Reform of the MSEC: will disability groups be assigned in 2025?
24 October 19:00Medical and Social Expert Commissions (MSECs) will cease to operate as separate legal entities from 1 January 2025. Their functions will be transferred to cluster and supercluster hospitals, Health Minister Viktor Liashko said at a briefing. This is part of a major reform of the medical examination system, which includes new approaches to determining disability and modernising processes through digitalisation. The details were analysed by
The new structure and its functions
Cluster and supercluster hospitals, created as part of the Ministry of Health’s hospital planning, will ensure the performance of the MSEC functions, says Viktor Lyashko. These hospitals will have at least 20 areas of medical care and access to the Electronic Healthcare System (EHS), which will allow for decision-making based on digital data. It will also ensure transparency of processes and minimise the possibility of abuse. Lyashko noted that the EHR will make it possible to track all the actions of healthcare professionals in the event of investigations or appeals, including in criminal cases.
Personnel and financial changes
An important part of the reform is solving staffing problems. All hospitals connected to the EHIF will receive payment for medical and social expertise depending on the number of examinations. According to the Minister, this will encourage hospitals to work more efficiently. At the same time, Lyashko announced the launch of a separate budget programme starting in 2025, which will not be part of the Medical Guarantee Programme but will be administered by the NHSU.
Abandonment of the MSEC: new approaches to rehabilitation and support
The Ministry of Health plans to abandon the concept of medical and social expertise in its current form. According to the new model, the assessment of working capacity will be based on the international classification of functioning, which has already become a national classifier. Various agencies will be involved in the process: The Ministry of Social Policy to determine the functions that a person has lost, the Ministry of Economy to help with retraining or employment, and the Ministry of Education to organise retraining.
This new system is designed not only to provide additional payments, but also to create conditions for a person to return to social and economic life.
Expert opinion: challenges and doubts about the reform
Despite the government’s optimism, experts are sceptical about large-scale changes. Valeriy Klochok, Head of the Centre for Public Analysis “Vezha”, in an exclusive commentary for
“It is impossible to cancel what cannot be cancelled. This is a classic situation for our ministries. For example, when a minister changes, the staffing table changes, and new people are appointed to key positions. The same may happen with the reform of the MSEC. Perhaps a new commission will appear with a different name – for example, the Medical and Social Expert Commission (MSEC). However, this will not solve all the problems that have accumulated in the system,” said Valeriy Klochok
The expert noted that the current system of MSEC operates on the principles inherited from the Soviet Union. In his opinion, these principles are outdated and ineffective.
“The MSECs work as they did in 1991, and little has changed. The system does not meet modern challenges and is corrupt and non-transparent,” Klochok emphasised
He also focused on the problem of fake disabilities, which, according to him, is particularly acute in Ukraine.
“It is not really clear how the reform will be able to solve the issue of fake disabilities. How will such cases be identified? How and who will be responsible for establishing them? These questions remain open,” Valeriy Klochok
The expert also noted that the reforms proposed by the government are often a reaction to problems rather than a solution.
“We are again fighting the consequences, not the root cause. This is the main problem. Officials can make adjustments to the system, but without a clear understanding of how to address the root issues, the changes will remain only on paper,” summarised Valeriy Klochok
Time will tell whether the MSEC reform will be a significant step towards modernising Ukraine’s healthcare system. However, it is now clear that its success will depend on the effectiveness of its implementation and the ability to overcome the challenges of bureaucracy and corruption.
Author – Anastasia Fedor