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The Chamber of Physicians and Dentists as a Self-Government of the Health Care Service
Professional self-governments are an important part of the health care service. According to the article 5, statute 1 of the Polish Constitution professional governments representing workers of social services and controlling, in the interest of public safety, the standards of such professions may be appointed by the law of the parliament. Following the words of Prof. Michał Kulesza, "[...] the Constitution transfers certain public duties to the national government and its administration. Other social obligations may be transferred to decentralized entities and public institutions, indicated by the law, including professional corporations." Such a corporation is a part of the decentralized administration and is fully autonomous in performing public duties on its own responsibility. The scope of its autonomy is precisely described by the law. Membership in the corporation is not voluntary or obligatory, but results directly from the letter of law - thus membership is an automatic consequence of obtaining certain rights (to perform professional duties) or fulfilling requirements described by the law. As a result, the objective of the self-government of professions of public trust is, by law, to make incorporated professionals responsible for public issues. Those corporations are established by law and have the status of decentralized public administration.
Self-governments of professions of public trust, that is professional corporations, may only refer to those professions whose performance evaluation cannot be made from the outside and which are important for the public interest. The scope of interest of professional corporations ranges from professional ethics, establishing and enforcing the code of conduct, representation of its members and issues in the state administration, to granting rights to perform professional duties (it is done under the supervision of state authorities, which monitor obeying the law in the course of actions - an independent court is the ultimate decision-maker).
Before 1918, the Physicians. Chamber had been slowly evolving on Polish territories annexed by Austria and Prussia. After Poland obtained independence in 1921, medical circles persuaded the parliament to pass a law establishing physicians chambers. In 1938, the law was amended to bring chambers of physicians and dentists into being. Development of the medical self-government was interrupted in 1939, by the outbreak of World War II and, in 1950, by the communist authorities. Neither the nazi, nor the communist system(s) were in favour of independent self-government, therefore they attempted to destroy the institution. Yet, the efforts of Polish health care workers made the authorities of the Peoples Republic of Poland, on May 17, 1989, grant them the status of a profession of public trust and allow physicians and dentist to establish a professional corporation (Official Journal No. 30, item 158 with later amendments). Finally, after 40 years of neglect, all medical circles were incorporated in a unified organization covering the whole area of Poland. The law of 1989 also means that every doctor and dentist working in or intending to work their profession must be a member of a respective regional medical chamber.
The self-government of health care service is by law responsible for: monitoring and supervising duly performance of medical professions, establishing ethic and moral standards for all professionals, representing and shielding medical workers, integrating medical circles, unifying the health care service, cooperating with domestic and international science centers, universities and research and development facilities; maintaining social service stations, providing material aid for doctors and their families, managing the assets and economic actions of medical chambers and performance of other duties described by law. These duties are performed by granting rights to perform the medical profession, registering all individual and group practices, supervising residents, negotiating work standards and payments, giving opinion on doctors. incapability to perform their duties, chairing committees that select chiefs of hospitals and other managerial positions, and by preparing training programs for doctors with at least 5 year intervals in performing their professions. The self-government assists in professional training (obtaining specialties and additional skills) of medical staff and cooperates with the government administration, Post-graduate Medical Training Center, medical associations and universities and encourages continuous development of its members. Moreover, it is responsible for leisure, sports and other entertainment and activities. Other duties of the self-government include maintaining an internal employment agencies and social service institutions. In case of misfortune, a member of the medical chamber is financially supported by the Co-operative Saving and Crediting Bank (SKOK - Spółdzielcza Kasa Oszczędnościowo-Kredytowa). The self-government is also a co-founder of CSCBs of regional medical chambers. Other institutions include the Regional Screener for Professional Responsibility and the Regional Medical Court.
The Regional Screener for Professional Responsibility with deputies is responsible for supervising performance of professional duties according to best medical standards, ethic rules and law.
The Regional Medical Court adjudges in cases on professional responsibility and violation of ethical standards and has the right to deprive members of the corporation of their rights to perform professional duties.
The self-government is also responsible for protecting interests of individual and group members of medical chambers. It cooperates with the central administration, territorial self-governments, political organizations and other professional governments on issues related to health care and work standards.
The highest authority of a regional medical chamber is the Regional Medical Assembly, in case of the state it is respectively the State Medical Assembly, in which regional structures are represented by delegates. The delegates are elected during meetings of medical staff working in a particular area according to electoral laws established by the Polish Chamber of Physicians and Dentists: the elections are popular, equal, direct and secret. The laws do not limit the number of candidates. The term lasts 4 years and a candidate may only serve two terms.
Delegates to the State and Regional Medical Assemblies are elected to the same electoral laws.
Ładysław Nekanda Trepka
Deputy Secretary of Regional Medical Council