Reform of the domestic healthcare system is a fundamental change in the organizational and economic principles of management in accordance with the market conditions and European standards. The current stage is a transition in the implementation phase. Although many steps have already been taken, the “point of no return” has not been achieved yet.

Therefore, in order to ensure the reform continuation and irreversibility, the following steps need to be taken:

• Complete the introduction of new financial mechanisms based on the “money following the patient” principle at the primary medical care level and implement them at the level of specialized and highly specialized medical care (both outpatient and inpatient).
• Institutionalize the “patient routing“: appointment with a specialist doctors and other services are provided free of charge only after referral be a family doctor.
• Approve the program of medical guarantees for all levels of medical care.
• Ensure full electronic workflow in the healthcare system.
• Complete the medications and medical supplies procurement reform, introduce a unified stock system to track the purchased medications and medical products.
• Complete the development of a public healthcare system, ensure division of functions and powers between the CMU, the Ministry of Health of Ukraine and other public authorities in the public healthcare system.
• Ensure conditions for the implementation of the State Policy Strategy for Healthy and Active Longevity of the Population till 2022.
• Introduce European approaches to epidemiological surveillance, which will cover both infectious diseases and non-infectious diseases, improve the mechanism of infection control and epidemiological surveillance.
• Implement a plan to combat non-communicable diseases and implement measures for European integration, in particular the implementation of EU directives on transplantation, blood safety, tobacco control.
• Create a network of biological safety centers on the basis of the “One Health” concept at the Ministry of Health of Ukraine.
• Continue to actively implement immunization measures in order to ensure a high level of immunization of the population as part of the national security plan.
• Ensure the implementation of the rural medicine development program.
• Ensure the institutional implementation of the emergency medical care reform, adopt the Good Samaritan law.
• Ensure implementation of the International Classification of Functioning, Disability and Health (ICF) and launch a full-fledged Rehabilitation and Disability Reform (Disability Determination Service).
• Reform the patent system and provide conditions for the free competition in the market of pharmaceuticals and medical devices.
• Reform the system of pre- and post-graduate medical education on the basis of the achievements of modern medical science and evidence-based medicine.
• Introduce a system of professional licensing for doctors.
• Ensure the development of medical self-government as an institution regulating the quality of medical services and protecting the rights of healthcare professionals.
• Ensure the involvement of NGOs in providing medical and social services and ensure financing for these services, in particular from local budgets.
• Continue active cooperation with the public sector, engaging civil society organizations as much as possible in the decision-making process and ensuring prompt and transparent communication on the healthcare system transformation.

Author: Tetiana Yurochko

Co-author: Svitlana Bubenchykova, executive director of Healthcare Platform NGO, the manager of the RPR’s Healthcare Reform Team

Peer-review: Liliia Olefir, Halyna Skipalska

One of the most important tasks for civil society representatives is the communication and promotion, both in Ukraine and among international partners, of two documents developed by more than 100 industry experts of the Reanimation Package of Reforms Coalition.

1. Toronto Principles– vision of the principles of reforms development in Ukraine until 2023.
2. Industry Briefs on Reforms in Ukraine which contain information on achievements, risks and necessary future vectors for the reforms.

Tymofii Badikov, the UP