Mykolaiv plans to merge 3 large hospitals into a single «megahospital»: Emergency hospital, No. 4 and No. 1

The Mykolaiv Health Department has come up with an initiative to reduce the number of hospitals in the city from six to three by merging them.

The relevant draft decision, which is being submitted to the deputies for consideration, is posted on the website of the Mykolaiv City Council, «NikVesti ».

In addition to the merger of hospitals, maternity hospital No. 3 will also be subject to the reform, which, unlike other city maternity hospitals that were merged with hospitals last year and became departments, remained an independent legal entity.

It is proposed to join City Hospital No. 1 (director Maria Gracheva, city council member from the party «Proposal») to the Emergency Medical Care Hospital(EMC) (director Oleksandr Demianov) and City Hospital No. 4 (director Larysa Dergunova).

Maternity hospital No. 3 (Dubky) (director Yuriy Dyachuk) is to be merged with maternity hospital No. 3 (director Oleh Ishchenko) in the Namyr neighbourhood and city children's hospital No. 2 (director Lyubov Savchuk).

Hospital No. 5 (director Olena Terentyeva) in the Korabelnyi district is not planned to be reformed.

The explanatory note to the draft decision states that its purpose is to «improve the provision of healthcare services to the residents of Mykolaiv and to form a capable network of healthcare facilities» in the city. The draft decision was developed by the municipal property department.

It is envisaged that the merged healthcare facilities will receive the status of separate structural units (branches) and retain the scope of healthcare services.

The same draft decision proposes that the deputies approve the charters of the updated municipal non-profit enterprises and approve the composition of the commissions for the reorganisation of hospitals that will lose the status of separate legal entities.

This issue was considered at a meeting of the Commission on Legality and Deputy Ethics held on Friday, 16 May. According to Iryna Shamrai, the head of the city's health department, the need for such a reform and merger of healthcare facilities is due to the need to form a network of cluster hospitals that will receive compensation for the services provided by the National Health Service of Ukraine «at an increased coefficient». If this does not happen, she said, city hospitals will receive only 60% of the state budget for medical services provided to the population starting in 2026.

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 Oblasts.

- 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 city 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.

Back in 2023, the city health department announced that three cluster multidisciplinary hospitals were to be established in Mykolaiv.

In addition to the second-line reform, Mykolaiv also returned to the idea of reducing the number of primary healthcare centres from seven to two by merging them.

Optimisation of maternity hospitals in Mykolaiv

As you know, in May 2023, the city authorities in Mykolaiv began to study the issue of merging maternity 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 preserve only one specialised medical facility in the city a mistake.

Reduction of staff in Mykolaiv polyclinics

The idea to downsize 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, only administrative staff.

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.