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Back to red: allowing specialists to provide primary care would be a step backward for Poland

BMJ 2014; 348 doi: (Published 30 April 2014) Cite this as: BMJ 2014;348:g3030
  1. Tomasz Tomasik, lecturer, Jagiellonian University Medical College, Poland, and president, College of Family Physicians in Poland
  1. mmtomasi{at}

Proposed legislative changes would return the country to the flawed communist model, says Tomasz Tomasik, with paediatricians and internists offering primary healthcare

Poland is making an important decision about the future of primary healthcare (PHC) in the country—not on the basis of evidence but rather opinions, prejudices, and stereotypes.

At the end of 2013, the health minister, Bartosz Arłukowicz, proposed legal amendments that would allow specialists in internal diseases and paediatrics to work in the national health system as primary care physicians.1 Parliament’s lower house approved these amendments on 21 March 2014 and the upper house on 10 April. The president, Bronisław Komorowski, is now considering the adoption of the new law. If passed, it will return Polish primary care to the communist model of two decades ago, which Russia and Belarus still use.2

The College of Family Physicians, of which I am president, and two associations of primary care providers (the Health Care Employers’ Federation and the Employers’ Association) disagree with this move because, as the college has argued, such specialists “are not prepared to guarantee comprehensive, complex and coordinated care for …

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