war crimes in Ukraine

The Tribunal for Putin (T4P) global initiative was set up in response to the all-out war launched by Russia against Ukraine in February 2022.

Conclusions on monitoring of patients’ rights

The monitoring carried out two rural districts of the Kharkiv region shows clearly how empty the words about free medical care are

The monitoring was carried out in two rural districts of the Kharkiv region. It found the following.

-   Only ambulance and district doctors can be said to provide accessible and reasonably high-quality medical services. The work of those two services in the region was well-organized. 

81.3% of the respondents both knew their district doctor and gave a positive assessment of their work. More than 80% said that they had not encountered problems when calling an ambulance (the service covers a broader range of services than in many countries like the UK – translator). and more than 69% said that it comes within half an hour.

There were also fairly few complaints about the specific work of doctors – 65.5% said that the doctor was thorough in examining patients and provided urgent medical care, and another 21.2% said that the doctor was quick in carrying out checks, would give painkillers and transport patients to the hospital.

Worth noting that more than half (58.1% said that they didn’t have to pay anything for ambulance services. This is a major factor in ensuring accessibility of medical care.

-   Two thirds of those surveyed are not in a hurry to visit a hospital and go there only in acute cases (37.2%) or only in the most extreme cases (29%). The main reason was inability to pay for doctors’ services, tests, procedures and operations (53%). The respondents were in no doubt that they would have to pay since according to the survey around 70% pay for medical services.

-   A significant problem impacting upon availability and quality of medical care in the region is access to medical equipment. Most respondents said that they lacked such access. 19% said that some diagnostic and treatment equipment was available in their district hospital if one paid, however many said that the problem was not only paying, but also having to travel somewhere and make appointments in advance. 24.3% had no idea how they could get such access.

-   One of the most frightening prospects for people in the district was having a medical operation. Firstly, the local facilities are not sufficient and most people (56.2%) said that they would have to travel to the district centre or city. Many also feared the results of an operation. 23% said that they avoided going to doctors out of distrust. However the greatest fear was linked with the considerable costs which the family budget might simply not be able to cope with. Only 6.4% of those who had needed an operation said that all operations had been free of charge, and another 1.4% said that a part of the operation had been free. Thus only 8% of residents of the Kharkiv region, according to these results, would have access to free medical operations. 14.3% had had to pay for medicines, bandages, while another 36.4% said that on top of this, they had had to pay for the doctors’ work, and even for the very possibility of getting an operation. In all 92.1% of those who needed an operation were forced to pay for it.

-   Most of the people from the two districts were effectively unable to receive adequate treatment due to the inaccessible cost of medicines. This furthermore did not only apply to the poorer groups in society, but to people on higher incomes, regardless of whether they were living in a district centre, small town settlement or village.

-   Around 70% had with varying degrees of frequency provided remuneration for medical services provided, which once again confirmed that, despite what the Constitution states,  in the districts studied medicine is de facto not free of charge.

-   87.3% had never used medical insurance. Against a background of virtually total payment for medical services in the areas surveyed, the overwhelming majority had never used insurance-based medical services. The vast majority of people are willing to pay for quality medical care, and a well-thought-out system of medical insurance is needed which would be available in all populated areas. However the existing system of medical insurance is not available to most residents of the region and even among those who had been able to avail themselves of its services, the assessment was that it was ineffective and in need of improvements.

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