What Changes Will Draft Law No. 7117 ‘On Improvement of Accessibility and Quality of Health Care Services in Rural Areas’ Bring for Ukrainians?

On November 14, 2017, the Verkhovna Rada of Ukraine adopted in the second reading Draft Law No. 7117 ‘On Improvement of Accessibility and Quality of Health Care Services in Rural Areas’ with 280 votes in favor.  As part of the ongoing healthcare reform in Ukraine, this Draft Law enables cooperation with local authorities in reforming rural medicine and addressing the urgent issues of rural doctor shortages and poorly equipped outpatient clinics and/or rural health posts.
  
Rural Health Care Today
  
More than 13 million Ukrainian citizens currently live in rural communities. Most physicians and health care providers are not willing to work in rural areas, because rural medicine in Ukraine is funded far below needs, and most rural healthcare facilities lack proper infrastructure and/or are not even equipped with basic facilities. For instance, 71% of rural healthcare posts across Ukraine have no access to water supplies, 75% lack sanitation services, and 82% of rural outpatient clinics have no sanitary units at all.
  
There are 4,000 outpatient clinics and 12,700 rural health posts in 23,000 villages and urban settlements across Ukraine. In most cases, rural doctors redirect their patients to seek more qualified medical advice or treatment in ‘rayon’ or ‘oblast’ clinics. By comparison worldwide, primary health-care providers in rural areas work effectively and treat up to 80% of patients at local medical facilities.
  
What changes will Draft Law  #7117 bring to rural medicine in Ukraine?
  
First and foremost, this draft law is intended to create conditions for the improvement of the accessibility and quality of health care services in rural areas. Health care facilities will gain autonomy in managerial and financial decision-making  functions to become more independent.  This is part of the Law of Ukraine ‘On Amendments to Certain Legislative Acts of Ukraine Regarding the Improvement of Laws on Activities of Health Care Institutions’, providing for the implementation of measures to reform the health care system in Ukraine with the aim of establishment of a network of state and community owned health care institutions having sufficient levels of autonomy to provide efficient and timely medical care services for the people. Equally important, Draft Law #7117 is in tandem with the package of Draft Laws #6327 and #6604 (‘money follows the patient’) which change the model of rural health care financing to ensure that rural health care facilities receive additional funding for the development of proper infrastructure, and rural healthcare providers receive competitive salaries.
  
Moreover, an effective health care infrastructure should be developed and additional ambulance stations and clinics should be constructed in many villages across Ukraine. Public transportation and the patient’s need to travel to a certain location to see a doctor are the issues to be addressed almost everywhere. All the above mentioned problems require resources, and Draft Law #7117, initiated by the President, will provide almost $200 million dollars in funding for the development of health care infrastructure in rural areas over the next two years.
  
This funding is intended to ensure that rural communities will receive

• additional ambulance stations with the possibility of accommodation for the physician's family,
• automobiles for physicians to be able to travel between villages,
• new medical equipment,
• access to high-speed Internet.

Draft Law #7117 is part of the current medical reform that enables cooperation with local authorities in addressing urgent rural healthcare issues. Many rural communities have already confirmed their willingness to offer doctors accommodation for a symbolic price of one hryvna to attract physicians and health care personnel to work in their localities. This means both that rural doctors will not spend money on rent, and be able to make more money than their colleagues in cities.
  
Our common goal is simple and clear: to create the necessary conditions and ensure that rural doctors provide primary health care services of the same quality as their urban colleagues. You can continue to make a difference by:

1. Following us on Facebook: like our posts and join the conversation to support healthcare reform implementation.
2. Forward this newsletter to your friends and family so that they can subscribe to our mailing list for the latest information on healthcare reform in Ukraine
3. Follow the Minister of Health on Twitter: like our posts and retweet them. Join the discussion.
4. Check our website often for updates at www.moz.gov.ua  

Together we are bringing an international standard of healthcare to Ukraine!
  
From Your Team at the MOH

Грушевського 7

Ukraine