The Verkhovna Rada Committee on Health Issues suggested 396 amendments to the bill No. 6327 on medical reform in Ukraine, which level the essence of the document, says acting Minister of Health Ulana Suprun. "We must state the fact that most of these amendments level the very essence of the medical reform proposed by the Ministry of Health and the Government of Ukraine. Instead of reforming the entire medical industry, after nearly 400 amendments to the draft laws, it is a reform of the primary link of medicine," Suprun told a press briefing on Wednesday.
The Rada committee proposes to alter the key positions of the bill and ditch the concept of co-payment of medical services. The amendments provides only a distinction between medical services that are 100% covered by the state (green list), and the services fully paid by the patient (red list). In addition, the list of state-guaranteed services covered by the state has been significantly expanded.
"In fact, we are returning to where we have started. The amendments suggest that the state will guarantee the volume of services that the state is unable to provide. For 25 years, we have guaranteed free medicine that was a fiction," Suprun said.
In addition, the parliament working group decided to abandon the approval of international medical guidelines (protocols) at the level of law. Instead, deputies suggested a variety of options for verification and approval of clinical guidelines by Ukrainian structures.
"We believe that this creates serious corruption risks. Medical protocols are essentially knowledge based on the results of scientific research. The knowledge and facts that are used to treat people around the world do not require any "approvals" or "verification" to be applied in Ukraine," Suprun stressed.
The amendments to the bill left untouched the concepts of contracts with medical institutions, a guaranteed package of medical services and medicines, which the deputies renamed into the "program of state medical guarantees", the idea of independent customer of services, the National Health Service and the development of the eHealth system. "But this is not a reform that all the doctors expected and demand from us, all of which are only half-steps," Suprun added.
The ministry opposes maintaining medical subventions at the primary level, noting that this will divide the health care system into two separate parts and will encourage family doctors to immediately refer patients to the level of specialized treatment rather than treat them themselves. The primary financing system will remain within the existing administrative and corruption vertical and will not trigger quality changes at the level of primary medical care, the health ministry believes.
"Instead of regulating this market, this will contribute to chaos and corruption on the ground. Poland made a similar error during the healthcare reform and lost years of opportunities. If the parliament supports this vision, the reform will be completely lost even at the primary link level," said the minister.
The Ministry of Health demands to find a way to leave principles and essence of medical reform set forth in the bill, voted by the Verkhovna Rada in the first reading and demands the committee "to stop sabotage and issue a conclusion on the bill".
The parliament approved the key medical reform bill as the basis on 8 June but ditched the related bill No. 6329 on the accompanying changes to the Budget Code.