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The health service was in such a jock here that they decided to have a so-called “white summit” of various interest groups – doctors, economists and so on. I can’t recall off hand the name of my representative there but anyway, they’ve come up with a plan to get the health service out of the jock. The chairman of the steering committee, Professor Marek Safjan (he’s not a politician or a doctor or a patient but a judge), has some interesting comments on the nature of the consultative process: “our document must be accepted in full or rejected in full. There is no other way.” Perhaps he hasn’t got out of the habit yet of instructing juries. Among the proposals that I must accept or reject en masse is the introduction of a symbolic fee for visiting doctors. Perhaps I should rephrase that in case children or people for whom money is no object are reading: Among the proposals that I must accept or reject en masse is the introduction of a “symbolic” fee for visiting doctors. People regularly kill each other over symbols. Another proposal I must accept or reject is that of giving people the right to pay for operations in public hospitals if they don’t want to wait their turn (more commonly known as “bribery”). Naturally you would only be allowed to skip the queue on condition that this does not happen at the cost of patients waiting in the queue. (All in today’s Gazeta Wyborcza.)

So it would seem that the white summit mountaineers have come up with the wonderful idea of formalising and legalising the existing jock.

Janusz Głowacki used to smuggle criticism past the censor by dressing it up as extravagant praise, comparing favourably, for instance, the since-forgotten socialist realist book Głupia sprawa (A Silly Matter) by Dobrowolski with the publication of the first Polish translation of Ulysses. He says he got letters from some readers saying: you know, that Głupia sprawa is okay but still I think Ulysses might be a bit better. How would Głowacki fare (he’s still around) in today’s uncensored world? How would he deal with this from Gazeta Wyborcza, the story of the latest in a line of heroic hospital managers held up for us all to admire:
“Strajkujcie sobie, ile chcecie. Nie uległ strajkom, głodówkom, łzom. Połączył trzy szpitale, zwolnił 40 proc. pracowników. Wygrał wojnę z komornikami. W ciągu czterech lat uratował przed bankructwem wałbrzyską służbę zdrowia.”
“Strike as much as you like. He did not give in to strikes, hunger strikes or tears. He joined three hospitals together and sacked 40% of the staff. He won the war with the bailiffs. In four years he saved the Wałbrzych health services from bankruptcy.”
What a guy, eh? He sacked 40% of the staff. What guts! He closed two hospitals. What balls! He did not give in to hunger strikers. What manliness! I don’t know how a Głowacki would deal with this kind of official discourse. Unless he wrote it himself.

Poland’s public health service is still in a jock. Doctors out, nurses out, patients being evacuated—I’ve lost track to be honest. But here comes Agata Nowakowska of Gazeta Wyborcza to take me by the hand and patiently explain that “Raising Health Insurance Contributions Only Puts Out Fires,” (the title of her opinion piece in today’s paper). Her logic runs as follows: since equal access to health services is already a fiction there is no point in investing in public health (i.e. by raising – during an economic boom, mind you – the health insurance contribution paid by taxpayers, whom she cloyingly reduces to “emerytki” and “nauczycielki,” i.e. female pensioners and female teachers).

Sick people go private not because they are naturally capitalist but because the public service is an underfunded shambles. Nowakowska’s is the same circular argument used by Marek Rocki in his attack on publicly funded education: The state should stop funding BLANK because it underfunds BLANK. You can fill in the blank any way you please: orphanages, fire engines, nursing homes…

… for the failure to post any of the deluge of comments over the last few months. This was due to a combination of spam and technical incompetence: in blocking spam to one post I somehow disabled all commenting. Your comments are now up on the relevant pages but I’ll post a few replies of sorts here. Most of it will mean little or nothing to you, I’m afraid, but it’s the internet and paper is cheap.

It’s true: a PESEL is not a social security number except in the sense that in many countries your social security number is the only numerical identifier you have. A PESEL is only that: a numerical identifier. In general it’s always a mistake to volunteer more information than you are asked for by bureaucrats.

I’m afraid I’m going to cop out of the post on the abolition of MA theses: it turned out that the proposals reported in the Dziennik were “only” proposals and ministry officials hastened to say so when the whole establishment kicked up stink about the changes. They were just leaking/floating another scheme.

Something similar happened when Giertych announced the changes to the reading list for school children. Poland laughed and they wheeled out some ministry flunky to say they were only “proposals.” In this case, though, I understand a lot of the proposals were enacted. To speak of “MAs by research” was a bit sloppy on my part. The hitherto primary academic degree in Poland is called a “magister” and includes a thesis but there is of course a very large taught component.

It’s good to hear from you Damo. Who knows the primesidents’ precise motives for introducing the vetting procedure? I’m tempted to say that it’s less about eliminating the left than personal spitefulness and score-settling. I admit it’s a bit pop-psychological to lay the blame for government policy in a 35 million strong, functioning democracy at the feet of the personalities of its primesident but it’s just a feeling I have. There is no left left in Poland.

I write Health Care Bingo drunk. It’s a provocation and I don’t really think Poles are too mean to pay for a proper public health care service but– wait a minute. I do think they’re too mean to pay for it out of central taxation. Why else are there only varying shades of right wing parties in the country? And I’m sober now.

As mentioned previously, hospitals here in Poland are being overrun by bailiffs as the government agrees to bail out only a few of them. One of the reasons being offered for this disastrous turn of events is that there are too many hospitals. There may well be something in this but I would find it a little easier to swallow if there had been any mention of this problem before the current crisis. “Allowing hospitals going bankrupt would be good for the hospitals and for the patients. It would allow the protection of essential equipment from bailiffs” writes Elżbieta Cichocka in Gazeta Wzborcza (Feb 9th). Where were the leading articles calling for the closure of hospitals before now? After all, this is the crusading GW, motto: “it’s not all the same to us.”

The Polish health service is in a jock. Several hospitals in the ?l?sk region have had the pleasure of forming a close acquaintance with the bailiffs and it’s back in time to the Victorian era of Do-gooding as a whip around is organised to keep taxpayer-funded hospitals afloat. If this were happening in a socialist country it would be held up as proof positive that socialism does not work.

Many commentators are commentating on the reasons why the Polish health service is in a jock. Here I present a cut-out-and-paste version of office bingo to help you while away the hours of talking heads talking about why the Polish health service is in a jock. You have to choose just three of the following commonly proferred explanations of why the Polish health service is in a jock. As soon as you hear or read one, award yourself the given number of points. The winner is whoever amasses the most points.

Reasons why the Polish health service is in a jock:
1. the managers of hospitals are incompetent (1 point)
2. the managers of hospitals are corrupt (1 point)
3. trade unions (1 point)
4. Fidel Castro is a dictator (2 points)
5. all the nurses have got the hell out and are working for five times their Polish wage in Irish hospitals scrubbing toilets (2 points)
6. all the doctors have got the hell out and are working for ten times their Polish wage in Irish hospitals parking old people on trolleys in the corridors of Saint James’s hospital, Dublin (4 points)
7. Andrzej Lepper, minister for agriculture, is looking out for the interests of his constituents, the bastard (2 points)
8. the miners. They earn more than the average wage and they get to retire early, before their health is broken in half by the mines (2 points)
9. did I mention Fidel Castro? (2 points)
10. too many hospitals (1 point)
11. too few hospitals (1 point)
12. spies: it’s all a “provocation” (1 point)
13. Poles are too mean to pay for a proper health service. They’ll pay a bribe if it’s their own in-grown toe-nail but pay for the new hip of some old boot you’ve never even met before? Forget about it: that’s communism (25,000 points)

You would think that with their glorious and recent history of trade unionism the Poles would know a thing or two about striking. Today’s Dziennik carries a story about the doctors’ strike. It seems that the good doctors are manning the picket lines in their public hospitals in the morning and then, in the balmy afternoons, gracefully retiring to their oak-panelled private consultancy chambers where those members of the public who were denied state treatment earlier during the day can now buy it from the “striking” doctors.

The article is accompanied by a picture of Dr. Andrzej Spisak, his hands spread out in wide-eyed wonder that anyone might find this behaviour anything less than ethical. His lab coat bears the name of a limited company…

A tightly-edited, coherent entry today:
An initially unpromising article about ambulance services in the current (print edition) Polityka reveals (apart, of course, from the under-funded mess that Poland has inevitably made of its emergency services) that hospitals in Poland were located not in places determined by the needs of the surrounding civilian population but according to Warsaw pact plans; that is, where the powers-that-were foresaw heavy casualties in the event of NATO invading. (What? NATO invade? Boy were the communists ever wrong about the peace-loving North American Treaty Organisation.)

But this was not just communist paranoia and to-hell-with-the-masses. America�s interstate highway system was built to cope with mass evacuation in the event of a nuclear attack. The botched evacuation of New Orleans suggests that the communist threat may have been no more than a justification for massive state intervention in the automobile industry rather than the spur for developing a meaningful emergency plan. Either that or the plan had not been updated since 1956.

Nor was little “neutral” Ireland untouched by considerations of war and peace, though in the case of Ireland the enemy was within. The hideous University College Dublin campus in Belfield is popularly believed to have been designed to stymie hot-headed sons of strong farmers and future civil servants from rioting. The only flat, open space in the middle of campus is a reservoir for water cannons - sorry, a water feature. The open spaces are broken up by broad, shallow, steps too steep for a wheelchair but shallow enough for an armoured personnel carrier. All this conspires against large gatherings of people, unless the Student Union take it into its head to protest on the football pitches or in the now capacious car parks.

It would be nice to think that more enlightened attitudes prevail today. But, as Paweł Walewski reports, in Poland’s health services the siting of hospitals with accident and emergency wards has in the recent past been dictated more by local officials’ overweening ambitions than by real needs.