Why do “primary” doctors’ salaries differ so much, and how does local self-government come into the picture?

By Yevhen Meshko, chief doctor of the Communal Non-Profit Enterprise “Primary Healthcare Centre of Mukachevo”,

regional coordinator of the U-LEAD with Europe Programme for healthcare reform support in the Zakarpattia Oblast

With the transition to the capitation system of primary healthcare financing and autonomisation of healthcare institutions providing primary healthcare services, I hear a radically different views of healthcare workers. Some of them admit fantastic changes, someone is sure that nothing has changed in terms of remuneration. There are even isolated cases of claiming that the situation has become worse compared to targeted subventions.

So what affects salaries?

I want to distinguish two concepts – financing and payment. Financing is about where from and how much money to get, how to increase money inflow. Payment is how we spend this money: what for and in what amount, etc.

Funding is roughly the same in all medical institutions, but the payment options vary greatly. The leadership of primary healthcare establishments plays an integral role in this process.

Why, with relatively homogeneous wage funds (since they fluctuate within 70-100% of revenues), does the average salary in different institutions range from UAH 5 to 25 thousand? To do this, I would introduce another coefficient – the ratio of doctors’ posts to other medical staff. Why doctor’s posts? These are the employees who bring income to the enterprise, since patients sign declarations on the choice of a doctor.

I know a vivid example when proportion of doctors and nurses in the Pereyaslav-Khmelnytskyi Primary Healthcare Centre is 80/80 – and the ratio of doctors to all other posts is 1 to 1.7. At my enterprise, this proportion is 1 to 3.

In conclusion, I would like to note that financing will always be insufficient, as with each subsequent hryvnia, needs will also increase. And it is up to you to choose how to use the funds.

The full version is available in Ukrainian – please click HERE

Колонка відображає винятково позицію її автора. За достовірність інформації відповідає автор колонки. Точка зору редакції порталу «Децентралізація» може не збігатися з точкою зору автора колонки.
25.03.2019 - 14:11 | Views: 18144
Author list afe6d31d5a9fd70e79c8a0db94b98a95

Author: Євген Мешко

Tags:

healthcare

Share the news:

Коментарі:

To add comment you should be authorized or sign_in
Read more:

14 May 2021

With integrity to success: how to build a business-friendly municipality – online forum of U-LEAD and EUACI

With integrity to success: how to build a...

The event is going to take place on May 18, 2021. U-LEAD with Europe and the EU Anti-Corruption Initiative jointly...

14 May 2021

May, 17 – a webinar on educational establishments reorganization and financial autonomy

May, 17 – a webinar on educational...

At 14:00 on May, 17, 2021 the DECIDE Swiss-Ukrainian project is holding a webinar, entitled “Educational...

14 May 2021

Fire safety in the Kiptivska hromada

Fire safety in the Kiptivska hromada

Here is another good story from the Kiptivska hromada in the Chernihiv oblast. The Kiptivska hromada knows how to...

14 May 2021

Modernised ASC opened in Fastiv hromada with support by the EU-funded U-LEAD with Europe Programme

Modernised ASC opened in Fastiv hromada with...

  On 14 May, a modernised Administrative Service Center (ASC) opened in Fastiv hromada in Kyiv...

14 May 2021

Measure thrice: a golden rule of the legislative work

Measure thrice: a golden rule of the...

A legislative process demands a more careful work, a thorough analysis of the national and foreign practice, as well...