It’s been a week since I came to Poland. Here is the first part of my account of the medical aspect of the move.
Before I start, here is a mention of a couple of other things that hit me but about which I will not write (at least not now). First, I need to buy a car and nothing can prepare you for car prices here. Bloody hell, they’re expensive. And if you factor in the level of pay, car prices are astronomical (in contrast with the UK). Then it’s the advertisements – life in Poland seems to be centred around medical and quasi-medical products. Hardly anything else is advertised here. Third, I simply cannot watch the Polish national broadcaster (all of you moaning about the BBC – do stop immediately!).
Let me now come to this post’s point. I came into contact with what is the Polish health service. I can access free healthcare, as (just about) all Polish citizens, except, to be completely honest, I don’t even know how. As the most of those Poles who can, I chose to go private. This is because, for example, I can choose who I see and even if I have to wait for the doctor’s availability, the wait is way shorter than on national healthcare. In Poland (just about) every physician has a private surgery, which, over the last couple of decades or so, moved out of doctors’ homes into private healthcare centres. You go, you pay, and the doctor will see you. A number of websites will tell you whether patients like the doctor (or not) and will allow you to make an appointment. In order to see the most popular of doctors (it is unclear whether they’re popular because of the fee or the care) you will need to wait, sometimes a few weeks.
However, as I had made an appointment before I flew over, I was able to see a specialist doctor (lest I identify her, I am not going to say anymore) on the day after my arrival. And so, here I came, my first medical consultation in Poland (which was already followed up by another one) was about to happen. Below is the first of my three main observations of medicine in Poland. The next two blogposts will be about, first, how medicine is practiced in Poland (in contrast to the UK) and, second, about what (probably) could count as shared decision-making. Before I continue, I want to say that I am truly delighted with how the visits went (which, I hope will be clear in the next two posts) and the aim of today’s post is to make an account of what awaits you, should you ever fancy coming over to this part of Eastern Europe.
So, in this post, I am going to write about my first observation – money. For if you go private, you pay, and then you pay some more. You start with paying for the visit. Doctors’ fees vary but, as far as I have been able to ascertain, they are anything between 25*) and 100 pounds a visit (approximately, at the current exchange rate), depending on your location and, importantly, the academic degrees of your doctor (the higher the degree, the higher the fee). This is expensive, as the minimum monthly take-home pay in Poland is about 400 pounds, while the median is about 600 pounds. It’s worth saying that how high the fee is doesn’t have to translate into anything, for example into how long the consult is. You can read accounts of people paying, say, 50 quid, for literally a 3-minute consultation during which the physician will write you a script for a month’s supply of medication. Needless to say, after the month, you will need to see them again (yes, another 50 quid) for another prescription. I guess it all depends on the morals of the doctor. And whether they have urgent expenditure, I suppose.
After (in some cases before) you pay the doctor’s fee, you obviously need to pay for the tests (bloods and others). Mine were about 50 pounds (they were extensive), just to give an idea of what you can pay. I chose to do them in a public hospital (cheaper) which was further away but the results were available online within a few hours. Yes, you have guessed it, you can do bloods privately in a public hospital.
And no, I’m not done. When you are prescribed medication, you need to go to the pharmacy and get it. I had to pay about 35 pounds. I commented on it and the friendly pharmacist told me that I should not be complaining. She sang praises of the doctor I had seen as she had written a prescription for about 3 months (no need for repeated consultations!). It turned out that my medicines were quite cheap, there are people who pay over 100 pounds a month. When the friendly pharmacist saw that my eyes were opening wider and wider, she said that her job is made quite shit (do beg your pardon) by people having to decide on the spot which medication they take, as they can’t afford all that their doctor had prescribed. I had nothing witty, funny, or interesting to say, so I left.
As ever, things are more complicated, especially if you’re hospitalised for an acute illness. But ‘complicated’ can mean better and it can mean worse. Just saying.
And so, we come to the conclusions of this post. My first observation is that of sadness. About 20+ years ago, I did see an elderly woman reduced to tears by not being able to pay for her medication. I was standing in a long queue in a pharmacy and after brief deliberation I decided to offer to pay, but another person’s offer came quicker. I don’t know whether the woman was embarrassed more or perhaps grateful. Perhaps both at the same time. In the end, I was pleased I was not on the receiving end of her gratitude. I too would have been embarrassed. You can only wonder how much she was able to afford the next time she went to buy her medication. I hoped that 20+ years on, such scenes were a thing of the past. There is extreme sadness in realisation that access to medication is secured by your ability to pay.
My second observation is for my British friends. Save the NHS. Imagine that all you need to pay in a year is about 120 pounds (and that’s the annual fee for your medication if you’re chronically ill). The rest: consultations and tests, all free of charge. Cherish your NHS, it’s a national treasure.
As I said, the next post will be about how medicine is practiced. And it will not be so sad.
*) The numbers I quote come from a number of reputable (I think) sources found on the Polish Internet.