In the draft State Budget for 2025, officials demanded that all medical institutions be transferred to treasury accounts, which would effectively cause a collapse in the healthcare system and leave millions of patients without the necessary medical care during the war.
If the draft state budget is adopted in this form, medical institutions will not be able to promptly manage their own funds, procure medicines and pay salaries to doctors in 2025. Thanks to the autonomy that hospitals gained in 2018 by opening their own bank accounts, these problems have been resolved. Now they may return again and cause even more negative consequences for patients who need continuous treatment during the war.
“The first risk that the medical community sees is delays in all monetary payments. We all remember how doctors used to go on strike every year before the healthcare reform was implemented because salaries were not paid on time. This problem will definitely return if more than 2,000 institutions join the Treasury in addition to all other state employees. They are already taking 2 weeks to 2 months to get their payments approved by the Treasury. When new companies join, there will simply be no hands to provide timely service, so doctors’ salaries and procurement of medicines will be delayed for months,” says Yulia Brykulska, head of the NGO Medical Leaders.
Thus, starting from 1 March, hospitals will have to wait for months to pay their bills for medicines, consumables, etc. Patients will feel the delays in procurement when hospitals do not have the necessary medicines, guaranteed treatment will effectively stop, and total extortion and informal payments will return to replace it. The entire healthcare reform and the autonomy of medical institutions, which is so necessary in times of war, may stop working in 2025.
“Everything the patient community has been fighting for years is now under threat. Hospitals without medicines and staff in a country at war threaten to collapse the entire medical system. Medical facilities will not be able to respond quickly to emergencies, for example, in the event of air raids, and patients with serious illnesses and wounded soldiers and civilians will be left without guaranteed treatment. This will also trigger an increase in shadow payments from patients. “The Treasury accounts are a huge rollback to the scoop from which the medical system has recently escaped, and of course, the destruction of one of the fundamental principles of the medical reform — the autonomy of institutions!” says Inna Ivanenko, Executive Director of the CF “Patients of Ukraine”.
The negative impact will not end with patients and doctors, as the addition of 2,000 new users to the Treasury system may also cause delays in defence procurement.
The medical and patient communities are calling for the removal from the draft State Budget for 2025 of the requirement to transfer hospitals to treasury accounts. This is in order to preserve the autonomy and mobility of medical institutions during the war and to preserve the achievements of the healthcare reform.
