SAG Secretariat collects proposal to the Strategy through meetings, where the speakers present their suggestions and comments as well as through e-mails.

In the beginning of January the SAG Secretariat analyzes the received proposals and provides summarized version to the consideration of the SAG Coordination Council. Coordination Council will prepare Strategy 2.0 by the end of January 2015 with approved comments collected from the public discussions.

Strategy 2.0 will be presented at the regional public discussions. Collection of comments to the Strategy from the regional public discussions and international organizations is planned until February 6^th. Then the Strategy will be finalized by the SAG Coordination Council by the end of February. In the end of February the meeting with the stakeholders will be organized in the MoH where the final version the Strategy will be presented.

The Draft Reform has been developed by the Strategic Advisory Group on Healthcare Reform under the Ministry of Health with the support of the International Fund “Renaissance”. The current Health Minister Alexander Kvitashvili is a member of the working group. “In Ukraine people demand changes and already in 2015 decisive steps should be taken to start them. This approach has proved to be successful in Georgia, – said Alexander Kvitashvili, the Minister of Health of Ukraine, – we will immediately start the reform of the healthcare sector management once the deputies of the Verkhovna Rada of Ukraine endorse the Government’sAction Program”.

“This is the first precedent when influential experts, doctors and patients, in partnership with the major international organizations have developed the Strategy of reforming the healthcare system, which will be implemented in the state — says Olga Stefanyshyna, the Executive Director of the CF “Patients of Ukraine”, the Head of the Secretariat of the Strategic Advisory Group, — it is extremely important to make this process public and open. It is the patient who will feel changes in the system. That is the reason we have arranged a public discussion with patients today, where everyone can express their views and give recommendations”.

According to the authors of the draft the cornerstones of the reform are: liberalization of medical services market, reduction of overregulation of the health care sector, establishing the efficient mechanism of state funds reallocation aimed to pay for the services provided to a patient, and not for the maintenance of medical buildings (currently 75% of state funds are spent on keeping the medical buildings and hospital beds). After the sector is reformed this money will be spent for the doctors’ services meaning the implementation of the principle “money follows the patient”.

One of the main tasks in the draft Strategy for health care reform is transformation of the network of medical facilities which are located unevenly in Ukraine. Our country is a leader of the rating by the number of beds per capita: in Europe there are on average 500 beds per 100 000 people, while in Ukraine – 950.

Experts suggest introducing the autonomy of medical institutions, which will allow removing the burden of paying for utilities from the state and help attracting investments into this sector. In addition, it will allow bringing the number of hospitals into line with the real needs of people in a natural way. Released budget funds are suggested to be used for enlarging access of rural population to the modern district hospitals, particularly by building roads and transport.

In rural areas, where currently 30% of the population of Ukraine lives, family physicians will work as private entrepreneurs. Payment for their work will be handled using a mixed system. The community will be able to control the quality of the work and payment for the doctor’s services, and will have the right to terminate the agreement with him if necessary.

Currently the draft reform is at the stage of public discussion, and not only sector experts and doctors can join it, but anybody who wants to. Discussions will continue until the end of January 2015 and will be held both in Kiev and in the regions.

The Expert Group on health care strategy development includes 12 national and international experts.

Contact for media: Natalya Krasnenkova 067 465 54 26, krasnenkova@prhouse.com.ua

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“In Ukraine people demand changes and already in 2015 decisive steps should be taken to start them. This approach has proved to be successful in Georgia, – said Alexander Kvitashvili, the Minister of Health of Ukraine, – we will immediately start the reform of the health care sector management, examine the possibility of optimizing the hospital network, introduce important initiatives on procurement and access to medicines”.

Studies show that every second Ukrainian refuses to visit a doctor because of the inability to pay for the treatment. “This is not normal when in the country with free healthcare, which is guaranteed by the Constitution, half of the population can not afford it, – states Volodymyr Kurpita, the Head of the Expert Council of the Strategic Advisory Group on the reform of the health care system. – And this is because our government ineffectively spends money on medical system created in Soviet times. In fact, the lion’s share of money is spent on maintenance of sometimes even empty premises and beds, and meager staff wages”.

One of the important steps of the draft reform is to optimize the network of health care facilities which are distributed unevenly in Ukraine. Our country is leader in the ratings by the number of beds per capita: in Europe there are on average 500 beds per 100 thousand population, in Ukraine – 950.

Experts suggest to introduce the autonomy of medical institutions, which will remove the burden of paying for utilities from the state and help attracting investments into this sector. In addition, it will allow bringing the number of hospitals into line with the real needs of people in a natural way. Released budget funds are suggested to be used for enlarging access of rural population to the modern district hospitals, in particular by building roads and transport.

In rural areas, where currently 30% of the population of Ukraine lives, family physicians will work as private entrepreneurs. Payment for their work will be handled using a mixed system. The community will be able to control the quality of the work and payment for the doctor’s services, and will have the right to terminate the agreement with him if necessary.

“In Ukraine we have the Soviet system based on excessive government regulation of everything – starting from premises to staff, – says Oleg Petrenko, the expert of the Strategic Advisory Group. It has to be broken fundamentally. Today the village doctor must work in a medical station, a doctor must have a nurse to assist, even if he sees only 1 patient per week. Each medical station must have a toilet, and where there is a toilet, there must be a cleaner. As staff of the medical station already consists of more than 3 persons, there must be an accountant, and where there is an accountant there is a safe with money and therefore the security must be hired. In this way staff consisting of 1 doctor grows to 5 people”.

Experts say that the optimization of hospitals should not be performed through administrative methods – it will be a logical consequence of the introduction of autonomous medical institutions and the transition to a system of payment for services. Currently no head doctor has a right to reallocate available hospital funds in the most efficient way. The money is spent not on the departments or areas that need them most, but according to the norms inherited from the Soviet era. For example, when a hospital is run out of money for gasoline for ambulance vehicles, the head doctor may not reallocate funds from another department, where there are vacant beds and there are no patients. After granting greater autonomy to hospitals they will be able to decide which departments are fully occupied and need additional funding, and which can be closed. The same applies to wages. More qualified doctors can get higher salary, while those who do not have patients standing in queue to get an appointment – no. Thus the structure of hospitals and doctors will be adjusted to the real needs of people.

Currently the draft reform is           at the stage of public discussion, and not only sector experts and doctors can join it, but anybody who wants to. Discussions will continue until the end of January 2015 and will be held both in Kiev and in the regions.

The draft reform has been developed by the Strategic Advisory Group on the reform of the health care system in Ukraine under the Ministry of Health with the support of the International Renaissance Foundation.

The group consists of 12 international and Ukrainian experts.

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The Document is ready for public discussion which starts on December 5, 2014 and will run until February 2015. Every interested citizen can take part in the public discussions. The discussions will take place both electronically and in the format of public discussion.

To take part in the public discussion of the Draft Strategy in the form of public debate, you should:

1. View the link and see the dates and schedule of the discussions.
2. Fill in the Form for participants.
3. Identify whether you want to participate as a speaker or a participant.
4. If you want to participate as a speaker you will need to make a short speech (presentation) of required format, include your suggestions for the Strategy.
5. Send the presentation to saghealth@gmail.com no later than 2 days prior to the discussion. For example, of the discussion is scheduled for December 15, the deadline for presentation – December 12, 18:00.

Important to note that if you wish to make comments, ideas and proposals that may significantly influence the proposed Draft Strategy, please register as a speaker at the public discussion so you can bring your ideas straight to the developers of the Strategy.

To take part in the public discussion of the draft Strategy electronically, please, use the following Form.

Important! Proposals received in format different from the proposed, will not be considered.       

Consideration of proposals which will be received during the public discussions in the format of public debate or electronic format left to the discretion of the members of SAG.

Strategic Advisory Group is ready to hear the public opinion, expert community, patients, business, doctors and other interested personnel in order to consider the most appropriate in the Document.

We invite everyone to register and participate in public discussions!