Policy

The Ministry of Health vs. Ukrainians Abroad: How Millions of Citizens May Lose Access to Medicine

ANALYSIS

The Ministry of Health of Ukraine, in the third year of the full-scale invasion, decided to check which family doctors have gone abroad but are still registered in the medical institution and to resolve the issue of their dismissal. And also to deprive millions of Ukrainians who live in Europe but receive free consultations and treatment in their homeland, coming home once or more a year, of medical care in Ukraine. What is the essence of the innovation and what will it lead to, Komersant ukrainskyi analyzed.

Ukraine is verifying the data of doctors and patients who are abroad, Health Minister Viktor Lyashko said at a telethon. According to him, there are family doctors who have left the country but are still listed as doctors. Such doctors should terminate their declarations and sign new ones.

“The head should have informed us that the person is not in place, and all declarations, if it is a family doctor, should be rewritten either to another family doctor or terminated so that people can go to another one. This situation leads to the fact that other doctors work for the one who left, but without additional remuneration,”

– Lyashko explained.

But the main thing is that, according to the minister, a doctor from abroad cannot provide quality medical care. For example, they cannot issue a sick leave, provide vaccinations, and so on. At the same time, they plan to deprive patients of access to medical services in Ukraine.

“The same situation will be with patients. If they are abroad, they should not be included in our database to receive medical care. These are manipulations that will be detected,”

– emphasized Lyashko.

According to Lyashko, the Ministry of Health, together with the Ministry of Finance and the State Border Guard Service, verifies the data of doctors and patients abroad to avoid manipulations.

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The doctor must be present, but the patient does not have to be

The minister’s words about the impossibility of being treated remotely were a bit surprising. After all, the reform launched by former Health Minister Ulana Suprun envisaged that care would be provided remotely, via video. But, according to Minister Lyashko, remote treatment is not justified. Another thing is that family medicine has long been in need of improvement. Recently, it has been very difficult to get an appointment with a family doctor, with most of them scheduled for weeks in advance. At the same time, the office is empty. “Left-handed records” of appointments are made in order not to lose NHS funding. Patients are abroad, but they get paid for them here. There is a problem. And, of course, doctors can do little to help via video. But the most disadvantaged will be those patients who actually come to Ukraine for treatment, although they live outside the country. Will they be able to receive state-guaranteed medical care after verification?

According to Viktor Serdyuk, head of the Patients’ Rights and Safety Protection Council, it was time to put things in order in the healthcare sector long ago. After all, if a doctor is abroad, he or she cannot fully provide services to a patient who is in Ukraine.

“Yes, a lot of primary care can be done remotely, and there is even a term for it – telemedicine. On the other hand, a doctor must be ready to see a patient, conduct an examination, and perform procedures. Referrals to subspecialists and prescriptions can be obtained electronically, by phone, consultation on what medications to take, and so on. Therefore, a doctor should be at work, in the outpatient clinic, and be able to see a patient. But the idea of “disconnecting” patients from their doctors based on the territorial principle is directly contrary to the law,”

– says Viktor Serdyuk in his comments to .

Based on the Ministry of Health’s attempts to track where and who the patients are, a patient has the right to choose a doctor regardless of where they are.

“A resident of Uzhhorod can sign a contract with a doctor from Kharkiv. And on what grounds can a citizen be deprived of access to medical care just because he temporarily lives in another country, although he is 50 kilometers away from the outpatient clinic with which he has signed a contract? This is nonsense,”

– Viktor Serdyuk notes.

So far, these are statements, although, unfortunately, official. Let’s see what kind of regulatory document they will turn into. I don’t know how patients’ declarations can be canceled based on their stay in a particular territory or abroad. At the same time, Viktor Serdyuk believes that the forced reduction in the number of patients will not affect the NHSU’s cost savings. A penny is allocated per patient, so the salaries of family doctors are not that high.

At the same time, the physical absence of a certain number of patients allows family doctors to work:

1. Develop and implement telemedicine.
2. Pay more attention to those who remain, especially those who need special attention, with serious illnesses. That is, the doctor will even improve the provision of medical care to those who need it.

“If a doctor has left the country, then he or she really can’t provide full medical care to his or her patients – in this case, it is clear that such a doctor should not be kept. But for patients who live abroad but come home for treatment, it is not clear what they are guilty of, why they should be denied access to medical care. This is complete discrimination,”

– Viktor Serdiuk believes.

Update declarations by March 1

Starting March 1, 2025, all declarations that do not pass verification will be recognized as inactive. This means that patients may lose access to state-guaranteed medical services.

What is patient data verification in the EHR?

This is the process of confirming the relevance and accuracy of patient information. It is necessary for:

• Correct registration of patients in the system.
• Avoiding errors in searching for patient information.
• Reducing the risk of duplicate or erroneous records in the system.

The verification procedure is carried out through the exchange of data between the Electronic Healthcare System (EHS), the State Register of Individuals – Taxpayers (SRFT) and the State Register of Civil Status Acts (SRACSG).

Verification applies to children aged 14-18.

All minors must obtain a taxpayer identification number (TIN). After obtaining the TIN, they should provide this information to their family doctor for inclusion in the declaration.

If a child aged 14-18 has received an ID card (biometric passport), the data from it must be entered into the system instead of a birth certificate.

Persons who have changed their personal data, received a new passport or changed their phone number must also update these data through their family doctor.

Starting March 1, 2025, the declarations of patients who have not been verified will be recognized as inactive. This means that such patients will not be able to receive state-guaranteed medical services.

Author: Alla Dunina