Following the open dialogue between patients, authorities and international organizations, held on October 1, 2019, subsequent resolution was adopted on the fundamental steps of further changes in the health care system, on which parties agreed.
Financing of the industry
Fight for an increase in health care financing of up to 4% of GDP in 2020, with a further increase of up to 7% in accordance with the recommendations of the World Health Organization, adopted by Ukraine and enshrined in the Law of Ukraine ” On State Financial Guarantees of Public Health Services”. This will drastically allow to reduce informal payments from the pockets of patients and expand the provision of treatment to all patients with serious illnesses. What is important, this level of funding will help ensure universal coverage of a state-guaranteed health care package for all patients, regardless of the level of care.
Continuing transformation in the healthcare system
- On the basis of universal access to health care services, to introduce a competitive “money-for-patient” financing model at all levels of medical care in 2020, ie money is paid only for actually provided medical services, not for beds, which will create an opportunity for systemic improvement of quality of medical services and patient comfort.
- Continue implementation of the program of medical guarantees in accordance with the Law of Ukraine “On State Financial Guarantees of Public Health Services” for all types of medical care. This will allow for efficient and prompt distribution of funds at all levels of health care delivery (primary, specialized, highly specialized, emergency medical care, rehabilitation and palliative care).
- Introduce a co-payment model of medical services into the legislation, which will expand the scope of medical services guaranteed to patients.
- Promote the development of private insurance in the segment of medical services and medicines not covered by the state-guaranteed package.
- Promote the transition in 2020 to all public, municipal and departmental health care facilities into a single medical space, where a state-guaranteed package of health care services will be provided, to give patients maximum selection of health care facilities.
- Ensure legislative regulation of the training and capacity development of physicians and all medical staff.
- Work on transferring licensing of doctors and nurses to professional medical associations.
- Promote the development of public health and implement prevention programs for major non-communicable diseases.
- Strengthen the public health surveillance system, including the ensuring proper laboratory control and investigations.
- Introduce monitoring of the social determinants of health and the development of national and regional public health programs.
- Promote the development of a European blood safety system and state support for voluntary donation in Ukraine.
- Promote the development of an electronic healthcare system in Ukraine.
- Introduce European standards for quality control of medicines and medical products in Ukraine.
Medicines and medical products
- In 5 years, bring funding of centralized procurement programs closer to fully meet the real need of Ukrainian patients for medicines and medical products.
- Develop targeted government programs for financing expensive diseases.
- Introduce a medical technology assessment tool that will allow decision making to fund government programs based on treatment effectiveness criteria.
- Establish legislative foundations for the efficient operation of the State enterprise “Medical Purchases of Ukraine”, as the main organization that implements new transparent procurement mechanisms at both national and regional levels, and ensures that there is no corruption risk in procurement.
- Expand the Affordable Medicines Program with additional nosologies and medicines to give patients more immediate access to treatment.
- Adopt a bill regulating patent reform in the field of medicines, introduce a parallel import mechanism for medicines from other countries. This will provide reducing the price of medicines both for national and local purchases and in the pharmaceutical sector, and will make it impossible to continue the monopoly on medicines artificially.
- Promote access to medicines. In particular, introduce legislative requirements for the use of cannabinoids as state-level drugs and for scientific research.
- To legislate the development of transplantation in Ukraine, to approve a number of bills after which Ukraine will be included in the international donor registry, to provide for post-transplant rehabilitation. Provide access to bone marrow transplantation from a non-family donor for children and adults, that will help hundreds of patients with hematologic and oncological diseases receive vital therapy; to enable hospitals to independently organize the search for bone marrow donors in international registers, pay for the cost of such a search, and collect stem cells (bone marrow) and import transplants to Ukraine.
We, the undersigned, make decision to adhere to the abovementioned benchmarks in the transformation of Ukraine’s healthcare system for the benefit of the patient.
In order to ensure transparency, openness and professionalism in adopting strategic national priorities, it was decided to create a Strategic Advisory Group of Independent Experts, who will form the basis of the Health System Development Strategy of Ukraine for 2021-2025 as a continuation of the National Health Care Reform Strategy in Ukraine, which is ending its operation.