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Health privatisation is wrecking Ukraine's ability to fight Covid-19

Morning Star editor Ben Chacko talks to Ukrainian Communist Party leader PETRO SYMONENKO about the destruction of the country’s healthcare system through ‘the guillotine of medical reform’ and what this means for the people amid the Covid-19 pandemic

UKRAINIAN doctors have slammed “war” conditions in its hospitals as they struggle to cope with the coronavirus outbreak.

Britain’s NHS is struggling due to years of cuts — resulting in chronic staffing shortages — and the impact of Andrew Lansley’s privatising 2012 Health and Social Care Act on healthcare supplies. But in Ukraine, crippling healthcare “reform” is taking place even as the pandemic rages.

The marketising reforms are resulting in mass hospital closures, as the government passes responsibility for paying utility bills to individual hospitals rather than covering them. 

The package — a shift towards a US-style insurance-based healthcare system — is the brainchild of US citizen Ulana Suprun, a healthcare entrepreneur of Ukrainian ethnicity shipped in after the Maidan coup of 2014 to take charge of the health ministry. 

Fascists and neonazis provided the “boots on the ground” for the coup, which has resulted in the reinvention of nazi war criminals such as Stepan Bandera as national heroes. But the United States and EU were primarily concerned with bringing Ukraine into their orbit and opening its sizeable markets to foreign exploitation. 

Suprun was not the only foreigner brought in to do the job: the former Georgian president Mikheil Saakashvili was installed as governor of Odessa and now heads a National Reform Council tasked by President Volodymyr Zelensky with “deregulation in the business environment” and “working with investment communities in many different countries.” 

But she is perhaps the most notorious in Ukraine, nicknamed “Dr Death” for the catastrophic impact of her privatisation drive. 

Suprun is no longer in post, and Zelensky has himself attacked her policies, saying they will result in the closure of over 300 hospitals and the loss of 50,000 healthcare workers’ jobs. But he doesn’t appear willing to change direction.

“The destruction of free medicine in Ukraine started with the destruction of Soviet power from 1991,” Ukrainian Communist Party leader Petro Symonenko tells me.

“But the main attack on the healthcare system occurred after the February armed coup in 2014 and the seizure of power by comprador oligarchs, nationalists and crime bosses under the direct patronage of the United States.

“Medical reform in the form in which it has been implemented grossly violates the constitution, which guarantees free medical care and prohibits reducing access to medical facilities. 

“And it has destroyed the time-tested healthcare and preventive medicine system developed and implemented by the outstanding Bolshevik doctor Nikolai Semashko” (who held the post of People’s Commissar for Public Health in the Soviet Union from 1918-30 and is widely credited with laying the foundations of its groundbreaking comprehensive free public healthcare system). 

“Public health has ceased to be a state issue and is turning into a business tool for medical oligarchs.

“The whole reform is in essence just a reduction in budget expenditure for healthcare, and consequently a massive closure of hospitals, clinics and other centres. More than 800 hospitals and about 100,000 hospital beds have been liquidated. 

“The salaries of doctors are humiliatingly low — not only in comparison with other countries but also compared to wages in Ukraine. That is why between 60-70,000 health workers have left Ukraine in search of livelihoods since the start of the reforms.”

As the Morning Star reported last month, an infectious disease specialist working in a hospital in Chernivtsi, western Ukraine, and treating Covid-19 patients called Olha Kobevko earned just £140 a month, approximately the Ukrainian minimum wage.

“Here’s a striking example of how the state evaluates the work of a doctor,” Symonenko says. 

“The average wage of a dishwasher in Ukraine is 40 hryvnia (£1.20) an hour, of a courier, 60 (£1.80). 

“At the same time if we divide the number of hours spent by a neonatologist in the resuscitation of newborns, it comes out at about 30 hryvnia an hour” (just 90p).

On April 1 the “second phase” of Suprun’s reforms kicked in, entailing “the closure of almost all tuberculosis and mental hospitals.

“This despite the fact that Ukraine has the highest incidence of socially dangerous diseases in Europe.

“The Covid-19 epidemic has forced adjustments. Two medical reforms have been slowed down — but not for long.”

President Zelensky’s public attacks on Suprun’s reforms — echoed by current Health Minister Maksym Stepanov — are dismissed by Symonenko as “verbiage.”

“In an epidemic they try to calm growing discontent among doctors and calm down the population,” he says.

“Medical spending, like spending on all social programmes, is being cut in favour of military spending and law enforcement.

“And under the guillotine of medical reform the elderly will be the first to fall. Three-quarters of healthcare spending goes on people aged 65 and over. And since the goal of medical reform is to reduce government spending, it, like pension reforms, will be continued to cut this category of the population.

“The reform will continue. Because the Zelensky regime is a continuation of the Poroshenko regime. And that brings us to your next question: whether the Zelensky government is different in character to the Poroshenko one when it comes to the drive to privatise public assets.

“Privatisation and the sale of national treasures to foreign corporations, financial and industrial groups will be carried out in ‘turbo mode.’ 

“We can see this by the way the On Land law and the so-called ‘anti-Kolomoisky law’ [a banking reform] are adopted. The first turns Ukraine into the patrimony of big landowners and opens the way to a practically uncontrolled disposal of land to foreign capital, which deprives the state of the ability to ensure food security. 

“The second puts the country’s banking system under the complete control of the IMF, and therefore the United States, and destroys Ukraine’s financial security.

“And Zelensky, like Poroshenko, is not going to end the civil war in the Donbass.

“Everything is being done to get out of the Minsk peace process. The fact that the United States is behind this is confirmed by the candidacy of the new US ambassador to Ukraine, a retired general who worked for many years in military intelligence concerning the USSR and was also a senior US adviser on Ukrainian defence issues” (Keith Dayton, whom Donald Trump nominated for the role on May Day).

“As with Poroshenko the fight against corruption is simply PR and a means to redistributing the proceeds of corruption from one business clan to another.

“The most corrupt official, Poroshenko himself, not only remains free but continues to receive dividends from corrupt schemes launched during his presidency.

“Therefore one can characterise the reforms of the Poroshenko and Zelensky regimes only as the surrender of state interests.”

It’s a grim outlook for Ukrainians with a global pandemic to contend with.

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