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The law on the extension of the autonomization of clinics does not eliminate the reluctance of some local authorities and chief physicians to change methods of work

Interfax Ukraine as of December 27th, 2019

Vitalii Savchuk, counsel, attorney-at-law at Legal Alliance Company

According to Vitalii Savchuk, counsel at Legal Alliance Company, the law on extension of autonomization of clinics (bill No.2428) which will let healthcare facilities join the medical reform and has been deposited with the President of Ukraine for signing, does not eliminate reluctance of some local authorities and chief physicians of some clinics to change methods of work.

"The law will not eliminate the reluctance of some local authorities and chief physicians to take responsibility and change methods of work. I heard this is called "conservatism", however, I would use the word "sabotage" as more accurate," Mr. Savchuk told Interfax-Ukraine.

The lawyer has noted that the adopted law extends the period for grace autonomization procedure for healthcare facilities. “This is important and good, especially for Kiev,” he said.

Mr. Savchuk has recalled that in 2017 the concept of “medical services” was introduced into the legislation of Ukraine, the principles of funding healthcare institutions were also changed to depend on the volume of medical services provided to patients rather than on the number of beds in hospitals.

"Healthcare institutions were provided financial and managerial autonomy to use their resources efficiently. In fact, healthcare facilities are authorised to act as business entities. Therefore, funding for hospitals should depend on the quality of their management, work of doctors and the efficient use of available resources," the lawyer said, explaining: conditions on which healthcare facilities could join the medical reform and switch to new payment terms require, first of all, reorganization in non-profit enterprises (state-owned and communal non-profit enterprises), the so-called "autonomization" of clinics.

At the same time, the law on medical reform adopted in 2017 prescribed that by the end of 2018 hospitals would enjoy preferential conditions for autonomization without the need to pre-pay debts and evaluate property.

“Not all institutions took advantage of their chance during the grace period. Now, not only the grace period (autonomization) has ended, but the Civil Code also prohibits the reorganization of institutions by transformation.” The autonomization seems to have ended, at least for those who did not manage (to conduct it)," he said.

As reported, on December 20th, the Verkhovna Rada supported bill No. 2428 on amending certain legislative acts in the healthcare sector, which provides, inter alia, for the extension of the grace regime for the autonomization of healthcare facilities by a year. The bill prescribes the unblocking of the possibility of reorganization of healthcare facilities through transformation, as provided for by law No. 2002-VIII.

The document also provides for the postponement of the deadline for the introduction of the medical guarantees program for all types of medical care, which has been established by the law on medical guarantees, till April 1st, 2020, which will allow healthcare institutions to complete the reorganization process.

In addition, it is expected that the grace period for the transformation of healthcare facilities from budgetary institutions into state-owned and communal non-profit enterprises will last until December 31st, 2020. The grace period will include excuse from fulfilment of creditor obligations payable upon reorganization and the need to obtain consent to replace the debtor in obligations, from the need for a compulsory evaluation of property; simplified procedure for the transfer of real estate; the possibility of using own revenues to form the authorized capital of established enterprises, etc.


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