How Ukrainians join implementation of healthcare reform: results of All-Ukrainian tour “ZminyTY”

The healthcare reform approved by the Parliament this autumn is supported in the regions of Ukraine. Physicians, local authorities – including AHs – public activists and experts joined the process of future changes development, expressing a number of requirements and proposals for the reform implementation.

On 21 December, the public organisation “Centre UA” presented the results of public consultations within the framework of the All-Ukrainian tour “ZminyTY” with the most active communities in 23 oblasts of the country on introduction of changes in the healthcare system, at the Ukraine Crisis Media Centre. “ZminyTY” tour was conducted with the financial support of the U-LEAD with Europe: Ukraine – Local Empowerment, Accountability and Development Programme, as well as with the support of the Government of Sweden.

Public consultations were held jointly with the representatives of the Ministry of Health of Ukraine and experts of the Reanimation Package of Reforms coalition. Healthcare reform discussions took place with the representatives of local self-government bodies, managers, healthcare communities, public activists and experts within 4 months. More than 2 thousand Ukrainians took part in 23 public consultations, joining the formation of a new state policy.

Doctors called the need to re-obtain the license and accreditation when reorganising into non-commercial communal enterprises, outdated material and technical basis, as well as a lack of understanding of the principles for calculation of the service cost of specialised and highly specialised healthcare as the key problems of the healthcare reform implementation. Doctors are looking forward to proposals from the MOH to resolve these problems, as well as clear clarifications on interactions between the healthcare links during a transition period, the soonest possible definition of service requirements from the National Health Service and expansion of the National List of the Main Medicines.

Ulyana Suprun, Acting Minister of Health, noted that the ministry will take into account the results of public consultations in the preparation of by-laws and will communicate the answers to the most important questions posed by the representatives of the healthcare community and local self-government:

“The representatives of the Ministry of Health travelled the entire country for a second time over the year. Our goal was not a one-way communication, but a dialogue between the state and citizens that Ukraine lacks so much. In Kyiv, you can come up with a concept on paper, but for it to work, you need to take into account the feedback of practitioners, people in the regions. Just like it was after the first tour “ZminyTY”, we will definitely take into account the collected proposals and opinions in by-laws’ preparation and further work of the ministry.”

Collection and due account of opinions of the reform executors and those who will be affected by these reforms, should become a standard for the work of the executive authorities prior to decision-making, for the successful development and implementation of qualitative changes.

“We became convinced that Ukrainians are ready to support the negotiated and jointly developed changes. To implement effective reforms, it is important to collect opinions, criticism and wishes regarding the changes from hromadas affected by these state decisions. And it is necessary to work with the voiced risks and take into account appropriate proposals in the development of a new state policy,” summarised Inna Borzylo, executive director of the NGO “Centre UA”.

The results of public consultations on education reform, carried out within the framework of the “ZminyTY” tour, will be presented separately in January 2018 with the participation of the representatives of the Ministry of Education and Science, together with the CEDOS think tank.

Astrid Kohl, Head of the Communications, Dialogue and Networking Unit of the U-LEAD with Europe Programme, emphasised at the conference: 

“U-LEAD provides support to the Government of Ukraine in terms of decentralisation and sectoral decentralisation reform, in particular, healthcare and education reforms. Our aim is to contribute to the establishment of a multilevel government, that is transparent, accountable and responds to the needs of citizens. And then it comes to the communications and the dialogue aspect – that is not about just providing information, but also getting all stakeholders involved, considering their opinions in the policy making process. And therefore, I guess this is the most successful feedback, that the results of the consultations provided by the Centre UA with the support of U-LEAD are actually fitted in the policy making process of the line ministries.”

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