This year, the amalgamated communities will have an opportunity to independently develop the system of primary care in their territory. Also, in the nearest future, there will come into being a methodology for the establishment of the secondary care system, that is, the system of medical circuits. These steps will resolve the existing problems pertaining to the establishment of a system of high quality services in the amalgamated communities and co-ordinate the actions of central bodies of executive power and local self-government in the course of the healthcare sector further reform.

"Decentralisation is not only the transfer of powers and funds to the local level. Our task is to provide services of new quality to people. Currently, all territorial bodies are being reformed and we have to show how, in the context of changed management system, educational, healthcare services will be rendered, how cooperation will be established with the pension fund, law enforcement authorities, how fire and police stations will work. Thus, each territorial community will understand how the system works", Vice Prime Minister - Minister of Regional Development, Construction, and Housing and Communal Services of Ukraine Hennadii Zubko noted at the interdepartmental meeting during which the concept of reforming healthcare sector in the context of decentralisation was presented to the heads of regional healthcare departments and representatives of the amalgamated territorial communities.

"Jointly with the Ministry of Health, we have developed a concept of implementation of healthcare services in the amalgamated territorial communities in the context of decentralisation. In the course of the first six months, we have to determine the definitive mechanism, so that we approve the 2017 budget within the framework of adopted concept and such laws which will allow arranging for the financing of the primary, secondary, and tertiary care elements of the healthcare", the Vice Prime Minister added.

The participants of the meeting agreed that, at the current stage of the local self-government development in circumstances of decentralisation, prompt decisions should be made to resolve urgent issues of rendering healthcare services both at the primary and secondary level.

At the initiative of the Ministry of Regional Development, the legislation was amended so to allow the amalgamated communities still this year not only to receive monetary funds from the state budget for the primary healthcare but to determine how those services have to be rendered. The amalgamated communities will be able, independently or in cooperation with others, to establish primary care centres, develop ambulance or medical and obstetrical stations or make use of the services rendered by general practice doctors, that is, family doctors engaged in the healthcare business as private entrepreneurs.

The relevant order of the Ministry of Health was signed and referred to the Ministry of Justice for registration.

In terms of establishment of the secondary healthcare level, it is planned to develop and approve within one month a methodology for the establishment of medical circuits, with the participation of professionals from the Ministry of Health, Ministry of Regional Development, and leading experts.

After that, a regulation governing the structure of medical circuits has to be approved by the Government; amendments to the Budget Code in terms of financing of secondary care programmes, as well as amendments to the Law of Ukraine "On Fundamental Principles of Ukrainian Healthcare Legislation" in terms of medical circuits management have to be made.

The primary purpose of such changes is the modernisation of the healthcare structure, as well as the transition to an optimal model of healthcare services in the state, establishment of a sole healthcare space where the patient can receive a high-quality service at any place in the country.

As it was reported, a working group was established at the Ministry of Regional Development comprising representatives of the Ministry of Health, the Ministry of Regional Development, and experts who worked out specific tasks to be implemented for the purposes of organising high-quality medical care at the primary and sub-regional levels.

The presentation of the "Decentralisation in the Area of Healthcare System of Ukraine" is posted HERE