Voshko I. Formation and implementation of state policy in the field of health care in Ukraine

The dissertation is devoted to the scientific and theoretical substantiation of the formation and implementation of the state policy in the field of health care of Ukraine and to the definition of the directions of improvement of the state management of the development of its principles. The dissertation considers the relevance of the state health policy in Ukraine, which is one of the most important ways to ensure the proper preservation, functioning and development of society; current area of research in the field of knowledge «Public Administration». According to experts of the Ukrainian medical community, the main problems of medical reform in Ukraine are: the obsolescence of the current state policy and the lack of a new state policy in this area. The results of the expert survey show that the reform is constrained by the lack of: a new state policy (99.9% of respondents) and a strategic vision of the new health care system in Ukraine (92.6%). The state policy as a subject and object of public administration is studied. It was found that political activity providespolicy management mechanism in the country (industries, including health). This mechanism combines non-state and state mechanisms. The latter mechanism is regulated by regulations. However, the foundations of medical legislation also defined the sectoral mechanism by which the formation state policy is referred to the competence of the Verkhovna Rada of Ukraine. The analysis of scientific and expert-analytical works revealed a number of problems of medical reform in Ukraine. The expert survey identified five most important issues. The first of them is the current obsolescencestate health policy; inconsistency with the modern methodology of its development and implementation. These problems caused all the other problems. Foreign experience shows that in the world medical reforms are due to increased financial costs for the health care system; the need to strengthen its ability to improve public health. These problems have been addressed during the reforms through the introduction of a number of mechanisms. The implementation of reforms had difficulties and unexpected consequences. Under the influence of external innovations and values, economic and political factors, such as management system; political status of the Ministry of Health. The content of health reform strategies was different due to significant differences: national, economic and historical; state system, groups of influence. The main factors for the success of reforms are the availability of Strategies, strategic directions, priorities and plans. Their formation took a long time. The pace of implementation of reforms was determined by: the presence of political will and quality of governance, the choice of the type of structure of the governance system and the «window of opportunity»; information infrastructure, professional competence of reformers