The Foundation Stands in Support of the Primary Healthcare Sector Reform
The preparation stage of the primary healthcare reform will last from January till June. During this period of time doctors working in the primary healthcare sector will have to adjust to a new work format and explain the forthcoming changes to their patients. It is expected that Ukrainian healthcare will switch to the insurance model. There is no information about the reform other than the information announced by the officials of the Ukrainian Healthcare Ministry during their presentations and regional meetings.
Every Family Needs a Doc
Beginning with the 1st of July 2017, patients will be able to make a choice of a physician, a pediatrician, or a family doctor, and sign a healthcare services contract with him/her. Such services will be covered by the state through the National Healthcare Insurance Agency (which is not established yet). It is assumed that a doctor will receive around UAH 210 per one patient a year and UAH 1000 per family with two children. This financing will cover the primary healthcare as provided for by the state-guaranteed package of medical services. There is also no information about what exactly services will be included in the package.
The selection of a doctor won’t be linked to a specific location; a patient may conclude the contract with the doctor at his/her actual place of residence or chose a specialist even from another city or region.
“Here comes the question whether the patient wants it. Because the family doctor has to be around twenty-four hours a day and be able to arrange a day-patient department or home care under his/her supervision. Supposedly, a doctor who lives and works in Valky may have patients from Kharkiv. But how will he/she be able to follow such people up?” shared her considerations Maryna Orlova, Chief Medical Officer of the Primary Healthcare Center in the Valky district.
Meanwhile, a missing contract with a doctor may not serve as a reason to deny the provision of primary healthcare services.
Private Healthcare Practice Is Priority
Family doctors will also have a choice to either work for a healthcare institution or to carry out private practice as private entrepreneurs. The Ministry of Healthcare gives priority to the second option. Today it is primarily dentists who opt for it, yet the majority of family doctors will eventually shift to private practice as well. At least, that’s what the Ministry expects, while healthcare specialists at locations are more careful in their estimations.
“The doctors of retirement or preretirement age are unlikely to start private practice, because in order to do that they need to get a license, formalize a pile of documents, search for the premises to lease, and hire medical staff. Yet, it’s a nice opportunity for young practitioners. Out of eighteen family doctors working in the Vovchansk district only three showed interest in starting the private practice,” said Karyna Litsa, the chief medical officer of theCommunal Healthcare Institution“Primary Healthcare Center of the Vovchansk District”.
In fact, patients don’t care what choice the family doctor will make. It is assumed that healthcare specialists will treat patients strictly on the basis of local protocols, which are now revised with due consideration of the evidence-based medicine.
What about Villages?
Whether the rural population will be able to fully enjoy the healthcare reform opportunities is still an open question. Because of the lack of medical staff, it is unlikely that rural citizens will have any choice. As an example, seven out of 18 outpatient clinics available in the Vovchansk district have no family doctors at all; in four of them doctors work part-time, while in the majority of primary healthcare units family doctors receive patients once a month. Thus, villagers have limited access even to primary healthcare.
The Charitable Foundation for Social Development of the Kharkiv Region believes that such a situation may be remedied by the on-site medical visits. For two years it is successfully implementing its own healthcare program for rural population.
“We have formed several medical teams that travel across villages providing the people with free examinations, they are even equipped with an ultrasound examination device. This is both convenient and effective healthcare for villagers, because it allows early diagnostics and treatment of diseases. In my opinion, if the state adopts this practice and includes it in the planned reform, it will help strengthen the accessibility of primary healthcare in the rural area,” stated Yevhen Shapoval, Chairman of the Management Board of the Foundation for Social Development.
This year medical teams of the Foundation will begin their work in autumn. Same as before, the doctors will provide medical examinations to rural population in all districts of the Kharkiv region. People will be consulted by a cardiologist, an ophthalmologist, a traumatologist, a gynecologist, a neuropathologist, and an ultrasound diagnostician.