The Project experts continue discussing healthcare reforms during “Labyrinth” live talk-show of Kharkiv oblast state TV-company

The latest “Labyrinth” social-political talk-show of Kharkiv oblast state TV-compamy dedicated to healthcare reforms was aired on 26 August 2008 and attended by representatives of EU Project “Support to secondary healthcare reform”. This time discussion was based on the problem of healthcare services quality and positive impact on healthcare quality to be carried out by organizational and management changes within the healthcare system. The matter concerned new management strategy for Ukrainian healthcare system based upon necessity of establishment of inter-territorial communal economic hospital associations in the form of inter-territorial non-profit hospital corporations. The first corporation of this kind is expected to be established in Kharkiv oblast with Lozova and Blyznyuky central rayon hospitals as well as Lozova city hospital to be its participants.

The following persons were invited for discussion: head of oblast healthcare department of Kharkiv oblast state administration, Mr. Galatsan O.V.; the Project experts, Mr. Volodymyr Rudiy and Mr. Bela Kaunzinger; chief doctor of Kharkiv oblast clinical hospital, Mr. Berezka M.; chief doctor of Blyznyuky central rayon hospital, Mrs. Polikova L. and chief doctor of Zolochyv central rayon hospital, Mr. Gavva O.

While starting the program, the presenter asked the present about the essence and meaning of signature of the Memorandum on establishment of inter-rayon communal hospital corporation of Kharkiv oblast healthcare system and Ukraine in general. This question was explicitly answered by the head of oblast healthcare department of Kharkiv oblast state administration, Mr. Galatsan, national health policy and legal coordinator, Mr. Rudiy and international healthcare finance expert, Mr. Kaunzinger.

Mr. Olexander Galatsan stated that healthcare facility network in Kharkiv oblast had been historically formed: different healthcare facilities have unequal resources. However, merging, systematization and coordination of financial, material and technical, human and transport resources of those facilities would allow improving quality of healthcare services provided for Lozova and Blyznyuky rayon population.

National health policy and legal coordinator, Mr. Volodymyr Rudiy, stated that the idea of inter-rayon communal hospital corporation establishment was the first to be considered in Ukraine and its basic objective was quality improvement for those healthcare services provided for population of those rayons included. Establishment of an inter-rayon communal corporation would allow merging financial, material and technical as well as human resources; afford allocating duties on different healthcare services for population among the participants in the most appropriate way in terms of quality and cost-effectiveness; remove doubling of efforts with different services; increase participants’ responsibility rates on quality support and effective usage of public funds allocated for financing healthcare system. Realization of this idea may be the initial step towards practical implementation of organizational healthcare model used in the most European countries and based on hospital regions (okrugs) strategy. Expansion of management and financial autonomy of Ukrainian communal hospitals was one of the key prerequisites to contribute into development of economically grounded stimuli and incentives at those facilities to provide the highest quality and cost-effectiveness possible. In its turn, implementation of this key prerequisite would demand changes in economic and legal status of hospitals – corporation members-to-be. Kharkiv oblast had initially experienced those changes during implementation of the previous EU project “Health Financing and Management in Ukraine” and communal non-profit enterprises based on Zolochyv and Blyznyuky central rayon hospitals had already been established.

Mrs. Larysa Polikova, chief doctor of Blyznyuky central rayon hospital, addressed to activity advantages of her headed hospital with a communal non-profit enterprise status and expressed a thought that establishment of an inter-rayon communal hospital corporation would sufficiently strengthen historically-based and effective cooperation between healthcare facilities of Blyznyuky and Lozova rayons and make it more transparent and efficient.

Mr. Bela Kaunzinger, international Project expert, said that Ukrainian healthcare system faced a specific challenge: provide sufficient level of healthcare services with the current low financing level. In order to complete that task, new management structures would have to be developed. Hospital corporation model would allow forming a role of any participating hospital in a new manner. Due to that, more efficient allocation and usage of limited resources would be possible.

Mr. Oleksiy Gavva, chief doctor of Zolochyv central rayon hospital, shared his experience in development of a communal non-profit enterprise at the basis of Zolochyv central rayon hospital. He emphasized that transformation of such an establishment from a budget-funded facility into a communal non-profit enterprise would allow its board allocating current funds freely, flexibly and timely, whereas a hospital had high autonomy level in decision-making for the current strategic development of a hospital. In his opinion, reorganization of communal hospitals into non-profit enterprises was the most grounded model of organizational and management changes to be rationally distributed with further healthcare reforms in Ukraine. Development of inter-rayon corporations would allow further development of their new capabilities obtained after changes in economical and legal status.

The discussion topic provoked keen interest and many phone calls to the studio. The audience was interested in the way how the idea of inter-rayon communal hospital corporation had emerged, whether there had been any European experience in this field among EU members, who financed that experiment and whether its implementation would help in fighting corruption in healthcare facilities, improving their financial and material-technical support, etc.