Committee members upheld the provisions of the Programme, concerning the changeover to distribution of funds using the Service-Payment principle, recommended by the WHO for countries with a developing healthcare system.To implement these provisions, the Deputies note, a number of legislative acts and legal enactments should be adopted on the operation of Public Health institutions, including their operation in the field of medical insurance. ‘Otherwise, in this country it could happen, that some Public Health institutions will be made redundant and shut down, and the State will not provide sufficient financial resources to pay for those services established in The Constitution of Ukraine´, the People´s Deputies stressed. Closing down and declaring medical institutions redundant, when not backed up by a comprehensive healthcare system reform, could further aggravate the situation with regard to the medical treatment of the population, Committee members insist.
The Committee does not understand the Government´s intentions to implement ‘The Programme for Control of Distribution of Counterfeited Medicines for 2009/12´, as this control is already carried out by the relevant authorities, who have not put forward any additional plans for the allocation of State funds towards their activities. In addition, such a Programme could affect free competition of drug manufacturers, and lead to corruption in this area.
The Committee fully endorses the introduction of obligatory Medical Insurance in Ukraine. However the Programme suggests the adoption of two conceptually different Laws on Medical Insurance, i.e. ‘On Obligatory State Social Medical Insurance´, and ‘On Obligatory State Medical Insurance´, implying that the Government´s objectives in this programme display no cohesion.
Members also drew attention to some of the priorities declared in the Programme, which are not supported by the corresponding financial allocation in the State Budget 2008, and among them the funding of a 20% bonus to employees of rural Public Health institutions, and increasing the salary levels of medical workers to make them equal to those in the Budget areas (education, culture) and industry.
The Programme proposes the ‘setting up and renovation of village Out-patient departments and First-Aid Posts, and fitting them out with medical equipment´. However, the Law ‘On State Budget 2008 and Amendments to Several Legislative Acts of Ukraine´ has cancelled the Law ‘On Amendments to Budget Code of Ukraine´ envisaging the financing of rural healthcare from District Budgets. It means, stressed Committee members, that the Government undertakes to initiate further amendments to the Budget Code of Ukraine.
At the same time, other, although no less pressing, matters, have been left beyond the Government´s deliberation. Problems such as the introduction of medical aid standards, and modernization of logistics in Public Health institutions, have not yet been dealt with.
The majority of the People´s Deputies agreed that the Governmental Programme lacks a single purposeful concept for the development of Public Health in Ukraine, and that the objectives of this Programme are not aligned with the sector´s demands and public needs. Some of the said objectives are in conflict with The Constitution of Ukraine and current legislations, and can lead to corruption within the Public Health sector.
The outcome of the deliberation was that four People´s Deputies voted in favour of the Decision, and four against it.