Ukraine’s healthcare system continues to function even amid full-scale war, constant shelling, and overcrowded hospitals. The reform, which began before 2022, changed the principles of access to services, financing, and the role of the patient. Today, the state guarantees a wide range of free assistance, but practical use of this system often requires an understanding of the rules and a willingness to defend them.
Humanitarian Media Hub, in collaboration with the Patients of Ukraine Charitable Foundation, is launching a podcast about medicine called “120 Beats per Minute,” dedicated to how the Ukrainian healthcare system actually works. The project is hosted by journalist Nazar Onysko and Inna Ivanenko, executive director of the Patients of Ukraine Charitable Foundation.
The family doctor is the point of entry into the system
The family doctor or therapist remains the gateway to healthcare. They determine the patient’s treatment plan, issue referrals, monitor chronic conditions, and explain which services are covered by the state.
“The family doctor or therapist is the point of entry into the healthcare system. Every adult must have one, and every child must have a pediatrician. This is the person who truly understands your health condition. They understand your risks and chronic diseases,” explains Inna Ivanenko.
According to her, the format of communication depends on the specific doctor: some work through messengers, others exclusively during live appointments. Medical consultations can also be conducted by phone, allowing you to receive referrals or recommendations remotely if you have established contact with the doctor.
Choosing a doctor and digital services
Electronic appointment booking systems such as Helsi and Health24 have changed the way patients visit doctors, making queues more predictable. At the same time, the fragmentation of services creates confusion, as different institutions work with different platforms.
“If you have already installed this app, it is extremely easy to make an appointment with a doctor. You can immediately see all the available slots, easily choose a time that suits you, and arrive. There are no queues; you simply walk into the office and get everything you need. You don’t pay anything. In fact, I am really looking forward to the introduction of a single patient office at the state level. It will really simplify people’s lives,” says Inna Ivanenko.
Despite their shortcomings, digital services make it possible to choose a doctor and a facility in any region of the country. Electronic referrals are valid regardless of place of residence, and the state pays for the service to the facility chosen by the patient.
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Private medicine at public expense
The reform has made it possible to receive free services not only in public but also in private institutions. This applies to primary care, specialized treatment, oncology, and reproductive medicine.
“This is precisely what the reform provides for. It’s a great thing for competition between institutions for patients. When there is competition for patients, they try to provide the best possible services so that patients will choose them. When public and private hospitals compete, the quality of services improves,” emphasizes Inna Ivanenko.
Funding is provided through the National Health Service of Ukraine as part of the Medical Guarantees Program, which covers dozens of medical care packages.
Why the ambulance doesn’t come
During the war, the approach to emergency care has changed. Teams mainly respond to cases that are directly life-threatening. High fever or exacerbation of chronic conditions usually require a visit to a family doctor.
“Call 103! Doctors there provide consultations, ask about all the symptoms, and ask in sufficient detail. They advise the patient on what to do in certain cases. This is how emergency services work all over the world. We cannot waste the resources of emergency doctors in our circumstances. When explosions occur every day, causing enormous destruction, and people under the rubble really need help. We cannot waste this resource on ‘I feel bad, come to me and do something,’” explains Ivanenko.
What the state pays for and where abuses occur
The state covers inpatient treatment, operations, consumables, medicines, and diagnostics within the Medical Guarantees Program. Requests to buy “film,” “gloves,” or make a “voluntary contribution” are illegal.
“Voluntary donations are the same as informal payments. There is no control over these funds,” emphasizes Inna Ivanenko.
The Patients of Ukraine Foundation regularly advises people who encounter demands for money in hospitals. In many cases, it is enough to contact the management of the institution or the NSZU hotline to resolve the situation.
The role of patients and public oversight
The reform has made patients active participants in the system, responsible for their own rights. The realization that services are already paid for by the state changes the balance in interactions with medical institutions.
“Patients should say: I am informed, I am registered, and I will now enter the office,” emphasizes Ivanenko.
One of the tools for change is the supervisory boards at hospitals, which are intended to strengthen public control and reduce corrupt practices. Their emergence is gradually becoming the norm for large medical institutions.
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