In the Ukrainian healthcare system, the state is increasingly delegating a part of medical services to private clinics. This approach in itself aligns with the logic of medical reform: the patient gains the right to choose a hospital, and funds "follow the patient." However, a crucial question arises in this model: does the state sufficiently scrutinize those to whom it effectively entrusts budget money and citizens' health? Read about the criteria for selecting partners for the National Health Service of Ukraine, reputational risks, and patient safety in the UNN material.
In a model where the state procures medical services from private and communal institutions, the issue of partner selection becomes not only technical but also a matter of security. This is because it's not just about financial contracts, but effectively about the state's trust in a specific private medical institution and a recommendation for patients to seek care there.
The requirements for such partners are quite formal: the presence of a license, equipment, medical staff, and appropriate infrastructure. However, in many countries around the world, another important criterion is added to this – the reputation of the medical institution and its history of interaction with patients.
Government Contracts and Reputational Risks
Assessing the reputation of potential partners has long been applied in areas where large financial resources or public trust are at stake. This includes, in particular, the compliance system, which has become a standard for international business and financial institutions.
Thus, international banks, before cooperating, check partners not only from a legal perspective but also in terms of reputational risks. The reason is simple: even a formally legal operation with a partner surrounded by suspicions or scandals can create systemic risks for an entire company.
A similar principle is relevant for medicine. This is especially important in wartime conditions, when the Ukrainian healthcare system is already operating under significant strain.
As former Minister of Health Oleh Musiy noted in a comment for UNN, the Ukrainian healthcare system still lacks clear mechanisms that would allow assessing the quality of medical institutions' work and responding to possible violations.
There is practically no quality control because there are no assessment criteria, they have not yet been introduced by anyone. By no one: neither the Ministry of Health nor the NHSU. Therefore, control indicators, unfortunately, are one of the painful topics and areas that are not yet properly present in our system, as they should be.
NHSU Contracts with Odrex Clinic
One example of risky cooperation is the NHSU's contracts with the scandalous Odesa private clinic Odrex. As UNN previously reported, the clinic is involved in 10 criminal proceedings related to suspicions of fraud and improper performance of medical duties.
In addition, stories of patients who report possible problems during treatment at this medical facility regularly appear in the public domain. Some of these stories are published on the Telegram channel StopOdrex, which was created by the families of patients who died at the clinic and people who consider themselves victims of treatment there, after repeated blocking of the website due to lawsuits from Odrex.
At the same time, it is important to note that the mere fact of criminal proceedings does not mean establishing the guilt of the medical institution or its employees, as only a court can make final conclusions in such cases.
However, the very scale of public discussion around the clinic raises questions about the state's approaches to partner selection. Currently, despite public scandals, Odrex remains one of the largest private partners of the NHSU. According to the service itself, in 2023 alone, the clinic received over UAH 53 million in budget funding within the Medical Guarantees Program.
And in 2026, the Odrex clinic operates under several packages of the state medical guarantees program: primary care, treatment of strokes and heart attacks, rehabilitation.
Obviously, formally, such cooperation does not contradict the current rules of the Medical Guarantees Program. However, the situation itself raises a broader question: is it enough for the state to check only the technical compliance of medical institutions with the requirements, if criminal investigations, public patient complaints, and public discussions about the quality of care arise around one of the largest partners.