Michał Zabdyr-Jamróz

This text is a commentary and a response to the article entitled Proposal for changes in the health care system in light of the nurses opinion poll (in 2018–2020). The Summary section and the abstract of the article in question instead of presenting “nurses’ opinions [on] proposals for changes in the health care system in Poland”, only contain authors’ opinions on the topic, which have not been substantiated by any evidence. The purpose of this text is to (1) draw attention to this discrepancy between the opinions of the surveyed nurses and the conclusions presented by the authors; (2) indicate in what areas the authors’ conclusions differ from the state-of-the-art on the subject and from the actual conditions of the health system; (3) discuss and develop the most valuable and accurate observations or opinions of the authors themselves. The article in question is an interesting basis for the discussion on the prevalence of knowledge that is not substantiated in the state-of-the-art but still considered obvious and self-evident among professionals and experts in the Polish health sector.

This paper concerns the events that occurred in the span of thirty years – from the 1986 Ottawa Charter for Health Promotion to the 2016 Vienna Declaration supporting it. The purpose, however, is not to discuss the substance of these events, but what should be defined as their context, in particular the political one. The text is divided into two parts relating to both of the documents mentioned, where the content of the message about health promotion formulated at that time is presented, together with the context in which it was created and received, and – briefly – its consequences. With reference to the context of the Vienna document, the issue of post-truth era will be discussed in more detail. The analyses devoted to the two parts will include addressing two problems that affect the issues under consideration: the concept of Health in All Policies and the issue of the susceptibility of various social classes to the arguments presented in health promotion programmes.

Public debate concerning Poles health, accessibility to health care services, long time waiting lists for the most emerging medical services , namely  ontological treatment, as well as many other fundamental health cares system  question, due to the hot period of political elections, became much more visible in last months. Politicians have to tackle such issues  under  Polish citizens  pressure however this particular group influence seams to be underestimated. The complexity of problems, differentiated and multiplicity of health needs, accompanied with very intensive development of medical sciences and technologies on one hand and the economical rationalization on second hand constitute the unavoidable conditions  in the sphere of choices that can not be disregarded. This difficult and politically risky process, strongly dependent on interrelations between different interests groups – with the political parties amongst them – starts at the stage of political programs creation. The article goal is to describe and evaluate particular political parties programs in this sphere, aiming at the possible future scenario concerning dimensions of health policy and public health  in Poland. The paper constitutes an attempt of comparative analysis in the sphere described above, showing the frames of national.

The aim of this paper is a systematic description and classification of the deliberative poll (DP) as a potentially innovative method of participation in health policy. The paper discusses the theory of deliberative democracy and a specific method of deliberative polling, as well as examples of its application, along with critical commentary. It summarises the characteristics of DP: advantages and disadvantages, as well as conditions for proper application. In this context an important distinction is made between two ideal types of participation: co-decision and consultation. A key feature of the latter is its advisory, and not decisive, character. DP is considered an example of such non-decisive, consultative participation.

From among the numerous analyses of the health crisis caused by the COVID-19 pandemic, the authors looked for those that would enable assessment of institutional solutions. They put forward the thesis that good institutions (with appropriate regulations, means and expert support) constitute an essential resource enabling fast, accurate, and effective measures in terms of protection and therapy.

The authors turned to experts from other countries with whom they have been cooperating for many years in the field of public health and used their competences in the field to answer questions about public governance in the first six months of the pandemic outbreak (January to June 2020) when lockdowns were widely implemented and then gradually lifted. Particularly significant for the assessment of health crisis management, the experts chose countries that are diverse in terms of: state of decentralization, social structure, and resources available, as well as healthcare organization and political tradition in dispute resolution.

Reports from Italy, the Netherlands, United Kingdom, Norway, Germany, the Czech Republic, Ukraine, and Canada (with focus on Ontario) – attached as an appendix – were supplemented with direct consultations. The comparative analysis of the obtained information and the exchange of opinions are the subject of this article. In the comparative analysis, we also refer to Polish activities and solutions. The Polish perspective of public management signifies a concern for the neglected area of public health. This article is enriched with the authors’ reflections and generally formulated recommendations.