Poland's health care strike is likely to shift the government's focus to internal matters.

By Anna Dunin

The ongoing strike of medical personnel in Poland looks set to weaken the government and shift its attention to the internal situation and away from foreign engagements, though the crisis is unlikely to bring the government down.

The government is unlikely to be able to provide additional funding for the country's public health care system to the extent that would satisfy striking medical workers and the immigration of health care professionals to western and northern Europe will likely continue to intensify. Faced with a shortage of doctors and nurses, the government will have little choice but to look to the east to recruit medical personnel.

Doctors from 285 of Poland's 600 hospitals launched an open-ended strike on 21 May in which they provided only emergency medical services, according to Polish media sources. The doctors are demanding 100 percent pay raises and more funding for the health care system.

Frustrated by a lack of response from the government, health care workers have begun handing in group resignations (80-90 percent of personnel in some hospitals) that will come into effect in October, and hundreds have begun a hunger strike. While there is no specific information on the number of those striking nationwide, tens of hospitals in each of Poland's 16 regions have joined the strike, while only a few have quit, according to local media sources.

Nurses joined the strike on 19 June, and 20,000 health care workers began a demonstration in front of the prime minister's office. Their demands included pay raises, better working conditions and for Poland to spend 6 percent of the country's gross domestic product (GDP) on health care, rather than the current 3.7 percent. Three nurses representing the group entered the PM's office, and waited for the meeting with the PM, who only met with them after seven days, local media reported.

On 23 June 300 miners and steelworkers, and on 25 June, 100 teachers joined the demonstration. The nurses enjoy public support, which the Poles prove by providing them with food, tents, blankets and money during the ongoing protest. As a form of repayment, the protesting nurses, midwives and doctors conducted free prophylactic examinations for Warsaw's residents on 30-31 June.

The ongoing strike is unlikely to bring down the Polish government, but is highly likely to weaken it significantly. The leader of the coalition, Law and Justice (PiS) Party will focus more on the internal problems instead of international issues, in an attempt to gain public support before the next elections.

The health care workers have kept their protest apolitical and are cautious with the support they receive from the opposition.

Over 67 percent of Poles do not give credence to the government's claims that the protest is a political provocation against the ruling party and support the striking medical personnel. Despite the popular support they enjoy, the health care workers are unlikely to be able to mobilize the general population beyond current levels.

Despite falling support for PiS, it is not expected to be ousted from power. Other members of the coalition, radical parties of the right: Self-Defense and the League of Polish Families are determined to keep the alliance, as they are highly unlikely to be able to form it with any other party, and they are too weak by themselves to form a government.

The coalition has majorities in both houses of the parliament, so a successful vote for premature elections is highly unlikely. The health care strike, along with other internal issues, including a scandal with files of secret collaborators with Polish security, which appear to be disclosed only when convenient to the government, continue to weaken the ruling coalition, however, making it unlikely that it will spend political capital on unpopular external security projects such as the US missile shield or Polish military missions in Iraq and Afghanistan.

Compared to Poland, financial incentives for working in the western part of the EU are significant, particularly in the UK, Ireland, Denmark, Sweden and Germany, which do not have enough medical professionals. According to the Polish Chamber of Physicians, 6 percent of Polish doctors emigrated in 2004 through 2006, including 17 percent of the country's anesthetists. One-third of the Polish doctors between the ages of 25 and 35 plans to work abroad, and 80 percent of medical students declare they will emigrate once they graduate. Taking advantage of cheap airfare, some doctors regularly travel to the UK, where they earn US$2,704 in just one weekend by working night shifts. Ireland, England, Spain and Germany actively seek Polish professionals and widely advertise. Sweden, struggling with an aging society, will need to hire 100,000 new health care workers by 2030 and has already turned to the Polish doctors with job offers.

In Poland, the monthly salary for a general doctor is US$460 and US$1,080 for a specialist. The nurses make on average US$388 monthly, and both groups often work up to 80 hours a week. In the UK, a basic nurse salary is US$2,000 a month, but can be many times higher depending on experience and specialty, and the average monthly salary of a general practitioner is US$17,700.

The Polish government will likely offer to fulfill some demands of the striking health care workers, enough to make them return to work, but not enough to keep them in Poland in the long run. The emigration of the young health care workers, who know foreign languages, will likely intensify. The older ones, who want to stay in Poland, will be able to walk away from the protest with a sense of success and dignity.

The PM announced that the government is not able to offer any raises because of the tight budget, and added that the only way to offer to the medical workers what they expect would be by raising taxes. He wants society to consider the potential increase of tax rates in a referendum. Opponents see the referendum as a manipulation and an attempt by the government to decrease public support for the nurses, as the Poles are not able to affect other government spending, including lacking public support military missions abroad. Most Poles (71 percent) are against the referendum and will likely boycott it. If the government offers demanded raises to the medical personnel, it is likely that other social groups including teachers, miners and steelworkers will begin striking and ask for raises as well.

The Polish health care system is in a very poor condition. It is extremely under-funded; the 3.7 percent of GDP spent on health care is one of the lowest among the Organization for Economic Cooperation and Development (OECD) member countries, which on average spend 9-10 percent of their GDP for that purpose. Widespread corruption in the system is also a problem, and there has always been a social and governmental degree of leniency in this area. However, starting in 2001, the Poles started perceiving corruption as a serious social problem.

It is likely that the formation of the Anti-Corruption Bureau (CBA) and their recent activity in investigating of the corruption cases in the public health care system, including the arrests of well known doctors, added to the doctors' determination to protest. While the doctors are afraid to take bribes, they likely cannot make the living off their salaries.

It is likely that government's announcements of high economic growth in Poland caused the demand for salary raises by state employees. The unemployment rate has been falling and reached 13 percent in May this year, as compared to 16.5 percent in May 2006. The growth of the GDP accelerated from 3.6 percent in 2005 to 6.1 percent in 2006. While the government takes credit for the economic development, society does not see any improvement in their standard of living, which increases social dissatisfaction with the ruling party.


Faced with the shortage of doctors and nurses, the Polish government is likely to turn to the east, for example to Ukraine, for medical personnel. Ukrainian nurses, making about US$100 monthly, are likely to accept job offers with Polish salaries, which despite being low, are still a much higher than those found in Ukraine. This will likely require a change of regulations which currently make it impossible for foreign medical professionals to work in Poland without official Polish recognition of their diplomas.


Mercyhurst-ISN intelligence briefs offer foresight into issues that are likely to dominate news headlines and policy agendas. The briefs are a joint initiative of the ISN and Mercyhurst Institute for Intelligence Studies and are composed and referenced using open sources.


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