On April 24, the Ministry of Healthcare of Ukraine published Methodological Recommendations for hospitals wishing to convert from budgetary institutions into municipal non-profit enterprises (to be autonomous). This conversion gives doctors freedom to manage their own fund and cooperate with international and national investors, among other things.
Recommendations developed by ILF together with a World Bank consultant and Kharkiv Expert Group on Healthcare Reform will help territorial communities transform hospitals into a more effective organizational form even before the autonomization law comes into force. Let us clarify that the bill 2309a-d adopted on April 6 start working six months after that. In the meantime, Methodological Recommendations act as roadmap. And they will still be relevant later on, as they can walk communities and clinics through the process.
A key step in reorganizing a municipal enterprise is the decision of the local council which owns the hospital. The council must also decide how the company is going to receive medical subvention until the National Healthcare Service starts operating: by signing contracts for servicing the population, through budget programs or through subsidies.
In addition, the Recommendations clarify issues on labor relations and taxation of reorganized hospitals.
"It’s a complicated but necessary process," explains one of the document’s authors, lawyer Olena Khitrova, Head of Medicine and Pharmacy Practice at ILF. “Many hospitals have already converted - in Chuguyev, Zolochev, Uman, several in Kiev. People stop fearing autonomization and begin to understand the need for it. But hospitals still require advice: not long ago I got a call from Odessa asking me explain everything step by step and share draft documents. The Recommendations do just that."
Aside from instructions, the Recommendations contain a draft charter of a hospital that provides primary healthcare as a public non-profit enterprise. Adopting it is recommended in step # 5 of the algorithm. You can find the Methodological Recommendations on the website of the Ministry of Healthcare.