Public-private partnership in the medical field: how a private doctor can deliver medical care through municipal health care facilities

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Currently there is a situation when public and municipal health care facilities are reorganized and reduce their personnel.

There is a frequent practice when Primary Health Care Centers are forced to cease their activities at separate addresses - neighborhood primary health centers . This is due to the lack of funds from the provision of medical care at such addresses for maintenance of their premises located at separate addresses. For the most part, it is due to the implementation of the principle "the money follows the patient."

All this turns out to be a pressing problem for the countryside and its residents, primarily because it complicates their access to medical care.

One of our Clients, who has come to us with a very relevant and interesting question,  is dealing with this problem: 

How can a private doctor help the local community maintain the functioning of neighborhood primary health centers when the health care institution itself is no longer able to provide for their upkeep and the medical staff who work there?

This material will be useful for local governments that have faced a similar problem, and doctors who want to include the municipal property of local neighborhood primary health centers in the asset list.

Related article: What steps are to be taken to start private medical practice?

The essence of the matter

At the place of the Client’s medical practice, the Center for Primary Health Care has reduced the number of medical care places - neighborhood primary health centers- due to the small number of patients served. However, local governments, local residents and our Client were interested in maintaining and further functioning of these neighborhood primary health centers.

Therefore, it was necessary to find the answer to several questions:

1. Does the law provided for the possibility of financing the medical activities of a sole trader from the local government budget if the Client, as a sole trader, will provide health care to the local residents  free of charge?

The current legislation in the field of medicine allows for both the state / municipal and private health care institutions or sole traders individual to do their medical practice and provide health care.

In addition, the Law of Ukraine “On Local Self-Government in Ukraine” allows local authorities to carry out activities aimed at developing all types of medical services, as well as developing and improving the network of medical institutions of all forms of ownership, both private and state or municipal.

Also, the legislation gives the village council bodies the right to take actions to increase the availability and quality of medical care for the needs of the local population.

Related article: Helped to obtain medical licenses for municipal enterprises from different regions of Ukraine

2. Can local authorities turn over the premises of neighborhood primary health centers to a sole trader?

Current legislation provides for the right of local authorities to transfer property, including real estate, namely buildings, structures and premises, for use or lease, to private persons, both legal and natural.

Yet, the rental of property is carried out on the basis of bidding. This option is not suitable for everyone, since it involves significant costs and time.

3. How to make sure that local authorities transfer the premises of neighborhood primary health centers to the Client for use, without a bid and without obligatory contribution of funds to the state budget?

The Client wanted to contribute to public-private partnerships in the form of knowledge and skills in the field of medicine.

The answer to the question about the proper organization and financing of this process was outlined in the final consultation.

What did we end up offering the Client?

Considering the wishes of the Client:

  • promptly, but not costly, have them and local authorities implement the idea of keeping health care institutions’ activities for local residents;
  • speed up the procedure without participating in the competition.

We suggested that the Client conclude an agreement with local authorities on joint activities between him/her as a sole trader, on the one hand, and the manager of the premises of local neighborhood primary health centers, on the other hand.

What was the result of the Client’s cooperation with our company?

The Client received a full understanding of the situation and a specific plan for translating his ideas into reality.

Now the Client is negotiating with local authorities to sign a joint activity agreement, in which:

On the part of local authorities, the contribution will be:

  • premises for neighborhood primary health centers; 
  • funds;
  • equipment necessary for the provision of medical services.
On the part of our Client, the contribution will be:
  • professional medical knowledge, skills;
  • license for medical practice.
Now our cooperation with the Client continues already in the form of legal support in obtaining a license for medical practice for him/her as a sole trader.

If you want to understand the process of obtaining a license through your own effort, you can get more information in our video material.

Having this license available  is necessary for concluding an agreement between him/her and local authorities.

Related article: Individual doctor’s license

If you want to receive qualified legal advice in the field of medicine from our specialists or obtain a license for medical practice, you can get in touch with our company in a way that is convenient for you.

Publication date: 17/07/2019

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