Publication date: 09.05.2024
Halyna Tretiakova and Mariana Bezuhla note that today the MSEC as a link in the rehabilitation route is unnecessary and does not lead to the achievement of rehabilitation goals.
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It is proposed to exclude the obligation of a person to undergo a medical examination at the MSEC and to provide for the right of a person to determine the form of his or her participation in the MSEC meeting - in person or online.
The MSEC will enter into the electronic healthcare system (EHS) information about adults who have undergone a medical and social examination, namely: information from the examination report and mi-nutes of the commission meeting, the commission's decision, and an individual rehabilitation program.
MPs have prepared the relevant point changes to the disability determination procedure and the digitalization of the MSEC process.
For example, the Verkhovna Rada recently registered draft law 11225 on amendments to certain laws of Ukraine to improve the procedures for conducting medical and social expertise (MSEC). The project was initiated by Galyna Tretyakova, Mariana Bezuhla and others.
The draft law addresses certain procedures for undergoing medical and social examination, in particular, it is proposed to exclude the obligation of a person to undergo a medical examination at the MSEC and to provide for the right of a person to determine the form of his or her participation in the MSEC meeting (in person or online).
The proposed amendments, according to the authors, will "unlock" the possibilities of digitalizing the patient's route (both civilian and military), relieve the financial, time and physical burden on patients who have to spend health, money and time on the road (to get to the place of the MSEC meeting and return home or to the place of deployment of the military unit), waiting in lines.
The amendments to the Law "On Rehabilitation of Persons with Disabilities in Ukraine" also require the MSEC to interact with the interdisciplinary rehabilitation team (IRT), make timely decisions on confirming a permanent disability and establishing the status of "person with a disability" or "child with a disability"; enter information about adults who have undergone a medical and social examination into the centralized disability data bank (CDB) and the electronic healthcare system (EHS).
After the law is adopted, the Cabinet of Ministers' regulations, orders of the Ministry of Health and the Ministry of Defense should be amended to ensure the implementation of the mechanism:
- not the person, but the person's documents are sent to the MSEC for medical and social examination;
- access of MSEC doctors of the "family doctor" level to the EHS;
- interaction of doctors of healthcare institutions, MDRC, VLC, and MSEC through the patient's electronic medical record.
"The implementation of the changes proposed by the draft law is consistent with the measures taken by the government to simplify access of civilian and military patients to all components of the rehabilitation system (electronic queues for the HCPC, submission of documents for disability through Diia, etc. - the authors note.
According to the MPs, with the adoption of the Law "On Rehabilitation in the Healthcare Sector" No. 1053-IX of December 3, 2020, "the problem of the parallel existence of two rehabilitation systems - the "out-dated" MSEC system (unproven, based on a medical approach, disability group and the provision of sanatorium and resort treatment), and rehabilitation in the healthcare sector (proved, based on a modern, holistic approach) - has become more acute."
"Today, the MSEC as a link in the rehabilitation route is redundant and does not lead to the achievement of the rehabilitation goals - restoration of health to the highest possible level. It is an outdated, corrupt and bureaucratic system that combines excessive powers, which puts the patient in a vulnerable position and undermines trust in the healthcare system. Thus, the MSEC combines both medical and social functions (determining the need for social services). Both civilian and military patients emphasize the problems in the work of the MSEC," the initiators of the bill point out.
Referring to the opinion of human rights organizations, MPs point out that the MSEC is inappropriate, in fact, patients are not examined during the MSEC meeting due to lack of time and specialists of the relevant specialization; the MSEC should not examine patients, since according to the Law "On Reha-bilitation of Persons with Disabilities in Ukraine", this is the responsibility of the interdisciplinary rehabilitation team (IDT); documents prepared by a doctor (health care facility) and the MDRC are sufficient to establish a disability group (even in the absence of the MDRC, the MSEC doctors still cannot provide a proper assessment of the state of loss of functionality); undergoing the MSEC is a traumatic practice for patients.
In addition, according to them, the activities of the MSEC have widespread corruption factors, including the lack of electronic document flow and transparency of the MSEC's work; the lack of clear deadlines (beginning and end of the deadline) for decision-making in the legislation; the lack of clear criteria or nosologies in the legislation that determine the period for establishing disability; the absence of unified requirements for the execution and justification of MSEC decisions, which makes it difficult to appeal them.
"The so-called 'big reform' of the rehabilitation system is being delayed.
Therefore, there is an urgent need for point changes in the procedure for conducting medical and social expertise to improve the procedures for establishing the degree of permanent disability, disability group, and implementing a compensation strategy based on an individual rehabilitation plan for civilian and military patients," the initiators of the bill believe.
Thus, we can see that the amendments to the current law were adopted taking into account the changes in the requirements of the time and the imposed martial law in Ukraine, as well as the fact that a legal analysis of the situation, analysis of documents and a legal opinion were conducted,written consultation .
