As noted by a people’s deputy from the Samopomich Union faction, Deputy Chairperson of the Parliamentary Committee on Health, Iryna Sysoyenko, the decision to create hospital districts in Ukraine is right and consistent with the recommendations of the World Health Organization, but under current conditions it is quite premature.
According to Iryna Sysoyenko, its prematurity lies in the following facts:
- Currently, it is impossible to assess the real need for different kinds of hospital care, since we don’t even have a full and fair understanding of the number of people living in those or other areas (for example, in Kyiv-Sviatoshyn, Brovary district of Kyiv there live far more people than it is indicated in the statistics of the previous years).
- As soon as the primary care doctors (pediatricians, physicians, family doctors) begin to work effectively, we will have good level of preventative medicine, early disease detection, therefore, the number of patients who will need help in hospitals will decrease.
“That is to say, whatever we plan now in the current situation of chaotic hospital patient stream and the ineffective primary health care system may turn to be absolutely irrelevant tomorrow. And what’s then? Start all over again? We will have to change the structure of hospital districts, since the need for specialized hospitals may change drastically,” said Iryna Sysoyenko.
In addition, the process of hospital districts creation has caused much controversy on the local level.
“The absence of the legal framework for the creation of hospital districts makes it possible to speculate on the subject and gives way to some individual local officials’ making decisions on their own. Formation of a hospital district should be a common decision of people residing in a particular area (in communities, cities, districts), taking into account the principles of the medical and economic feasibility.
Therefore, it will be fair to involve representatives of communities, cities and districts to the formation of hospital boards. These should be hospital boards that will decide which hospital should become an intensive care hospital of the second level, which one an intensive care hospital of the first level, and which hospitals should be restructured, which roads must be repaired in order to ensure that ambulances come on time and most importantly, that the medical care is available, quality and timely.
And the last issue: the government should clearly define the financial responsibility for this process. If there is no direct additional state funding to complete the constructions, to equip the intensive care hospitals, to restructure hospitals, or if this funding is imposed onto local budgets, nothing will happen. This is due to the fact that the medical subsidy is far from being sufficient even now, and the costs for hospital utility services have been imposed onto the local budgets, which has led to a significant reduction of the budgets of districts and cities,” informs Iryna Sysoyenko.
However, despite the fact that the hospital districts formation process has been launched by the government, it must be immediately supplemented with additional by-laws with a clear mechanism of implementation of this process.
Therefore, Iryna Sysoyenko emphasizes, the government should urgently adopt:
- A mechanism for the calculation of need (volume) of the secondary (specialized) care.
- A regulation on hospital boards.
- Clear criteria for the creation of full-service intensive care hospitals of the first and second levels, including the necessary facilities and technical equipment, the list of departments in hospitals.
- A regulation on hospital districts.