Warsaw hospital audit uncovers 110-hour shifts, phantom role, and double payments

Background

The audit was ordered after media reports, including by Zero and Onet, revealed that Dawid Kacprzyk, a doctor training as an anaesthetist and a former Civic Coalition councillor in Warsaw's Ursus district, earned approximately 1.6 million PLN in 2025 at the Southern Hospital. Reports also alleged that politicians from the ruling party were admitted ahead of ordinary patients. Trzaskowski had already dismissed the hospital's management and supervisory board before the audit results arrived on his desk on Monday, 3 August. The affair had also cost two deputy mayors their jobs: Renata Kaznowska and Aldona Machnowska-Góra resigned at the start of July, and Izabela Marcewicz-Jendrysik took over responsibility for health in the city on 15 July.

Audit findings

On Wednesday, Trzaskowski presented the audit's key conclusions, dividing them into three groups: systemic problems of Polish healthcare, management irregularities at the Southern Hospital, and matters for prosecutors. The audit covered all municipal hospitals, but the scale of problems at the Southern Hospital was described as unprecedented. Doctors on civil-law contracts, who are not protected by working-time regulations, worked shifts of 48, 60, and 72 hours without a break. The record was 110 hours, almost five days. One physician averaged more than 400 hours a month.

The phantom coordinator

The most glaring irregularity concerned the SOR coordinator role held by Kacprzyk. The audit found that the position did not exist in the hospital's organizational regulations.

The hospital paid for a function that formally did not exist in its structure for a year and a half.

Kacprzyk's hourly rate rose from 230 PLN to 300 and then 330 PLN, more than experienced specialists, without any written justification. The hospital had a valid contract with him but still opened a competition and awarded him another contract at a higher rate. He also held a separate 10,000 PLN monthly contract for duties that partially overlapped with his shifts, creating a risk of double payment. Kacprzyk had access to the hospital's camera system, and no records were kept of who used it.

Double billing and oversight gaps

The hospital had an electronic entry and exit system, but it was not used to verify doctors' working hours. Payments were made based on schedules and doctors' own declarations, "on their word," Trzaskowski said. The audit found that the same eight-hour shift was billed to two different departments simultaneously, and one doctor provided services at another facility during hours paid by the Southern Hospital. The NFZ had fined the hospital for excessive ambulance waiting times, and documentation often failed to confirm a doctor's presence. Trzaskowski said the doctor at the centre of the case had since submitted 33 corrections to his invoices, covering more than half a million zloty, which he returned to the hospital.

Reaction and reforms

Trzaskowski said he was "outraged" by Kacprzyk and denied ever discussing the hospital with him.

I am outraged by the figure of Mr Kacprzyk and the people he invoked.

Trzaskowski stressed the limits of the exercise, saying the audit describes the irregularities found but does not determine criminal responsibility. Prosecutors have already opened two investigations, the Supreme Medical Chamber is running its own proceeding and the national audit office has published a critical report. The audit produced 44 recommendations, covering working-time controls, an end to billing on the basis of schedules and declarations alone, clearer rules for awarding contracts and stronger patient safety measures. Vice-mayor Izabela Marcewicz-Jendrysik announced that oversight of all Warsaw hospitals would be consolidated under a single entity, and a team of specialists would draft new rules for health service competitions. A management system to monitor doctors' working time will also be introduced.

When management does not show the true picture, owner supervision becomes blind. That is why we will change this whole system.