Ukrainian lawmakers voted through a long-delayed overhaul of the health system on Thursday that the state’s Western backers say will raise standards and tackle a culture of bribe-taking in surgeries and hospitals.
The European Union and the International Monetary Fund have been pressing for faster reform is a country where lives are more than five years shorter than the European average, according to the World Health Organization.
But opponents of the changes, including many opposition MPs, say the more Western-style system will force patients to pay for their medicines for the first time, leaving the poorest with no healthcare.
The legislation lets patients choose their own doctor, rather than have one foisted on them – a move the government said would encourage medics to improve service and give them less opportunity to demand kickbacks for treatment.
The bill also sets out which medicines are paid for by the state and which ones patients will have to buy themselves.
Backers have said it would be clearer than the present system, where medicines are in theory covered by the state, but patients often have to pay to get hold of pills when supplies run short.
The government’s task is to provide a quality medical system for citizens rather than “do nothing and tolerate the misery that we have in Ukrainian hospitals,” Prime Minister Volodymyr Groysman told parliament after the vote passed.
The government has been pushing for closer links to the European Union since a popular uprising ousted pro-Russian former president Viktor Yanukovich in 2014.
Ambassadors from the G7 leading powers released a statement saying the legislation was “a sign that Ukraine is ready and committed to moving forward with its vital reforms”.
The legislation, which was steered by the United States-born acting Health Minister Ulana Suprun, has undergone 893 amendments and faced repeated criticism, including from Olga Bogomolets, the head of the parliamentary healthcare committee.
Bogomolets said on Facebook on Thursday the changes would result in hospital closures and fewer doctors and medicines in rural areas, calling them tantamount to “genocide”.
Supporters of the changes say vested interests who benefit from corruption in the current system spread scare stories about the reform.
Protesters camped outside parliament this week accusing President Petro Poroshenko of stalling on other legislation, including the creation of special anti-corruption courts and a move to strip lawmakers of automatic immunity.