Municipal Health: 22% of Mykolaiv residents have not visited a family doctor in the last three years

There are currently 7 primary healthcare centres in Mykolaiv, archive photo by NikVesti

The Mykolaiv City Health Department has found that over the past three years, 22% of city residents have never visited their family doctor.

This was reported by the head of the city health department, Iryna Shamrai, during a meeting of the deputy commission on the law of the Mykolaiv City Council on 16 May, according to NikVesti.

The mayor's office found out that the National Health Service of Ukraine has reduced the packages under which seven Primary Healthcare Centres(PHCs) in Mykolaiv receive compensation from the state for their work since 2025. Thus, according to Iryna Shamrai's estimates, the primary healthcare centres will lose 17.2 million hryvnias because some patients who have signed declarations have not visited their family doctor for more than three years.

Advertising

«The NHSU did not pay at all for this number of patients, for which, compared to 2024, there are more patients declared for 2025, but who have not visited their family doctor in the last three years,» said Iryna Shamrai.

According to her, the worst situation is in Primary Healthcare Centre №4, where 37% of patients have not visited their family doctor for more than three years. In this regard, there is the largest amount of unpaid funds to the NHSU — 5 million 470 thousand hryvnias.

«The second place is taken by the 6th Centre: 31% of patients have not visited their family doctor for more than three years. In this regard, the amount of funds they have also significantly decreased compared to the previous year. In total, all institutions are minus 17 million 222 thousand hryvnias,» said Iryna Shamrai.

Nominally, the Mykolaiv primary healthcare centre has signed declarations with 336,223 patients, but the National Health Service has paid for 262,884 patients.

«This money is distributed to 263 GPs, paediatricians and therapists working in primary care. If we simply divide this, we will get 999 declarations per doctor on average. This is not taking into account the fact that the maintenance of an excessive number of administrative and economic staff of the centres leads to the fact that if the situation does not improve now, and it has not improved, because our institutions, compared to the first quarter of 2025, have again slipped by 4,330,000 hryvnais from the planned funds that the NHSU planned to pay to our centres,» said Iryna Shamrai.

Due to the difficult financial situation, some centres are already sending healthcare workers on unpaid leave (at their own expense). At the same time, Iryna Shamrai voiced the position of the city authorities: only administrative and economic staff can be sent on leave at their own expense, which today costs 24 million hryvnias a year for all primary healthcare centres, the official stressed.

«We see that some centres, in particular, 6 and 1, are already sending their employees — both doctors and nurses — on unpaid leave. We have met many times, and I have warned the managers that you cannot send either doctors or nurses on unpaid leave. Because this is the contingent that earns money today. The administrative and economic staff of the institution can go on leave, which costs 263 doctors 24 million a year,» said Iryna Shamrai.

Explaining the need to optimise the centres, Iryna Shamrai said that today «the maintenance of administrative and economic staff in the centres will lead to the fact that in November and December, with such payments, there will be no funds to pay salaries in the centres in full».

«For six months of this year, we have actually been on the verge of running out of money. I do not understand why the heads of our institutions have not done a proper job of verifying our patients. But the situation is what it is,» said Iryna Shamrai.

Earlier, it was reported that Mykolaiv decided to liquidate five primary healthcare centres by merging them with two other existing ones. The decision provides for the merger of five polyclinics with two others — №2 and №3. In particular, polyclinics №1 and №7 are to be merged with Centre №2, and polyclinics №4, №5, and №6 with Centre №3. It is noted that the network of outpatient clinics and the scope of medical services should be preserved.

The idea to reduce primary healthcare centres became known in early June 2024. By order of the mayor, Oleksandr Sienkevych, 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 reported NikVesti 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, 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.

Reorganisation of Mykolaiv hospitals

As you know, the Mykolaiv Healthcare Department has come 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 №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 №4 are to be merged with hospital №1;
• Maternity Hospital No. 3 and Children's Hospital №2 — to Hospital №3 (Dubky);
• Hospital №5 (Korabelnyi district) will not be affected by the reform.

During the commission meeting, Iryna Shamrai, Head of the Mykolaiv Health Department, explained that the need to reorganise and merge large hospitals in Mykolaiv this year was due to the requirements of the National Health Service of Ukraine to provide full funding for medical services provided.

Olena Kiseliova, head of the deputy commission on legality of the Mykolaiv City Council and a member of the European Solidarity party, expressed strong criticism of the plans to reorganise the city's medical network.

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 №1 and №2, merging them into City Hospital №1 and City Hospital №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 №2 in Mykolaiv, 42 people were laid off. The staff of Maternity Hospital №2 called the decision of the city authorities to actually liquidate and preserve only one specialised medical facility in the city a mistake.