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Draft law by Tretyakova and Bezuhla: Verkhovna Rada plans to change the procedure for conducting a forensic medical examination

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Parliament plans to consider a draft law on changes to the medical and social examination procedure. It is proposed to exclude mandatory examination by the MSEC and allow online participation, but there are comments from the Ministry of Finance and the Ombudsman.

At one of the next plenary sessions, the parliament plans to consider in the first reading the draft law "On Amendments to Certain Laws of Ukraine on Improving the Procedures for Conducting Medical and Social Expertise," initiated by MPs Galina Tretyakova and Mariana Bezugla, UNN reports.

Details

The draft law touches upon certain procedures for undergoing a medical and social examination, in particular, it is proposed to exclude the obligation of a person to undergo a medical examination at the MSEC and to provide for the right of a person to determine the form of his or her participation in the MSEC meeting (in person or online).

The proposed changes, according to the authors, will "unlock" the possibilities of digitalizing the patient's route (both civilian and military), relieve the financial, time and physical burden on patients who have to spend health, money and time on the road (to get to the place of the MSEC meeting and return home or to the place of deployment of the military unit), waiting in lines.

The amendments to the Law "On Rehabilitation of Persons with Disabilities in Ukraine" also stipulate that the MSEC is obliged to interact with the interdisciplinary rehabilitation team (IRT), make timely decisions on confirming a permanent disability and establishing the status of "person with disability" or "child with disability"; to enter information on adults who have undergone medical and social assessment into the centralized disability data bank (CDB) and the electronic healthcare system (EHSS).

After the law is adopted, the Cabinet of Ministers, the Ministry of Health and the Ministry of Defense will have to amend their regulations and orders to ensure the implementation of the mechanism:

  • not the person, but the person's documents are sent for medical and social examination to the MSEC; 
  • access of MSEC doctors of the “family doctor” level to the EHS; 
  • interaction between doctors of healthcare institutions, MDRC, VLC, and MSEC through the patient's electronic medical record.

"The implementation of the changes proposed by the draft law is consistent with the measures taken by the government to simplify access of civilian and military patients to all components of the rehabilitation system (electronic queues for medical examinations, submission of documents for disability through Diia, etc.)," the authors note.

The initiators of the legislative changes believe that MSECs are inappropriate; in fact, patients are not examined during MSEC meetings due to lack of time and specialists of the relevant specialization; MSECs should not examine patients, since according to the Law "On Rehabilitation of Persons with Disabilities in Ukraine", this is the responsibility of the interdisciplinary rehabilitation team (IRT); documents prepared by a doctor (health care facility) and the MDRC are sufficient to establish a disability group (even in the absence of the MDRC, the MSEC doctors still cannot provide a proper assessment of the state of loss of functionality); undergoing an MSEC is a traumatic practice for patients.

At the same time, there are a number of comments to the draft law. In particular, the Ministry of Finance sees additional financial burdens on the budget, specifically regarding the introduction of information on adults who have undergone medical and social expertise, as well as individual rehabilitation programs, into the electronic healthcare system. The Ukrainian Parliament Commissioner for Human Rights does not support this draft law at all and notes that the issues of reforming the system of medical and social expertise, changing the methodology for establishing disability, the stages of implementation of the new model, identifying possible risks and the need for regulatory changes aimed at ensuring an adequate level of social protection for people with disabilities should be addressed comprehensively, not point by point, as proposed by the draft law. The Ombudsman believes that this document will not solve the problematic issues in the field of MSEC and proposes to develop a comprehensive document to reform the system of medical and social expertise.

Lilia Podolyak

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