Group manager

Bubenchykova Svitlana

Lead expert

Civil Society Organisations:

  • CF «Patients of Ukraine»
  • Advocacy center «Life»
ISSUES TO BE RESOLVED BY THE REFORM

The healthcare system in Ukraine has not changed ever since the country gained independence in 1991. The authorities had neither interest nor motivation to change this sector. Today, Ukraine has an extensive system of healthcare establishments founded back in the Soviet times, which neglects real needs of the public in the sphere of healthcare, as well as international trends of modernization. Healthcare facilities in the form of budgetary institutions are limited in their activities and lack independence when making decisions on daily management and activities. Outdated infrastructure, low wages, and residual financing lead to a critical situation in the healthcare sector in Ukraine. As a result, the healthcare system is extremely inefficient. The public gets poor and often untimely medical assistance despite the fact that a significant share of the state budget is allocated to the healthcare system. This problem especially affects the low-income citizens who cannot pay for their own treatment.
Neither patients, nor healthcare professionals have doubts about the necessity of the reform. The main objectives of the reform set by the Parliamentary healthcare committee and the Ministry of Healthcare of Ukraine are based on the common criteria – quality and affordability of medical care. The stand of the authorities on this issue raises no questions, whereas the ways to achieve these objectives are quite questionable, especially considering the fact that healthcare professionals and patients are not as involved in the process of changes as it should be.
Given the need of urgent changes in the healthcare system, implementation of mechanisms for the effective use of resources, activities of all branches of power should be open and consistent.

GOAL I. STATE-OWNED AND MUNICIPAL HEALTHCARE FACILITIES WITH A SUFFICIENT LEVEL OF AUTONOMY AND FUNDING PROVIDE MEDICAL SERVICES IN AN EFFICIENT AND AFFORDABLE MANNER
  1. Introduce new mechanisms of using budget funds to pay for medical care, change the procedure of distributing the funds between the healthcare establishments.

Decision-making authority: Verkhovna Rada, Cabinet of Ministers.

  1. Approve the guaranteed level/package of medical care financed out of the state budget, as well as the procedure of calculating its cost.

Decision-making authority: Verkhovna Rada, Cabinet of Ministers.

  1. Formalize legislatively the terms of autonomy of healthcare facilities and the timescale of autonomization, determine the methodology and the recommendations concerning reorientation of hospitals.

Decision-making authority: Verkhovna Rada, Cabinet of Ministers.

  1. Turn healthcare establishments into state-owned and municipal non-profit enterprises operating on the principles of autonomy and efficiency (both medical and economic).

Decision-making authority: Cabinet of Ministers.

  1. Finish the reform of emergency care by establishing central and regional control centers, ensure gradual upgrade of the vehicle fleet.

Decision-making authority: Cabinet of Ministers.

  1. Review the state programs in healthcare in order to ensure effective use of funds.

Decision-making authority: Cabinet of Ministers.

  1. Develop a unified license for all the healthcare establishments with the right to administer drugs.

Decision-making authority: Cabinet of Ministers.

  1. Approve technical requirements for using information technologies in the sphere of healthcare to protect information. Create conditions for introducing electronic medical cards.

Decision-making authority: Cabinet of Ministers.

  1. Introduce a transparent procedure of recruitment to the state-owned and municipal healthcare establishments with a centralized electronic jobs database.

Decision-making authority: Cabinet of Ministers.

  1. Approve the procedure of queuing for medical treatment in the state-owned and municipal healthcare establishments.

Decision-making authority: Cabinet of Ministers.

  1. Conduct an audit of the state-owned establishments, enterprises, and institutions subordinate to the Ministry of Healthcare, an audit of medical equipment, and a census of healthcare professionals by specializations.

Decision-making authority: Cabinet of Ministers.

GOAL ІI. HIGH-QUALITY MEDICAL CARE
  1. Identify mechanisms, sources, and forms of payment to the healthcare professionals providing primary care. Simplify the requirements for obtaining a license for the doctors providing primary care and approve the form of a service agreement between them and the state.

Reduce requirements for technical support of the facilities providing primary care.

Establish a network of state-owned laboratories to provide the guaranteed package of diagnostic tests, determine the procedure for concluding contracts with the private network of laboratories.

Decision-making authority: Cabinet of Ministers.

  1. Introduce reference pricing for medicines. Introduce the system of reimbursement for medicines procured under state programs. Approve a National list of essential medicines.

Decision-making authority: Cabinet of Ministers.

  1. Introduce a system of analysis and reporting of medical errors. Ratify the Convention on the Protection of Human Rights and Dignity of the Human Being with regard to the application of biology and medicine.

Decision-making authority: Verkhovna Rada, Cabinet of Ministers.

  1. Implement new approaches to undergraduate and postgraduate medical education, adopt a standard of medical education.

Decision-making authority: Cabinet of Ministers.

  1. Approve the unified clinical treatment protocols, simplifying the procedure of developing and approving protocols. Introduce international expertise of protocols.

Decision-making authority: Cabinet of Ministers.

  1. Abolish the offices of external principal specialists, giving their powers over to the professional associations.

Decision-making authority: Cabinet of Ministers.

  1. Abolish the categories of healthcare professionals, introducing instead the bonuses for the work performed.

Decision-making authority: Cabinet of Ministers.

GOAL IІІ. NEW SYSTEM OF PUBLIC HEALTH
  1. Develop and adopt new mechanisms of funding the system of public health.

Decision-making authority: Cabinet of Ministers.

  1. Formalize legislatively the powers and the activity of public health centers. Determine the procedure of inspecting public health enterprises and establishments.

Decision-making authority: Cabinet of Ministers.

  1. Introduce the system of raising awareness of healthy lifestyle and its economic support.

Decision-making authority: Cabinet of Ministers.

  1. Formalize legislatively protection of public health from the harmful effects of tobacco.

Decision-making authority: Verkhovna Rada.

  1. Establish the standards of quality and safety of blood, tissues, cells and organs, and non-infectious diseases in accordance with the EU Directives.

Decision-making authority: Cabinet of Ministers.

  1. Eliminate conflict of laws as to mandatory preventive vaccinations.

Decision-making authority: Verkhovna Rada.

  1. Develop a system of training of public health professionals. Establish public health as a multidisciplinary education specialty.
GOAL ІV. PUBLIC CONTROLS THE ACTIVITY OF HEALTHCARE
ESTABLISHMENTS
  1. Formalize legislatively public control over the observance of rights of patients and healthcare professionals by establishing supervisory boards in healthcare facilities.

Decision-making authority: Cabinet of Ministers.

  1. Develop and adopt a standard procedure of setting up supervisory boards at the healthcare facilities and to determine their powers.

Decision-making authority: Cabinet of Ministers.

  1. Approve a standard procedure of electing the management of healthcare facilities on a competitive basis with the participation of the public.

Decision-making authority: Cabinet of Ministers.

  1. Approve a transparent procedure of referring the patients for medical treatment abroad at public expense.

Decision-making authority: Cabinet of Ministers.

GOAL V. AFFORDABLE MEDICAL PRODUCTS OF EUROPEAN QUALITY
  1. Adopt regulations on medical products in accordance with the principles of the EU.

Decision-making authority: Cabinet of Ministers.

  1. Obligate the agencies assessing conformity with technical regulations to check the medical products as efficiently as the relevant notified bodies of the EU do.

Decision-making authority: Cabinet of Ministers.

  1. Streamline and simplify the procedure of assessing conformity of those medical products which have undergone relevant certification in the EU.

Decision-making authority: Cabinet of Ministers.

  1. Sign an Agreement on Conformity Assessment and Acceptance of Industrial Products (ACAA) with the EU concerning medical products as a primary mechanism for removing technical barriers to trade.

Decision-making authority: Cabinet of Ministers.

GOAL VІ. PROFESSIONAL SELF-GOVERNMENT IN THE HEALTHCARE SYSTEM INTRODUCED
  1. Engage professional organizations to the process of formation and approval of educational standards, treatment protocols, and other documents related to medical practice.

Decision-making authority: Cabinet of Ministers.

  1. Engage professional organizations to the analysis of complaints about the activity of the healthcare establishments and healthcare professionals.

РDecision-making authority: Cabinet of Ministers.

  1. Introduce professional self-government in dentistry.

Decision-making authority: Verkhovna Rada, Cabinet of Ministers.

ADDITIONAL INFORMATION

Group experts

  • Bubenchykova Svitlana
  • Khytrova Olena
  • Kondratiuk Serhii
  • Kotliarevska Svitlana
  • Lanskyi Roman
  • Lapii Fedir
  • Olefir Liliia
  • Stoika Otto
  • Rymarenko Kateryna
  • Skipalska Halyna
  • Solokha Yuliia
  • Badikov Tymofii
  • Panfilova Yana
  • Yurochko Tetiana
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