Author: Yuriy Petrushenko, Doctor of Economic Sciences,

Financial Adviser of the Sumy Local Government Development Centre

From now on the hospital is funded by the AH

Since the beginning of 2018, the hospital in the town of Trostyanets has changed its owner. The institution moved to the balance of the Trostyanetska amalgamated hromada from the Trostyanets Rayon Council.

The situation is rather extraordinary as this is the first case in the Sumy Oblast, when the AH (whose boundaries do not coincide with the borders of the rayon) took on the rayon hospital along with the primary healthcare facilities.

The hospital comprises:

• 7 outpatient clinics of general practice of family medicine,
• outpatient clinic with family doctors,
• town outpatient clinic (pediatric)
• 10 rural health posts,
• 13 paramedic stations.

Already in 2017, the cost of maintaining the Trostyanets Rayon Hospital exceeded the amount of healthcare subvention that came to the rayon budget and the town of Trostyanets. The deficit amounted to about UAH 10 million and was covered due to own funds of the Trostyanets town budget and budgets of the rayon villages.

As practice has shown, the management of the AH has not only a desire, but also a developed action plan that has already started being implemented: the optimisation of the hospital personnel has been carried out quickly. By means of downsizing vacancies’, excessive job combinations, separate repair team and other positions failing out from the direct chain “patient – quality healthcare services”, it was possible to reduce annual expenses by UAH 1 million. In addition, it is planned to increase the energy efficiency of the institution. Already in 2018, the renovation of hospital wards in the therapeutic department and purchase of new necessary equipment are foreseen.

The centralised establishment of secondary link healthcare institutions within the framework of the reform of the formation of hospital districts may conflict with the principle of subsidiarity. The criteria that form the basis for the establishment of hospital districts are, on the one hand, objective (financial resources of the state, number of residents, distance / time of arrival to the hospital), but, on the other hand, do not take into account an important factor that significantly affects hromada development – the presence of strong local leaders and teams ready to take risks and implement innovations for a better future.

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