More and more disabled persons declare their willingness to start work. The vocational activation programmes supporting the disabled absorbed PLN 300 million within the past three years. However, they were not effective enough. A problem is for instance the attitude of employers who hire the disabled for the traineeship which is sponsored by the state but afterwards they rarely prolong the employment agreement. The results of the NIK audit, which was part of a larger European audit evoked interest of the Sejm Deputies and the institutions responsible for vocational activation of disabled persons. Good practices used by other countries, e.g. a very effective Swiss system of vocational reintegration - may be successfully implemented in Poland in the near future.
Key audits of NIK part2
The NIK audit confirmed that the system of qualifying patients for an organ transplant makes it impossible for a person outside the National Waiting List to undergo a transplant procedure. The sequence on the list is determined only by the medical criteria. The key problem of the Polish transplantology is still a too small number of organs for transplantation. To increase the chances of people waiting for an operation, hospitals should be more proactive in identifying potential donors. The hospital directors, explaining little activity of their institutions, mention many reasons of that situation: an extraordinarily complicated procedure for determining the brain death, objection of the family or the lack of hospital wards being critical for obtaining the organs from the deceased (neurology, neurosurgery, Intensive Therapy Unit and Critical Care Unit). The issue is also complicated by the lack of cooperation between individual units and insufficient knowledge of some doctors in terms of donor registration procedures. According to the NIK audits, though, the biggest impediment remains a too small number of transplant coordinators.
In 2011, NIK also had a closer look at the hospital commercialisation process. In most of the audited institutions the transformation does not bring about the expected results. The queues of patients do not get any smaller and a part of hospitals, already as companies with a local government share, run into debt again. It is the case mainly in the hospitals where the whole transformation process amounted to the accounting operations, that is the debt relief, while in the hospital as such the status quo was maintained. The audit revealed that the then directors became the heads of a half of the transformed hospitals. It did not help in maintaining transparency or repairing the situation. As a consequence, the hospitals which incurred significant losses before the commercialisation, fell into another spiral of debt after the transformation. At the same time profits were made by the hospitals which started to manage well before the commercialisation. They owed it to the real changes, as adaptation of their own structure to the market requirements, headcount optimisation, good work organisation and effective negotiations with the providers of medicines and medical equipment.
