On the second phase of health reform and the prospects of organ transplantation in Ukraine –read the second part of an exclusive interview with the leader of MZ Zoriana skalecki for the 24 channels.
About the second wave of health reform
Talk about reforms of secondary care medicine, which will begin operating from 1 April. Tell me how everything will look.
April 1 – just the tipping point, and the changes we need to make, will be held the next few years. We begin the first very important step, we are changing the model. Previously, we just transferred money medical subventions for the maintenance of the institution.
Now talking about what companies will receive the money for the provided medical services. They will prepare a report that will indicate how many services provided.
In fact, this is only the first stage in the change model. In 2021 we will allocate more budget and more services will be paid more and more – so that the hospital could develop and raise wages. This year is a turning point in the transition to a financial model. As for the hospital it changes the rules of many processes.
For Ukrainian citizens, this means that hospitals will begin to compete, to compete. After all, people often complain not so much on the quality of medicine as service. Not so communicated, or uncomfortable bed (was – 24 channel) in the hallway.
Those are the things that still accompanied the delivery of health care and bring a lot of discomfort while staying in a medical facility. Today it can have a positive dynamics. Even in 2020, when funding has increased, perhaps not as desired, the Ukrainians already feel the quality. At least for four priority services, payment for which occurs at higher ratio: heart attacks, strokes, childbirth, newborn care.
Skalecka promises that Ukrainians will feel the quality in 2020
However, there are still diagnostics. Family physician gives direction to receive medical care, it is free and the hospital gets paid for it. If patients don’t want to go to the hospital, because there are not provided all the conditions, financing, and should not be consumed. We are not rich enough to just give money and not to control them.
And if it’s small towns?
They can leave the therapeutic Department. The therapist can also provide important help. We don’t want the doctor just to have. We want high quality support, so should provide it. If the patient with certain diseases goes to the doctor every two weeks, a doctor may and rusty, looks like his patient, and he needed advice.
First, we must care about the quality of medical care. Second – the activities of local authorities. The key thing, which requires continuous hard work, is that local authorities as the owners of most of the hospitals in Ukraine are not aware of being a full owner.
I’m not saying that you should always invest money. Can the control, management, monitoring. Well manages their property, the head of the institution? Local authorities usually do not understand that this is their area of responsibility. For our part, we will affect. Perhaps even via a license, but it should do just local authorities. We much talk about it and work.
To join this reform, only those medical institutions, which have certain equipment?
For different types of services there are certain requirements to the institution. If this surgery, we understand that there has to be a good anesthesia Department, specialists, equipment for surgeries. If this is a rehab or therapy Department, they impose other requirements. Extra requirements we put forward.
A way to solve the problem when there is not enough equipment for a contract are joint hospital, cost optimization. This should not be that when there is no chief physician, then there is no institution. We have a school there, there are doctors and patients.
The merger is one of the ways to save money that are not going to help the patient, and the content companies. That is, for example, there are 2-3 institutions, each of which has both the Director and the deputies, and accounting. If we combine them in one institution, as a minimum, these positions can save money and pay doctors salary. The need for such additional employees is not always available. At the same time, these institutions then become more powerful in their capabilities.
Many hospitals are willing to join?
There are examples in areas where there are unions. For example, the Odessa region. Because they calculated and saw the efficiency of this solution. This is primarily interested in the owner the local authority. The main thing – desire.
What services for citizens will be free after implementation of reforms, and for which you will need to pay extra?
Reform will not happen in one day, it may last for two years, but our first decisions concern the first of April. Today we counted and added additional cost. Is medical care services for acute heart attack, stroke, childbirth, neonatal care.
The Minister of health of Ukraine Zoryana Skaletska
Why? Because of acute heart attacks and strokes – is one of the largest causes of death in Ukraine. We need to understand that a full opportunity to provide their quality is not about health care but about saving lives. With regard to neonatal and newborn care children – to minimize the mortality. The same applies to childbirth to preserve the life of the mother and child at birth.
On transplantation in Ukraine
With regard to transplantation. You need to have a coordinators who would organize the process. How many coordinators in Ukraine and when they start to work?
In fact, a transplant coordinator and is already working in Ukraine. Their professionalism within institutions quite effectively. Over the past two months in Ukraine has had two heart transplant, which was not the last 13 years. This is due to the fact that there are transplant coordinators and they are learning. Some of them have already been abroad on an internship. But this is only the first steps.
A key goal is to make all-Ukrainian coordination center, where the institutions between the regions will provide the opportunity to maximize the interaction of donors and recipients. Now in the test mode will be launched system of electronic registers transplantation. To run as fast as possible all the process of selection of recipient and donor.
Prices on transplantation of organs in Ukraine: what is known?
Allotransplantation of kidney from live donor or a dead donor-body will cost 323 798 hryvnias. ABO-incompatible kidney transplantation will cost 721 230 hryvnia. Transplantation of complex “heart-lungs” will cost 535 280 hryvnia. Liver transplant or part – 855 039 hryvnia.
The price of allogeneic hematopoietic stem cell transplantation with donor phase is 1 360 141,36 hryvnia. Autologous transplant will cost 1 308 393,3 hryvnia. For the removal of organs from a donor-cadaver will have to pay 74 086 hryvnia
For transplantation, it is important to have specialists, transplant coordinators and the ability to rapidly implement logistics on the territory of Ukraine. Very progressive is that it used to be that you can only do this in Kiev or Kiev. Today there are many hospitals that are willing to engage in this process.
Zoryana Skaletska spoke about organ transplantation in Ukraine
We have “pilots”, which included hospitals, who are willing to do it intensively. I must say on organ transplantation: many Ukrainian citizens we send abroad, though they are professionals and ready to do it in Ukraine.
This question is not only in the reduction of funds, but also the reduction of stress. When you can get treatment while in Ukraine, together with their family and in the comfort of psychological and physical conditions. Do not carry heavy flight, not to be in a confused state.
An important step is the preparation of conducting bone marrow transplants in Ukraine, because most people, especially children, are obliged to go abroad. And we have to do this process in Ukraine, too. Therefore, transplantation is the one treatment that saves lives. We do everything that these procedures took place in Ukraine, and by the end of 2020, hopefully will have very good statistics.
About the personal life of the Minister of health Zoriana Skalecki – read here.