Given the high levels of behavioural risk factors such as smoking, harmful alcohol consumption and obesity, a better balance between disease prevention and care may help to improve population health status and reduce health inequalities, while at the same time reducing pressures on the health and long-term care systems. The Polish government has embarked on a programme of ambitious reforms of the health system, and some of these reforms will influence health care governance, accountability and planning (Box 1). Similarly, the replacement of activity-based funding with prospective annual budgets, and the switch from maximum to minimum limits, represent a substantial transition in hospital management and administration, and pose a challenge to ensure financial and clinical accountability, as well as monitoring and evaluation of performance.