Pay limits for Polish health professionals: what the act passed by the Sejm contains.

The act amending the Act on healthcare services financed from public funds, passed by the Sejm on 22 October 2026 on the basis of a government bill (print No. 3157), sets an upper limit on the pay of doctors, nurses and other health professionals in facilities that have a contract with the National Health Fund (NFZ).¹² The limit has two parts: a maximum hourly rate and a maximum monthly amount. Both are calculated as a multiple of the minimum wage, so they rise along with it.

The act also changes the rules of employment: it limits total working time, requires at least a half-time post in a hospital, prohibits contracts concluded through intermediary companies and bans setting pay as a percentage of the contract. At the third reading the Sejm added a ban on providing NFZ-funded services for a doctor who has knowingly certified something untrue. Below we describe each change separately: in the wording adopted by the Health Committee, with the amendments adopted by the Sejm.³⁴ The Sejm has not yet published the text of the act as passed.

What stage the act has reached

The bill reached the Sejm on 28 September 2026. The Health Committee held the first reading on 7 October and recommended that it be passed. On 20 October, after the second reading, the bill went back to the committee with 29 amendments and 9 minority motions. The committee gave its opinion on them on 21 October.⁵⁴

On 22 October the Sejm passed the act: 229 MPs voted for, 144 against and 67 abstained.² The act now goes to the Senate, which has 30 days to deal with it: it can adopt it without changes, amend it or reject it. The President then signs the act within 21 days, or refers it to the Constitutional Tribunal or returns it to the Sejm.⁶

The Senate may still change the text — we add every change after each further stage to the change history below the article.

How the clubs voted

The act was supported by MPs of KO (Koalicja Obywatelska, Civic Coalition), Lewica (The Left), Centrum (Centre), Polska 2050 (Poland 2050) and most of PSL (Polish People’s Party). The PiS club (Prawo i Sprawiedliwość, Law and Justice) voted against. MPs of Rozwój Plus (Development Plus), Konfederacja (Confederation), Konfederacja Korony Polskiej (Confederation of the Polish Crown), Razem (Together) and Demokracja Bezpośrednia (Direct Democracy) abstained.²

KO, Lewica, Centrum, Polska 2050 and most of PSL voted for the act, PiS against

Vote on the bill as a whole229 : 144for : against · 67 abstained · 20 did not vote

• for
• against
• abstained
• did not vote

For

KO (156)149 · 0 · 0 · 7Lewica (21)21 · 0 · 0 · 0Centrum (15)14 · 0 · 0 · 1Polska 2050 (15)14 · 0 · 0 · 1PSL (32)29 · 2 · 0 · 1

Against

PiS (147)0 · 138 · 2 · 7

Abstained

Konfederacja (16)0 · 0 · 16 · 0Demokracja Bezp. (4)0 · 0 · 4 · 0Razem (4)0 · 0 · 4 · 0Korona (3)0 · 0 · 2 · 1—Unaffiliated (7)2 · 2 · 3 · 0Rozwój Plus (40)0 · 2 · 36 · 2

How each MP voted

Koalicja Obywatelska (Civic Coalition) (156)

for: 149

Adam Krzemiński, Adrian Witczak, Agnieszka Hanajczyk, Agnieszka Pomaska, Aleksandra Kot, Aleksandra Uznańska-Wiśniewska, Alicja Chybicka, Alicja Łepkowska-Gołaś, Alicja Łuczak, Andrzej Szewiński, Anna Sobolak, Anna Wojciechowska, Apoloniusz Tajner, Arkadiusz Marchewka, Arkadiusz Myrcha, Artur Gierada, Artur Łącki, Barbara Dolniak, Barbara Nowacka, Bartosz Zawieja, Bogusław Wołoszański, Bożena Lisowska, Cezary Tomczyk, Czesław Mroczek, Danuta Jazłowiecka, Dominik Jaśkowiec, Dorota Łoboda, Dorota Marek, Dorota Niedziela, Elżbieta Gapińska, Elżbieta Gelert, Elżbieta Polak, Ewa Kołodziej, Franciszek Sterczewski, Gabriela Lenartowicz, Grzegorz Napieralski, Henryk Szopiński, Henryka Krzywonos-Strycharska, Iwona Hartwich, Iwona Karolewska, Iwona Kozłowska, Iwona Krawczyk, Izabela Leszczyna, Jacek Karnowski, Jacek Niedźwiedzki, Jakub Rutnicki, Jan Grabiec, Janusz Cichoń, Jarosław Urbaniak, Jarosław Wałęsa, Jerzy Meysztowicz, Joanna Frydrych, Joanna Kluzik-Rostkowska, Jolanta Niezgodzka, Karolina Pawliczak, Katarzyna Kierzek-Koperska, Katarzyna Królak, Katarzyna Lubnauer, Katarzyna Matusik-Lipiec, Katarzyna Osos, Katarzyna Piekarska, Katarzyna Stachowicz, Kazimierz Plocke, Kinga Gajewska, Klaudia Jachira, Konrad Frysztak, Krystian Łuczak, Krystyna Sibińska, Krystyna Skowrońska, Krystyna Szumilas, Krzysztof Bojarski, Krzysztof Gadowski, Krzysztof Grabczuk, Krzysztof Habura, Krzysztof Mieszkowski, Krzysztof Piątkowski, Krzysztof Truskolaski, Lucjan Pietrzczyk, Łukasz Horbatowski, Łukasz Ściebiorowski, Maciej Lasek, Maciej Tomczykiewicz, Maciej Wróbel, Magdalena Filiks, Magdalena Kołodziejczak, Magdalena Łośko, Magdalena Roguska, Małgorzata Gromadzka, Małgorzata Niemczyk, Małgorzata Pępek, Małgorzata Tracz, Marek Chmielewski, Marek Gzik, Marek Hok, Marek Krząkała, Marek Rząsa, Marek Sowa, Maria Janyska, Maria Koźlakiewicz, Mariusz Popielarz, Mariusz Witczak, Marta Golbik, Marzena Okła-Drewnowicz, Mateusz Bochenek, Michał Jaros, Michał Krawczyk, Monika Rosa, Monika Wielichowska, Patryk Gabriel, Patryk Jaskulski, Paweł Bliźniuk, Paweł Kowal, Paweł Masełko, Paweł Olszewski, Paweł Papke, Paweł Suski, Piotr Adamowicz, Piotr Borys, Piotr Głowski, Piotr Kandyba, Piotr Lachowicz, Przemysław Witek, Rafał Siemaszko, Renata Rak, Robert Dowhan, Robert Jagła, Robert Kropiwnicki, Robert Wardzała, Roman Giertych, Sławomir Nitras, Stanisław Gorczyca, Stanisław Lamczyk, Sylwia Bielawska, Tomasz Głogowski, Tomasz Kostuś, Tomasz Nowak, Tomasz Siemoniak, Tomasz Szymański, Urszula Augustyn, Urszula Koszutska, Urszula Zielińska, Waldemar Sługocki, Weronika Smarduch, Witold Zembaczyński, Włodzisław Giziński, Wojciech Król, Zbigniew Konwiński, Zdzisław Gawlik, Zofia Czernow

did not vote: 7

Adam Szłapka, Aleksandra Gajewska, Andrzej Domański, Barbara Grygorcewicz, Donald Tusk, Marcin Bosacki, Michał Kołodziejczak

Lewica (The Left) (21)

for: 21

Agnieszka Dziemianowicz-Bąk, Andrzej Szejna, Anita Kucharska-Dziedzic, Anna Żukowska, Arkadiusz Sikora, Bożena Borowiec, Daria Gosek-Popiołek, Dariusz Wieczorek, Dorota Olko, Jacek Czerniak, Joanna Wicha, Katarzyna Kotula, Katarzyna Ueberhan, Krzysztof Gawkowski, Marcin Kulasek, Piotr Kowal, Tadeusz Tomaszewski, Tomasz Trela, Wanda Nowicka, Wiesław Szczepański, Włodzimierz Czarzasty

Centrum (Centre) (15)

for: 14

Aleksandra Leo, Barbara Okuła, Barbara Oliwiecka, Elżbieta Burkiewicz, Ewa Szymanowska, Marcin Skonieczka, Mirosław Suchoń, Norbert Pietrykowski, Paulina Hennig-Kloska, Rafał Kasprzyk, Rafał Komarewicz, Ryszard Petru, Sławomir Ćwik, Żaneta Cwalina-Śliwowska

did not vote: 1

Izabela Bodnar

Polska 2050 (Poland 2050) (15)

for: 14

Adam Gomoła, Adam Luboński, Bartosz Romowicz, Bożenna Hołownia, Ewa Schädler, Kamil Wnuk, Łukasz Osmalak, Maja Nowak, Michał Gramatyka, Paweł Śliz, Piotr Górnikiewicz, Piotr Strach, Szymon Hołownia, Wioleta Tomczak

did not vote: 1

Agnieszka Buczyńska

PSL – Trzecia Droga (Polish People’s Party – Third Way) (32)

for: 29

Adam Dziedzic, Agnieszka Kłopotek, Andrzej Grzyb, Bożena Żelazowska, Czesław Siekierski, Dariusz Klimczak, Henryk Kiepura, Henryk Smolarz, Ireneusz Raś, Jacek Tomczak, Jarosław Rzepa, Jolanta Zięba-Gzik, Krzysztof Paszyk, Magdalena Sroka, Marek Biernacki, Michał Pyrzyk, Mirosław Maliszewski, Mirosław Orliński, Paweł Bejda, Piotr Zgorzelski, Radosław Lubczyk, Stanisław Tomczyszyn, Stefan Krajewski, Tadeusz Samborski, Urszula Pasławska, Wiesław Różyński, Władysław Bartoszewski, Władysław Kosiniak-Kamysz, Zbigniew Sosnowski

against: 2

Marek Sawicki, Urszula Nowogórska

did not vote: 1

Zbigniew Ziejewski

Konfederacja (Confederation) (16)

abstained: 16

Andrzej Zapałowski, Bartłomiej Pejo, Bronisław Foltyn, Grzegorz Płaczek, Karina Bosak, Konrad Berkowicz, Krzysztof Bosak, Krzysztof Mulawa, Krzysztof Szymański, Krzysztof Tuduj, Michał Połuboczek, Michał Wawer, Przemysław Wipler, Ryszard Wilk, Sławomir Mentzen, Witold Tumanowicz

Demokracja Bezpośrednia parliamentary group (Direct Democracy) (4)

abstained: 4

Jan Ardanowski, Jarosław Sachajko, Paweł Kukiz, Tomasz Rzymkowski

Razem parliamentary group (Together) (4)

abstained: 4

Adrian Zandberg, Maciej Konieczny, Marcelina Zawisza, Marta Stożek

Konfederacja Korony Polskiej parliamentary group (Confederation of the Polish Crown) (3)

abstained: 2

Sławomir Zawiślak, Włodzimierz Skalik

did not vote: 1

Roman Fritz

Unaffiliated MPs (7)

for: 2

Paweł Zalewski, Tomasz Zimoch

against: 2

Joanna Mucha, Łukasz Mejza

abstained: 3

Janusz Kowalski, Marcin Józefaciuk, Paulina Matysiak

Rozwój Plus (Development Plus) (40)

against: 2

Anna Kwiecień, Maria Koc

abstained: 36

Agnieszka Ścigaj, Andrzej Gut-Mostowy, Andrzej Kryj, Anna Baluch, Anna Cicholska, Fryderyk Kapinos, Grzegorz Macko, Grzegorz Puda, Ireneusz Zyska, Janusz Cieszyński, Krzysztof Kubów, Krzysztof Lipiec, Krzysztof Szczucki, Łukasz Kmita, Łukasz Schreiber, Marcin Gwóźdź, Marcin Horała, Marek Jakubiak, Marzena Machałek, Mateusz Morawiecki, Michał Cieślak, Mirosława Stachowiak-Różecka, Monika Pawłowska, Olga Semeniuk-Patkowska, Paweł Jabłoński, Paweł Rychlik, Piotr Uściński, Robert Gontarz, Ryszard Bartosik, Ryszard Terlecki, Sylwester Tułajew, Szymon Giżyński, Szymon Szynkowski vel Sęk, Wiesław Krajewski, Wojciech Zubowski, Zbigniew Chmielowiec

did not vote: 2

Elżbieta Duda, Włodzimierz Tomaszewski

Prawo i Sprawiedliwość (Law and Justice) (147)

against: 138

Agata Wojtyszek, Agnieszka Górska, Agnieszka Soin, Agnieszka Wojciechowska van Heukelom, Aleksander Mrówczyński, Andrzej Adamczyk, Andrzej Gawron, Andrzej Kosztowniak, Andrzej Śliwka, Anita Czerwińska, Anna Dąbrowska-Banaszek, Anna Gembicka, Anna Krupka, Anna Milczanowska, Anna Paluch, Anna Pieczarka, Anna Schmidt, Antoni Macierewicz, Arkadiusz Czartoryski, Artur Chojecki, Artur Szałabawka, Barbara Bartuś, Bartłomiej Dorywalski, Bartłomiej Wróblewski, Bartosz Kownacki, Bogumiła Olbryś, Bolesław Piecha, Bożena Borys-Szopa, Czesław Hoc, Daniel Milewski, Dariusz Matecki, Dariusz Piontkowski, Dominika Chorosińska, Dorota Arciszewska-Mielewczyk, Edward Siarka, Elżbieta Witek, Ewa Leniart, Ewa Malik, Filip Kaczyński, Grzegorz Lorek, Grzegorz Matusiak, Grzegorz Piechowiak, Grzegorz Woźniak, Henryk Kowalczyk, Iwona Arent, Jacek Bogucki, Jacek Osuch, Jacek Sasin, Jacek Świat, Jan Dziedziczak, Jan Kanthak, Jan Mosiński, Jan Warzecha, Jarosław Krajewski, Jarosław Sellin, Jarosław Wieczorek, Jarosław Zieliński, Jerzy Materna, Jerzy Polaczek, Joanna Borowiak, Joanna Lichocka, Józefa Szczurek-Żelazko, Kacper Płażyński, Kamil Bortniczuk, Katarzyna Czochara, Kazimierz Choma, Kazimierz Gołojuch, Kazimierz Gwiazdowski, Kazimierz Smoliński, Krzysztof Ciecióra, Krzysztof Sobolewski, Krzysztof Tchórzewski, Leonard Krasulski, Lidia Burzyńska, Lidia Czechak, Maciej Małecki, Magdalena Filipek-Sobczak, Małgorzata Golińska, Małgorzata Wassermann, Marcin Grabowski, Marcin Ociepa, Marcin Porzucek, Marcin Warchoł, Marek Ast, Marek Gróbarczyk, Marek Kuchciński, Marek Matuszewski, Marek Subocz, Marek Suski, Marek Wesoły, Maria Kurowska, Mariusz Błaszczak, Mariusz Gosek, Mariusz Kałużny, Mariusz Krystian, Michał Jach, Michał Kowalski, Michał Moskal, Michał Woś, Michał Wójcik, Norbert Kaczmarczyk, Patryk Wicher, Paweł Hreniak, Paweł Sałek, Paweł Szrot, Piotr Babinetz, Piotr Gliński, Piotr Kaleta, Piotr Król, Piotr Polak, Piotr Uruski, Przemysław Czarnek, Przemysław Drabek, Rafał Bochenek, Rafał Romanowski, Rafał Weber, Robert Telus, Robert Warwas, Sebastian Kaleta, Sebastian Łukaszewicz, Sławomir Skwarek, Stanisław Szwed, Szymon Pogoda, Tadeusz Chrzan, Tadeusz Woźniak, Teresa Pamuła, Teresa Wilk, Tomasz Zieliński, Urszula Rusecka, Waldemar Andzel, Wioletta Kulpa, Witold Czarnecki, Władysław Dajczak, Władysław Kurowski, Zbigniew Dolata, Zbigniew Hoffmann, Zbigniew Kuźmiuk, Zbigniew Rau

abstained: 2

Dariusz Stefaniuk, Katarzyna Sójka

did not vote: 7

Grzegorz Gaża, Jarosław Kaczyński, Krzysztof Czarnecki, Marcin Romanowski, Radosław Fogiel, Wojciech Szarama, Zbigniew Ziobro

The shape of the act was also decided by the votes on amendments and minority motions. We set out the most important of them below, with the author of each motion according to the committee reports.³⁴

The ban on NFZ-funded work passed with 20 votes against; lower limits and a shared declaration system were rejected

Selected votes on amendments and minority motions to the act on pay limits for health professionals

	Result	For	Against or abstained
Ban on providing NFZ-funded services and a public register of bans (minority motions No. 1, 3–6, 8–9; an MP of Rozwój Plus)	Adopted, 416 / 20 / 0	All clubs and groups except both Konfederacja groups	Against: Konfederacja (16), Konfederacja Korony Polskiej (2)
Working-time declarations in the P1 system (minority motions No. 2 and 7; an MP of Rozwój Plus)	Rejected, 188 / 231 / 18	PiS, Rozwój Plus, Razem	Against: KO, PSL, Lewica, Centrum, Polska 2050; Konfederacja abstained
Deleting the requirement of a half-time post in a hospital and the employer’s consent (amendment No. 7, PSL)	Rejected, 179 / 203 / 43	PiS, Konfederacja, 17 PSL MPs	Against: KO, Lewica, Centrum, Polska 2050, 9 PSL MPs; Rozwój Plus abstained
Lower caps: 10× instead of 12× and 13× instead of 16× the minimum wage (amendment No. 21, PiS)	Rejected, 187 / 246 / 0	PiS, Rozwój Plus, Razem	Against: KO, PSL, Lewica, Konfederacja, Centrum, Polska 2050
Limits calculated from the average wage, e.g. 3× and 6× a month (amendments No. 12–14 and 16–19, Razem)	Rejected, 5–7 MPs for	Razem and some unaffiliated MPs	Against: the other clubs
Termination with the notice period observed when a health professional does not agree to a contract change that brings pay within the limit (amendment No. 24, Lewica)	Adopted, 228 / 208 / 2	PiS, Rozwój Plus, Lewica, Konfederacja, Razem	Against: KO, PSL, Centrum, Polska 2050
Labour Code protection for terminations during the transitional period (amendment No. 27, KO and Lewica)	Adopted, 404 / 9 / 19	All clubs and groups except both Konfederacja groups	Both Konfederacja groups abstained; 7 KO MPs against

The committee recommended adopting the KO amendments (one of them tabled jointly with Lewica), which clarify the exceptions and procedures described below, and rejecting the rest.⁴ The Sejm followed this recommendation with two exceptions: it adopted the Lewica amendment on the notice period and the minority motions on the ban on NFZ-funded work, which the committee had earlier rejected.

What changes compared with the current rules

The current rules are set out in Articles 26 and 96 of the Act on medical activity, and the practice of “employee leasing” (leasing pracowniczy) and percentage-based pay is described in the explanatory memorandum to the bill.⁷¹

Whom the limits cover

The act refers to a “person practising a medical profession” (osoba wykonująca zawód medyczny), so not only to doctors. This term from the Act on medical activity covers people entitled to provide healthcare services, including nurses, midwives, paramedics and physiotherapists.³

The scope of the two main limits differs:

• the working-time limit counts employment with all providers, including work in one’s own practice outside a medical establishment (Article 132aa(1));
• the pay limits cover pay for services under an NFZ contract, paid by facilities that have such a contract (Article 132ab(1) and (7)).

A facility may therefore pay for privately funded work without these limits. The time spent on that work, however, counts towards the two full-time posts.

Hourly rate: 1/20 of the minimum wage

The gross hourly rate of base pay for services under an NFZ contract may not exceed 1/20 of the minimum wage. In 2026 the minimum wage is PLN 4,806 (≈ €1,090), so the limit is PLN 240.30 (≈ €55) an hour.⁸ The provision applies to employment contracts and, through the cross-reference in paragraph 6, also to contractor agreements and other civil-law contracts.³ In the description of the version sent for consultation in July, the hourly rate applied to people working under contracts.⁹

The act links the limits to the minimum wage rather than to the average wage. The Sejm rejected amendments that would have calculated them from the average wage.⁴ For comparison: the average wage in the economy in 2025 was PLN 8,903.56 (≈ €2,020),¹⁰ so a rate of PLN 240.30 is about 4.3 times the average hourly wage at 160 hours a month (PLN 55.65).

The limit applies to base pay. On top of it a facility may grant:

• a performance bonus;
• allowances due under statute, up to the amount set by that statute;
• a seniority allowance, in public facilities;
• additional pay for a managerial role, e.g. head of a hospital department, and for teaching and research duties;
• additional pay for organ retrieval and transplantation in clinical transplantology, for highly specialised services and for work in trauma centres.

The narrowing of transplantology to organ retrieval and transplantation was added by an amendment adopted at the third reading.⁴¹¹ All these allowances, however, must fit within the monthly cap.

Monthly cap: three thresholds

The second limit is the maximum average monthly pay. The average is calculated over a settlement period of no more than four months, so a month with more hours can be balanced by a lighter one.³

The total cap is 16 minimum wages, or about 8.6 times the average wage

1. Minimum wage in 2026 1× the minimum wagePLN 4,806
2. Average wage in 2025 1.85× the minimum wagePLN 8,903.56
3. Half-time post with one provider 4× the minimum wagePLN 19,224
4. Full-time post with one provider 8× the minimum wagePLN 38,448
5. Full-time post with allowances, e.g. for a managerial role 12× the minimum wagePLN 57,672
6. Total with all providers 16× the minimum wagePLN 76,896

The two limits are consistent with each other. A full-time post is about 160 hours a month, and 160 × PLN 240.30 gives exactly PLN 38,448, i.e. 8 times the minimum wage. Two full-time posts are 320 hours and PLN 76,896, i.e. 16 times. This is how the explanatory memorandum to the bill calculates the amount.¹

The memorandum also placed transplantology, highly specialised services and trauma centres in the 12-times group,¹ but paragraph 8 in the committee’s version expressly listed only statutory allowances, seniority and managerial, teaching and research roles.³ An amendment adopted at the third reading added the pay under paragraph 5 to paragraph 8, so these three types of work also fall within the 12× threshold.⁴

Before taking up a job, the health professional submits a declaration of their total maximum pay across all facilities. Any change affecting this total must be reported within 7 days. The head of the facility then has 3 working days to propose a change to the contract that keeps the total within the limit. If the health professional does not agree within the following 3 working days, the head terminates the contract.³ The committee wanted this to happen without the notice period being observed. The Sejm deleted those words with the Lewica amendment, so the ordinary notice period applies.⁴

Calculator: how the limits change

All the limits are fixed fractions or multiples of a single amount, so they rise and fall with it. From 1 January 2027 the minimum wage will be PLN 4,950 (≈ €1,120),¹² and the limits will rise with it. The average wage is a “what if” scenario — the act does not use it.

The limits rise along with the amount they are calculated from

Reference amount

Minimum wage 2026PLN 4,806Minimum wage 2027PLN 4,950Average wage 2025PLN 8,903.56Your own amountPLN

Pay limits calculated from the selected reference amount

Limit	Multiplier	Amount
Hourly rate	1/20	PLN 240.30
Half-time post with one provider	4×	PLN 19,224
Full-time post with one provider	8×	PLN 38,448
Full-time post with allowances	12×	PLN 57,672
Total with all providers	16×	PLN 76,896

Reference amount: PLN 4,806.

• Minimum wage 2026: Dz.U. 2025 item 1242
• Minimum wage 2027: Dz.U. 2026 item 1213
• Average wage 2025: M.P. 2026 item 192

Working time: at most two full-time posts in total

The total working time of a health professional across all providers may not exceed twice the full-time working hours in a month. Full-time hours are 8 hours multiplied by the number of working days in the month, minus public holidays falling on weekdays. Under a civil-law contract, the full-time equivalent counts, i.e. the number of hours in the contract.³

The limit does not include time spent on standby outside a medical establishment to provide services under an NFZ contract: standby “on the phone”, with travel in on call-out (Article 98 of the Act on medical activity), and standby at the patient’s place of residence or stay. The second case and the narrowing to services under an NFZ contract were added by an amendment adopted at the third reading.⁴

Before taking up a job, the health professional submits to the head of the facility a declaration of their total working time in all workplaces. Any change in working time with another employer must be reported within 7 days.³

Hospitals and clinics: at least a half-time post and the first employer’s consent

In hospital treatment and in hospital-based specialist outpatient clinics (AOS), under an NFZ contract, a doctor, nurse, midwife, physiotherapist and paramedic must have at least a half-time post or its equivalent under a civil-law contract.³⁴ The explanatory memorandum gives the aim: frequent rotation of people on part-time posts makes it harder to manage the treatment of a single patient and increases the risk of errors.¹

Each further such job requires the consent of the heads of all the hospitals in which the health professional already works. The procedure has four steps:³⁴

1. 01.

   Request.

   The health professional asks the heads of the hospitals where they work for consent to a further job, of at least a half-time post.

2. 02.

   14 days.

   The head replies within 14 days. No reply means consent — the health professional submits a declaration to that effect to the new employer.

3. 03.

   Refusal with an offer.

   Consent may be refused only because of unmet staffing needs: in writing, with an offer of more working time at the refusing hospital.

4. 04.

   Half-time or leave.

   A person who has so far worked in one hospital below a half-time post, where the hospital is short of staff, receives an offer to increase their working time. If they do not accept it and want to work in a second hospital, the head refuses consent and terminates the contract. If the hospital does not need more of their work, the head refuses consent without an offer.

The half-time requirement does not cover:

• on-call duty and shift work outside normal working hours, except for planned procedures;
• services provided by geriatricians, pathologists and psychiatrists — this exception was added by an amendment adopted at the third reading;⁴
• clinics in which shorter working time results from the schedule of the NFZ contract;
• a person who works in only one such hospital and submits a declaration to that effect.

The Sejm rejected the PSL amendment, which would have deleted the entire requirement of a half-time post and the employer’s consent, by 179 votes to 203.²

Where a field is short of staff or on-call duty needs to be covered, the president of the NFZ may, at the facility’s request, agree to a derogation from the limit of two full-time posts and from the half-time requirement, for up to 6 months. No reply within 14 days means consent. In the event of a sudden death, a long absence of an employee or force majeure, the head of the facility may waive these requirements on their own, for 21 days.³

Contracts with individuals, not companies

The act amends Article 26 of the Act on medical activity, which allows a hospital to commission healthcare services from outside. Today any entity performing medical activity, including a company, can take on such a commission.⁷ After the change, a commission for work in a hospital may be given only to an individual with a sole professional practice. A hospital will commission services from another medical entity only if that entity provides them in its own establishment or at the place of call-out.³

The explanatory memorandum calls the current practice “employee leasing”. A hospital commissions services from a company that is formally a medical entity but in practice only supplies staff. When a company is the party to the contract, working-time restrictions do not apply to it, and it is difficult to establish the total working time of a specific person.¹

A contract for services must last at least 3 months, unless the type and number of services justify a shorter one. It must specify the total number of hours, the hourly rate and the maximum monthly working time and pay. A facility financed from public funds awards the contract through a competitive tendering procedure.³

Pay not as a percentage of the contract

The pay of a health professional for services under an NFZ contract may not be set as a percentage of the amount the facility receives under that contract (Article 132ab(12)).³ According to the explanatory memorandum, with such an arrangement every increase in the NFZ’s pricing of services automatically raises pay. The government sees this as one of the sources of a “wage spiral” and of hospitals’ debt.¹ We describe how this mechanism shows up in disclosed payments in our text on record payments.

Inspections and penalties

The health professional submits the declarations on working time and pay under criminal liability for making a false statement (Article 233 § 6 of the Criminal Code). The facility keeps them for 10 years.³

A head of a facility who breaches the requirements on the limits commits a petty offence punishable by a fine of up to PLN 30,000 (≈ €6,810) (new Article 193). The act also extends the NFZ’s inspection powers:³

• facilities with an NFZ contract must provide information, including on services outside the contract, and staff records: contracts, qualifications and working-time records;
• the NFZ may also request such records from facilities without an NFZ contract;
• the NFZ may inspect again a matter it has already examined if new facts come to light or the previous inspection breached the law;
• explanations given to NFZ inspectors are made under criminal liability for making a false statement.

According to the regulatory impact assessment, the NFZ will hire about 400 additional staff for inspections, including 352 in the inspection department at its head office. In 2027–2036 this will cost a total of PLN 545.24 million (≈ €124 million).¹

Deadlines and adjustment of contracts

The act is to enter into force one month after its promulgation. Existing contracts must be brought into line with the new requirements within 6 months of that date.³ The consultation version allowed until 31 December 2026 for this.⁹ The government replaced that deadline with a six-month transitional period.¹³ The provisions on the ban on providing NFZ-funded services will enter into force later, 6 months after promulgation.³

If a contract cannot be adjusted, the head of the facility terminates it: an employment contract with a notice period no longer than under the Labour Code, a civil-law contract with at most one month’s notice.³ The committee proposed that the provisions protecting employees — including consultation with a trade union and pre-retirement protection (Articles 38, 39 and 41 of the Labour Code) — should not apply to these terminations. The Sejm deleted this provision with the KO and Lewica amendment, so the protection applies.⁴

Collective agreements and pay regulations must be adjusted within 6 months. In the committee’s version, those not adjusted would lose force in full. After the amendment adopted by the Sejm, they are invalid only to the extent that they conflict with the limits, and labour law applies to that extent.⁴

A person who works in several hospitals designates one of them, when contracts are adjusted, as their “primary provider” (świadczeniodawca podstawowy). Its head decides on consent to the other jobs.³

Other changes in the act

The act also amends provisions that do not concern the pay of health professionals:³

1. 01.

   Tariffs and cost accounting. The Agency for Health Technology Assessment and Tariff System (AOTMiT) will be able to price a service outside its annual plan if the minister agrees or does not reply within 7 working days. It will also gain the right to check how facilities keep their cost accounts. For failing to remedy irregularities or to submit data, the president of the NFZ will be able to impose a contractual penalty.

2. 02.

   Directors of NFZ regional branches. They will be appointed and dismissed by the president of the NFZ, after consulting the branch council.

3. 03.

   NFZ employees. Without the consent of the president of the NFZ they will not be able to work at the same time for facilities or pharmacies that have an NFZ contract or are applying for one.

4. 04.

   Equal treatment of patients. The Act on patients’ rights will gain a new Article 8a: a ban on discrimination in access to services, including on grounds of origin, citizenship, religion, sexual orientation, disability, sex and age.

5. 05.

   Night and holiday care. Hospitals in the hospital network will provide it on application to the president of the NFZ. Those that provide it today will be able to withdraw 3 months after notifying the NFZ branch.

6. 06.

   Medical Research Agency. The NFZ’s contribution to the Agency will be “up to 0.3%” instead of a fixed 0.3%. The act sets a minimum: PLN 200 million in 2027, PLN 550 million in 2028 and PLN 350 million a year in 2029–2031. According to the impact assessment, this is where the money for the new NFZ inspectors is to come from.

Ban on providing NFZ-funded services and the register of bans

The committee rejected two groups of amendments tabled by an MP of Rozwój Plus, so the Sejm voted on them as minority motions.³¹⁴ It adopted the first by 416 votes to 20 and rejected the second.²

The adopted group introduces a ban on providing services financed from public funds. The president of the NFZ imposes it by decision on a doctor or dentist if an NFZ inspection or information from the Social Insurance Institution (ZUS) shows that they knowingly:³

• certified something untrue about providing a service, e.g. about performing a procedure, in medical records or in a document on the basis of which the facility settles accounts with the NFZ;
• certified something untrue about the time or place of work, e.g. in working-time records, a duty roster or an invoice;
• issued a sick note inconsistent with the facts;
• issued another certificate or medical opinion inconsistent with the facts so that the patient or someone else would gain a benefit.

The ban lasts from one month to 8 years. The president of the NFZ takes into account the seriousness and number of the breaches, how long they lasted, the amount of money unduly spent and the consequences for patients. A person who breaches the rules again, during the ban or within 10 years of its end, receives a lifetime ban. A ban is not imposed for an obvious error or for a mere difference in medical judgement, and no proceedings are opened 5 years after the breach. The ban also applies by operation of law to a doctor whose authorisation to issue sick notes ZUS has withdrawn for a knowingly false certificate.³

The decision takes effect on delivery. The doctor may appeal against it to the labour and social insurance court, which has 30 days to hear the case. An appeal does not suspend the ban, but the court may suspend it on request. The ban does not apply to help given in a sudden threat to life or health when no other doctor is available.³

The president of the NFZ keeps a public register of bans in the Public Information Bulletin (BIP), with an interface for automated checks. The register gives the first name and surname, the licence to practise (PWZ) number, the legal basis and duration of the ban, and information on any appeal. The data also go to the Central Register of Doctors kept by the Supreme Medical Council. After the ban ends, the entry disappears from the public part.³

1. 01.

   A facility with an NFZ contract. Every day before work starts, it checks its doctors in the register. The NFZ does not pay for services by a doctor subject to a ban and demands repayment, and entrusting services to such a doctor or failing to check the register carries a contractual penalty of up to 1% of the annual value of the NFZ contract.

2. 02.

   The patient. Has the right to know that a doctor is subject to a ban: at registration, before the visit and on appointment booking websites. Every medical entity, including a private one, has the duty to inform. For breaching it, the Patient Ombudsman may impose a fine of up to PLN 1 million.

3. 03.

   ZUS. For the duration of the ban it suspends the doctor’s authorisation to issue sick notes and blocks it in the system.

4. 04.

   Petty offence. Providing NFZ-funded services despite a ban and knowingly allowing a doctor subject to a ban to provide them are new petty offences under Article 193.

The ban applies only to work financed from public funds, so a doctor subject to a ban can continue to treat patients privately. The provisions apply to breaches committed after they enter into force, 6 months after the act is promulgated.³

The second, rejected group would have moved the working-time declarations to the P1 IT system. In it the health professional would have listed all the facilities where they work, and the heads of those facilities would have seen their declarations.³ PiS, Rozwój Plus and Razem voted for; KO, PSL, Lewica, Centrum and Polska 2050 voted against.²

Notes 14laws, data and statements we relied on

1. Government bill amending the Act on healthcare services financed from public funds and certain other acts, print No. 3157 (in Polish), 28.09.2026 — explanatory memorandum (aims of the limits, “employee leasing”, percentage-based pay, staff rotation) and regulatory impact assessment (calculation of PLN 76,896, NFZ staffing and costs). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

2. Sejm of the Republic of Poland, 67th sitting, 22.10.2026 — vote No. 149 (in Polish) on the bill as a whole (229 for, 144 against, 67 abstained, results by club) and votes No. 125–148 on minority motions and amendments, including No. 125 (motions No. 1, 3–6, 8–9: 416 for, 20 against), No. 126 (motions No. 2 and 7: 188 for, 231 against) and No. 130 (amendment No. 7: 179 for, 203 against). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

3. Report of the Health Committee on the government bill, print No. 3193 (in Polish), 7.10.2026 — text of the bill adopted by the committee (Article 1 points 7–8, 9, 14, 20–24, 26–27; Articles 2–7) and minority motions No. 1–9 (No. 1, 3–6, 8–9: ban on providing NFZ-funded services, register of bans, duties of facilities, patients’ rights, ZUS, entry into force after 6 months; No. 2 and 7: the P1 system). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰

4. Additional report of the Health Committee, print No. 3193-A (in Polish), 21.10.2026 — 29 amendments from the second reading with their authors and the committee’s recommendation. Adopted by the Sejm: No. 4 (standby outside the establishment), 8 (half-time requirement, exceptions for geriatricians, pathologists and psychiatrists), 9 (consent procedure), 15 (transplantology), 20 and 25 (service relationship, paragraph 5 in the 12× threshold), 24 (notice period), 27 (deletion of the exclusion of Articles 38, 39 and 41 of the Labour Code) and 28 (invalidity of non-compliant provisions of collective agreements and regulations). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴

5. Sejm of the Republic of Poland, progress of the legislative process, print No. 3157 (in Polish) — received 28.09.2026, first reading in the Health Committee 7.10.2026, second reading 20.10.2026 and referral back to the committee, additional report 21.10.2026, passed 22.10.2026. ↩

6. Constitution of the Republic of Poland (in Polish; Dz.U. 1997 No. 78 item 483) — Article 121 (Senate: 30 days to adopt the act without changes, amend it or reject it) and Article 122 (President: 21 days to sign, a referral to the Constitutional Tribunal or return of the act to the Sejm). ↩

7. Act on medical activity (in Polish; consolidated text Dz.U. 2026 item 156) — Article 26(1) (commission for an entity performing medical activity or an individual) and Article 96(1) (work beyond an average of 48 hours a week with the employee’s written consent). ↩ ↩²

8. Regulation of the Council of Ministers of 11 September 2025 (in Polish; Dz.U. 2025 item 1242) — minimum wage from 1.01.2026: PLN 4,806. ↩

9. Rynek Zdrowia, “Limit 240 zł za godzinę i 76,8 tys. zł miesięcznie dla medyków, maksymalnie dwa etaty. Jest projekt” (“A limit of PLN 240 an hour and PLN 76.8 thousand a month for health professionals, two full-time posts at most. The bill is out”, in Polish), 25.07.2026 — the version published by the Government Legislation Centre (RCL) on 24.07.2026: a rate of 1/20 of the minimum wage for people under contracts, contracts to be adjusted by 31.12.2026. ↩ ↩²

10. Announcement of the President of Statistics Poland (GUS) of 9 February 2026 (in Polish; M.P. 2026 item 192) — average wage in the national economy in 2025: PLN 8,903.56. ↩

11. Alert Medyczny, “Sejm uchwalił ustawę o limitach wynagrodzeń medyków” (“The Sejm has passed the act on pay limits for health professionals”, in Polish), 22.10.2026 — description of the amendments adopted, including transplantology limited to organ retrieval and transplantation. The Sejm had not published the result of the vote on amendment No. 15 (No. 136) as of 22.10.2026. ↩

12. Regulation of the Council of Ministers of 14 September 2026 (in Polish; Dz.U. 2026 item 1213) — minimum wage from 1.01.2027: PLN 4,950. ↩

13. Rynek Zdrowia, “Limity wynagrodzeń przyjęte przez rząd” (“Pay limits adopted by the government”, in Polish), 22.09.2026 — six months to adjust contracts. ↩

14. Rynek Zdrowia, “Prezes NFZ będzie mógł zakazać lekarzowi dożywotnio pracy w publicznym systemie” (“The NFZ president will be able to ban a doctor from working in the public system for life”, in Polish), 22.10.2026 — minority motion of the Rozwój Plus club adopted by the Sejm. ↩