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
Directive 2013/11/EU excludes health services provided to patients from its scope. The Polish Act of 2016 excludes disputes over services provided in the general interest (art. 5(5)(a)), and the register of authorised entities kept by the President of the Office of Competition and Consumer Protection contains no entity for healthcare. 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.
B2B track · Hospital–Supplier
Amicable dispute resolution for companies working with hospitals
Disputes between a hospital and a medical device manufacturer, distributor, service provider or software vendor are purely commercial. Consumer restrictions do not apply, so the Centre’s clause can be written into the contract on the day it is signed. At the heart of such a dispute there is usually a technical fact or a settlement of accounts — which is why the track starts with an expert, not a lawsuit.
Who it is for
Equipment, implants, diagnostics. Acceptance, incidents, contractual penalties, MDR compliance.
Overdue payments, interest, instalment settlements, delivery terms.
SLAs, response times, downtime, spare parts and post-warranty service.
Licences, interoperability, data migration, GDPR and cybersecurity.
Allocation of funds, rights to results, partner liability.
How it works — four levels
A case enters at the lowest level and moves up only if the parties fail to agree. Agreement at any level closes the case.
Prevention
The Centre’s clause in the contract, review of SLAs and acceptance terms, training for procurement teams.
Technical review
A neutral expert from the Centre’s list establishes the technical facts. Ends with a findings report.
Mediation
Contractual mediation under the Polish Code of Civil Procedure. A court-approved settlement has the force of a court settlement.
Arbitration
The sector’s permanent arbitration court — only where there is an arbitration agreement. Without one: the common court, with the findings report.
Typical disputes
| Area | Example of a dispute |
|---|---|
| Performance of a public procurement contract | contractual penalties, delivery delays, price indexation, acceptance |
| Service and equipment availability | response time, downtime, who is liable for a failure |
| Payments | arrears beyond the statutory term, interest, repayment schedule |
| Regulatory compliance | medical device status, incidents, corrective actions |
| Data and cybersecurity | data processing agreements, incidents in the supplier’s system |
| Software and AI | licences, HIS interoperability, system performance against specification |
What the hospital gains
- Disputes over downtime, acceptance or penalties resolved in weeks — with an expert who understands the equipment and the clinical process.
- Continuity of supply and service: the dispute does not halt cooperation.
- A documented mediation attempt, which the Polish Public Procurement Law requires in a statement of claim (Art. 593(1) PPL).
- A model clause and SLA review before the contract is signed.
- Confidentiality — the dispute does not become public.
- System-level lessons, without the parties’ data, improve future contracts and tenders.
What the supplier gains
- Mediators, arbitrators and experts who know hospitals, the MDR and public procurement — not just the code.
- Faster recovery of receivables through settlement instead of years of litigation — important because a change of creditor of a public healthcare unit (SP ZOZ) requires the consent of its founding body.
- Technical facts established by a neutral expert before contractual penalties accrue.
- The client relationship preserved — the dispute ends in a conversation, not a judgment.
- Predictable cost: fees based on the value of the dispute.
- Confidentiality towards competitors.
The legal basis of the B2B track
| Provision | What it provides | Relevance for the B2B track |
|---|---|---|
| Art. 1157 Code of Civil Procedure (KPC) | Disputes over property rights may be submitted to an arbitration court. | The entire hospital–supplier portfolio is arbitrable. |
| Art. 11641 KPC | Arbitration agreements in disputes with consumers — only after the dispute has arisen. | The restriction does not apply between businesses — the clause can be in the contract from the outset. |
| Art. 1831 et seq. KPC | Mediation based on the parties’ agreement; a court-approved settlement has the force of a court settlement. | The Centre’s mediation clause in every supply, service and licence agreement. |
| Art. 591(1) Public Procurement Law (PPL) | In a dispute arising from a contract, either party may request mediation or another amicable resolution. | The Centre’s track is also available for public procurement contracts. |
| Art. 593 PPL | A statement of claim must state whether mediation was attempted; for contracts from EUR 10 million (supplies, services) and disputes above PLN 100,000, the court refers the parties to mediation. | Mediation conducted at the Centre documents the attempt at amicable resolution. |
| Art. 8(2) Act of 8 March 2013 on counteracting excessive delays in commercial transactions | Where the debtor is a public healthcare provider, the payment term may not exceed 60 days. | Payment disputes are recurrent — payment mediation and instalment settlements as standard. |
| Art. 54(5)–(6) Act on Medical Activity | A change of creditor of an SP ZOZ requires the founding body’s consent; an act without consent is null and void. | Settlements must respect this requirement; mediation is an alternative to assigning receivables. |
| Regulation (EU) 2017/745 (MDR), GDPR, Directive (EU) 2022/2555 (NIS2) | Obligations of device manufacturers, data controllers and entities subject to cybersecurity rules. | Compliance disputes resolved with regulatory and IT experts. |
This overview is for information only and does not constitute legal advice. Legal status: October 2026.
Modular — as needed
Each element is available separately: the clause and rules alone, a technical expert opinion alone, payment mediation, or the full package including arbitration. We are developing the track with the Polish Hospital Federation and industry organisations; companies and hospitals interested in the pilot are welcome to get in touch.
The Centre is in formation
Institutions and organisations interested in taking part in the preparatory work — including the conciliation standard pilot and the B2B track for MedTech companies and distributors — 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
- Art. 591 and 593 of the Act of 11 September 2019 — Public Procurement Law — mediation in procurement disputes
- Art. 8(2) of the Act of 8 March 2013 on counteracting excessive delays in commercial transactions — 60-day payment term for public healthcare providers
- Art. 54(5)–(6) of the Act on Medical Activity — change of creditor of an SP ZOZ subject to the founding body’s consent
Systemic analysis: Between a complaint and a claim there is nothing — the gap in the Polish system and the design of the Centre, with the legal basis and sources.
