undergone extended public consultation and has been modified after analysis of comments. It is now waiting for the Committee to examine the Council of Ministers on Digitalism.
Will fresh regulations enter into force? For now, it seems that the task inactive needs many amendments to gain acceptance of both the medical community and the Ministry of Finance.
Legal basis:
Draft amendment of the Act on the Social safety strategy and certain another laws in consultation
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