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The closer the end of the year is, the more alarming and catastrophic articles on withdrawing cheap drugs from pharmacies and drastic price rises of the remaining ones appear in the press. The blame for this impending alleged impasse on the drug market is put down to both producers and the harmonisation process itself to which we became obliged by signing the Accession Treaty.
Harmonisation is a common term referring to a complicated and costly process of adjusting medicinal products registration documentation to numerous European Union legal requirements. In 2002, preparing our country to the membership in European Union, a good number of fundamental changes were introduced to the act Pharmaceutical Law, where, by a faithful implementation of EU regulations, new requirements which a medicinal product should meet to go through the admission to trade procedure (in the past: the registration procedure) successfully, are described in detail and rather comprehensibly.
At the same time, completing the harmonisation process (one of its crucial elements is adding the bioequivalence certificate to the registration documentation) by producers guarantees availability of harmonised medicinal products in retail and wholesale trade after 31st December 2008.
This rigorous approach to the medicinal products market was supposed to guarantee Polish and other EU citizens access to effective and safe drugs. more

It was a year full of implantological events, of which the most significant, promoting Poland, Warsaw and Polish implantology, was the 17th Convention of European Association of Osteointegration(EAO). Three years ago, for the first time in EAO history and as the first capital in the eastern block Warsaw was chosen as the location of the Convention. The choice of the place and subject turned out to be perfect since both the Convention participants' and EAO authorities' expectations were fulfilled.
The chairmen of the Convention were Prof. David Harris (Trinity College, Dublin) and me - the author of these words (Prof. Andrzej Wojtowicz - edit. note). The Convention gathered almost 3000 participants accommodated in "Kongresowa" Hall as well as in Concert and Warsaw Halls of the Palace of Culture and Science. Its convenient location (proximity of numerous hotels) had favorable impact on attendance and integration of implantologists from 64 countries from all over the world (there was no Russian delegation). Among the participants there was also a group of fellow doctors from the Ukrainian Implantological Society. more

5th November 2008 is the last day of the first settlement period for doctors and dentists who gained their doctor's licences (the right to exercise a profession) before 5th November 2004. For all the other doctors the first settlement period is over 48 months after the date of gaining a doctor's licence. Fulfilling the obligation of professional enhancement in the first settlement period may be documented with certificates issued not later than on 5th November 2008. We remind - 200 points have to be collected.

Before you start to collect the training documentation you are supposed to read the regulation of the health minister of 6th October 2004 on the ways of fulfilling the obligation of professional enhancement of doctors and dentists, which can be found at the Regional Medical Chamber in Warsaw website (www.warszawa.oil.org.pl). The regulation includes a list of accepted forms of professional enhancement, the number of points and limits assigned to each of the forms and the required documentation.

The documents confirming professional enhancement issued prior to the effective date of the said regulation remain valid, and educational points obtained before the date shall be classified in the first settlement period.

As the regulation does not specify the starting date of the first settlement period, the gap has been filled by the Supreme Medical Council with a resolution of 19th September 2008, which settles 27th September 1997 as the starting date, which is also the date of making the Act on Doctor's Profession effective. Thus the first settlement period lasts 11 years and 2 months.

All the documents obtained in the said period (as well as the student's registration book have to be submitted in a folder with a doctor's name, surname, telephone number and licence number (please organise the documents in chronological order).

In case of certificates and diplomas from courses, congresses, conventions, conferences and symposia the documents are supposed to be originals. more

On 22nd September during a conference "Reforms in Public Health Service: Needs - Challenges - Benefits" organised by nurses in Głuchołazy the minister of health Ewa Kopacz announced changes in legal regulations. She explained that she meant "these independent activities which can be performed by a nurse on her own without a doctor's presence or request. It is connected with my idea to group doctors in wards, so that the most responsibility is laid at nurses". That is all we can read in an announcement at the official website of the Ministry of Health. I have been working in health care sector for over thirty years (excluding the studying period) in many different health care establishments (city hospitals, clinical hospitals, out-patient clinics, medical centers and ambulance services) and I have the greatest respect for the profession of a nurse. During all these years I have also met the best professionals among them. With all due respect for their profession, I cannot, however, imagine a nurse carrying out their activities without a doctor's order. I mean medical activities, of course, not giving a patient a glass of water or anything of that kind. I do not know a country (I mean, a civilized country) where auxiliary staff - and a nurse's job belongs to such a category is allowed to take actions independently and not at a doctor's request (excluding the resuscitation in emergency which should be started by every citizen having some idea of it).
I wonder what patients, insurance companies, courts and finally nurses alone would say to such an idea presented by the ministry. How many times I have heard on my duties: "Doctor, do something please, as I cannot insert a needle/ apply a probe or a catheter ..." (!)
When it comes to the second part of the idea, included in the announcement of the ministry, and concerning "grouping duty doctors", I guess it refers not to grouping in wards but in hospitals so called "hospital duties".
But these have been already implemented in some hospitals and functioning for some time. Many directors, however, after a trial period are withdrawing from the experiment (quasi-savings only and sometimes more harm than benefits). I think the person writing the announcement has either very little idea of the health care system or intended to the minister of health, "galling" doctors at the same time. more

Andrzej Włodarczyk

ANNOUNCEMENT
of THE REGIONAL ELECTION COMMITTEE in WARSAW
of 18th April 2008
on obtaining the mandate of the Deputy Regional Commissioner for Professional Liability for 2005-2009 term of office
According to article 23, point 6 of the Act of 17th May 1989 on medical chambers (Journal of Laws No. 30, item 158, as amended) read with § 7 (1) point 2, § 7 (4) and § 47 of the resolution No. 76/04/IV of the Supreme Medical Council of 23rd April 2004 on regulations of election to authorities of medical chambers and election of delegates to the National Medical Convention and detailed procedure for the dismissal of members of the said authorities and the said delegates - it is announced what follows:

Due to the expiry of the mandate of the Deputy Regional Commissioner for Professional Liability doctor Jan Skarbek-Kiełłczewski and according to the resolution No. 8/2008 of the Regional Election Committee in Warsaw of 18th April 2008 on expiry and obtaining the mandate of the Deputy Regional Commissioner for Professional Liability for 2005-2009 term of office, doctor Barbara Chodzińska was appointed the Deputy Regional Commissioner for Professional Liability for 2005-2009 term of office.

Chairman of the Regional Election Committee
Janusz KOSTRZEWA

On 13th June this year the Sejm of the Republic of Poland adopted a resolution on accepting transplantation as a method of treatment.
The resolution reads as follows: "Considering that organ transplants have been present in Polish medicine for over 40 years and Polish transplanologists are in the lead among the world specialists in this field and that it is a necessary, effective and safe method of treatment often being the only chance to prolong life of many patients, the Sejm turns to the society with an appeal for common acceptance of the method".
At the same time, the MPs made an appeal to the central and local authorities for moral and material support in any educational actions promoting the topic.
The Speaker Bronisław Komorowski thanked professor Wojciech Rowiński, the head of The Polish Transplantology Union (Polska Unia Transplantacyjna), for his initiative and work in the process of preparing the resolution.
mkr

On 5th May, Monday, I left, as usual, for work. An elderly man was walking in front of me. I reached a crossroads and overtook him. The elderly man turned out to be a guru of Polish urology - Professor Stefan WESOŁOWSKI.
- 'Professor, how nice to meet you!', I said.
- 'My fellow', replied the Profesor, 'nice to meet you too.'
- 'And how are you feeling, Professor?', I asked.
And at that moment the Professor made a few jumps, demonstrating his vitality.
- 'My fellow, do you know that on 16th August I will be 100 years old! Nobody would believe that but it's true.'
Professor Stefan Wesołowski is a walking history of medicine. He is a genuine raisin in a bit mouldy cake, which Polish medicine is at present. He is a creator of the best urology clinic in Poland. His life achievements would be enough to fill up biographies of several professors.
It is our, younger doctors' and students', duty to celebrate this anniversary with all due honours. I appeal to the authorities of Warsaw Medical University, to minister Kopacz and to Supreme Medical Council (NRL) to honourably celebrate the Professor's 100th birthday. For his long, hardworking life and for his merits for urology Professor Stefan Wesołowski should be suitably honoured.
This anniversary must not be missed!
Jerzy Borowicz

University education must follow new standards and qualities of educating students. Teaching at the Medical University of Warsaw, including eleven medical departments, makes us obliged to have a wider look at the idea of medical humanism. We must teach our students to look at patients through the prism of their needs - not only medical but also social, psychic and individual. Our university, now in particular, has to concentrate on educating doctors, dentists, masters of pharmacy, analytics, nursing, midwifery and health care not only through training them in the field of medical examinations, even if they are based on the latest hi-tech solutions but also to continually extend humanisation of all these professions. A graduate of the Medical University of Warsaw should be a health care worker and a patient's trusted friend at the same time. University scientific centres ought to be equipped with modern instrumentation and devices, have excellent scientific staff and perfect research work organisation.

A graduate of the First Faculty of Medicine at the Warsaw Medical Academy (1969). A professor, doctor of medicine, a surgeon transplantologist. Since 1998 the head of the Faculty and Clinic of General, Transplantation and Liver Surgery in Clinic Hospital in Banacha Street. Was the first in Poland to perform a successful liver transplant from an unrelated donor (1994) and a transplant from a living donor (1999). The Deputy Dean and then the Dean of the First Faculty of Medicine in the years of 1996-2008. The initiator of publishing "The History of the First Faculty of Medicine at the Warsaw Medical Academy". Elected the Rector of the Medical University of Warsaw on 4th April this year for the 2008-2012 term of office.

It is over forty years now since the first transplant of kidney taken from a deceased donor was done in Poland. I was one of the doctors taking part in that surgery and afterwards I was taking care of the patient as well as of other patients in the postsurgery period.
The programme of organ transplantology was developing slowly. There ware no legal regulations, not enough qualified medical centers, but first of all both medical environment and society were unfamiliar with the new treatment method. Initially - for over a dozen of years - only renal transplants were performed. The successful heart transplant - carried out by prof. Zbigniew Religa in 1986 - considerably improved social attitude towards that way of treating patients and resulted in a systematic increase in the number of kidney, heart and later also liver transplants.
In 1995 the Parliament adopted Act on procurement and transplanting human cells, tissues and organs. According to the act taking organs from a deceased donor is allowed as long as the donor did not object to it during his/her lifetime. The act defined the rules of recognizing and stating the death of brain by an independent commission; it also specified situations in which it is possible to take a kidney (and a fragment of a liver) from a living donor. The act was amended in accordance with the European Directive two years ago.
Implementation of the act together with the effort of the whole medical environment and support of the Supreme Medical Council shifted our country to the top half of European Union countries in terms of the number of transplanted organs from deceased donors. Such were the statistisc two years ago. Unfortunately, last years' events of political and media character have brought about a decline in the number of organs taken from the dead by 45%. We have performed only 651 kidney transplants, 178 liver and 63 heart ones. There is no data on how many patients have died waiting in vain for the transplant surgery.
We used to think that too few transplant surgeries were the result of not full social acceptance of that treatment method. Nevertheless, it seems that presently an equally important reason is reluctance of our environment to identify possibilities of obtaining organs from the dead and refusal to take part in recognizing and stating the death. In my opinion there is a lot of truth in it. After publishing The Appeal to the Society, Parliament and Medical Environment in "Gazeta Wyborcza" on 29th January this year I received a few phone calls from strangers telling me that after the death of their relatives doctors refused to take organs for transplantations from them. I answered the callers that those must have been exceptional cases. I know, however, it is not true!
I perfectly understand how hideous the calumny of deliberate killing patients in order to obtain organs for material benefits are. Last year I was a subject to similar calumnies in several newspapers myself. I realize that the present situation in the health care system, idle discussions in the Seym, our salaries and lack of perspectives may bring discouragement. However, I think that fighting for our rights we should show the ones in power that we don't forget about our duty to save lives.
We shall remember that there is no transplantation without obtaining an organ from a dead person. And there is no organ obtaining without an identification of possibility to obtain organs!
Let's show the society that fighting for our rights we do not forget about people who will die without our help.

Prof. Wojciech Rowiński, M.D., PhD - the national consultant on transplantology

Our own headquarters is a very important matter for the Chamber. Thus, at the very beginning, the most important information on the matter. A few months after our 25th Jubilee Regional Convention, upon the consent of the Regional Medical Council in Warsaw (Resolution No 517/R-V/07 of 18th May 2007), the Regional Medical Chamber in Warsaw bid for and purchased for PLN1,5 million a plot adjoining our headquarters at 18 Puławska Street in Warsaw. The plot with an area of 554 m2 has 4 garages for passenger cars and workshop premises of an area 103 m2. A notarial deed was signed in August last year. The purchase of the plot means that the Chamber, after pulling down the garages, will have a car park for about 30 cars within the plot at its disposal and in the future the headquarters may be expanded.
Having dealt with formal matters, the renovation and modernisation documentation was drawn up. For different reasons, beyond the investor's control which is the Regional Medical Chamber in Warsaw - the work on documentation and the investment cost estimate together with obtaining the renovation works permit was completed in March this year. The next step was selecting a contractor to perform the renovation works. The contractor undertook to complete the works within seven months. All the given facts indicate that at the end of the year we will be able to move into our new seat in Puławska Street. more

Małgorzata Skarbek's interview with Jacek PASZKIEWICZ, the President of the National Health Fund (NFZ)

Will the National Health Fund (NFZ) decide to change the rules of contracting medical services, and if so - when will it happen?
Introducing new rules of calculating payments for medical services in hospitals, according to the principles of Homogeneous Patients Groups (jednorodne grupy pacjentów - JGP), is planned for 1st July this year. Therefore, in the second half of the year new rules will be in force. Preparations to the operation are proceeding in accordance with a previously arranged schedule.

Does it mean that funds for particular voivodships will be changed?
Financial plan for 2008 has been approved and no significant changes are expected.

Is the value of a single point going to change after the implementation of the new system of financing health care services?
The value is going to be different but I am not able to define it at present.
We are just in progress of preparing the changes. So far the cassification of all Homogeneous Patients Groups has been worked out and agreed with the experts. At the moment we are working on new economic solutions. We are at the stage of cost analyses. We are also preparing executive solutions conected, among other things, with IT applications necessary to implement the new rules of calculating payments.

Will the National Health Fund departments renegotiate contracts with health service providers or conclude new contracts with them?
We will announce a new competition of tenders. According to the schedule, the information materials are supposed to be ready by 30th April, so that the tenders can start in May.

of 4th January 2008 on the situation in polish health care system
The medical environment has been pointing out the main reasons of numerous problems of Polish health care system for years. Additionally, the Regional Medical Council in Warsaw observing the fast economic development of our country reminds that health care is a priority for the vast majority of Polish people. In such circumstances the responsibility of public authorities for the poorest, sick and suffering citizens, as well as for a few hundred thousand of those taking care of them, is obvious. Unfortunately, the responsibility has not been carried out properly for decades.
In that situation the Council wishes to remind that according to the medical environment while searching for the best organisational solutions aimed at providing Polish people with modern and safe health care, and the medical employees with proper working conditions, it is necessary to guarantee the system financing relevant to its real needs. To achieve it, the following steps must be taken:
- to increase the compulsory health insurance contribution to the level of 13% of the basis for assessment of the contribution;
- to make the state-funded premium for some groups of people real (first of all, for the biggest of them - farmers) and rise it to the level of the premium paid by citizens;
- to define the range and standard of guaranteed health benefits relevant to financial possibilities of the state budget;
- to specify statutory proper level of minimum salaries for medical workers;
- to give up the present way of contracting health benefits and replace it with a system allowing a patient to choose a medical institution in which the benefits are to be performed (open contracts);
- to introduce co-financing of health benefits by patients concurrent with designing protection system for the poorest;
- to implement regulated competition in the market of both compulsory universal health insurance and supplementary private health insurance.
The Regional Medical Council in Warsaw requests the 9th National Doctors Convention to turn, on behalf of the medical environment, to legislative and executive powers, as well as to opinion-creating environments with an appeal to launch an immediate serious debate over necessary changes in health care system, in which the voice of the medical environment expressed mainly by the medical self-government - being an important element of a democratic civil society - cannot be missing.

of 4th January 2008 on the situation of doctors' environment in Poland
The Regional Medical Council in Warsaw feeling obliged, as doctors' self-government, to represent professional interests of physicians and dentists by ensuring them the best possible conditions to perform their duties, as well as bearing responsibility for performing them in accordance with good medical practices and for providing the citizens of the Republic of Poland with proper health care and:
- noticing unchanging (in spite of significant growth of Polish economy) low level of public expenditures on health care (particularly visible in comparison with other European Union members);
- observing determination of the authorities to ensure Polish people the widest possible range of state-funded health care services having not enough funds to cover their costs;
- experiencing enormous progress in medicine bringing about more and more costly diagnostic and therapeutic procedures, and consequently, chances for better health care (as standard services!);
- observing progressive ageing of Polish society and, in consequence, continuously increasing demand for costly health care;
- noticing the tendency of the National Health Fund (Narodowy Fundusz Zdrowia - NFZ) to increase the number of ordered medical benefits and to refuse to make the medical benefits price list real at least at the level allowing to cover economically grounded costs;
- seeing a tendency to ensure health safety of Polish citizens and to keep the lowest in Europe financial support at the expense of drastically lowered salaries of medical workers, doctors in particular - especially if we consider their qualifications and professional liability;
- states that the situation inevitably leads to maintaining the salaries of many public health care sector employees on a scandalously law level and continuing a tendency, inherited from the previous political system, to treat medical environment, and doctors and dentists in particular, as hostages of the state's responsibilities towards its citizens.
In that situation the Regional Medical Council in Warsaw finds it absolutely necessary to introduce the following changes by means of suitable legal regulations:
- immediately increase public expenditures on health care so that they will reach the level of at least 6% of Gross Domestic Product shortly;
- precisely define, considering disposable funds, the range and conditions of delivering health benefits available in public health care system;
- finance services ordered by the public payer on the level of at least economically grounded costs of performing;
immediately guarantee all physicians and doctors remuneration not lower than that defined in stance No. 2 of the 8th National Doctors Convention of 6th January 2006 on statutory regulation of the minimum salary of doctors which reads: "a minimum salary should be dependant on every doctor's professional qualifications and amount to, respectively, three times the average national salary in enterprise sector announced by the Central Statistical Office (GUS) - for a specialist, and two times the average national salary in enterprise sector announced by the Central Statistical Office (GUS) - for a doctor without specialisation."

Warsaw, 3rd October 2007

We wish to express our indignation and concern about the future of Polish democracy, in connection with a statement made by the Prime Minister of Poland Jarosław Kaczyński during a television debate with a former President of Poland Aleksander Kwaśniewski, watched by around 10 million viewers in our country: The only threat which we face now is that the corruptive corporation system, which we are trying to eliminate and which we have frightened away a little, will come back.
In that way, the Prime Minister suggests that there is a corruption "pact", connected with self-governing corporations of professions of public confidence, which are an achievement of the revived democracy in Poland.
Self-governments of professions of public confidence operate in accordance with article 17 of the Constitution of the Republic of Poland, accepted in a referendum by a majority of Polish citizens: By means of a statute, self-governments may be created within a profession in which the public repose confidence, and such self-governments shall concern themselves with the proper practice of such professions in accordance with, and for the purpose of protecting, the public interest.
One of the tasks undertaken by self-governments in Poland is, apart from complying with the principles of professional ethics, fighting with pathologies. Carrying out their tasks, self-governments are an element of a civil society, which is normally not accepted in totalitarian systems - that was the reason why communist authorities eliminated inter alia medical chambers, and limited the powers of a solicitors' self-government leading to its considerable incapacitation.
We perceive the Prime Minister's statement as the announcement of liquidation of self-governments of professions of public confidence, which will result in limiting the civil liberties in our country.

The President of the Main Council of Nurses and Midwives Elżbieta Buczkowska The Chairman of the Regional Medical Council in Warsaw Andrzej WŁODARCZYK

The Secretary of the National Veterinary Medical Council Marek Mastalerek The Dean of the Regional Bar Council Jacek Trela

There are borders which, if crossed, imply that - even in our environment, perceived from the outside as hermetic and reluctant to acknowledge their guilt - it is essential to react publicly, particularly in the situation when one of the parties remains silent, and the other is the mass media.
Therefore, having concern for good reputation of a doctor's profession in mind, I turned to the Regional Screener for Professional Liability to commence an explaining action regarding the statement of the Warsaw Regional Medical Chamber member, published in "Nasz Dziennik" on 6th August 2007 about the action of blood collection during Woodstock Stop ("Przystanek Woodstock") event on 3rd and 4th August 2007. more

Andrzej Włodarczyk

Every doctor and dentist working or intending to work in their profession in Poland must be, by the power of law, a member of a respective local medical chamber.
The Chamber of Physicians and Dentists (CPD) is the only institution representing and handling the issues of medical staff. Furthermore, it sets and controls the standards of medical practices.
The Regional Medical Chamber in Warsaw is responsible for the majority of the Mazowsze province (all districts except Płock, Gostyń, Sierpc and the city of Płock). It associates about 25.000 doctors and dentists.

Andrzej Włodarczyk, MD
The Chairman of the Regional Medical Council in Warsaw

According to the article 5, statute 1 of the Polish Constitution professional governments representing workers of social services and controlling, in the interest of public safety, the standards of such professions may be appointed by the law of the parliament. Following the words of Prof. Michał Kulesza, "[...] the Constitution transfers certain public duties to the national government and its administration. Other social obligations may be transferred to decentralized entities and public institutions, indicated by the law, including professional corporations." Consequently, the government of the health care service is an important element of the public service. More...

of the Warsaw Regional Medical Council Chairman of 23rd February 2007
Referring to the recently disclosed so called corruption scandals in departmental hospitals in Warsaw and as the chairman of the Regional Medical Council, in whose area the said events are taking place, I hereby present my stance on the matter.More...

In the December issue of "Puls" there was an article on the professional burnout of the medical personnel. Five hundred doctors living in the Mazowsze province were selected and sent a survey with a return envelope (in accordance with an agreement with the Polish post office).
Yet, by the end of January 2006, only 39 surveys had been sent back. Consequently, in February a telephone survey was carried out among random doctors. The results from both surveys were sent to psychological analysis.

The Medical In-service Training Center now provides an evaluative questionnaire on its courses. We encourage you to fill it in after every training, conference or symposium you have participated in. Your remarks on its contents and organization will be carefully analyzed by the Regional Medical Council and used to improve the future courses. Please send your remarks by fax (022 313 19 65) or via e-mail edulek@warszawa.oil.org.pl

The next session of RMC's Presidium is scheduled on january 7.

Prescriptions for retired and pensioner doctors are issued free of charge at the Warsaw RMC office (ul. Grójecka 65a, pok. 18a, 2nd floor) on Tuesdays, Wednesdays and Thursdays between 9a.m. and 2p.m.

Editors of the "Puls" magazine request all doctors to confirm their post addresses.In case of a change of address or cancellation of subscription please also contact us by phone/fax (022 82836 39) or via e-mail: adresy@miesiecznik-puls.org.pl lub tel./fax: 828 36 39.

We remind you that membership fees are obligatory by law.

The office of the Regional Medical Chamber also holds an employment agency, where any health care institution may place a job advertisements free of charge. Every job offer should include information indicated below. The offers are gathered in a data base and presented as a printout. Invalid job offers are removed and the data base is updated every 4-6 weeks.

According to a regulation of the Minister of Health (Official Journal 04.213.2164) from September 28, 2004, concerning medical prescriptions, number blanks for reimbursed prescriptions had to be introduced since July 1, 2005. The Mazowsze Branch of the National Health Fund launched on May 16, 2005, the Medical Prescription Numbering System (MPNS), which allows to download prescription numbers or print prescriptions from an Internet application. The MPNS is available at the following address:
https://85.128.74.173/ap-recepty/
To use the online application it is prerequisite for a doctor or a paramedic to sign a contract with the Mazowsze Branch of the National Health Fund permitting them to issue reimbursed prescriptions. More information on the MPNS can be found at the following address: http://www.nfz-warszawa.pl/index/recepty

Make-ups, regulations and documents issued by particular committees can be found in "Topics" section of the Theme Committees website.

If you are a member of the Regional Medical Chamber in Warsaw and have a valid Working Permission, then you already have a free e-mail at the oil.org.pl domain.