For many patients in Poland, a medical referral is no longer a guarantee of care, but the start of a precarious waiting game. In recent months, the reality of healthcare access has shifted from long queues to outright cancellations, leaving some to fear that the delay in their diagnosis will be fatal. The sentiment is best captured in the desperate words of patients calling hospitals: “I will not live to spot the new date. I will die.”
This crisis is the direct result of a policy shift by the Narodowy Fundusz Zdrowia (NFZ), the National Health Fund. Since April, a directive issued by NFZ President Filip Nowak has fundamentally changed how diagnostic tests—including MRIs, CT scans, colonoscopies, and gastroscopies—are funded. In a move that critics say effectively means the NFZ zabiera pieniądze pacjentom by starving the facilities that treat them, the fund has slashed reimbursements for tests performed beyond the initial contractual limits.
Previously, the NFZ covered the full cost of diagnostic procedures even when they exceeded the agreed-upon contract. Under the new rules, hospitals may only receive a reimbursement of 50% to 60% of the costs, depending on the specific test. For many healthcare providers, this gap creates a financial deficit that is impossible to sustain without risking bankruptcy.
The Puławy Collapse: From 900 to 100
The systemic impact of these limits is most visible at the District Hospital in Puławy, Lubelszczyzna. The facility, which previously managed a high volume of diagnostic imaging to serve its community, has been forced to implement drastic cuts to avoid crippling debt. Until recently, the hospital performed between 800 and 900 MRI scans per month. Following the NFZ’s funding shift, that number has plummeted to just 100 patients per month.
Hospital Director Marek Paździor has been blunt about the consequences of this reduction. He notes that the MRI laboratory’s financial limit for the entire year has already been exhausted. According to Paździor, pushing a diagnostic test from the spring to the autumn is not merely an administrative delay; for many patients, such a postponement can be a “death sentence.”
The resulting logistical nightmare falls on the shoulders of the frontline staff. Anna Pietrasiak, a nurse at the Puławy hospital, describes a daily routine of delivering devastating news. Patients who had waited months for a scan in April or May are now being told their new appointments are scheduled for October or November.
“The fury is enormous. People are completely innocent in this. They received a referral, they signed up, their date was approaching, and then they find out they have to wait further,” Pietrasiak said. “There are curses, nerves, screaming, and sometimes crying. We hear on the phone, ‘but I will not live to see the new date, I will die.’ It’s very tough for the patients, and for us.”
A Bureaucratic Loop of Frustration
The tension is exacerbated by a paradoxical administrative process. When patients, desperate for care, file official complaints with the NFZ regarding the lack of available dates, the fund responds by demanding explanations from the hospitals. The NFZ asks why the facility is refusing to provide timely help to the sick—despite the fact that the NFZ itself removed the funding necessary to perform those very tests.
This creates a cycle where hospital administrators must justify their inability to provide care to the same agency that capped their budget. For the nursing staff, the situation is one of total helplessness. Pietrasiak emphasizes that the staff is often the target of patient anger, despite having no control over the funding mandates. “Patients are powerless, but we are powerless too, since we have no way to help them,” she said.
Impact of NFZ Funding Changes on Diagnostics
| Metric | Previous System | Current System (Post-April) |
|---|---|---|
| Reimbursement Rate | 100% (even above contract) | 50% – 60% (above contract) |
| MRI Monthly Volume | 800 – 900 tests | 100 tests |
| Patient Wait Times | Standard contractual queue | Extended by several months |
| Financial Risk | Low (Funded by NFZ) | High (Hospital absorbs 40-50% cost) |
The Human Cost of “Over-Contract” Limits
The core of the issue lies in the definition of “over-contract” services. In a healthcare system with rising demand and aging populations, the actual need for diagnostics almost always exceeds the theoretical limits set in a yearly contract. When the NFZ provided full reimbursement for these overages, hospitals could prioritize patient health. By shifting to partial reimbursement, the NFZ has effectively forced hospital directors to choose between the financial solvency of their institution and the lives of their patients.
This shift disproportionately affects those who cannot afford private healthcare. While wealthier patients can pivot to private clinics to receive an MRI or CT scan within days, the residents of regions like Lubelszczyzna who rely on the public system are left with no alternatives. The result is a two-tier system where the speed of a diagnosis—and the chance of survival—is determined by a patient’s bank account rather than their medical urgency.
Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Patients experiencing healthcare delays should consult with their primary care physician or a patient rights advocate.
As hospitals continue to struggle with these limits, the medical community is calling for a revision of the funding model to prevent further diagnostic collapses. The next critical checkpoint will be the upcoming quarterly review of NFZ expenditures, where health advocates are expected to push for the restoration of full reimbursements for essential diagnostic imaging.
Do you have experience with diagnostic delays or the current NFZ limits? Share your story in the comments or contact our newsroom.
