Health care reform is the latest one from the reform package. Formally, it was launched on Jan. 1, 2017. To implement the first stage of the reform, the Ministry of Health developed a reform plan for 2017-2020, which was introduced on Feb. 8 at a meeting of the Ministry. As of now, it hasn’t been approved by the Government.
The main objectives of the Ministry of Health in the short term according to the introduced plan are:
➤ To introduce a new funding model for primary, secondary (specialized) and tertiary (highly specialized) medical care.
➤ To create a legal basis for a new system of health care financing.
➤ To create a single national customer of health care services – the National Health Service Department of the Ministry of Health.
➤ To create a single electronic system for the exchange of medical information.
➤ To create hospital districts.
➤ To make budgetary health care establishments autonomous.
While the health care reform has not started yet, the process of reform implementation in other areas gave rise to significant changes in the health care system as well. Thus, a medicine procurement system has changed due to introducing ProZorro. Now, this process is carried out through the independent organizations, before it was performed by the Ministry of Health, enabling theft and fraud.
Moreover, the system of funding hospitals has changed. Thus, starting from Sept. 2016 state funds for hospitals are allocated not for a number of “beds,” but on the principle “money follows the patient.”
In the long term, the reform aims to provide all Ukrainians with full and affordable health insurance.
Government bodies responsible for the reform: the Ministry of Health of Ukraine.
Reform expert – Zoriana Chernenko, a leading expert on health reform of “The Reanimation Package of Reforms”, an Associate Professor at the National University of Kyiv-Mohyla Academy.
➤ Reduction of a number of beds in regional hospitals according to a fewer quantity of patients.
➤ Covering of all hospital utility expenses by the local authorities from Jan. 1.
Measures to be taken:
➤ Introduction of service agreements between a patient and a doctor, implementation of the medical service control, creation of a system for reporting protocols.
➤ Introduction of a health insurance system.
➤ Creation of a public authority – National Health Insurance Agency with offices in every region.
➤ Approval of new treatment protocols based on the international standards.
➤ Creation/reforming of dispatch service agencies. Development of the standard protocols for the actions of medical staff in the emergency car.
➤ Creation of a single registry of patients.
➤ Improvement of the level of training of doctors. Reorganization of medical universities and creation of clinics on their basis.
Key laws adopted under the reform:
➤ The Law “On Amendments to the Tax Code of Ukraine concerning the Exemption of Value Added Tax on Import and Supplies of Medicines and Medical Devices” (entered into force on June 5, 2015).
➤ The Law “On Amendments to Some Laws of Ukraine concerning Providing Timely Patient Access to Needed Medicines and Medical Products through Public Procurement Involving Specialized Organizations that Purchase” (entered into force on Jan. 8, 2016).
➤ The National Strategy for health reform in Ukraine for the period of 2015-2020 (2015).
Laws to be adopted:
➤ The Draft Law “On the Basis of the State Policy” (referred to the Parliament).
➤ The Draft Law “On Amendments to the Law of Ukraine on the Procedure for health care reforming in Vinnytsia, Dnipropetrovsk, Donetsk regions and Kyiv” (It provides the extension of the pilot project).
➤ The Draft Law “On Amendments to Some Laws of Ukraine on Protection of Public Health from the Harmful Effects of Tobacco” (referred to the Parliament).
➤ The Draft Law “On Amendments to Certain Legislative Acts of Ukraine on optimization of the system of central executive bodies in the field of sanitary and epidemiological welfare” (referred to the Parliament).
➤ The Draft Law “On Medical Self-Government” (referred to the Parliament).
➤ The Draft Law “On Health Care Institutions and Medical Services” (drafted).