What changes in the healthcare system should Ukrainians expect in 2018?


The first tier of changes introduced by the healthcare reform will touch upon the primary healthcare system. Acting Healthcare Minister and the reform support team envisage what to expect.

The healthcare reform will come into effect in January 2018. At the initial stage, the changes will touch upon the level of primary healthcare only. “We are already explaining how we will be implementing the law, as sometimes in Ukraine very good laws are adopted but not implemented, and thus they don’t work,” emphasized Ulana Suprun, acting Healthcare Minister of Ukraine, at a press-briefing at Ukraine Crisis Media Center. “As it is stipulated by the law, in 2018 we will change the financing system for primary healthcare – it concerns family doctors, pediatricians, doctors of internal medicine, and general practitioners. It is not going to happen in a day. We will be changing the system of financing primary healthcare gradually in course of the entire year.”

Starting from January 2018, each patient will have to choose his/her family doctor, not necessarily at the place of registration. Next step is to sign the declaration with the doctor. To make it possible, medical clinics and primary healthcare centers will have to become legal entities, doctors with private practice will have to get registered as private entrepreneurs. Among the services provided for free is the first consultation, basic tests, cardiogram, issuing a certificate of absence from work, etc. “You don’t have to pay anything for these services to the family doctor. The doctor cannot accept money for these services – otherwise, you will be ‘framing’ him/her for a bribe. In this case, the National Healthcare Service can break the contract with him/her. Everything is covered by the state: the doctor will receive the money directly from the state budget,” acting Healthcare Minister Suprun said.

Medical expert of the Reanimation Package of Reforms Oleksandr Yabchanka explained how the policy for the healthcare reform was formed. Before the draft law was elaborated, the acting Healthcare Minister and her deputies visited each regional center to hold public discussions. After presenting their vision of the reform at these events, they were asking both doctors and patients what they would like to get as the result of the medical reform. “Patients are tired of not knowing how to thank the doctor, of not knowing how much money to give. And patients are tired of not knowing what to expect when they get sick. Patients want clear and understandable guarantees from the state,” Yabchanka said. “Doctors, in their turn, are tired of taking up the role of either a beggar or a racketeer. Doctors want to be getting a decent salary in return for the quality work they do.”

Unfortunately, not all the MPs took the adoption of the medical reforms in the first reading positively. Such a reaction was caused by the lack of awareness and by the intention of some politicians to raise their own popularity. Many MPs also started spreading the myth that medical services in question will be partially covered. “It means that these politicians are either twisting the facts intentionally or had not read the law before it was submitted for the second reading,” noted MP Serhii Berezenko (Petro Poroshenko Bloc). He also emphasized that there needs to be strict control over the reform implementation both on the part of the authorities and of the civil society.

Healthcare Minister Ulana Suprun also reminded that next year the changes will touch upon the primary healthcare only. “What is happening in clinics and at hospitals will not change since January 1, 2018. It will stay the way it is now. Only effective January 1, 2020, we will start introducing another financing system at this level,” Suprun reminded.