Aspects of legal regulation of the provision of medical services
The article focuses on the need to respect human rights in the provision of medical services in Ukraine. It is strictly unacceptable to restrict citizens of Ukraine in receiving free medical services, since such a right is provided for by Art. 49 of the Constitution of Ukraine. It is proposed to consider that a medical service includes all types of medical care and is a special activity in relation to human health. The concept and main signs of medical services are revealed, it is established that the state, local governments, legal entities and individuals, including the patient, can be the customer of medical services. Ukrainian legislation governing the provision of medical services does not meet international standards. The positive experience of the EU countries (France, Denmark, Slovakia) and the world (Australia, Canada) shows that access to medical services is provided within the framework of medical insurance, in most cases free of charge, and is controlled by authorized state organizations.
The purpose of the article is to determine the content, signs of medical services, classification criteria for their subjects, disclose the features of their legal regulation, clarify the problems of legalization of medical services and improve legislation taking into account foreign experience. The research methodology is based on a systematic approach, which is determined by the specifics of the topic of the article, and is also associated with the use of general and special research methods. The comparative legal method and the method of legal analysis were used in the study of legislative rules governing the provision of medical services. Using the method of legal analysis, groups of subjects of medical legal relations in the field of medical services are determined and their powers are analyzed. The formal logical method was used to differentiate the criteria for distinguishing between the legal structures “medical care” and “medical service”. The results of the study contributed to the identification of certain legal problems that arise when citizens receive medical services and require immediate resolution. It is also advisable to introduce compulsory state health insurance.
About local state administrations: Law of Ukraine No. 586-XIV of 9 April, 1999, Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/ru/586-14
Aluttis, K, Sorensen, R Pace, B. Helmut (2015) The impact of the EU Directive on patients' rights and cross border health care in Malta. Health Policy. 119, 10, 1285-1292. https://doi.org/10.1016/j.healthpol.2015.08.015
André den Exter (2017) The Right to Healthcare Under European Law. Diametros . 51: 173–195..doi: 10.13153/diam.51.2017.1037
Antonov, S.V. (2006) Civil liability for personal injury in the provision of paid medical services. (Thesis PhD). Institute of State and Law V. M. Koretsky, Kyiv, 206 p.
Arulkumaran S (2017) Health and Human Rights. Singapore Med J; 58(1): 4-13. doi: 10.11622/smedj.2017003
Bobrysheva, O. V. (2014) Efektyvnyi rozvytok ta funktsionuvannia rynku medychnykh posluh v umovakh hlobalizatsii ekonomiky ta intehratsiinykh protsesiv v okhoroni zdorovia // Visnyk Dnipropetrovskoho universytetu. Ser.: Ekonomika. T. 22, 8(2). 12-18. URL. http://nbuv.gov.ua/UJRN/vdumov_2014_22_8(2)__4 [In Ukrainian].
Castillo, С, Garrafa, V, Cunha, T, Hellmann F. (2017). El acceso a la salud como derecho humano en políticas internacionales: reflexiones críticas y desafíos contemporaneous. Ciência & Saúde Coletiva. 22 .7 .//doi.org/10.1590/1413-81232017227.04472017
Castleberry C. (2015) A human right to health: is there one and, if so, what does it mean. Intercultural Hum. Rts. L. Rev., 2015. 8/26/2015
Charter of social rights and guarantees of citizens of Independent States. Retrieved from: https://zakon.rada.gov.ua/laws/show/997_655
Civil Code of Ukraine: Law of Ukraine No. 435 -IV of 16 January, 2003. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https: //zakon.rada.gov.ua/laws/show/435-15
Constitution of Ukraine: Law of Ukraine No 254к/96 of 28 June, 1996. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https: https://zakon.rada.gov.ua/laws/show/254%D0%BA/96-%D0%B2%D1%80
Denisova, L. L., (2019) The annual report of the Ukrainian Parliament Commissioner for Human Rights on the state of observance and protection of human and civil rights and freedoms in Ukraine. Retrieved from: http://www.univ.kiev.ua/content/upload/2019/-697223196.pdf
Dixit, S. K., Sambasivan M. (2018) A review of the Australian healthcare system: A policy perspective. SAGE open medicine. 6: 12. doi: 10.1177/2050312118769211. [In England].
Dujardin B. (1994) Health and human rights: The challenge for developing countries. Social Science & Medicine. 39, 9, 1261-1274. https://doi.org/10.1016/0277-9536(94)90358-1
Fundamentals of Ukrainian legislation on health care: Law of Ukraine no. 2801-ХІІ of 19 November 1992. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/2801-12
Hagger L.E. (2004) The Human Rights Act 1998 and medical treatment: time for re-examination. Archives of disease in childhood, ;89:460–463. doi: 10.1136/adc.2003.037218
Health index. Ukraine, 2018. Retrieved from: ttp://health-index.com.ua/zvit_index_2018_ukr.pdf
Herbert E.G.M. Herman (1997) Patients' rights in the European Union: Cross-border care as an example of the right to health care, European Journal of Public Health. 7, 3, 11–17. https://doi.org/10.1093/eurpub/7.suppl_3.11
Herts, A. A. (2015) Medychna posluha yak obiekt pravovoho rehuliuvannia. Naukovyi visnyk mizhnarodnoho humanitarnoho universytetu. Ser.: Yurysprudentsiia. 15 (2). 11–13. [In Ukrainian].
Juškevičius, J, Balsienė J. (2010) Human rights in healthcare: some remarks on the limits of the right to healthcare. Jurisprudencija, 4(122), 95–110.
Kalashnikov, K. N., Kalachikova, O. N. (2014) Dostupnost i kachestvo mediczinskoj pomoshhi v kontekste modernizaczii zdravookhraneniya // Ekonomicheskie i soczialnye peremeny: fakty, tendenczii, prognoz. 2 (32). 130-142. DOI: 10.15838/esc/2014.2.32.10 [In Russia].
Kingston, L.N., Cohen, E.F. & Morley, C.P. (2010). Debate: Limitations on universality: the "right to health" and the necessity of legal nationality. BMC Int Health Hum Rights. 10, 11 https://doi.org/10.1186/1472-698X-10-11.
Lehan, V.N., Slabkii, G. O, Shevchenko M.V., (2009) Stratehiia rozvytku okhorony zdorovia: ukrainskyi vymir. Kyiv, Sfera [In Ukrainian].
Life expectancy. World Health Organization. 2015. Retrieved from: http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends/en/
Markina, A. M (2018) Administrative and legal regulation of the provision of medical services in Ukraine (Thesis PhD). Public law research institute. Kyiv, 219 p.
Marova, S. F., Vovk, S. M. (2017). Medychna posluha yak tovar medychnoho rynku. Derzhavne upravlinnya: udoskonalennya ta rozvytok. Retrieved from: http://www.dy.nayka.com.ua/?op=1&z=1056 [In Ukrainian].
Meižis, V. (2013). The Healthcare System in Lithuania. Information from the site healthmanagement. Retrieved from: https://healthmanagement.org/c/hospital/issuearticle/the-healthcare-system-in-lithuani. [In England].
Melnik, P.S. et.al. (2018). Shchorichna dopovid pro stan zdorovia naselennia, sanitarno-epidemichnu sytuatsiiu ta rezultaty diialnosti systemy okhorony zdorovia Ukrainy. Kyiv: Medinform, 458. [In Ukrainian].
Nissen, A. (2018) A Right to Access to Emergency Health Care: The European Court of Human Rights Pushes the Envelope. Medical Law Review, 26, 4, 693–702, https://doi.org/10.1093/medlaw/fwx059
On approval of the Licensing Conditions for conducting business activities in medical practice: Resolution of the CM of Ukraine No. 285 of 02 March, 2016. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/285-2016-%D0%BF
On approval of the list of paid services that are provided in state and communal healthcare institutions and higher medical schools: Resolution of the CM of Ukraine No. 1138 of 17 September 1996. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/1138-96-%D0%BF
On approval of the Methodology for calculating the cost of medical services: Resolution of the Cabinet of Ministers of Ukraine No. 1075 of 27 December, 2017. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/1075-2017-%D0%BF
On approval of the Regulation on the Ministry of Health of Ukraine: Resolution of the CM of Ukraine No. 267 of 25 March, 2015. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/267-2015-%D0%BF
On licensing types of economic activity: Law of Ukraine no. 222-VIII of 02 May 2015. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/222-19
On state financial guarantees of medical services to the population: Law of Ukraine No. 2168-VIII of 19 October, 2017. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/2168-19
On the creation and implementation of medical and technological documents for the standardization of medical care in the system of the Ministry of Health of Ukraine: Order of the Ministry of Health of Ukraine No. 751 of 28 September, 2012. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/z2001-12
On the formation of the National Health Service of Ukraine: Resolution of the CM of Ukraine No. 1101 of 27 December, 2017. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https: zakon.rada.gov.ua/laws/show/1101-2017-%D0%BF
Pesennikova E.V., Gridnev O.V., Kuchicz S.S. (2017) Mediczinskie uslugi ili mediczinskaya pomoshh – aktualnyj vopros dlya gosudarstvennykh uchrezhdenij zdravookhraneniya. Issledovaniya i praktika v mediczine. 4. 156 –164. [In Russia].
Polyanskaya E. V. (2010) Ponyatie «mediczinskaya usluga» i osnovnye podkhody k eyo klassifikaczii. Molodoj uchenyj.1-2. T. 1. 244. [In Russia].
Rahman, R.M. (2006) Human rights, health and the state in Bangladesh. BMC Int Health Hum Rights. 6,4 https://doi.org/10.1186/1472-698X-6-4
Rozhkova E.V. (2011) Mediczinskie uslugi: ponyatie i osobennosti. Sovremennye issledovaniya soczialnykh problem 3. 40-44. [In Russia].
Rusnak L. M. (2016) Administratyvno-pravove zabezpechennia prava na okhoronu zdorovia v Ukraini. (Thesis PhD). Kyiv, 207. [In Ukrainian].
Self-assessment by the population of the state of health and the level of accessibility of certain types of medical care: a statistical guide. Retrieved from: http://www.ukrstat.gov.ua/druk/publicat/Arhiv_u/17/Arch_snsz_zb.htm
Some issues of the Public Oversight Board at the National Health Service: Resolution of the CM of Ukraine No. 271 28 of March, 2018. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/271-2018-%D0%BF#n10
Some questions regarding public health treaties under the medical guarantees program: Resolution of the Cabinet of Ministers of Ukraine No. 410 of 04 April, 2018. Legislation of Ukraine. Verkhovna Rada of Ukraine. Retrieved from: https://zakon.rada.gov.ua/laws/show/410-2018-%D0%BF#n46
Strizrep, Т. (2017) Health Financing in selected European countries. Retrieved from: file:///C:/Users/1722/Downloads/TS.%20Health%20Financing%20Review%20(eng)_24.pdf [In England].
Venediktova, I. V. (2014). Pravova pryroda medychnykh posluh. Naukovi zapysky Instytutu zakonodavstva Verkhovnoi Rady Ukrainy. 5. 44 ‒ 48 [In Ukrainian].
Vitkova, V. S. (2017) Konstytutsiine pravo na medychnu dopomohu ta yoho yurydychne zabezpechennia v Ukraini. (Thesis PhD). Uzhgorod, 208. [In Ukrainian].
Yarosh N. P. (2012) Suchasnyi stan, problemy standartyzatsii medychnoi dopomohy ta shliakhy yikh vyrishennia v umovakh reformuvannia systemy okhorony zdorovia Ukrainy. Ukraina. Zdorovia natsii. 1. 95 – 100. [In Ukrainian].