3 NHS - dental care in Poland and Abroad_C.doc

3/ NHS – National Healthcare System ( UK healthcare system established in 1948)               Paraphrase the words in bold.                            C

The majority of UK general dental practitioners are contracted to the NHS. The provision of NHS dental care is the responsibility of the local primary care trust (PCT).   NHS Trusts employ dentists directly in dentistry hospitals and the community dental services. As a result of major change transformations to NHS dentistry (introduced in April 2006), Primary Care Trusts (PCTs) are now responsible for routine care and specialised care services. Routine dental care refers to the work undertaken by dentists and their team (i.e. hygienists, therapists) to maintain good oral health. This includes providing patients with treatments such as scaling and polishing, fillings, extractions, as well as fitting bridges and dentures and advice on how to look after teeth and gums in order to prevent oral health problems. For more specialised care such as surgery within the mouth, orthodontics (straightening teeth), domiciliary care (at home), sedation (easing anxiety) and more complicated root canal and bridge work, your dentist may refer you to another dentist either at hospital or to another general dental practitioner. Still, in UK under the NHS system 80% of the cost of treatment..  The base for calculating health insurance premiums for persons is their income. In regard to insured persons who receive social security benefits, the base for calculating health insurance premiums is the gross amount: benefits (retirement pay and pensions, social welfare allowances). In most instances, premiums are calculated, collected and transferred by payers, namely by employers or institutions responsible for providing benefits, not by insured persons themselves. The insurance premiums are deducted from personal income tax. Some patients are entitled to free treatment even if no heath care contribution (premium) is paid from their remuneration or their parents’ earnings:

Children and young people under 18 years;     Young people under 19 years in full time education; Women who are pregnant or have a minor under 12 months; People with low incomes (i.e. those receiving certain state benefits:  Income Support, Job Seekers' Allowance, Working Families Tax Credit or Disabled Persons Tax Credit).

Dentists receive fixed fees per item of treatment for adults.  For children they receive a mixture of fixed fees per a given item and capitation payments (fee levied on the basis of a fixed amount per person).  Moreover,  practitioners receive continuing care payments for each patient on their list. Dentists may also offer certain treatment on a private basis whilst carrying out NHS treatment. 

Entry on an NHS list is not required for all general dental practices.  It is possible to work in a wholly private practice but the normal work permit requirements have to be met.

The Polish health care system has vastly drawn upon the experiences of the UK health system which underwent very similar reforms in 1990’s and is  currently undergoing deep-rooted organisational and financial changes. As with many other health care systems world-wide a market system is being introduced with purchasers and providers of health care.  Persons are covered by the general health insurance (on the compulsory or voluntary basis) and entitled to free health services in the territory of Poland. In Poland after 1999 there are three main sources of health care financing: the state budget, local governments and the National Health Fund. Health care providers are above all: doctors who practise within the health care system (general practitioners, dental practitioners and specialists), public and non-public health units (hospitals, first aid stations, dispensaries, health centres), out-patient clinics (individual, individual specialist, group). The supervision over the National Health Fund is exercised by the Minister of Health, while the supervision over the financial economy of the Fund has been entrusted to the Minister of Finance.

A person staying temporarily in the territory of Poland entitled to health care under EEA can receive primary health care, specialist out-patient care, hospital treatment, dental treatment, rescue services and ambulance transport. In case of need of out-patient specialist treatment a referral of the doctor who practises within health care system is required. No referral is required to following specialists: gynaecologist and midwife, dentist, dermatologist, venerologist, oncologist, ophthalmologist, psychiatrist, and for following persons: suffering from tuberculosis, infected with HIV, war invalids,

addicted to alcohol, stupefacients and in case of an accident, injury, childbirth, intoxication and life threat. 

Prescribed medicines can be purchased by the insured :for a lump-sum price (basic medicines and medicines made on recipe), or for 30 or 50% of the price of a medicine (supplementary medicines).

1/ Who is  always entitled to free treatment  under NHS scheme and why? How do NHSs in Poland and England work? 2/ What is a social insurance contribution? How are social premiums calculated? Explain this idea. 3/ On what basis do GDPs cooperate with NHS?   5/Find  similarities between Polish health care system and British health care system. 6/ How can noncitizens exercise their right to sponsored health care? 7/What would you improve in the Polish healthcare system ?  Speak from the point of view of a/ a patient   b/ GP

Fill in the missing words: 1/ detection,   2/ checkups,  3/ immediate  4/  eligible,    5/ associated ,  6/ in,   7/ episode,  8/ transplantation,   9/  living ,  10/ unrelated,  11/ coverage,  12/ appreciated,    13/   medical insurance,   14/ disability,   15/ diurnally,   16/ suppressive,     17/  to,    18/ rule out ,   19/ major 

There are two types of transplants:  using organs from ……….1/ donors, both ………..2/ or next of kin  and from donors who have died (non-living donors). A living donor, someone from ……………3/ or extended family, a spouse or close friend, a stranger who wished to donate an organ to anyone in need of a transplant, is the most…………4/ one.  Most private health insurance policies cover many expenses ………..5/   with organ transplants, medications and hospitalization .  ………………6/addition, most kidney transplant candidates are ………………..7/ for…………..8/ , which covers 80 percent of the cost of the transplant surgery. After………..9/, the patient will need to take medications to ……………..10/ rejection of a new organ. Medical insurance of the National Health Service covers 80 percent of the cost of these anti-rejection medications, called also…………… 11/ drugs but not the cost of other medications. For most patients, this insurance……………….12/  will stop after 36 months. However, if the patients are entitled ………………..13/  extra NHS coverage based on age or……………….14/, the cost of anti-rejection medications may be covered for as long as the patient stays on medicare. The patient needs to take medications ……………….. 15/to prevent rejection of a new organ:  16/  ……… drugs and antibiotics. Additional treatment may be needed if a rejection…………………….17/ occurs.  Regular ……………18/ at the transplant centre will ensure early……………………. 19/ and treatment of rejection.