Healthcare reform: public administration aspects

The list of measures related to public administration in the healthcare sector has been systematised: a working group has been established at the Ministry of Health of Ukraine; fruitful cooperation with scientists and practitioners has been established; political support has been received from the Government and Parliament; the National Health Service of Ukraine has been established; significant work has been carried out to promote the healthcare reform and explain its main provisions to doctors, medical staff and the public; a certain set of guaranteed healthcare packages has been formed. The authors summarise the most significant interim results of the healthcare reform as a reflection of the specifics of public administration of healthcare development: transformation of municipal healthcare institutions into municipal non-profit enterprises; introduction of a mandatory requirement for the head of a municipal non-profit enterprise to have a management education; refusal to fund the "presence" of a municipal non-profit enterprise; actualisation of the principle of "autonomisation" and introduction of the principle of "commercialisation"; creation of the National Health Service of Ukraine; abandonment of administrative-territorial "binding" of patients to healthcare facilities; signing of a memorandum on the creation of eHealth; introduction of the government programme "Affordable Medicines"; clustering of healthcare facilities and formation of capable networks within hospital districts. The authors identify the main problems hindering the healthcare reform: the existence of certain "groups of resistance to change"; insufficient competence and motivation of the staff of most healthcare institutions; insufficient material and technical provisioning of municipal non-profit enterprises; an epidemiological emergency; and the declaration of martial law as a result of the full-scale aggression of the Russian Federation. The priority areas of public response to challenges in the healthcare sector are outlined: development of a capable network of healthcare institutions; the reconstruction of destroyed or damaged as well as the development of existing healthcare institutions; increasing healthcare institutions' ability to generate revenue and attract investment; increasing public access to quality healthcare services; articulation of resources for treatment and rehabilitation of the population; development of medical tourism. Further scientific research should be devoted to the development of theoretical provisions and practical recommendations aimed at improving public administration of the development of the national healthcare sector