On January 1, Medical and Social Expert Commissions (MSECs) ceased to exist in Ukraine. Instead, new expert teams were formed to assess the functioning of the system. Like any reform, this one is also in the focus of attention of civil society institutions. This was the topic of a briefing organized by the League of the Strong NGO with the support of the International Renaissance Foundation.
According to Dmytro Lufer, Advisor to the Prime Minister of Ukraine on Healthcare and Social Policy, the regulatory framework concerning the criteria for referral, determination, and establishment has finally been collected from various documents of different levels into one resolution of the Cabinet of Ministers.
“In the course of the reform, approaches have been detailed and objectified. The forms of assessment have been defined – in-person, correspondence, remote and on-site. Now it is clear which people are included in which cases. The referral criteria have also changed. Previously, there was usually a waiting period of 120 days of long-term disability, but now certain diagnoses, conditions or medical interventions have been prescribed, after which a person can be immediately sent for an assessment. We are talking about the fact that the very path to obtaining the status is becoming clearer and, in many cases, simpler,” emphasized Dmytro Lufer.
The role of medical advisory commissions has been canceled for the referrals themselves. From now on, the doctor makes this decision alone. Special emphasis is placed on digitalization. Instead of paper documents, an electronic system has been introduced in which a doctor forms a referral.
Another innovation was the introduction of the principle of extraterritoriality. This means that you can choose a team in any healthcare facility.
What anti-corruption safeguards have been introduced in the new mechanism so that it does not follow the reputation of the liquidated MSECs?
According to the advisor to the Prime Minister of Ukraine, the system itself has certain anti-corruption elements. These include blinded distribution. “That is, any hospital that can send documents for evaluation has at least two teams of this profile, and the system itself distributes them between them. Also, until the last day, the team does not see the documents and does not know who will come to them,” informed Dmytro Lufer.
At the stage of reform implementation, civil society provided the government with its proposals to improve the procedure for establishing disability. This was stated by Daria Sydorenko, executive director of the NGO “League of the Strong”. “Together with the Ukrainian Helsinki Union and the public organization “Together Against Corruption”, we sent a letter to the Ministry of Health, where we identified ten steps to reform the procedure. The model that came into effect on January 1 took some of these proposals into account. For example, the time limit for consideration of a case has been set. It is currently 30 days. Also, a clear time limit has been set for establishing disability status for beer-related diseases and statuses,” she added.
Explanatory work has also been carried out, because the new procedure, like anything new, causes misunderstandings and fear, and high-quality information is important here. “To this end, we have developed a newsletter that has been distributed among hospitals and primary health care centers. Such bulletins have already been distributed to 223 healthcare institutions in six oblasts,” noted Daria Sydorenko.
The algorithm for appealing the decisions of the teams has also changed. Ihor Bevkh, lawyer of the advocacy department of the “League of the Strong”, told about the changes. “The Center for Evaluation of Human Functionality has been introduced, which in fact acts as an authority to review decisions,” he said. ”Previously, there were institutions whose decisions were not binding. A person was sent to Vinnytsia or Dnipro, where he or she was examined for two weeks. And the institute would say that the person had the first group of disability. The person returned to the commission, for which this decision was not binding, and it reserved the right to establish the third group.”
Moreover, the appeal mechanism has been digitized. Before the reform, a person had to file a complaint either with the health department or with the regional MSEC. They had to travel and it was not always easy to do so. Now, after the end of the examination, if a person does not agree with the assigned group, he or she can file a complaint electronically through a family doctor.
Source: УКМЦ