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DECLARATION
of participants of the training module organized
for representatives of rayons and towns of Ukraine who made a decision to
participate in propagation of the experience of the EU Project Health Financing
and Management in Ukraine
We, participants of the training module organized for
representatives of rayons and towns of Ukraine who made a decision to
participate in propagation of the experience of the EU Project Health Financing
and Management in Ukraine, the experience of the first steps in implementing
the experience of the Project’s pilot regions, declare that approaches proposed
within the Project allow creating incentives for all healthcare participants to
use limited resources of the sphere efficiently and to improve the quality of
healthcare services provided to population as well as to prepare the healthcare
system for future work in conditions of social health insurance model.
At the same there are a number of obstacles on the way of
propagating the experience which hamper the possibility to implement
administrative strategies proposed by the Project and directed at separating
the functions of the healthcare purchaser and healthcare provider, providing an
autonomous status to healthcare facilities as well as implementing state
procurement of healthcare services on a contractual basis.
We think that to eliminate these obstacles and to guarantee the
spread of changes proposed within the EU Project Health Financing and
Management in Ukraine, state authorities and local self-governmental bodies of
Ukraine should do their best to follow recommendations stated in the
Declaration of participants of the conference Autonomous Status of Healthcare
Providers and Implementation of Contractual Relations – Main Constituents of
the Healthcare Reform in Ukraine that took place in Yalta 25-25 September 2005.
At the same time we think that it is worth referring to the
Ministry of Health of Ukraine as a main recipient of technical assistance
provided within the Project to solve the following problems:
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At the level of the Cabinet of Ministers of Ukraine to develop and approve a
Standard Statute of the healthcare department of rayon state administration and
to introduce amends to the Standard Statute of Oblast Healthcare
Administration, Central Healthcare Administration of Kiev Municipal
Administration and Healthcare Administration of Sevastopol State Administration
according to which the mentioned departments will be responsible for
procurement of healthcare services at funds of the corresponding budgets.
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To develop and approve model statutes of state (communal) healthcare facilities
with the status of a state (non-profit) enterprise.
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To develop and approve model contracts on state procurement of healthcare
services within state guarantees of providing population with free-of-charge
healthcare at the level of primary, in-patient, specialized ambulatory and
emergency care.
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To recommend self-government bodies to establish healthcare departments within
executive bodies of municipal councils in towns of oblast importance.
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At the level of the Cabinet of Ministers of Ukraine to develop and approve
unified state tariffs on healthcare services to be bought at the expense of
state funds and the methodology of healthcare services cost estimation.
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To take all the actions dependent on the Ministry to unfreeze the procedure of
introducing amends to the Budgetary Code of Ukraine which envisage unification
of financial resources of rural healthcare at the level of rayon budget and in
future to introduce amends to the Budgetary Code of Ukraine directed at the
unification of financial resources of the healthcare system at the regional
level and to provide the transfer of the sphere to the use of a single payer
model.
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To refer to the Cabinet of Ministers of Ukraine and Verkhovna Rada of Ukraine
with proposals to review the amends to the Law of Ukraine On Procurement of
Goods, Works and Services at State Funds adopted 15 December 2005 and to
simplify the procedure of procurement from one participant and restricted
tendering envisaged by these amends which due to peculiarities of economic
relations within the healthcare system and specific character of healthcare
services are of practical importance for further implementation of the
healthcare reform.
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To refer to the Ministry of Finance of Ukraine with proposals to introduce
amends to the functional classification of budgetary costs directed at
providing a clear separation of primary and secondary healthcare funding.
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To take all the actions to approve unified minimal requirements to
IT-technologies which are used by healthcare facilities and healthcare
administrations and to establish a coordinating body which will develop,
introduce and control the performance of the tasks related to the
informatization of the healthcare system defined by the corresponding decisions
of state authorities.
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To facilitate provision of a multisectoral approach to the healthcare reform,
educational institutions, training and retraining the managerial staff of
central governmental bodies, local state administrations and self-government
bodies are recommended to include to the educational programs the questions
which relate to the possible ways of introducing changes in the healthcare
system of Ukraine on the basis of the approaches proposed by the Project and
which are widely used in countries, EU-members, and other developed countries.
We are also addressing the European Commission Delegation Office
in Ukraine and the Ministry of Health of Ukraine to do all their best to
facilitate the establishment and coordination of the activity on a permanent
basis and on the basis of pilot regions of the EU Project Health Financing and
Management in Ukraine and 1-2 information-resource centres of other regions
whose tasks are to facilitate further propagation of the positive experience of
the healthcare reforms obtained by the Project during its implementation.
The Declaration is approved unanimously by the participants of the
training module organized for representatives of rayons and towns of Ukraine
who made a decision to participate in propagation of the experience of the EU
Project Health Financing and Management in Ukraine during the closing seminars
which took place in Zhytomyr 30 March 2006 and Kharkiv 4 April 2006. It was
also supported by participants of the 6th Meeting of the Project Steering
Committee 6 April 2006.
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