The Mykolaiv City Health Department explained the need to merge hospitals this year: To get more money from NHS

The need to reorganise and merge large hospitals in Mykolaiv this year is due to the requirements of the National Health Service of Ukraine to provide full funding for medical services. This was stated by Iryna Shamrai, head of the Mykolaiv Health Department, during a meeting of the City Council's Legislative Committee on 16 May, «NikVesti ».

As you know, the Mykolaiv Health Department came up with an initiative to reduce the number of hospitals in the city from six to three by merging them. In addition to merging hospitals, the reform will also include Maternity Hospital No. 3, which, unlike other maternity hospitals in the city that were merged with hospitals last year and became departments, remained an independent legal entity.

• The ambulance hospital and hospital No. 4 are to be merged with hospital No. 1;
• Maternity Hospital No. 3 and Children's Hospital No. 2 - to Hospital No. 3 (Dubky);
• Hospital No. 5 (Korabelnyi district) will not be affected by the reform.

The official noted that Mykolaiv region is currently one of five across Ukraine where the process of forming a capable network has not yet been completed. The other four are: Donetsk, Luhansk, Zaporizhzhia, and Kherson regions.

- Today, there is an urgent need to create a capable network of cluster hospitals in our region. Next year, funding from the National Health Service of Ukraine will be tied to the established network. The number of cluster hospitals, which is calculated in accordance with the Cabinet of Ministers' resolution, is calculated in cities of regional significance as follows: one cluster hospital per 150,000 people. A city can offer no more than three cluster hospitals. Today we have seven inpatient hospitals. In order to preserve each municipal healthcare facility and receive the coefficients that are already being received by those regions with a capable network, it is proposed to merge," said Iryna Shamrai.

According to her, such a decision will make it possible to have the largest list of departments, including in the existing branches, after the merger, which will correspond to the cluster hospital, where all the necessary requirements will be taken into account.

Thus, according to Iryna Shamrai, Mykolaiv will be able to offer three cluster hospitals as part of a capable network: No. 1, 3, 5, «, which, when concluding the package for 2026, will have a multiplier coefficient».

- There are still general hospitals within the capable network, but they will receive a reduction coefficient from the NHSU. For every million earned, the institution will actually receive UAH 600 thousand," said Iryna Shamrai.

According to her, the network of specialised care facilities consisting of three cluster hospitals should be included in the hospital district, which will be approved by the regional council by the end of 2025 after agreement with the Ministry of Health.

- If a capable network is not formed as an association, some of the institutions will remain general institutions, and, unfortunately, they will not receive the coefficients within the capable network," said Iryna Shamrai.

She said that the healthcare department, despite the fact that the decision has not yet been discussed by the city council, has already held meetings with the staff of the hospitals that are proposed to be merged.

- The meetings were held on behalf of the city authorities. "We do not have a single facility that can accommodate 850 beds and receive 1,500 visits per shift, because historically, the network has been established as it is. The proposed merger of inpatient facilities will allow us to receive the maximum amount of funds from the NHSU in 2026. Each institution will remain in the same place where it is located, each will continue to develop, and we have plans for each institution to increase patient engagement in their services," the official said.

In her turn, Olena Kiselyova, head of the parliamentary commission and a member of the European Solidarity «» , quoted the Cabinet of Ministers' resolution on the formation of a capable network of medical institutions, which states that Mykolaiv region, as one of the frontline regions, can submit proposals for reform to the Cabinet of Ministers within six months after the end of martial law.

- The legislator draws our attention to the fact that there may be some specifics of activity or other nuances that either make it impossible or simply not the best period to take any truly revolutionary actions during martial law. Perhaps we should have waited," said Kiseleva.

Optimisation of maternity hospitals in Mykolaiv

As you know, in May 2023, in Mykolaiv, the city authorities began to study the issue of mergingmaternity hospitals. The number of births in the city was declining. On 31 July 2023, the Mykolaiv City Council decided to reorganise maternity hospitals No. 1 and No. 2, merging them into City Hospital No. 1 and City Hospital No. 3, respectively. The head of the city health department, Iryna Shamrai, explaining the need to reorganise medical facilities, stated that over the past 7 years, the number of pregnant women in Mykolaiv had decreased by 5 times.

Due to the actual liquidation of Maternity Hospital No. 2 in Mykolaiv, 42 people were laid off . The staff of Maternity Hospital No. 2 called the decision of the city authorities to actually liquidate and retain only one specialised medical facility in the city a mistake.

Reduction of polyclinics in Mykolaiv

The idea to reduce primary healthcare centres became known in early June 2024. By order of the mayor, Oleksandr Senkevych, a working group was set up to audit their economic efficiency. The head of the city health department, Iryna Shamrai, told «NikVesti» that seven primary healthcare centres in Mykolaiv were to be reorganised on behalf of the National Health Service and the Ministry of Health. However, the NHSU «NikVesti» reported that they did not give recommendations on «optimisation of» polyclinics, and the Ministry of Health assured that this idea was a local initiative, not a recommendation. Later, the mayor of Mykolaiv explained in a video message to the citizens that the cuts would not affect doctors, but administrative staff would be laid off.

At the time, the city council members did not support this initiative, and later the Secretary of the Mykolaiv City Council, Dmytro Falko, said that the number of primary healthcare centres would be reduced in 2025.