On 14 November 2017 the Parliament in its second reading adopted draft law No 7117 that should improve the affordability and quality of healthcare in rural areas. This draft law is the part of the healthcare reform and provides the opportunity to solve the urgent rural healthcare problems (i.e. the lack of doctors, poorly equipped outpatient clinics and rural health posts) together with the local authorities.
Current state of rural healthcare
Over 13 million Ukrainians live in villages. Doctors do not want to go there, because rural healthcare is funded according to the residual principle, and there are no indispensable conditions provided in the rural outpatient clinics and health posts. For example, 71% of Ukrainian rural health posts have no water supply at all, 75% have no sewage system, and 82% of rural outpatient clinics have no lavatory and bathroom facilities.
23 thousand villages and settlements have 4 thousand outpatient clinics and 12 700 rural health posts. Now they are usually redirecting patients to "rayon" or "oblast", where a qualified aid can be provided. For comparison: worldwide, the primary chain is working effectively in the rural area and covers up to 80% of medical appeals on the ground.
What changes will be faced in rural healthcare?
First of all, primary healthcare in the village should be affordable and qualitative. Therefore, healthcare practices should become autonomous and self-governed (for this purpose the law on autonomism has been adopted, and it has already entered into force). Real funding is equally important for healthcare practices in villages – and it will be provided by laws No 6327, 6604 ("Money follows the patient"). Medical personnel in villages will be able to earn decent money.
In addition, villages need to replan networks, build or upgrade outpatient clinics. The issue of public transport and patients’ arrival to doctors should be solved almost everywhere. All these issues are resources, and draft law No 7117, submitted by the President for the Parliament’s consideration, will provide UAH 5 billion to strengthen the village infrastructure in the course of two years.
Due to these investments, rural hromadas will be able to:
- build new outpatient clinics with the possibility of residence of the doctor's family,
- purchase cars so that doctors can move between villages,
- upgrade outpatient clinics’ equipment,
- provide high-speed Internet.
Draft law No 7117 is the part of the healthcare reform and allows to solve urgent issues together with the local authorities. Many hromadas say they are ready to lease their homes to doctors for UAH 1 – therefore, the doctor will not spend money on rent and his/her salary will be even higher than in the city.
Our common goal is to have the same quality of primary healthcare in the village as it is in the city.
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