Case Study: Care-related supports – Edward Szczeklik Specialist Hospital, Poland
Company / organisation name
Edward Szczeklik Specialist Hospital
Financial supports and flexible working hours
About the company / organisation
The Edward Szczeklik Specialist Hospital is one of two hospitals operating in Tarnów – a city in the south of Poland with about 115,000 inhabitants. The hospital is a public institution and employs 761 staff, 85% of whom are women and 25% of whom are individuals aged 50 years or older.
The hospital provides its employees with welfare assistance of various kinds. Some forms of this assistance are targeted explicitly at employees engaged in informal care-giving to family members, including persons with a disability and older dependents.
One type of offered assistance is the co-funding of a stay in a rehabilitation centre for children with a disability and their guardians. These stays are 50% funded by the State Fund for the Rehabilitation of People with a Disability (Państwowy Fundusz Rehabilitacji Osób Niepełnosprawnych, PFRON). The remaining cost is borne by the parents or guardians of the children, of which the hospital offers to cover 50%, or 25% of the total cost. All employees can apply for this co-funding, regardless of their position or function. The criterion is that the PFRON has qualified the child in question for a rehabilitation stay. This assistance has been offered since 2005, and every year, at least several individuals use this benefit.
Another form of assistance is a non-repayable benefit granted in cases of financial hardship. This form of support can be availed of by employees because of an illness suffered by themselves or a member of their family. Family members who qualify include a spouse, a child aged under 18, or under 25 in the case of a student (including children who have been adopted or fostered). This benefit can be applied for once a year on the basis of submitted invoices for treatment, medical certificates, and bills for medication. In the case of cancer or chronic disease, it is not always necessary to document the treatment costs incurred. This is because the committee takes costs that are not directly related to treatment, such as travel and accommodation. Usually these grants do not exceed 2280 zlotys (about €600), because up to this sum it is tax-exempt; however, one can also apply for a larger sum. The Social Committee which considers applications convenes once a month (or more frequently in case of an emergency). The committee takes into consideration the financial situation of the employee’s family, so the application should include details on income earned. The position held by applicant is not taken into account. Applications can be submitted once per year, although in cases involving enduring, serious disease or special types of hardship, employees can receive the benefit twice a year.
Yet another form of assistance is the hospital’s flexible approach to working hours. For a majority of the employees, working hours are established within the organisational units. This makes it easier to account for the individual needs of each person, including working carers. Within limits, most employees can benefit from flexitime. Those in a particularly difficult situation, like carers of very sick persons, may usually count on their co-workers’ understanding. They can schedule their working hours in a way that allows them to combine their job with familial obligations. To this end, the hospital management has issued an official recommendation that employees with difficulties in reconciling work and family responsibilities should receive practical support.
Rationale and background of the initiative
These support measures are financed by the hospital’s Employee Social Benefit Fund (ZFŚS). The ZFŚS is a financial instrument that is regulated by national law but managed and funded by employers and employees. While the general rules for allocation of ZFŚS funds are laid down in national regulation, recipient organisations can decide their own eligibility criteria for giving grants to individuals.
Every year the hospital develops a preliminary estimate of the ZFŚS budget. This allows the hospital to grant the above mentioned supports to working carers. The preliminary estimate is flexible and the means can be re-assigned during the course of the year, depending on what applications are submitted to the social committee. The social committee makes decisions about the assistance to be granted. The person responsible for the organisational aspect of these matters is the social benefit worker employed by the human resources and training section. All rules associated with the aid rendered are specified in the rules and regulations of the Employee Social Benefit Fund.
The hospital decided to include employees providing care to disabled children or seriously ill family members on the list of potential beneficiaries. Identifying this group is an innovative step, as people in this situation are not usually named on such lists. The internal decision was taken by the social committee, which includes members of the works council (labour union), representatives from management, human resources and other departments. The committee also includes representatives of labour unions, of which there are seven operating in the hospital at present.
The initiative emerged from a desired to assist employees in the event of a perceived major need. No additional qualitative or quantitative objectives have been specified.
The hospital has a well established tradition of seeking to be a ‘good employer’. This goal is grounded in a general ambition to be one of the leading hospitals in Poland in terms of the quality of services provided.
Results and assessment
Experience suggests that the employees make good use of the financial support offered. Regarding the option of co-funding the costs of rehabilitation care, assistance has been provided to between two and six employees per year since 2005. Here, payments have ranged from €100 to €200 per case.
Within the last five years, 22 employees have accessed the non-repayable benefit granted in the case of hardships. All of these employees were engaged in care for ill or dependent family members.
The amount granted in each individual case has not been large. However, the low level of income of the applicants has meant that they are often perceived as a significant relief to the employee’s family.
There is no statistical information available on the proportion of employees who are engaged in family care in their spare time. It is certainly higher than the number of applications received for financial support. The hospital’s human resources and training department is aware of some individual cases of working carers who do not apply for the financial support offered. It appears that these individuals are in a stronger financial situation.
The hospital does not perform any sort of evaluation of the support provided. Neither does it inspect the nature of the care responsibilities for those to whom the support is granted. The only purpose of this financial support is to provide help in some specific cases.
Nevertheless, it has been observed in individual cases that the scheme has had a positive effect on employee loyalty. Therefore it is assumed that the initiative does also produce benefits to the employer.
The hospital has won a large number of awards and polls, including some associated with human resources management and protection of employee rights:
- Polish National Ranking of Public Hospitals in the category of the Best Hospital in Poland 2004, 2005, 2006, 2007, 2008, 2009, 2010;
- winner of the Human Resources Management Contest 2006;
- honourable mention in the Leader of the Human Resources Management Contest 2007;
- Equal Opportunities Company 2007 for social awareness and readiness to employ people with disabilities;
- Equal Opportunities Company 2007 – third place in the category of large enterprises in the area of remuneration and reconciliation of job with familial obligations;
- Exceptionally ‘Mom-friendly’ Company 2007;
- Pearls of Medicine 2008 – honourable mention;
- Golden Pearl of Medicine 2010 –first place in Poland in the category of multi-profile hospitals up to 400 beds.
These awards are used to promote the hospital, for example in efforts to recruit staff for vacancies that are difficult to fill.
Issues, challenges and lessons learned
The hospital plans to continue this scheme, as it is evident that there is a serious need for financial assistance in certain cases.
Experience so far indicates that it tends to be the same group of employees who receive the rehabilitation benefit each year; some employees regularly avail of the rehabilitation services, while other decide not to make use of the support on offer.
It appears that some working carers in the organisation would be much less likely to avail of rehabilitation services if they did not receive this financial support. Addressing the specific challenges of working carers also means avoiding the risk that job performance suffers from working carers’ dual roles. A job in healthcare demands the full concentration of each employee. For this reason, it should be easy to justify efforts to prevent employees from coming to work tired or from being distracted.
Many employers in Poland allocate significant funds to Christmas bonuses or other holidays, integration events, and health insurance for their employees. In light of this, the hospital representative considers it unfortunate that support addressing the special needs of working carers is not very widespread yet. Many indications suggest that simply knowing an employer will provide support in a family emergency has a positive effect on work morale and loyalty among employees.
The hospital does not currently see a need for additional regulation on this issue, for example in national legislation. Some argue that the statutory rights guaranteed by law are frequently abused by employees to the detriment of their employer, not necessarily in accordance with an actual need. In contrast, the hospital management feels that the development of solutions internally, involving agreement from the various stakeholder groups, is a much better approach to meeting needs.
Case study authors:
- Katarzyna Świeżawska-Ambroziak
- Dominika Stelmachowicz-Pawyza.
- Renata Ziaja-Guzy, Head of Human Resources and Training Section, Edward Szczeklik Specialist Hospital, Tarnów, Poland, conducted on 13 January 2011.