In the beginning there was chaos
When the first case of SARS-CoV-2 was identified in Poland in March 2020, responsible state authorities and institutions, medical entities and services were not prepared for the epidemic outbreak – the NIK audit reveals. Nevertheless, the authorities did not declare the state of natural disaster. Instead, via a Special Act on COVID-19, they amended the provisions of law, under which even stricter restrictions, bans and orders were imposed. Besides, the Special Act lifted mechanisms ensuring proper public spending. As a result, the Chancellery of the Prime Minister and the Ministry of Health wasted PLN 82.3 million on defective and non-functional ventilators which did not comply with the Polish norms. NIK filed three reports to the prosecutor’s office concerning that issue.
The defective ventilators often posed a threat to patient safety and so they could not be used to control the epidemic.
Since a range of provisions implemented under the Special Act on COVID-19 raised significant doubts, the NIK President submitted two motions to the Constitutional Tribunal to confirm that some provisions of the Special Act and of the so-called amending act do not comply with the Polish Constitution.
14 unnecessary temporary hospitals for over PLN 600 million
Temporary hospitals in Poland were built in Poland since October 2020 on a scale unseen in Europe, without any plan or reliable analysis of the epidemiological situation or availability of medical staff, and also without any cost calculation – NIK established. According to the Polish SAI over PLN 612.6 million was spent ineffectively and without purpose on the creation, functioning and liquidation of temporary hospitals located in large-format buildings.
Nearly PLN 31.5 million was spent on three facilities there were created but never opened. Over PLN 29 million of that amount was used to establish and maintain a temporary hospital in Szczecin, where not a single patient was admitted.
The failure to coordinate activities nationwide resulted in an excessive reserve of COVID-19 beds and medical staff. As a consequence, from March 2020 to April 2022, the costs of maintaining readiness to provide healthcare to COVID-19 patients, in all the hospitals adjusted for that purpose totalled about PLN 7 billion. At the same time, the Polish state spent less than PLN 5 billion on the actual treatment of SARS-COV2 patients. According to NIK this is a symptom of unsound management of the hospital care system by two subsequent ministers of health.
Administrative decisions on the creation and organisation of the temporary hospitals were issued by the Prime Minister (12), the Minister of Health (26) and governors (3) under the Special Act on COVID-19, upon violating – to a various degree – the Code of Administrative Proceedings.
The data obtained by NIK shows that temporary hospitals opened in Europe because of the COVID-19 pandemic were treated only as an ad hoc solution. Usually one or two facilities of this kind were created in one country. In 11 European countries temporary hospitals were not built at all.
Graphic description
Temporary hospitals in Europe
Countries where temporary hospitals were created (data from SAIs):
- Poland (33 hospitals of which 32 admitted patients)
- Great Britain (9 hospitals, of which only 1 hospital admitted patients, 6 did not admit any patients and in case of 2 hospitals no patient admission data is available)
- Czech Republic (2: did not admit any patients)
- Germany (1: did not admit any patients)
- Netherlands (1: admitted patients)
- Spain (1: admitted patients)
- Italy (1: admitted patients)
- Estonia (1: admitted patients)
Countries where temporary hospitals were created (publicly available data):
- Hungary (1 – no patient admission data available)
- Lithuania (1 – no patient admission data available)
Countries where temporary hospitals were not created:
- France
- Belgium
- Luxembourg
- Switzerland
- Portugal
- Liechtenstein
- Austria
- Slovenia
- Croatia
- Bulgaria
- Greece
- Cyprus
- Denmark
- Sweden
- Finland
As for other European countries no data is available.
Source: NIK’s analysis based on data from SAIs of the countries listed above in response to NIK’s inquiry and publicly available data
PLN 9 billion for COVID benefits – beyond control of the Minister of Health and the National Health Fund
NIK has negatively evaluated the preparation and implementation of the Minister of Health’s recommendations on COVID-19 benefits. In 2020-2021, nearly PLN 9 billion was spent on this purpose. The Minister of Health and the President of the National Health Fund improperly and ineffectively supervised both the preparation and the implementation of those recommendations. They also failed to audit the adequacy of assigning and paying COVID benefits and did not react to improper execution of COVID benefit agreements by hospitals and ambulance stations. According to NIK there is a risk that it will be impossible to estimate the benefit amounts spent without reason or to reimburse those funds. As a consequence, some assets of the COVID-19 Prevention Fund will have to be considered as lost.
The Minister of Health allowed significant defects in the COVID benefit allocation system. As a result, the benefits were paid:
- to non-eligible persons (e.g. in “non-COVID” wards, for contacting a patient only suspected of the SARS-CoV-2 infection);
- several times to the same person for a given month exceeding the limit of PLN 15 thousand (up to PLN 41.5 thousand per month);
- the amount of PLN 15 thousand was paid to medical staff who attended to a SARS-CoV-2 patient (or a patient suspected of SARS-CoV-2) only once or for several minutes;
- to up to 31 medical staff representatives per one COVID bed or to 23 persons per patient – in line with the Minister of Health’s interpretation, the medical staff working in non-COVID wards were also entitled to the COVID benefits.
The “financial tool” created by the Minister of Health to support the medical staff taking care of COVID patients was distorted and became a mechanism for transferring “extra benefits” for the hospital personnel who were often not eligible to receive them.
