Ministry of Health of Ukraine and Children’s Medical Care Foundation started fellowship programs for neonatologists
Primary care in Ukraine is not longer dependent on one's permanent address, residence registration or the amount of bribes one can pay. Every Ukrainian can now choose a family physician, pediatrician or general practitioner at any outpatient medical facility across the country. Moreover, the state covers a basic package of primary care services and medical tests. The all-Ukrainian patient-doctor contracting campaign (the process of choosing a doctor and contracting) has already started.
For detailed information on how to choose a family doctor, read the article below.
STEP ONE – CHOOSE YOUR DOCTOR
The easiest way is to choose a doctor you know well, the one you visited before, when you were satisfied with both the doctor’s performance and treatment results. If you do not know any doctor like that, asking for recommendations from coworkers, neighbors, and friends is another good way to start.
You can also contact your local health department office to request a list of doctors who work in your community or district. Another option is to simply contact any health facility in your locality and ask about doctors who practice family medicine there. Public information about primary care doctors can be requested from the local health department or directly from the front-desk registry. Many healthcare facilities already have this information available on their own websites. Patients just have to decide which physician should best meet their individual needs.
Please note that a patient can now choose a doctor without reference to the registered place of residence. Patients simply choose a doctor who is good or who works in a nearby hospital, etc.
STEP TWO – CONTRACT WITH THE CHOSEN DOCTOR
Patients need to contract with the chosen doctor by signing the approved Patient Declaration Form. The National Healthcare Service shall have control over the due implementation of the agreement between a healthcare institution and the state (or the conformity of the services to the set standards).
The New Patient Declaration is a document of unlimited duration, which means that patients do not need to re-register every year. On the other hand, if a patient decides to contract with another doctor, it can be done at any time and the previous Patient Declaration is automatically terminated.
A Passport and an ID code are the two personal documents a patient needs to contract with the chosen doctor. To contract with a pediatrician (or family doctor who will also treat children), patients also need the child’s birth certificate and personal documents (passport and ID code) of either the parents or guardians.
The Patient Declaration Form is to be first completed in an electronic format: the doctor must enter patient’s data in an online record system. The important point here is that the completed form will appear in the system only after two-step verification: a doctor shall ask a patient to give the code sent to him/her in an SMS format. If a patient does not have a mobile phone, a doctor needs to take pictures or scans of the patient’s personal documents and attach them to the online declaration form.
Then, the declaration is to be printed and signed by both doctor and patient in two copies (one for each contracting Party) – and from that moment on this patient can contact his/her doctor at any time.
When the chosen primary physician is not available (on vacation or sick leave), patients may contact a back-up physician. If patient needs help and is currently in a different city, s/he shall contact the nearest primary care facility.
The Ministry of Health of Ukraine recommends that one family physician shall treat not more than 2,000 patients. There may be exceptions, for example, when a doctor works in a rural area with a population of more than 2,000 people.
Therefore, if you are sure that you have found a good doctor, do not waste time, because the doctor of your choice may have no place for new patients soon.
STEP THREE – YOUR FAMILY DOCTOR IS YOUR FIRST POINT OF CONTACT
Patients can contact primary care doctors with any health-related concerns. Experience from all over the world shows that most health problems can be addressed at the primary care level, especially when patients contact doctors in a timely manner. In addition to the initial examination and treatment, if necessary, primary care physicians also refer patients to specialists, prescribe medicines, including the ones covered under the "Affordable Medicines" Program (medicines obtained free-of-charge or with partial co-payment), and issue different medical certificates, sick notes, statements of good health, etc.
Bearing this in mind, patients should choose doctors who practice near their homes (or work) in order to reduce the commute time.
STEP FOUR – DO NOT BRIBE
The state-allocated money is secured for the patient to ensure that patients will not pay for medical care, as before, neither officially in private clinics, nor unofficially in state hospitals. In 2018, healthcare facilities are obliged to keep records of all services provided to patients and invoice the National Health Service. This means that there is a tariff set for every service provided at the primary care level, and the National Health Service shall pay every medical facility for each patient.
The tariff is the charge for the service rendered to one patient and in 2018 it is set at 370.00 UAH per year, while in 2019 it shall increase to 450.00 UAH. Therefore, primary care doctors who treat about 2,000 patients per year may receive an annual income of UAH 740 000 to UAH 1 million in 2018 and UAH 0,9-1,2 million in 2019. The tariff includes rental costs, personnel salaries, basic medical supplies and partially covers expenses for basic medical tests and analyzes. About half of these funds go for personnel salaries and another half – for other practice expenditures.
Following this rationale, the STATE now pays primary health care facilities for each and every patient to ensure that healthcare professionals make decent salaries and patients do not pay for primary care services out of their pockets. So please, when going to see the doctor, keep in mind that the services provided are not free and you don’t have to "thank" your doctor for his work – medical services are now covered by the state and money for financing the Ukrainian healthcare system is allocated from state budget (e.i. with collected taxes).
The eHealth website provides detailed information for both doctors and patients: Step-by-step instructions for Doctors, Step-by-step instructions for Patients.
On April 16, 2018 two Ukrainian specialists start a one-month fellowship in a new neonatology center in Krakow, Poland. Eight Ukrainian specialists are looking forward to starting their fellowships in the USA, Great Britain and Poland this year.
On September 25, 2017 the Ministry of Health of Ukraine signed the Memorandum of Understanding and cooperation with the Children’s Medical Care Foundation (CMCF). This was the first step towards cooperation aimed at improving neonatal care in Ukraine through the introduction and use of advanced neonatal practices, the latest techniques and procedures with proven effectiveness.
For over a decade, the CMCF has been funding innovative fellowship and training programs for the Ukrainian doctors, mainly at top medical centers in the United States, Canada, and Poland. Within the framework of the cooperation with the CMCF, every year ten Ukrainian doctors go to foreign countries for new knowledge, practical skills, and professional development. The program will continue to work, and to prevent the outflow of skilled professionals from Ukraine, the so-called ‘brain drain’, lawyers of the Ministry of Health of Ukraine have developed special contracts for program participants.
Oleksandr Linchevskyi, Deputy Minister of Health of Ukraine commented: "We realize the need to improve professionalism of the Ukrainian doctors and to give them the opportunity for developing new skills and acquiring practical experience at the best hospitals in the world, and these contracts will help us ensure an effective practice of knowledge exchange in the workplace after doctors return to Ukraine".
At the beginning of 2018, a team of experts, led by Head of the Polish Neonatal Society Professor Maria Katarzyna Borszewska-Kornacka and the CMCF Vice-President Yolanta Martynoff, started a comprehensive analysis of the neonatal care in all regions of Ukraine. First, they visited hospitals and perinatal centers in Odesa, Poltava, Kharkiv , Dnipro, and identified numerous gaps in the work of these healthcare facilities. Based on the study results in each region, the CMCF in cooperation with the Ministry of Health of Ukraine is planning to organize special trainings for the Ukrainian neonatal specialists and pediatricians.
The patient’s life and health directly depends on the level of doctor’s training and desire for professional development. Therefore, this cooperation as a form of investment in doctors’ training is really invaluable.
It includes involvement of the Ukrainian neonatal practitioners, pediatricians, nurses in the international exchange programs and trainings. The Ministry, healthcare institutions and CMCF should work as a team to achieve significant success in the neonatal care development in Ukraine.