He said irregularities included inadequate oversight of working hours, with some doctors working shifts of up to 110 hours, and cases in which physicians billed for work at two locations at the same time.
"We have 44 specific recommendations for Południowy Hospital," Trzaskowski told a news conference. "They are already being implemented, and the hospital will be held accountable for each of them."
The audit, conducted by City Hall, covered all municipal hospitals but identified the most serious problems at Południowy Hospital in southern Warsaw, Polish state news agency PAP reported.
The mayor said the findings fell into three categories: systemic problems affecting Poland's healthcare system, management failures at the hospital and issues that could warrant criminal investigation.
He stressed that the audit did not concern the quality of patient care.
Trzaskowski said many emergency departments rely heavily on physicians hired under civil-law contracts rather than as full-time employees.
Because such contracts are not subject to statutory working-time limits, some doctors worked marathon shifts.
"The audit found shifts lasting 48, 60 and 72 hours. The record at Południowy Hospital was 110 hours—almost five days," he said, adding that one physician worked nearly 400 hours in a single month.
The audit also found that the hospital had no formally established emergency department coordinator position, despite paying a doctor to perform the role for about 18 months.
According to Trzaskowski, the doctor's hourly rate increased from PLN 230 (EUR 53, USD 62) to PLN 330, exceeding the pay of experienced specialists despite the physician being only in the second year of specialist training.
Trzaskowski said the hospital already had a valid contract with the doctor but nevertheless held another procurement process and awarded him a second contract at a higher rate.
The same physician also received a separate contract worth nearly PLN 10,000 (EUR 2,300, USD 2,700) a month for duties that partly overlapped with his emergency department work, he added.
Trzaskowski also said the coordinator had access to the hospital's surveillance camera system, while the hospital kept no records of who had access to the system or when it was used.
Although the hospital had an electronic timekeeping system, it was not used to verify attendance, with staff instead paid on the basis of schedules and declarations, he said.
"In practice, payments were made on trust, even though tools to monitor working hours were available," Trzaskowski said.
He added that the hospital incurred nearly PLN 1.3 million in penalties from the National Health Fund (NFZ) during the audit period, including fines for excessive ambulance waiting times before patients could be admitted.
Auditors also found staffing shortages, including cases in which documentation failed to confirm the presence of the required physician and weekday registration desks were staffed by one employee instead of two.
The audit identified instances in which doctors were scheduled to work simultaneously at two different facilities and received payment from both.
"There were also cases in which physicians approved their own billing documents while having access to the IT system used to edit work schedules that formed the basis for those payments," Trzaskowski said.
After the issue was identified, one doctor submitted 33 corrected billing statements totaling more than PLN 500,000, he added.
Trzaskowski said most of the irregularities involved a single physician who is no longer employed at Południowy Hospital.
He announced that all Warsaw municipal hospitals had introduced electronic recording of doctors' actual working hours and called for a nationwide register tracking physicians' hours across healthcare facilities.
Trzaskowski also said all managerial functions should be formally established, contracts should include spending limits and any pay increases should require written justification.
He emphasized that Południowy Hospital continued to operate normally and said many of the audit recommendations had already been implemented, including adding a third emergency team to reduce ambulance queues outside the emergency department.
Trzaskowski said the city would publish the full audit reports on Friday after removing personal data and commercially sensitive information.
He also urged the public not to lose confidence in healthcare workers.
"We are doing everything possible to clarify this matter thoroughly. That is necessary to restore trust. Let doctors, nurses and other medical staff continue their work in peace," he said.
Deputy Mayor Izabela Marcewicz-Jendrysik, who oversees healthcare, said the city planned to centralize oversight of municipal hospitals, develop uniform procurement guidelines for medical services and introduce a citywide system to monitor physicians' working hours.
The audits were commissioned after media reports said Dawid Kacprzyk, a young emergency department coordinator at Południowy Hospital, earned more than PLN 1.6 million last year.
Media also reported that politicians from the governing Civic Coalition (KO) party received expedited treatment at the hospital, undergoing comprehensive examinations shortly after arrival.
Two investigations have been launched into the hospital. One concerns suspected fraud involving more than PLN 500,000, while the other focuses on alleged abuse of office.
The National Health Fund, which finances Poland's public healthcare service, is also inspecting Warsaw's municipal hospitals, and the National Labour Inspectorate (PIP) is expected to conduct a separate review of Południowy Hospital.
(pu/gs)
Source: PAP