Patients and primary healthcare physicians received a new list of services that the state guarantees to cover. 149 communal and 12 private institutions that have signed contracts with the National Health Service of Ukraine (NHSU) will receive first funding on the basis of the “money follows the patient” principle by mid-July, announced the heads of the Ministry of Health and NHSU at a joint press briefing, held on 2 July.

161 institutions will get first payments from NHSU

Financing on the “money follows the patient” principle starts in Ukraine. By mid-July, 161 primary healthcare institutions – 149 communal and 12 private ones – will receive first payments from the NHSU at a single rate for providsion of a specified package of services. These are more than 1000 outpatient clinics in 20 oblasts and in Kyiv. In total, these institutions serve more than 8 million people.

“From now on, the National Health Service is the financial guarantor of the fact that “the money follows the patient”. Every patient should have a clear list of services that he/she will receive for free and paid for by the state via the NHSU. From now on, in Ukraine, as in the whole civilised world, a particular person, and not a system, is in the centre of healthcare service. We are moving away from an ineffective Soviet approach. From now on, the state is for a person, and not vice versa. It is the NHSU, that is the leader of these changes, financial partner of new, transparent and honest relations between a patient and a doctor,” said Oleh Petrenko, head of the NHSU. 

Single tariff rate is the only standard of services

Since 1 July, the Order the Ministry of Health No. 504 as of 19 March 2018, which sets up a clear list of primary healthcare services, has entered into force.

For the first time Ukrainians will have the same standard of service and primary healthcare services, covered by their taxes. It does not matter where their doctor works: in a communal outpatient clinic, private hospital, or carries out his/her own medical practice as a physician-private entrepreneur.

If you are still looking for your doctor, do not worry – your district doctor will provide you with medical care. By the end of 2018 the state pays for the services provided by the healthcare institutions under both the declarations, and a territorial principle.

Specialised and highly specialised healthcare institutions in 2018 will be maintained at the expense of the healthcare subvention and will continue to work. In 2019, pilot projects on funding at tariff rates for medical services in specialised healthcare institutions will be launched in several oblasts. In 2020, institutions at all healthcare levels will switch to financing at a tariff rate with a clear list of services.

“Due to joint efforts, we are changing the approach to patient care. Every day I receive messages with gratitude from Ukrainians – doctors themselves call patients and invite them to sign a declaration. I got a letter from a family with children and two elderly people over 80 years old from Zaporizhzia. Paramedic Lyudmyla Yezhova invited them to sign a declaration with a family doctor. And now this family now has a doctor who cares about both the little ones and the the elderly. This is a very valuable asset that is now available to every Ukrainian. It is just the beginning. And we are coming to the point that in 2020, all medical services, covered by the state, will be in a clear and transparent list”, stressed Dr. Ulyana Suprun, acting Minister of Health of Ukraine. 

Salaries of doctors are in the hands of chief doctors

Now medical institutions are free to formulate their salary policy. Tariffs and staffing lists no more operate in autonomous healthcare institutions. And the salary is the subject of an agreement between the chief physician and his/her employees. 

Local authorities are a fullfledged member of changes in the healthcare system

“Local authorities play an important role in introducing changes in healthcare sector. The hromada is the owner of communal facilities and has to provide both computers, expendables, appliances under the equipment list for the primary healthcare institutions and make a decision on the autonomy of healthcare institutions. All this is obligatory for signing of an agreement between the institution and the NHSU. The NHSU guarantees the payment of medical services at a market rate, and the local authorities must ensure physical accessibility to this service – the corresponding infrastructure. The task of local authorities is to autonomise all healthcare facilities by the end of 2018. It will still have to be done, but special simplified conditions are in effect only this year,” said Pavlo Kovtonyuk, Deputy Minister of Health.

By 2019, all primary healthcare providers should switch to funding based on the “money follows the patient” principle under the contracts with the NHSU.

It is worth reminding that the national campaign “A Doctor for Every Family” began in April.

Over 3 months, 10,8 million people – i.e. every fourth Ukrainian – made their choice. This is the best illustration of the fact that doctors and patients are ready for change.

More than 22,000 primary healthcare physicians are registered in the Electronic Health System. They all sign declarations with patients. Family doctors account for the largest number in the system with more than 14 thousand registered physicians. Pediatricians amount to over 4 thousand.