Why the medical system does not protect the Ukrainian patient and how to change it - explains an expert

A Ukrainian patient often finds themselves alone with the system if treatment ends in complications or tragedy due to possible medical negligence. Despite the existence of control mechanisms, the state has not yet created an independent body that would genuinely monitor the quality of medical services provided and protect human rights in case of violations. As a result, patient complaints turn into years of lawsuits, expert examinations, and struggles for justice. That is why every new high-profile story in medicine only sharpens the question: how safe is treatment in Ukraine and does the patient have effective protection? What needs to be changed in the healthcare system so that Ukrainians have a higher level of protection, read in the UNN material.

The issue of protecting patient rights in Ukraine is increasingly being raised in the public sphere against the backdrop of stories related to the activities of private medical institutions. One of the most high-profile cases was the situation surrounding the Odesa clinic Odrex. Against the backdrop of a large number of criminal proceedings involving the clinic and its medical staff, as well as stories about negative treatment experiences at "Odrex," the StopOdrex public movement emerged. It was created by people who consider themselves or their loved ones to be victims of treatment at this clinic. Activists launched a website and a Telegram channel, where they anonymously publish patient stories, exchange information about the progress of cases, and support each other.

In fact, the emergence of this public movement was society's reaction to the state's lack of quick and clear mechanisms for responding to patient complaints.

Problems of the medical system: quality control and responsibility of doctors

Control over the sphere of medical services in Ukraine and patient protection remains limited, especially compared to European countries. Inna Ivanenko, executive director of the "Patients of Ukraine" Charitable Foundation, stated this in an exclusive comment for UNN.

In many countries, a special Quality Agency is responsible for quality control. Currently, there is no such independent body in Ukraine that would systematically control the quality of medical services. Because of this, patients are virtually left without protection in cases of improper treatment, and there is no mechanism that could promptly respond to violations of standards. The Ministry of Health is taking certain steps to improve the quality of care: it is introducing treatment standards and protocols, digitizing processes, and purchasing modern equipment. But without an independent body that would check how these standards are implemented in practice, the effectiveness of these measures is limited, and patients cannot be sure of the safety of treatment.

Former Minister of Health Oleh Musiy agrees with her opinion.

Quality control practically does not exist, because there are no assessment 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 places that are not yet properly present in our system, as they should be.

At the same time, he warns that without a review of approaches to industry management, proper funding, and personnel policy, the healthcare system will continue to degrade. In such a case, according to his assessment, negative trends will only intensify, and Ukrainians' access to medical care will continue to decrease.

Separately, experts draw attention to another systemic problem – the lack of personal responsibility of the doctor to the patient. As Inna Ivanenko explains, the current model actually complicates bringing a specific specialist to justice.

Another problem is the lack of personal responsibility of the doctor and the legal definition of "medical error." Currently, a medical institution, not a doctor, receives a license for medical practice (unlike most European countries). Accordingly, the medical institution is responsible to the patient. This complicates bringing a specific specialist to justice and limits patient rights. It is almost impossible for a patient to independently control the quality of certain services, so an independent state body should take this on.

Thus, the Ukrainian patient effectively finds themselves in a situation where they have neither the tools to control the quality of treatment nor a clear mechanism for holding a specific doctor accountable. According to Ivanenko, one way to solve this problem could be the introduction of personal licensing for medical professionals and medical self-governance.

Personal licensing and medical self-governance could become a separate mechanism for the personal responsibility of doctors and improving the quality of medical services. Through ethical and disciplinary committees, doctors could independently consider complaints, monitor compliance with professional standards among colleagues, and revoke licenses from unscrupulous specialists. The bill on self-governance in healthcare is currently stuck between the first and second readings, and its revision and adoption are critically important for patient protection.

In fact, it is about the need for systemic changes: from creating independent quality control to introducing personal responsibility of doctors. Without this, as experts note, the Ukrainian patient will continue to remain the least protected party in relations with the medical system.

Recall

These issues are also relevant in light of high-profile court cases. One such case is the case of the death of Odesa businessman Adnan Kivan in the private clinic Odrex, which has become one of the most high-profile cases in the medical field in recent years.

Within the framework of the proceedings, two doctors of Adnan Kivan: surgeon Vitaliy Rusakov and oncologist Maryna Bielotserkivska are accused of improper performance of professional duties. According to the investigation, after the operation, the patient was not prescribed mandatory antibiotic therapy and there was no reaction to postoperative complications, which led to the development of sepsis and could have caused his death.

The case itself clearly demonstrates how complex and lengthy the process of establishing responsibility in the medical field is, as its consideration has been ongoing for more than a year. And also why the issue of clear rules, quality control, and patient protection is coming to the forefront today.