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EACEA National Policies Platform: Youthwiki
Poland

Poland

7. Health and Well-Being

7.8 Current debates and reforms

There are at least two directions in the current debates concerning young people’s health and well-being issues. The first of them - a debate relating to expenditure on health care services required by the medical community - is of a general nature. The Ministry of Health has published a material entitled All Together for health - a national health debate (Wspólnie dla zdrowia – narodowa debata o zdrowiu), which reads: "the decision to significantly increase state expenditure on health care services up to 6% of the GDP has created an exceptional opportunity for introducing changes to the health service system, so it can operate more effectively. The optimum use of higher than ever public expenditure for health care requires - as Łukasz Szumowski, Minister of Health says - a public debate. We intend to set priorities and objectives by engaging in a nationwide dialogue, together with various communities: patients, doctors, nurses and other medical professions, employers and experts". Although the planned increase of public expenditure should be the starting point for the discussion, it should also include the problem of ageing society, epidemiological challenges and technology development. The debate should be aimed at "developing a system which would strike a balance between social needs, the financial and economic capacities of the State and social capital involvement". The debate was summed up in August with the report Strategic directions of healthcare system development in Poland. Result of the national debates on health care development, a summation (Strategiczne kierunki rozwoju systemu ochrony zdrowia w Polsce. Wyniki ogólnonarodowej debaty o kierunkach zmian w ochronie zdrowia, dokument podsumuwujący). The document includes a few mentions of young people’s health - children were indicated among groups that especially demand healthcare; one of the priorities of public health was pointed out to be the need to increase the awareness of health risks through educating the youth; the need to slow down (and preferably reverse) negative health trends among the young people through the introduction of health classes to elementary and middle schools was pointed out. Up until now, the debate has not resulted in concrete actions based on the aforementioned document. Further discussions in this field are to be expected.

Another debate, which has already been referred to Polish Parliament as a bill, focusses on compulsory immunisation. The Polish Vaccination Knowledge Association “STOP NOP” is the author of draft amendments to the Act on Prevention and Combating Infections and Infectious Diseases in People (Ustawa o zapobieganiu oraz zwalczaniu zakażeń i chorób zakaźnych u ludzi). It intends to waive the obligation of compulsory vaccination and make it voluntary. However, as the Chief Sanitary Inspector says, "from the perspective of public safety and citizens’ health, each change likely to lower vaccination ratios exposes us to the return of diseases which are almost forgotten". The project for the Act was rejected in the fall of 2018, but the question of vaccination availability is still extant and may well return to the public debate, especially in the context of the COVID-19 vaccine

Many debates involving health issues in Poland are ideology-based and the admissibility of pregnancy termination is the best example thereof. Issues linked to dependencies and addictions are also part of such discussions. Poland definitely prefers the paradigm of total abstinence from psychoactive drugs, which significantly hinders harm reduction activities. In the same way, mental and ideological limitations affect the issue of treating people carrying HIV. There are no uniform and universal medical procedures in relation to them. This is all the more important as new social phenomena are emerging, which are the cause of this and many other infections, such as prostitution of young males involving those entering Poland by crossing the Eastern border, or so-called chemsex which means taking drugs or consuming alcohol to enhance sexual  pleasure which, in turn, leads to a total loss of control and increased exposure to infection.

The most recent legal change concerning psychoactive substances relates to amendments to the Act on Counteracting Drug Addiction, which treat 114 psychoactive substances used in legal highs in the same way as traditional drugs. This, in turn, causes further penalisation of the phenomenon. Currently, the possession and supply of such substances carry the same penalties. People opposed to this solution say that excessive penalisation for possessing psychoactive substances makes it impossible to implement effective harm reduction measures in relation to abusers.

Activities aimed at the protection of the young generation from sexual abuse and its consequences are the subject of a debate currently in progress. The withdrawal of public funding provided to activities conducted by the Empowering Children Foundation (among other things in relation to providing the helpline for children and youth already discussed) is a tangible result of that dispute. The Foundation aims to protect the youngest citizens from harm and minimise the consequences that result from experiencing violence. Sexual violence is one of the frequently indicated form,s which has resulted in the emergence of this issue in public debates.

 

The ongoing COVID-19 pandemic has highlighted negative phenomena regarding the psychiatric health of the youth, which intensified the debate on children psychiatry in Poland and the necessary changes. In the period of the pandemic, there is a marked increase in the number of young people seeking help on the Telephone Helpline for the Young 116 111, and only in March 76 interventions have been conducted that had to do with the danger to the health or life of a child. It is a number almost twice as high as in previous month, and the scope of the interventions was the greatest in the 11 year history of the Helpline. The Helpline, to remind, has for a few years now, not been financed from public sources, only private, which remains a subject of protest and controversy.

Activities aimed at the protection of the young generation from sexual abuse and its consequences are the subject of a debate currently in progress. The withdrawal of public funding provided to activities conducted by the Empowering Children Foundation (among other things in relation to providing the helpline for children and youth already discussed) is a tangible result of that dispute. The Foundation aims to protect the youngest citizens from harm and minimise the consequences that result from experiencing violence. Sexual violence is one of the frequently indicated form,s which has resulted in the emergence of this issue in public debates.