About the second wave of medical reform
Let's talk about reforms, the secondary link of medicine, which should work from April 1. Tell us how it will look.
April 1 is only a turning point, and the changes we need to make will take place over the next few years. We begin the first very important step, we are changing the model. Earlier, we simply transferred money from a medical subvention for the maintenance of the institution.
In the first part of the interview, read if Ukraine is ready to fight against coronavirus
Now we say that institutions will receive money for the medical services provided. They will prepare a report where they will indicate how many services are provided.
In fact, this is only the first step in changing the model. In 2021, we will allocate even more from the budget and services will be paid more and more – so that hospitals can develop and raise salaries. This year is a turning point in the transition to a financial model. Because for the hospital, this changes the rules of many processes.
For Ukrainian citizens, this means that hospitals will begin to compete, compete with each other. Indeed, often people complain not so much about the quality of medicine, but about the service. We didn’t communicate so much, it was uncomfortable or the beds (there were 24 channels) in the corridor.
These are the things that so far have accompanied the provision of medical care and brought a lot of discomfort during a stay in a medical institution. Today, this can already have a positive momentum. Even in 2020, when funding increased, perhaps not as much as wanted, Ukrainians will already feel the quality. At least four priority services, which are paid at a higher rate: heart attacks, strokes, childbirth, neonatal care.
Skaletskaya promises that Ukrainians will feel the quality in 2020
However, there is still a diagnosis. The family doctor gives a referral to receive medical care, it is provided free of charge, and the hospital receives money for this. If patients do not want to go to the hospital because all conditions are not provided there, financing should not be spent. We are not rich enough to just give money away and not control it.
Important! Are Ukrainian hospitals ready before the start of the second stage of medical reform
And if it's small towns?
They can leave therapeutic departments. The therapist can also provide important help. We do not want a doctor just to have. We want the help to be of high quality, therefore we must provide it. If a patient with certain diseases gets to the doctor every two weeks, the doctor may forget how his patient looks and what he needs to be advised.
First, we must take care of quality medical care. The second is the activity of local authorities. The key thing, which requires long and painstaking work, is that local authorities, as the owners of most hospitals in Ukraine, do not recognize themselves as a full-fledged owner.
I'm not saying that you always need to invest money. It is possible control, management, monitoring. Does the head of the institution manage their property well? Local authorities usually do not understand that this is their area of responsibility. For our part, we will influence. Perhaps, even through licenses, but local authorities should do it more. We talk and work a lot about it.
Only those medical institutions that have certain equipment will be able to join this reform?
For various types of services there are certain requirements for the institution. If this is a surgical intervention, then we understand that there should be a good anesthetic department, specialists, equipment for surgical interventions. If this is a rehabilitation or therapeutic department, they have other requirements. We do not put forward unnecessary requirements.
A way to solve the problem when there is not enough equipment to conclude a contract are combined hospitals, cost optimization. It should not be that when there is no head doctor, then there is no institution. We have an institution, there are doctors and patients.
Great! What will be the priority in medicine for the government in 2020
Association of hospitals is one of the ways to save money that does not go to the aid of the patient, but to the maintenance of the institution. That is, for example, there are 2-3 institutions, in each of which there is a head, and deputies, and accounting. If we combine them into one institution, then at least in these positions we can save money and pay doctors a salary. The need for such additional workers is not always there. At the same time, such institutions then become more powerful in their capabilities.
Are many hospitals ready to merge?
There are examples in areas where associations occur. For example, Odessa region. Because they calculated and saw the effectiveness of such a solution. The owner himself, the local government, is primarily interested in this. The main desire.
What services for citizens will become free after the implementation of the reform, and for which it will be necessary to pay extra?
The reform will not happen in one day, it can last two years, but our first decisions concern the first of April. For today we have calculated and added the increased cost. This is medical care, services for acute heart attack, stroke, childbirth, neonatal care.
Minister of Health of Ukraine Zoryana Skaletskaya
Why is that? Because acute heart attacks and strokes are one of the largest causes of death in Ukraine. We must understand that a full-fledged opportunity to ensure their quality is not about providing medical care, but about saving lives. As for neonatal care, help for newborns – to minimize mortality. The same applies to childbirth – to preserve the life of the mother and baby at birth as much as possible.
About transplantation in Ukraine
Regarding transplantation. It is necessary for coordinators to organize the process. How many coordinators are there in Ukraine and when will they begin to work?
In fact, transplant coordinators already exist and are working in Ukraine. Their professionalism within the institutions is quite effective. Over the past two months in Ukraine, two heart transplants took place, which have not been the last 13 years. This is due to the fact that transplant coordinators have appeared and are being trained. Some of them have already been abroad on an internship. But these are only the first steps.
The key goal is to create an all-Ukrainian coordination center, where institutions between regions will provide for the possibility of maximum interaction between recipients and donors. Now in test mode, the system of electronic transplant registries will be launched. To perform as quickly as possible all the processes of selecting the recipient and donor.
Organ transplant prices in Ukraine: what is known?
Allograft kidneys from a living donor or a corpse donor will cost 323,798 hryvnia. ABO-incompatible kidney transplantation will cost 721,230 hryvnia. A heart-lung complex transplant will cost 535,280 hryvnias. Transplantation of a liver or its part – 855 039 hryvnias.
The price for allogeneic transplantation of hematopoietic stem cells with a donor stage will be – 1 360 141.36 hryvnia. An autologous transplant will cost 1 308 393.3 hryvnias. For the removal of organs from a donor-corpse will have to pay 74,086 hryvnia
For transplantation, it is important to have specialists, transplant coordinators and the ability to quickly carry out logistics throughout Ukraine. It is very progressive that they used to believe that this can only be done in Kiev or Zaporozhye. Today there are many hospitals that are ready to join in this process.
Zoryana Skaletska spoke about organ transplantation in Ukraine
We have “pilots” that include hospitals that are willing to do this intensively. I must say right away on organ transplantation: we send many Ukrainian citizens abroad, although we have specialists and are ready to do this in Ukraine.
This is not only a matter of reducing funds, but also reducing stress. When it is possible to receive treatment while in Ukraine, together with your relatives and in comfortable psychological and physical conditions. Do not endure a heavy flight, do not be in a bewildered state.
An important step is the preparation of bone marrow transplants in Ukraine, since most, especially children, are required to go abroad. And we must do this process in Ukraine too. Therefore, transplantation is the treatment that saves lives. We are doing everything so that these procedures take place in Ukraine, and by the end of 2020, I hope we will have very good statistics.
About the personal life of the Minister of Health Zoryana Skaletskaya – read here.