The Health Ministry’s new leadership is blocking the majority of its most important functions, according to an open letter to Prime Minister Oleksiy Honcharuk by Iryna Litovchenko, the director of strategic planning at the ministry.
“For almost a month, the political leaders of the Ministry have not signed important documents, interrupted the procurement of medicines for seriously ill Ukrainians, as well as the purchase of vaccines, which threatens the national security of the country,” Litovchenko wrote.
She added that all policy-making has been suspended and there has been no communication between the political team and the public servants, which puts healthcare reform at high risk and will delay scheduled reforms.
The blocked functions also include procurement of medications for seriously ill patients and the procurement of emergency vehicles, including in the war-torn Donetsk Oblast. All regulatory documents required for the function of the National Health Service have been “blocked,” she said. These documents are required to finance and operate over 1,000 primary health facilities and the “available medicines” program.
The director also told media that ministry staff had asked certain public servants to resign “voluntarily.”
The ministry’s press service was not immediately available for comment.
Honcharuk replied on his Facebook account that he respects the ministry employees’ right to express themselves to the Cabinet of Ministers and that the claims in the letter will be reviewed.
“I am sure that not a single honest, professional and competent person must be removed from their work without a good reason,” he wrote.
Procurement blocked
The patients’ rights NGO Patients of Ukraine on Sept. 24 also expressed concern about the interruption of pharmaceutical procurement taking place at the Ministry of Health. According to the NGO, the ministry blocked the signing of a series of documents to move forward with procurements.
The Ministry of Health has been partnering with international organizations including United Nations bodies, as well as the U.K.’s Crown Agents to acquire a variety of important medications. Proponents of this system said that it cut down on corrupt procurement and saved Ukraine 40 percent in drug costs.
Opponents say that this provides unfair competitive conditions for Ukrainian pharmaceuticals.
According to Patients of Ukraine, the Ministry of Health does not agree on international organizations’ estimates on procurement funds in the 2019 budget, which makes it impossible to transfer said funds to suppliers.
These estimates cover costs for drugs for cardiovascular diseases, metabolic diseases, oncology, diabetes mellitus, mulibrey nanism, Gaucher disease, mucopolysaccharidosis, multiple sclerosis, peritoneal dialysis,, blood donation, antiretroviral therapy, transplants and vaccines.
“In total, in the framework of cooperation with international specialized organizations, the supply of medicines and medical devices for a total amount of Hr 160,000,000 was blocked,” the organization wrote in a statement.
Patients of Ukraine was not immediately available for comment.
Tensions rising
These developments are troubling news for Ukraine’s pro-reform officials, who have been concerned that the new ministry leadership wants to halt or roll back the reforms achieved under previous acting health minister Ulana Suprun.
Suprun has been replaced by Zoryana Skaletska, a doctor of medical law and former head of the committee on health care reform at the Ministry of Health.
Multiple watchdogs are concerned that she is controlled by Mykhailo Radutskiy, former owner of the private clinic Borys and head of the Cabinet’s health committee. Radutskiy was photographed sending texts in the parliament that Skaletska was “his person” but he told media that the text was taken out of context. Skaletska denied knowing Radutskiy well.
Several of Skaletska’s chosen advisors and a lawmaker in the parliamentary healthcare committee had worked together or are associated with controversial former health minister Raisa Bogatyrova, who was charged with the embezzlement of over Hr 1 billion from the state budget. She returned to Ukraine at the end of August and was arrested upon arrival.
Firing staff now easier
On Sept. 23, President Volodymyr Zelensky signed amendments that simplify the procedure for firing government officials, which parliament had passed previously. The changes also make it easier to hire and fire state officials, expand grounds for their removal from office and introduce short and long term contracts for individuals working in government.
The amendments give ministers and heads of state agencies the power to cut staff and close departments. They also remove a provision requiring a special commission to assess the legitimacy of an official’s firing from Ukrainian legislation.
Suprun criticized the law, saying that now employees lose their protection from being pressured and fired.
“The new leadership wants “their” people in positions that can be managed manually. But civil servants work for the benefit of citizens, not ministers or deputies,” Suprun wrote on her Facebook account. “They are not ‘someone’s,’ they are not ‘Suprun people,’ and they have every right to voice their position when they disagree with something.”
Audit pending
Civil society groups have also been concerned about a planned audit of the health ministry and its procurements from July 2016 through August 2019 — when Suprun was minister.
The Association of Medical Manufacturers of Ukraine asked the health committee of the Cabinet of Ministers to audit the health ministry and its procurements from July 2016 through August 2019 — when Suprun was minister. The move drew consternation from pro-reform groups, concerned that this was the first step in getting rid of international procurements.
Petro Bagriy, the head of the association, told the Kyiv Post that his association does not want to remove international procurements, but does want to ensure that international drug suppliers are on a level playing field with Ukrainian companies, which, he said, are disadvantaged by uneven conditions.
Bagriy had been accused of using his companies and exploiting his connections with previous health ministry officials to win medical procurement tenders and sell drugs to the state at highly inflated prices, according to investigations by the Anti-Corruption Action Center, known as ANTAC, and investigative reporting project Nashi Groshi.
Bagriy denied being involved in any schemes, saying that his accusers lack any hard evidence.
