Value stream · Healthcare Poland Foundation
Between a complaint filed at the reception desk and a statement of claim, Poland has no forum where the facts can calmly be established. The Centre is being built to provide one.
Conciliation, mediation and arbitration for healthcare — with competence that is at once legal and clinical, within timescales counted in weeks.
1 July 2024
The regional commissions for adjudicating medical events were abolished. No successor performs the same function.
under 1%
Of cases at the investigative stage reach mediation within the medical chambers.
close to 60%
Of referred mediations end in settlement. The potential is there; the uptake is not.
A dispute is an event within a system of care
Not merely a legal incident. This assumption underpins the entire design of the Centre.
When an adverse event occurs, or providers disagree over settlement, a mechanism is set in motion that removes the resolution from the place and time of the event. Proceedings take years and end in a judgment on liability that repairs nothing in the clinical process.
Meanwhile the event ceases to be material for learning and becomes material for evidence. Staff begin to act defensively. The patient, who wanted to understand what had happened, receives a sum of money and silence several years later.
An institution that judges more than it can prove loses the confidence of both parties at once.
Three design principles
Proportion
The manner of resolution must be commensurate with the weight of the matter. A dispute over an episode settlement and a dispute over permanent harm cannot travel the same route.
Accountability without retribution
Just Culture is not a declaration of leniency. It is a distinction between systemic error, negligence and knowingly reckless conduct.
Accessibility of resolution
A patient who cannot afford litigation and a provider who does not want escalation have nowhere to go today. A forum changes the position of both at once.
Diagnosis — two ends and an empty band between them
At one end, a complaint examined by the very organisation it concerns. At the other, litigation lasting years. Between them institutions exist, but none performs the function of a forum for disputes.
Commissions abolished
Since 1 July 2024 pending cases sit with a team inside the Ombudsman Office, not a new adjudicating body.
The Fund compensates, it does not explain
An administrative benefit from PLN 2,393 to PLN 239,131. It restores no relationship and changes no procedure.
Chamber mediation is closed inside the profession
It runs alongside disciplinary proceedings, and a settlement does not conclude them — it only affects the penalty.
Consumer ADR excluded by statute
The 2016 Act, implementing Directive 2013/11/EU, excludes health services. The European ADR architecture bypasses healthcare.
The second, less visible band is disputes between providers: over the division of a single payment in a coordinated episode, over responsibility for a break in continuity, over settlements between consortium members. These are wholly commercial — and they give the Centre its first genuine caseload.
How it works — three pathways
A matter enters at the lowest level and moves higher only where agreement has not been reached.
01
Conciliation
14–30 days
A structured clarifying procedure within the institution, with an independent conciliator. It ends in a record — an agreed statement of facts.
02
Mediation
30–90 days
Contractual mediation under the Code of Civil Procedure. The settlement is approved by the court and carries the force of a court settlement.
03
Arbitration
90–180 days
A permanent arbitration court. Its domain is commercial disputes within the sector. With a patient, only on an agreement made after the dispute arose.
What hospitals gain
- Resolution in weeks rather than years — the matter stops absorbing the management.
- Predictability in coordinated care settlements and in consortia.
- An explanation given before a complaint turns into a dispute about money.
- Restored adverse event reporting — staff stop fearing that a report becomes evidence.
- An element of the risk profile that an insurer is able to price.
- Readiness for the foreign patient required under Directive 2011/24/EU.
What patients gain
- An explanation within weeks, concluded by a written record of the facts.
- Equality of the parties without litigation — proceedings led by an independent person.
- Cost to the patient nominal or nil.
- An outcome no court can award: an apology, a change of procedure, corrective action.
- A documented statement of facts that makes an application to the Fund easier.
What the Centre does not take away from the patient
Participation in proceedings before the Centre is voluntary and does not close the route to the ordinary courts, to the Medical Events Compensation Fund, to proceedings before the Patient Rights Ombudsman, or to proceedings on professional liability.
The law precludes any other construction: an arbitration agreement in consumer disputes may be concluded only after the dispute has arisen (Article 1164(1) of the Code of Civil Procedure). An arbitration clause in a consent form would be not merely ineffective — it would deny the idea on which the Centre rests.
The Centre is in formation
Institutions and organisations interested in taking part in the preparatory work — including the conciliation standard pilot — are invited to get in touch.
Legal bases
- Article 1157 CCP — arbitrability (Journal of Laws 2019, item 1495)
- Article 1163 CCP — arbitration clause in articles of association; commercial companies only
- Article 1164(1) CCP — arbitration agreements in consumer disputes, only after the dispute has arisen
- Articles 183(1) et seq. CCP — contractual mediation
- Act of 23 September 2016 on out-of-court resolution of consumer disputes — exclusion of health services
- Act of 16 June 2023 (Journal of Laws 2023, item 1675) — Compensation Fund; abolition of the regional commissions from 1 July 2024
- Article 113(3) of the Act on Medical Chambers — mediation within the chambers
- Directive 2011/24/EU; Directive 2013/11/EU
