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Home    Legislation    Legal environment for SHC Reform

Legal environment for SHC Reform

Project strategy

Legal obstacles/ support

Legal provision

Clear split between PHC, SHC and THC shall be provided and effective referral system between mentioned above levels of health care shall be established

The law does not provide for a clear definition PHC, SHC and THC.

Art. 35 Ukrainian Basic Law on Health.


The law does not clearly support the establishment of an effective referral system between PHC, SHC and THC.

Art. 6, 34, 35, 38 Ukrainian Basic Law on Heath.

The existing network of SHC providers shall be adapted to the actual service need.

On the one hand the law does principally support a more effective planning of SHC facilities at the local level, and also supports cross-boarder “rayon/city”, “rayon/rayon” and “oblast/oblast” reimbursement of SHC and THC services on the basis of agreements between corresponding local councils.

Paragraph. 30 Art. 26 Law on Self-Government in Ukraine; Paragraph 1 Art. 19 Law on Local State Administration; Art. 93, 101, 104 Budget Code of Ukraine.


However, the law does principally not support the reduction of the existing network of public SHC facilities. This hinders the closure of existing “medical care facilities”. Whether or not such facilities can be rededicated into “social care facilities” is questionable and not finally clarified.

Art. 49 Constitution of Ukraine.


The current taxation of health facilities approved by MoH is not clear and does not support a functional reorganization towards a hospital network. Particularly taxation does not support establishing joint inter-rayon hospitals (medical centers).

Order MoH # 385 dated by 28/10/2000

Clear spit between public purchasers and health care providers by implementation of contractual arrangements shall be established

On the one hand the law does principally support establishing contractual arrangements between public purchaser and public services providers (including health care providers particularly).

Temporary Regulations for Public Procurements approved by Resolution of Cabinet of Ministers of Ukraine dated 28 March, 2008 # 274.


On the other hand, the law does not establish a clear responsibility for local (oblast, rayon, city) health care administrations as the public purchasers.

Standard Statute of Oblast Health Care administration (adopted by Resolution of Cabinet of Ministers of Ukraine dated the 20 December, 2000 # 1845); Standard Statute of Rayon Health Care Administration (adopted by Resolution of Cabinet of Ministers of Ukraine dated the 28 November, 2007 # 1364).

SHC providers shall gain more autonomy for more flexibility to create incentives to quality and effectiveness

The law does principally support the reorganization of public health care providers as autonomous legal entities with the status of public (state and communal) enterprises (profit and non-profit).

Art. 3 Ukrainian Basic Law on Health; Art. 81, 83, 84, 85, 86, 87, 167, 168, 169, 170, 171, 172, 173 Civil Code of Ukraine; Art. 46, 52, 54, 62 – 72, 76, 77, 78 Economy Code of Ukraine.


The law does not clearly support the implementation of new output oriented provider payment mechanisms and stipulates only line-budget payment mechanism for all health care providers which use public finance resources.

Budget Code of Ukraine; Resolution of Cabinet of Ministers of Ukraine “On approval of Procedure for establishing, consideration, authorization and basic requirements to execution of trial budget for budgetary units” (dated 28 February, 2002 # 228)


The taxation law does not clearly support a change of status for public health providers and reorganization of public hospitals from budgetary units to public non-profit enterprises.

The Law of Ukraine “On income tax for enterprises”


The law does not support more effective planning of public SHC facilities human resources

Order MOH # 33


The law does not support of contractual staff arrangements, necessary for independent and efficient management of staff.

Art. 21 Labor Code of Ukraine

This project is funded by European Union This project is implemented by Consortium EPOS Health Consultants with ECORYS and NICO

The views in this publication do not necessarily reflect the views of the European Commission.