A system without proper control is doomed to decline - ex-minister Oleh Musiy on the crisis in the medical field
Kyiv • UNN
The Ukrainian healthcare system is experiencing a deep crisis due to the war, staff outflow, and the lack of real control over the quality of treatment. Former Minister of Health Oleh Musiy warns: without finances, a well-thought-out personnel policy, and clear criteria for accountability, the system will continue to decline, and patients' access to assistance will decrease. An example of such a decline is the "Odrex Case," which became a test for the state regulator and its ability to protect patients.
The Ukrainian healthcare system is under double pressure: war and internal management problems. Staff outflow, demographic crisis, and the lack of clear mechanisms for controlling the quality of treatment, according to former Minister of Health Oleh Musiy, can lead to a global decline in the industry and reduced patient access to care. Whether the Ministry of Health is currently able to ensure real control and protect patients, read in the UNN material.
The Ukrainian healthcare system needs a change in its approach to development. The current model, according to former Minister of Health Oleh Musiy, is unbalanced: it lacks sufficient funding, is not supported by personnel policy, and has no holistic development strategy for the industry in the context of war and demographic crisis.
In fact, this is a systemic problem – when changes are introduced, but without a proper resource base and long-term vision. And if the approaches are not reviewed, the ex-minister warns, it will mean a further reduction in Ukrainians' access to medical care.
The most negative consequences are caused by the inept policy in the healthcare system by the current government and the continuation of the so-called reform, which is not supported by anything: neither finances, nor personnel, nor a general policy on what to do with healthcare. Only negative trends will lead to disintegration, and the healthcare system will collapse more and more, unfortunately, so a change in the healthcare system requires a systemic and immediate solution. Without this, people will have even less access to the healthcare system and that's it.
Separately, the ex-minister draws attention to a problem directly related to patient safety – mechanisms for controlling the quality of treatment and the responsibility of medical institutions. In his opinion, clear rules of the game have not yet been formed in the country: there are no unified criteria by which to evaluate the work of hospitals and specific clinical decisions. And without criteria, there is no effective control in either the state or private sector.
"Quality control practically does not exist, because there are no evaluation criteria, they have not yet been introduced by anyone. By no one: neither the Ministry of Health nor the National Health Service of Ukraine. 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," Musiy comments.
In this logic, the question "can the system be trusted?" hinges not only on funding but also on accountability: what exactly is being checked, by whom, according to what indicators, and what are the consequences for a medical institution if a patient received inadequate care. When there are no answers, public tension grows, especially against the backdrop of stories about deaths in hospitals or complications after procedures, which are increasingly being discussed publicly.
Staff outflow amidst war and demographic crisis
Moreover, in wartime conditions, the Ukrainian healthcare system operates under double pressure. On the one hand – a demographic crisis: increased mortality due to hostilities, decreased birth rates, and mass emigration of Ukrainians abroad. On the other – a rapid reduction in the number of medical professionals who should be addressing these challenges.
According to Oleh Musiy, the country is losing highly professional personnel. Some doctors go abroad in search of stability and decent wages, while others leave the system due to the lack of a well-thought-out personnel policy. And this, in his opinion, is no longer just a consequence of the war, but a result of management decisions in the industry.
"There is a large outflow of highly professional personnel who have gone abroad, who are not in medicine, do not have adequate wages. The leadership of the ministry and especially the National Health Service of Ukraine cares more about finances than about personnel, this, probably, unsuccessful personnel policy affects the fact that there are fewer and fewer good doctors, unfortunately. Therefore, of course, this also negatively affects the speed and quality of care, and accordingly, may increase mortality," Oleh Musiy summarizes.
"Odrex case" as a test for the Ministry of Health: is the regulator capable of protecting the patient?
Against this background, a separate marker of the quality of state regulation of the medical sphere is the story surrounding Odesa's largest private clinic – Odrex. If, as Oleh Musiy claims, there are practically no clear quality control criteria in the system, then resonant cases should show whether the ministry is capable of performing its key function – to be not an observer, but a guarantor of patient safety.
After all, the Ministry of Health must not only issue licenses but also verify, react, and act in cases where systemic accusations accumulate around a medical institution. And if a private clinic is involved in 10 criminal proceedings, if a public movement StopOdrex arises against it, if patients' families publicly declare possible improper medical care – it is logical to expect an active and public position from the regulator.
If the Ministry of Health does not demonstrate the ability to react harshly to possible violations in medical institutions and patient complaints, trust in the entire healthcare system will inevitably be undermined.