Amendment to Article 59 of the Medical Activity Act – Some Remarks on the Financial Responsibility of Local Government Units for the Net Loss of Independent Public Healthcare Institutions

The article analyses the amendment to Article 59 of the Medical Activities Act, introduced in 2021 following a ruling by the Constitutional Tribunal. As a result of the amendment, the obligation of local government units (LGUs) to cover the net losses of independent public healthcare institutions (SPZOZ) was replaced with an option to do so. The authors highlight systemic issues in the financing of healthcare in Poland, emphasizing that the amendment did not resolve the growing debt problem of SPZOZ. While the reform formally reduced the financial responsibility of LGUs, Article 61 of the Medical Activities Act still holds them accountable for the debts of liquidated SPZOZ. The amendment introduced into the Polish law system was, in fact, fictitious. The legal status did not actually change. The article presents three potential solutions: transferring the obligation to cover SPZOZ losses to the National Health Fund (NFZ), shifting financial responsibility for liquidated institutions to the State, or legislatively clarifying the role of LGUs in financing healthcare. The analysis concludes that the lack of a comprehensive reform in healthcare financing continues to exacerbate SPZOZ debt accumulation and economic instability.