Passports for hospitals to be issued

The pilot project of the health care reform has just been launched in Dnipropetrovsk, and soon the reform will embrace the whole country. Dnipropetrovsk, Donetsk, and Vinnytsia oblasts were selected for the experiment, as well as the city of Kyiv. The Dnipropetrovsk governor Oleksandr Vilkul took the initiative and involved not only local statesmen and doctors, but also consultants from the British firm Deloitte, in developing the reform model. The oblast administration officials assert that not only had they studied, but had also taken into consideration the experience of the EU and CIS countries. The governor emphasized that according to the results of sociology polls, over 70 percent of the residents of the whole of Ukraine, including Dnipropetrovsk oblast, are not satisfied with the quality of medical care. “Today we have a situation when somewhat over six percent of the money allotted for the health care system is used for treatment of patients, whereas the rest is used to maintain the branch. We should implement drastic changes: raise the quality of medical services and make them more accessible. Unless we do so, Ukraine will never become a highly developed European state,” Vilkul stated.

The reform will start with the modernization of the emergency medical services. The task that has been set is to get doctors to arrive 10 minutes after a call in cities, and 20 minutes in the countryside, which is too optimistic a picture, if one takes into consideration the state of the roads and medical vehicles. For this the government should increase the number of emergency stations by 35 percent and the number of emergency crews and cars by 12 percent. They will all be united into a single oblast center of emergency medical services, financed from the oblast budget. The cars will be provided with mobile connections and the GPRS systems, which are supposed to increase their efficiency by one-third. The main accent in the reformed health care system will be made on first aid, since in European countries “over 80 percent of the residents’ calls starts and ends with a call to the family doctor.” Physicians and some other specialists who will lose their jobs as a result of the optimization of the hospital network are to be re-trained for family doctors.

Round-the-clock hospitals will be kept in 10 hospital districts — not all 22 village raions and 13 cities of Dnipropetrovsk region. The hospitals will be divided into institutions of intensive, planned, and recovery treatment, as well as hospices for hopeless cases. High-qualified medical treatment will be provided in specialized centers, located mainly in oblast centers. However, Vilkul promises that no hospital will be closed as a result of the “re-profiling” and a modernization passport will be issued for each of them, agreed upon with the experts and local authorities. Iryna Akimova, first deputy head of the Presidential Administration, considers that this invention of the Dnipropetrovsk statesmen is a safe guaranty for the population. “Healthcare reform is one of the components of the program of economic reforms that are being carried out in the country,” she reminded in her speech to the employees of the medical institutions of the oblast, “since this question is extremely sensitive; everyone uses the medical services, the approach should be decisive, but careful.” Akimova promises that in the legislation the health care reform will start with a VR approval of two laws: on the modernization of medical equipment in the pilot spheres, and on changing the fundamentals of the health care system. She hopes that these draft laws will be improved in the first and second readings before parliament goes on vacations. Akimova compared Ukraine’s current level of health care with the state of medicine in such poor African countries as Guinea and Togo: “We have twice as much hospital beds as all EU member countries, including the new ones, but life expectancy is 10 years shorter,” she said. Meanwhile, a mere 83 kopeks a day is being allotted for the treatment of a single patient.” Answering a journalist’s question, about why not a word had been said about the implementation of the insurance medicine, which is the base for the health care systems in EU countries, Akimova compared the domestic health care system with a hole-ridden vessel: “First we should fill in holes in it, and then replace it with a new system,” she said. The main reform-carrier of the country also avoided answering even a more “tricky” question on the elite medical institutions like Feofania. In spite of the declarations that Ukraine’s citizens should have equal access to high-quality medical services, the president’s comrade-in-arms admitted that there are no projects as yet on the cancellation of departmental medicine. She added modestly that she had never used the services of the Feofania Clinic.

The Dnipropetrovsk doctors, who listened to the speech of the first deputy head of the Presidential Administration, kept silent. Only the governor’s fellow townswoman, the head doctor at a Kryvy Rih hospital and head of the Vasylkiv Raion Council, had an opportunity to express her approval of the initiative. People were far from thrilled about Akimova’s thoughtless words on the lack of money. “Sometimes they say, give us more money, and we’ll solve everything. But it is easy when you have money and…” she started the phrase but never ended. The confused doctors from the oblast’s remote places were admonished with cheerful words that “he who goes will be able to reach the end of the road.” The words sounded quite ambiguous, as one of the audience said when leaving the assembly hall of the oblast state administration. The man, who preferred to remain unknown, said that in his opinion, the thing is not about reforming medicine, but giving new “artistic looks” to the ruins that have been left because of the beggarly funding in the last two decades. “They should start from changing the country’s taxation system and implementing a progressive scale of taxation, which will increase social expenditures. Otherwise the reform will be confined to merely the minimization of state expenditures on medicine and its degradation will aggravate,” was the gloomy prognosis of our interlocutor.