In the period from January 2017 to June 2020, the most important forms of assistance under the “For Life” program could be used to a small extent, the Supreme Audit Office stated in a report published on Tuesday.Instead of the planned 30, there were only six specialized centers across the country, which could offer coordinated neonatal and pediatric care for children.
The Supreme Audit Office also assessed that almost all forms of assistance were planned without a reliable diagnosis of the real needs of the groups that were to benefit from them, and a significant part of the costs related to the implementation of activities for the family were transferred to local governments. In the materials published on Tuesday, the Chamber reminds that the law “For Life” was adopted in November 2016, and in December, without public consultation, the government adopted the program “For Life”.
Its most important beneficiaries were to be women with complicated pregnancies and families with newborns who were diagnosed with severe and irreversible disability or an incurable life-threatening disease in the prenatal period or during childbirth. However, the audit of the Supreme Audit Office showed that in the analyzed period – from January 2017 to June 2020 – the most important forms of assistance intended for this particular group could be used to a small extent.
NIK: there were six instead of 30 care centers
Such care is authorized, in particular, by a certificate issued by an authorized physician, and yet no institution had complete data on the number and place of residence of those entitled to such assistance.
Instead of the planned 30s, by the end of the inspection, there were only six specialized centers across the country that could provide coordinated neonatal and pediatric care for children with the most severe diseases arising in the prenatal period of development or during childbirth. In four out of 16 voivodships, palliative and hospice care services were not available.
NIK: the level of subsidizing the remuneration of family assistants has been reduced
The authors of the Program assumed that professionally prepared family assistants – aid coordinators would be the key support link for this group of beneficiaries. The planned changes were to increase their number, broaden the scope of their activities and popularize the services they offer.
The Supreme Audit Office indicates that this did not happen due to the significant reduction in the level of subsidizing the remuneration of assistants. In 2017-2020, the family ministry transferred over PLN 100 million less to local government units for this purpose than assumed in the program.
NIK: the Prime Minister’s office did not launch the database
Despite the provisions of the program, until the end of the audit by the Supreme Chamber of Control, the Prime Minister’s office did not launch a database and portal with information on forms of support for disabled people, their families and carers, which NIK assesses particularly critically. It was one of the reasons for the low interest in some forms of aid. Only the publication of a digital guide about the rights under the Act on Support was stopped.
In turn, the Ministry of Education – as the Chamber points out – did not create the National Coordination and Rehabilitation Center, explaining that the provisions of the program in this respect go beyond the Education Act, which does not provide for such a separate unit. According to the Supreme Audit Office, in this case it is not necessary to organize a new facility, as the supervision and coordination of the activities of poviat coordination and rehabilitation and care centers could be taken over by, for example, a department or person designated in the ministry.
NIK: only one goal of the “For Life” program was fully realized
In the scope of the so-called health supply has only fully achieved one goal of the “For Life” program. Already in 2018, 13 breast milk banks were established, which in 2020 were used by over four thousand children, while three years earlier, only 46. The availability of diagnosis and prenatal therapy was also largely ensured to pregnant women with an increased risk of congenital defects of the child, although these tests were already available before the “For Life” program was launched.
In the opinion of the Supreme Audit Office, the main reason why the program did not operate as planned in the analyzed period was failure to comply with the obligations of its coordination and monitoring or their unreliable fulfillment by successive ministers for family and social policy, health, and voivodes.
As a result – as assessed by the Chamber – the reports on program implementation for 2017-2019 sent to the Prime Minister were incomplete and unreliable; on their basis, it was not possible to judge what had been done and what had not been done, and for what reason. The documents also did not contain information about the barriers that had been encountered in the implementation of tasks and proposed changes that would enable the achievement of the planned objectives of the program.
“For Life” program
Meanwhile, as NIK claims, from October 22, 2020, the “For Life” program has an even greater role to play. The Constitutional Tribunal then ruled that abortion due to severe damage or incurable disease of the fetus is inconsistent with the constitution, and according to the Ministry of Health, these are the most common reasons for the decision to terminate the pregnancy (95-98% of cases).
The program consists of 31 different types of activities, divided into six priorities. The audit of the Supreme Audit Office showed, however, that in the analyzed period, a significant part of the planned forms of aid could be used either to a limited extent, or the interest in them was low due to the lack of knowledge about the possibility of applying for such aid, or due to its improper allocation.
The value of the planned aid under the “For Life” program for 2017-2021 is nearly PLN 3.1 billion. By the end of 2019, as much as 86 percent of the amount planned for the implementation of tasks at that time, but – as indicated by the Supreme Audit Office – this is related to, inter alia, with four times higher than expected expenditure on providing coordinated care for pregnant women with complicated pregnancies.
Main photo source: PAP / Albert Zawada