Not all hospitals are equal: Why Polish facilities struggle to change their legal form

Poland’s local governments are often better positioned to supervise hospitals when they operate them as companies, yet roughly four in five municipally established hospitals still use the legal form known as SPZOZ, or independent public healthcare institution.

The mismatch reflects both financial and legal barriers. Hospital managers have little incentive to undertake a conversion, while regulations impose conditions that make changing a facility’s legal structure difficult. As a result, the model considered less advantageous for local authorities remains dominant.

Even establishing how many hospitals operate in Poland is not straightforward. Central Statistical Office data recorded 888 hospitals in 2024, excluding day facilities. More recent figures from the Central Business Information Center counted 1,065 hospitals at the end of January 2026, including 654 public and 411 private institutions.

Public hospitals are mainly run by local government units and universities. The discussion over their legal status therefore concerns a large part of the country’s publicly managed hospital network, where municipalities must balance oversight, operating arrangements and the practical obstacles to restructuring.