A/HRC/41/33/Add.433/Add.4
be pointed out that according to Article 9(1) of the GTCA, the provider provides services
throughout the duration of the agreement, in accordance with the work schedule specified
in the agreement and the material and financial schedule.
When signing an agreement for the provision of health care services, the provider
undertakes to provide all the services defined as guaranteed in the relevant executive
decrees to the Act, within the given scope and type of services for which the agreement has
been concluded.
It should also be pointed out It is to be underline that in the case of impossibility of
providing services, which could not have been predicted earlier, the provider is required to
immediately take steps to maintain continuity of services (transferring the patient to another
provider which can ensure the indicated service), at the same time notifying the
Voivodeship Branch of the Fund on this event and the actions taken.
Moreover, it should be emphasised that according to Article 8 of the GTCA, the provider
ensures services in a comprehensive manner, including the performance of the necessary
tests, including laboratory tests and imaging diagnostics, as well as medical procedures
related to the provision of these services. Therefore, if a doctor practising their profession
on the basis of an employment relationship or in the service informs the provider on the
refusal to provide the service in the situation specified in Article 39 of the Act of 5
December 1996 on the professions of doctor and dental practitioner, i.e. due to the
“contentious objection”, the provider is required to ensure the performance of this service
in a different way. The manner of providing health care services in a given medical entity
should be organised in such a way as to ensure, on the one hand, that doctors are able to
exercise their profession in accordance with their conscience and, on the other hand, that
patients have undisturbed access to the health services to which they are entitled.
Lack of possibility to provide services constitutes improper performance of the agreement,
for which a contractual penalty may be imposed on the provider in accordance with the
provisions of Article 29 et seq. of the GTCA, or even termination of the agreement in
accordance with the provisions of Article 36 of the GTCA.
As a rule, therefore, all medical entities (hospitals) that have concluded agreements with the
National Health Fund are required to provide the services provided for therein — to the full
extent and in accordance with the applicable law. The application of the “contentious
objection” should not affect this obligation.
In addition, it is also important that conscience is an individual category, so only particular
individuals can invoke the contentious objection. It is a right to free (i.e. free from any
pressure) self-determination in matters of world view, which is not fulfilled by a collective
refusal.
To sum up, if a doctor refrains from performing health care services inconsistent with their
conscience, the information obligation regarding the manner of performance of the
agreement with the National Health Fund in this respect lies with the provider, i.e. the
medical entity, in which the doctor refrained from performing this service.
Ad Part VII “Family and culture”, paragraph 60
It should be noted that a change will be introduced in the Programme “Family 500 plus” in
2019. The Programme will be amended by including also the first or only child being raised
until turning 18, regardless of the income. At present, the right to a 500+ child-support
benefit for the first child (the only or eldest child in the family up to 18 years of age), is
conditioned on the criterion of income. The income needs to be no more than PLN 800 net
per month per person in the family, or PLN 1,200 net per person in the family if a disabled
child is a member of the family.
The scope of the 500+ child-support benefit will be broadened to include more support for
families raising children, by enabling them to partially cover the expenses associated with
the satisfaction of life needs and upbringing of their children. The solution will enter into
force in July 2019.
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