Despite the fact that for 2021 the budget request of the Ministry of Health was 10,6 billion USD, only 4,4 billion USD was allocated to finance medicine. Healthcare Minister Maksym Stepanov directly states that doctors could massively rush abroad, where they would earn tens of times more. According to him, doctors should not expect an increase in salaries in Ukraine.
According to the minister, since the beginning of the pandemic, about 34,000 doctors who were registered in the health care system have already quit. These are only approximate prices: in reality, the figure could be much higher.
Why healthcare workers are leaving Ukraine?
Urologist Dmytro Veryha was one of the first to undergo the procedure of confirming his specialization in a simplified procedure and now works at one of the Polish clinics. The physician has ten years of work experience, has performed many operations, he worked in both state and private Ukrainian clinics. However, he had to move to Poland back in March 2020. The main reason was the salary.
According to Dmytro, a novice doctor in Poland receives about 5,000-7,000 zlotys (1,400-1900 USD). However, this is far from all income, because every shift, night shifts, extra-hour work are paid additionally. In addition, the medical salary gradually increases over time.
"Polish system implies that if you, for example, have been working there for six months, then you already receive a few zlotys more. The specialists who have been working there for some time have salaries of 3,500 USD. It depends on qualifications and experience," Veryha shared.
According to Vasyl Voskoboynyk, the head of the All-Ukrainian Association of Companies for International Employment in Ukraine, most doctors receive about 110 -200 USD per month.
"The money received by the head of the department in the capital's hospital will not be much more than that of a cashier in a supermarket. Moreover, doctors need to study for 6-8 years to get a profession," Voskoboynyk said.
The chairman of the Free Trade Union of Medical Workers of Ukraine, Oleh Panasenko, emphasizes: the dismissal of doctors stimulates medical reform, in connection with which the state completely shifted responsibility for healthcare to the local authorities.
"The new government generally agreed to transfer responsibility to these local councils for wages. How can they pay these payments? In Kyiv mental hospitals, doctors were sitting without a salary for three months because of this," says Panasenko.
On average, Ukrainian doctors in Poland receive 1600-1700 euros, as the First Visa company assures. The salary depends on the region, the hospital in which the doctor works, and his qualifications. Optimus Work notes about the same salary, 1100-2200 euros per month. Moreover, the representatives of the Polish company say that foreign doctors will be employed on the same financial conditions as the citizens of the country.
However, not only the salary makes people leave their homes forever. Another reason given by Ukrainian doctors is their attitude towards them and their interest in the personal development of the employee.
Dmytro Veryha said that Polish clinics are trying to constantly stimulate physicians in material terms, provide opportunities for training and development. After confirming the diploma, the doctor was provided with a new two-room apartment, fully equipped for the family, and the hospital provided everything necessary for work. In addition, the rights of a doctor abroad are fully protected by trade unions and the laws of the host country.
"They immediately treated me accordingly, provided with everything necessary. They understand that if a specialist invests money, teaches, attracts, helps with a salary, then he will be satisfied to work, earn decent money," the doctor said.
Vitaliy Havryliuk, a Ukrainian who specializes in gynecology but is currently undergoing diploma nostrification in Poland, agrees that respect for doctors is at a much lower level in Ukraine. In addition, corruption schemes affect career development.
There are no official statistics that would track the number of doctors who went to work in other countries. However, companies for the employment of Ukrainian citizens abroad report that by the end of the year the number of doctors wishing to work in Poland, the Czech Republic, and Slovakia has grown rapidly.
In particular, Ruslana Brovchuk, the director of Persha Viza, told 112ua.tv that in December the number of requests for work from doctors reached a hundred a day. The Polish company Optimus Work, which is engaged in the employment of foreigners, assured that as of January, several hundred doctors, mainly from Belarus and Ukraine, are already at the stage of filling out the documents. Among them are experienced doctors, academic teachers, and medical university researchers.
Future of Ukrainian doctors and patients
The conditions in which Ukrainian doctors are forced to work are well understood in Poland. The country has previously suffered from a shortage of doctors, but the situation with Covid-19 only exacerbated the problem. In this regard, the Polish authorities began to actively invite specialists from Ukraine and Belarus, where salaries, and the standard of living in general, are much lower.
In order not to leave hundreds of Poles without medical care, at the end of 2020, the country's President Andrzej Duda signed a law that accelerates the employment process for foreigners. Now our doctors should not wait for years for a work permit, but just confirm their specialization according to a simplified procedure. To do this, you must have three years of experience in the specialty for the last five years, documents to stay in the country, and also know Polish. In Poland, 1,500-2,000 doctors and 2,000-3,000 medical workers from Ukraine and Belarus are expected to come.
This simplification against the backdrop of high salaries, social security, comfortable living conditions, and ample opportunities for development could lead to an even greater increase in migration from our doctors in the future.
But it is more difficult for people after 40 to take such a step, because, over time, circumstances appear that keep doctors stay in Ukraine. Olena, a cardiologist from Khmelnytsky, admits that she is not ready to leave her home yet, because her children, old parents, and permanent patients remain here.
Although migration is not a way out, and a number of specialists, one way or another, would remain in the country, Ukrainians would face a sharp deterioration in the quality of services provided. To survive, doctors would increasingly have to work part-time and earn extra money in private clinics. And this cannot but affect the level of medical care in state clinics.
Stay or go away?
Vasyl Voskoboynyk is convinced that if the state healthcare policy is not changed, the situation may become critical. He emphasizes: changes in medicine take decades, therefore, after a long period of degradation, nothing can be changed without an effective development strategy for the industry.
The Federation of Free Medical Trade Unions assured that, first of all, it is necessary to change the financing system itself.
The last bill with relevant proposals was registered on May 12, 2020, No. 3464 "On State Social Insurance Medicine." It states that industries such as pediatrics, emergency medical, emergency medical care, psychiatry, tuberculosis should be financed by a separate line of their state budget. And planned pathology at the hospital level – at the expense of insurance companies.
In addition, there should be uniform unified protocols according to which certain diseases are treated. At the same time, it is important to understand that not only high salaries and equipped hospitals make our doctors move to live in another country. Social protection, higher pensions, stability, and confidence in the future make Poland even more attractive to Ukrainians.
And until the standard of living in Ukraine comprehensively improves, it will be impossible to talk about the termination of the trend of labor migration of doctors.