Current Issues of Improving the Legal Regulation of Medica l Practice, Medica l Activities and Medica l Self-Government in Ukraine

Abstract

Problem setting. The foundations of Ukrainian legislation on health care, adopted by the Verkhovna Rada of Ukraine on November 19, 1992, laid the foundations of the legal mechanism for the functioning of the national medical system. Currently, the medical system is going through a complex process of transformation, and this requires new legislative decisions on the issues of medical practice, medical activity, and medical self-governance. Тarget of the research is to analyze the current legislation regulating medical practice and medical activity in Ukraine and to develop proposals for solving its current problems. Analysis of recent researches and publications. Ukrainian scientists studied various issues of the functioning of the medical system of Ukraine. Among recent studies, the collective monograph “The Unified Medical Space of Ukraine: Legal Dimension” of 2022 should be singled out [22]. This work examines various issues of the functioning of the medical system of Ukraine after the beginning of its reform in 2017. However, the problems of legal regulation of medical practice, medical activity and medical self-governance are not considered in the monograph P. Mazur, M. M. Tyshchuk [6], S. Ternova [7] dealt with issues of medical self-governance, but they did not connect the success of its implementation in Ukraine with the liberalization of legal regulation of medical practice and the status of a doctor. Article’s main body. Medical care is an integral part of the concept of medical practice. When defining the concept of medical care, the legislator unites all persons who directly provide it into a general group of medical workers, without dividing into professional groups (doctor, nurse / medical brother, etc.). As a result, the subjectivity of these persons is nullified, their status is not defined. The current legislation does not contain the concepts of medical activity, activity of medical nurses/medical brothers. On the other hand, in connection with the active work on the preparation of national legislation on self-governance in the field of health care, the question of the need to separate subjects involved in the provision of medical care is acutely emerging. After all, world experience shows that states develop self-government in accordance with the professional division of medical workers medical, nursing, pharmaceutical. Real effective medical self-government in Ukraine is impossible without giving doctors more freedom for their own professional realization. In the entire democratic world, a doctor is a representative of a free profession, has various options for his own professional realization, determines his own workload and level of income, can carry out activities on the basis of a professional license without additional formalities and attachment to workplaces. On the other hand, in Ukraine, the majority of doctors are salaried employees with state-regulated workload and wages. The conclusion is substantiated that the medical community can be prepared for the introduction of medical selfgovernment only in case of simplification of state regulation of medical practice and provision of economic freedom to the doctor, i.e. the opportunity to work not only as an employee or self-employed person (as today), but also on the basis of civil law contract (subcontract) or as a self-employed person. The legal mechanism for licensing medical practice is not an effective tool for monitoring the quality of medical care and bringing to justice entities that violate the requirements established by the state. The conclusion is substantiated that replacing the licensing of medical practice with the declaration of its proceedings should become a general rule of regulation of medical practice. Conclusions and prospects for the development. The transition to the declaration of medical practice, the increase of legal opportunities for the professional implementation of doctors, the introduction of medical self-government and the individual certificate for the right to practice medicine will be a powerful impetus for the development of the domestic medical system in the direction of European standards of medical practice and medical activity.