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Is there a way out of the so-called medical reform in Ukraine

23 February 2019

Есть ли выход из так называемой медицинской реформы в Украине

For discussion. Alternative assessment of medical reform in Ukraine.

It is especially painful for me, a person who grew up in a family of doctors, to see how the health care system in Ukraine is being destroyed. Unfortunately, few of our contemporaries know that in the 1970s many foreign delegations from Belgium, Germany, Sweden, Japan and other capitalist countries came to a small city on the territory of the great Soviet Union to study the unique health care system, which was effectively implemented in the district center-the city of Korostyshev, Zhytomyr region.

Doctors from different countries carefully studied the experience of the local CRH, where at that time for about 10 years worked as chief physician my father Vladimir  Peshko. His experience is one of the clearest examples of the fact that the pre-1991 health care system of Mykola Semashko was and is one of the most effective and adapted to the conditions of Ukraine.

The system of Semashko provided three-level medical care to the population, including Ukraine, that is, medical care was close to the rural population and the most remote villages, which are sometimes 100 kilometers or more from the Central district hospitals, where qualified medical care was provided. In the primary care setting, which includes feldsher-midwife points (FAPs) and rural ambulatory, were either primary care (FAPs), or primary medical care. This made it possible to quickly and timely help the rural resident, which is especially important in conditions of urgent (emergency and life-threatening) conditions that require immediate assistance, for example, various household and industrial injuries, accompanied by severe bleeding; acute gastrointestinal bleeding caused by gastric ulcer, duodenal ulcer or acute bleeding of the colon. The same emergency care is required by patients with acute bleeding associated with diseases of the female organs (acute uterine bleeding due to fibromatous changes, ovarian apoplexy, etc.); emergency conditions: acute myocardial infarction, hypertensive crisis with encephalopathy, stroke, acute pulmonary hemorrhage and many other acute pathologies.

It is the timeliness of first aid in these conditions that allows us to save the lives of our people. Primary healthcare has not only medical care, but also took a decision to transport these patients to hospital where the conditions were and the necessary specialists — specialists of the corresponding profile: therapeutic, surgical, and gynecological, — providing the patient is first qualified medical care.

If the doctors of the primary and secondary levels during the emergency consultation decided on the need to provide the patient with highly specialized medical care, that is, treatment by a neurosurgeon, orthopedist-traumatologist, thoracic, abdominal or vascular surgeon, ophthalmologist, maxillofacial surgeon or otolaryngologist, then such a patient, after providing him with secondary qualified medical care, was transported by road or helicopter, sanaviation aircraft to the nearest regional hospital. It was in the regional hospitals that highly specialized departments were opened, where highly qualified doctors of surgical profile worked: neurosurgeons, thoracic, abdominal surgeons, traumatologists, maxillofacial surgeons, vascular surgeons, urologists, gynecologists and other doctors of narrow and high qualification.

In regional hospitals there were also specialized therapeutic departments: cardiology, gastroenterology, neurology, pulmonology and others. In fact, it was the regional hospitals that were and are the main centers where the sick person could receive highly specialized medical care.

In the capital of Ukraine, Kiev, worked highly specialized and highly specialized institutes of the Academy of medical Sciences of Ukraine, as well as the Department of Kyiv medical Institute named after A Bohomolets, which employed some of the most experienced and highly qualified, we can say unique specialists in various fields of the medical industry. This is the Institute of cardiac surgery
Amosov, Institute of surgery named after academician A. Shalimov, Institute of gerontology, Institute of endocrinology, Institute of Nephrology, Institute of urology, Institute of pulmonology, Institute of Pediatrics, obstetrics and gynecology (PAG) and others.

It is in these medical institutions that patients with the most complex forms of various diseases were treated. They were equipped with the advanced laboratory and instrumental diagnostic base at that time. All this allowed to provide sick people in Ukraine with the most complete specialized and most effective medical care. At the same time I want to pay special attention to all Ukrainians that all this treatment was provided to citizens of our country free of CHARGE!!!

So briefly I tried to explain to the citizens of our country, what was the medical care in the Soviet Ukraine!

And now I want to explain to you what happened to what was once one of the most effective health systems in the world. Since the beginning of the 80-ies of the last century, when the economy of the USSR due to a number of objective and subjective reasons began to fall apart, the financing of the medical industry began to decline catastrophically. The process of the collapse of the medical industry has become progressive. The main ” reason was the lack of funding, the development of total corruption, the fall of responsibility and morality of the new generation of doctors and other medical staff.” All this has been happening for the past 27 years. But with the arrival to the management of the medical track of people who are not professionally trained, as it was with the Ministers of health of Ukraine (Georgians A. Kvitashvili, an American with secondary medical education U. Suprun), the medical industry of Ukraine began to fall apart before our eyes. Therefore, the average Ukrainian had the impression imposed by Pro-American “personnel” that the existing health care system in Ukraine is ineffective and incapacitated. But in fact, these people (parasites on budget money, which is allocated by the state more than twice less than the minimum needs and which are stolen by 70-80 percent, not reaching the medical institutions, especially the patients themselves) carry out a deliberate thought-out plan for the complete collapse of the unique health care system, the most adequate for our country, taking into account the numerous points that I will talk about in my next article, where I will be able to very clearly demonstrate, that the idea of creating a new health care system called “Insurance medicine”, the so-called telemedicine and the reform of rural medicine announced by the government is nothing but a purposeful genocide of the Ukrainian people!

Anatolii PESHKO, academician and first Vice-President of the Academy of economic Sciences of Ukraine, doctor of economic Sciences, candidate of medical Sciences.