The process of forming hospital districts is a part of the healthcare reform and decentralization reform. The main objective of these changes is improving quality of medical infrastructure on local level. Representatives of the relevant ministry and the public are explaining the principles and the progress of the reform.
Principles of the reform
Medical infrastructure existing in Ukraine is ineffective. Ukraine is the fourth biggest country in the world in terms of number of hospital beds per capita, but quality of medical service is low, fixed assets are worn-out and equipment is outdated. It is the most clearly noticeable in regions. It has been suggested to solve this problem through hospital districts. Activities on their formation will continue till the end of 2017 and will take place in three stages. Borders of hospital districts will be formed, hospital council created and district development plan drawn up. The first stage is in progress at present. Changes are administered on national and local levels with participation of the Cabinet of Ministers of Ukraine, Ministry of Healthcare, local authorities and the public.
Hospital district and council
According to the reforms plan, a hospital district will unite healthcare institutions within certain territory. This means the institutions that provide specialized medical care. A hospital district should include at least one multi-specialty intensive care hospital. Hospital districts envisage formation of hospital councils from representatives of districts, towns, amalgamated territorial communities and doctors – everyone responsible for development of their hospitals. Nevertheless, it will happen according to a certain pattern. A hospital council shall form a hospital district development plan to understand real workload. It will assign functions, directing flows to a hospital with doctors and equipment available. This also envisage improvement of transport system and roads on the territory of community – first of all those leading to hospitals. Then assessment of resources and investment needs will follow. “A hospital district is an instrument of prioritization – it will show where investments should be made first of all, so that the community can feel the impact instantly in the form of medical care,” said Pavlo Kovtoniuk, Deputy Minister of Health of Ukraine during discussion at Ukraine Crisis Media Center.
Borders of hospital districts will not coincide with administrative division, and a hospital district will have no center. “Principles of a hospital district formation are as follows: it is a full set of institutions providing secondary level services (specialized medical care – UCMC), population, potential patients that provide the required workload for each institution and the fact that by common sense people will seek medical help in their own hospital districts,” explained Yuriy Hanushchak, director of NGO “Institute of territorial development”.
Reform progress
14 regions submitted their projects at present. “We presented a project of five districts and started discussions. Then we travel around the entire Chernihiv region and talked [to local authorities]. As a result, a new number – seven – came out. Then we received requests from some areas who wanted to join more powerful districts. We ended up with four powerful hospital districts and submitted proposals to the Ministry of Health,” said Petro Harmash, Head of Public Health Department of Chernihiv regional State Administration.