Ukraine’s medical reform once promised a simple and fair system: a patient gets a referral, and the state pays for the service. In reality, Kyiv has turned out very differently. Today, finding a free ultrasound or undergoing Holter monitoring under the Medical Guarantees Program is almost an impossible mission.
Ultrasound “cash only”
Patients in the capital are increasingly facing the fact that free examinations exist only on paper. The National Health Service of Ukraine officially guarantees ultrasound within basic primary care services. But as soon as you try to find a clinic offering a “guaranteed” joint ultrasound, it quickly becomes clear that the reform does not work here.
In most hospitals, ultrasound is exclusively a paid service, regardless of a family doctor’s referral. Formally, the explanation is “no contract with the NHSU.” In reality, the state allocates funds, but patients are forced to pay again.
“Holter” only through Tetiana Anatoliivna
The situation with referrals for Holter monitoring is no better. The service is listed in the NHSU electronic system, and there is even a specific address — an endocrinology center in Kyiv. Booking can be done online without any issues. But on-site, it turns out that the examination is only possible with the permission of the local “office owner” — a doctor named Tetiana Anatoliivna.
The reason for refusal sounds absurd: “we don’t have batteries for the device because the Ministry of Health does not pay for Holter monitoring.” And the reform that was supposed to eliminate informal practices and under-the-table payments once again slides into a feudal logic where connections decide everything.
Why the system is falling apart
The problems of Kyiv’s healthcare system are not new. There is no hospital in the capital that fully meets the standards of the reform. The so-called clustering exists mostly on paper: smaller facilities are merged into “super-clusters” to receive more funding, but services are not actually provided.
Instead of receiving comprehensive care in one institution, patients are forced to travel across the entire city — from clinics to hospitals, from one doctor’s office to a private center for paid ultrasound.
Billions invested — but no services
The Ministry of Health has supplied hospitals with hundreds of units of expensive equipment, including 233 CT scanners. However, some of them remain idle or are used only a few times a day instead of dozens. This indicates either sabotage or systemic issues that artificially create a shortage of services.
Medical reform, Kyiv-style
On paper, Kyiv is the showcase of Ukrainian medicine. In practice, it is a city where “reform” has turned into fiction. A patient with a referral is not a patient, but a petitioner. And a doctor who “has no batteries” is not an exception, but a symbol of a decaying system.
While the Ministry of Health reports successful implementation of reforms, in reality the reform in Kyiv is already close to being buried. It remains only in electronic databases and presentation slides.
Want to check how the reform works in Kyiv?
Try to find a free ultrasound or get a Holter test without “permission” — and you will understand that in Ukraine’s capital, healthcare reform exists only in words.