The Ministry of Health supervises the compliance with the methodology for the establishment of hospital districts, and the communities independently determine the quantitative and qualitative composition of health care institutions in a hospital district. That was emphasised by Deputy Minister of Health Pavlo Kovtoniuk, commenting on the matters contained in applications filed by individuals being concerned with a probable closing of hospitals. "Communities will bear the responsibility for the manner of how the hospitals have to operate", the Deputy Minister noted.
"I would like to draw your attention to the fact that boundaries of a hospital district and those of an administrative and territorial structure differ and, for the Ministry, it is only a detail where the centres are determined by local authorities. What is important, there should be such structure of hospitals in place which ensures the accessibility of a qualitative health care service for each individual. If there arise any questions regarding the attachment of any territories to one or another hospital, it is the competence of local authorities", Pavlo Kovtoniuk stated.
He reminded that any rumors about the closure of hospitals were not true since it was forbidden to do so by the legislation. Just the contrary, the idea of hospital districts lies in the planning of hospitals development. At the same time, local authorities should assume the responsibility and explain to people the necessity of converting inefficient health care institutions or departments within them into social care institutions, rehabilitation centres, etc.
"The Ministry and the Cabinet of Ministers have begun to receive letters from members of various level councils complaining about "poor" distribution of territories within the framework of hospital districts. This proves the willingness of local authorities to shift the responsibility for the lack of dialogue within the communities onto the central government authorities. The Ministry of Health of Ukraine emphasises once again that the management and decision-making now fall under the competence of communities. We are aware that this process will be painful, but Ukraine should make the way from administrative command form of government when the centre instructs what should be built and in which place to democratic one when the local authorities will assume the responsibility for conveniences of life of their community", Pavlo Kovtoniuk noted.
The Ministry of Health of Ukraine and the Ministry of Regional Development and Construction and Housing and Communal Services of Ukraine have prepared letters to be sent to city mayors, heads of Oblast (Regional) State Administrations, Rayon (District) Councils and Oblast (Regional) Councils with clarifications on the sphere of responsibility of local authorities at the phase of hospital districts formation.
For reference purposes
It is a reminder that, according to the regulations, a hospital district should comprise not less than one multi-disciplinary intensive care hospital of the first and/ or the second level and other health care institutions.
The list of medical interventions in providing secondary care will be approved by the Ministry of Health of Ukraine, as well as the exemplary list of hospital facilities and resources.
Also, the document establishes standard quantities of patients to care. Thus, a multi-disciplinary intensive care hospital of the 1st level should take care of not less than 120 thousand persons, a 2nd level hospital - not less than 200 thousand persons.
The boundaries and composition of hospital districts should be determined so that the residents living there have access to the secondary care within the boundaries of their hospital district.
As a rule, a city with the population exceeding 40 thousand where there is a multi-disciplinary intensive care hospital of the second level shall be determined as the administrative centre of a hospital district.
The catchment area of the hospital district shall be determined by the ability to opportunely reach multi-disciplinary intensive care hospitals within a period of time not exceeding 60 minutes and it shall be equivalent to the catchment area radius of 60 kilometres.
The improvement of the network of health care institutions will take place in accordance with the following two principles: availability of medical care for an individual and appropriate load on the institutions to maintain the adequate professional level of health care specialists.
The list and number of hospital districts submitted to the central executive authorities for approval:
the city of Kyiv - 1 district
Kyiv Oblast - 4 districts
Kirovohrad Oblast - 4 districts
Mykolayiv Oblast - 4 districts
Poltava Oblast - 4 districts
Vinnytsia Oblast - 3 districts
Dnipropetrovsk Oblast - 5 districts
Zhytomyr Oblast - 4 districts
Zaporizhia Oblast - 5 districts
Odesa Oblast - 5 districts
Rivne Oblast - 3 districts
Khmelnytskyi Oblast - 3 districts
Cherkasy Oblast - 4 districts.
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