The legal basis for the functioning of teaching hospitals in Poland: selected issues

Abstract

Teaching hospitals occupy a unique position in the health care system. Due to their activity, which includes not only the provision of health care, but also teaching, under-and postgraduate training, and conducting research and clinical trials, they play a special role vis-a-vis general hospitals. This role, however, is not reflected in legal reality. Enacting a new piece of legislation on teaching hospitals with the exclusive aim of addressing the functioning of these facilities in the health care system has been at the centre of debate for many years. The question of teaching hospitals' functioning concerns, in particular, the funding of their additional tasks, which are distinct from the tasks performed by other health care entities. Teaching hospitals-just like other health care entities-participate in tenders organised by the National Health Fund on the same terms as other facilities, despite providing highly specialised services, in addition to carrying out the aforementioned research and clinical trials, and training medical staff.Teaching hospitals operate as autonomous public health care units (samodzielne publiczne zakłady opieki zdrowotnej) endowed with legal personality, founded by institutions of higher education. Sometimes the autonomy these entities enjoy is merely illusory, because it is limited by the decisions made by the founder, i.e. an institution of higher education, which in reality determines the teaching hospital's structure. A very important aspect of the hospitals' operation is the existence of academic teachers within the structure of teaching hospitals, whose primary place of employment are institutions of higher education rather than teaching hospitals themselves. The purpose of this article is to present the legal basis for the functioning of teaching hospitals in the organisational structure of the health care system.It should be emphasised that due to their multifunctionality, teaching hospitals fulfi l a very important role in the health care system: they jointly perform the abovementioned therapeutic, research, and academic tasks. In addition, these hospitals train students and offer adequate scientifi c and diagnostic support. Furthermore, teaching hospitals are required to organise medical internships and expert consultations. They are ABSTRACTThe teaching hospitals occupy a unique position in the health care system. The specifi c nature of teaching hospitals calls for a different legal regime from that governing other hospitals. Their activity includes not only the provision of health care, but also teaching, under-and postgraduate training, and conducting research and clinical trials. Teaching hospitals operate as autonomous public health care units endowed with legal personality, founded by institutions of higher education. This fact is not reflected in the provisions of generally applicable law, which lack regulations relating to the particular nature of the activity carried out by this type of health care entity.

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“…However, to make it possible, clinicians should be trained in the proper use of this type of analysis. A good place for this is to expand the meaning of the teaching hospitals, in which activities include not only the provision of health care but also teaching and under- and postgraduate training [ 31 , 32 ].…”