Who Is Calling for the Resignation of Ukraine’s Acting Health Minister?

More than 100 people gathered in front of Kyiv’s District Administrative Court on February 11 to support Ukraine’s acting Health Minister Ulana Suprun after she was banned from performing her ministerial duties by the court earlier this month.

Acting Health Minister Ulana Suprun during a Cabinet of Ministers session in Kyiv, Ukraine on February 7, 2018. Photo credit: Vladislav Musiyenko / UNIAN

The court issued the ban after Radical Party MP Ihor Mosiychuk filed a lawsuit against her, claiming that Suprun lacks the competence to head the Ministry of Health. The deputy also claims that Suprun holds the position illegally, because an acting position can’t be held for more than a month, and that she is still a citizen of the United States, which also does not comply with Ukrainian legislation.

On February 11, the administrative court started considering a petition to lift the ban, which was filed by the Ministry of Justice. It will consider the lawsuit against Suprun on February 15.

Suprun has been the driving force behind the country's big-scale medical reform. Hromadske looked at who is calling for her resignation and why there is not enough support from MPs to appoint her a full-fledged minister.

At War With the Committee

Suprun’s largest opponents form the majority of the parliament’s healthcare committee, which is headed by Petro Poroshenko Bloc MP and presidential candidate Olha Bohomolets. Just this year, this committee expressed distrust in Suprun twice, but the matter was contained to political statements. Parliament cannot dismiss an acting minister, because it didn’t appoint her to the post. This was done by the government in July of 2016.

Committee members blamed Suprun for the high mortality rate of the population, the massive departure of doctors abroad, and the delay in the primary health care reforms.

But a resolution calling for the dismissal of Suprun and Deputy Health Minister Oleksandr Linchevskiy, which was backed by the parliament’s healthcare committee cites incorrect numbers. It states, that if in 2016, there were 175,000 more deaths than those births, then in 2017, that number increased to 198,000. However, the negative population growth in 2016 amounted to 186,000, and in 2017 to 210,000.

However, if you look only at the demographic registry, it turns out that the worst ministers were Raisa Bogatyrova (1999-2000) and Vitaliy Moskalenko (2000-2002), because at the turn of the 1990s and 2000s, the there were 400,000 more deaths than births.

But what also needs to be factored in is that Ukraine’s birth rate has decreased over the past four years, which can be tied to the country’s poor economic situation. And the authors of the ruling ignored the fact that the death rate has decreased. Under the former Minister of Health, Oleh Musiy, 465,882 people died in 2014 - 100,000 more than under Suprun (363,987 - 2017).

The ministry has also been accused of botching the vaccination program for the population.

Head of Verkhovna Rada’s healthcare committee Olha Bohomolets (C) and her deputy Oleh Musiy (L) during a parliament session on May 10, 2016 in Kyiv, Ukraine. Photo credit: Oleksandr Kosarev / UNIAN

The resolution, which called for Suprun’s dismissal, states the level of vaccination amid the population has fallen below what is was in the 1990s. According to the World Health Organization in 2016 Ukraine had one of the lowest levels of vaccination in the past decade. In 2017, the number of people covered by the vaccination program increased.

There are also allegations of underfunding vital treatment programs in Ukraine. Treatment of cancer and cardiovascular diseases, which together are responsible for 80 percent of all deaths in Ukraine, only received 27 percent and 30 percent of the funding, respectively, the resolution claimed.

But the Ministry of Health purchases medicine in accordance with the allocated budget, which is approved by the parliament. This year it is 5.9 billion hryvnias, or some $217 million - less than half of what is needed. Accordingly, the adult oncology program was financed by 30 percent.

Despite the fact that the state oncology program ended in 2016, the financing for treatment did not stop. In 2017, 809 million hryvnias ($29.8 million) was allocated for purchase of anti-cancer medicine for adults, which is twice as much as the previous year. For children, it was 558 million hryvnias ($20.5 million), 200 million hryvnias more than in 2016. The cost of medicine for cardiovascular diseases is reimbursed under the "Available Medication" program.

Accounting Chamber Audit

Another line of conflict stems from Ukraine’s Accounting Chamber audit. Six months ago, both members of the parliamentary committee and MPs from opposition factions demanded that Suprun and Linchevskiy resign. Their reasons were based on a report from the Accounting Chamber, which looked at how money was spent under the “Treatment Abroad” program as well as Linchevskiy’s speech at a closed meeting.

The main claim of the supervisory authority was that there was inefficient spending, because every fourth patient didn’t recover. In response to this, Linchevskiy stated: “It’s cancer. They will all die. They all die without options. And the effectiveness of this program is zero percent...those cancer patients who need bone marrow transplants, all end up dying. Sooner or later."

This resulted in disciplinary proceedings being instituted against him. Later, the Health Ministry stated that Linchevskiy was attempting to explain that in the case of cancer patients who are going abroad for treatment under the program, each case should be considered separately because these matters don’t have performance indicators. Someone will be able to extend their life by five years, while another’s body may not be able to cope and they will die earlier. So can you count the money paid for the treatment of such a patient as wasted?

The matter was settled by a disciplinary commission who asked government experts to analyze whether there were any violations in Linchevskiy’s actions. They concluded that there weren’t.

In the fall, the Ministry of Health has started examining the legality of the Accounting Chamber’s audit by planning its own appraisal on how well the Ministry of Health spent the state budget for 2017-2018.

Political Games

Suprun’s biggest critic is Radical Party leader Oleh Lyashko, who, paradoxically, voted for the basic reformist law on financial guarantees for the provision of medical services. The main wave of criticism came last June, when the scandal with Linchevskiy happened. The “radicals” even turned up to a government meeting demanding the resignation of the health ministry's leadership.

The health ministry explain such protest with the scandal that arose a couple of months prior when the National Anti-Corruption Bureau of Ukraine opened a case against Lyashko’s assistant advisor Oleksandr Bogachev, who according to an investigation tried to bribe Suprun. He appeared to offer Suprun an apartment in exchange for helping to purchase expensive medical equipment for a hospital in Vyshneve, a suburb of the capital.

It was Radical Party’s Mosiychuk who filed a lawsuit in Kyiv District Administrative Court, which resulted in the suspension of Suprun from her position as acting minister.

Presidential candidate and leader of the Batkivshchyna political party Yulia Tymoshenko has also been calling for Suprun’s resignation. In early June, she brought up the Linchevskiy scandal at the conciliation council of faction leaders, accused the Health Ministry of corrupt medicine purchases and of testing experimental drugs on Ukrainians.

Why is Suprun Still not a Minister?

Suprun became head of the Health Ministry on August 1, 2016, on the tenth day after her appointment as deputy minister. At the time, there was no minister as Alexander Kvitashvili had resigned. His duties were performed by his deputy Viktor Shafransky.

Although there is plenty of support for Suprun, including from President Petro Poroshenko and Prime Minister Volodymyr Groysman, none of them made any special efforts to submit her candidature and get the necessary votes so she can become the health minister.

Votes from Poroshenko Bloc and the People’s Front with the support of the Samopomich party and some deputies who aren’t aligned with a faction should be enough.

The leader of the Radical Party of Ukraine Oleh Lyashko (R) and a party member Ihor Mosiychuk (L) speak with their fellow partymen in Verkhovna Rada on November 22, 2018 in Kyiv, Ukraine. It was Mosiychuk who filed a lawsuit in Kyiv District Administrative Court, which resulted in the suspension of Suprun from her position as acting minister. Photo credit: Mykhailo Markiv / UNIAN

Anastasia Krasnosilska, an expert at the Anti-Corruption Action Center, explains why, despite the Suprun’s successes in reforming medicine, some deputies will never vote for her to be minister.

“Among the deputies there are enough lobbyists for pharmaceutical business or those who directly earned from corrupt purchases. And these deputies do not want to appoint Suprun minister,” she said.

“For example, before the start of international procurement in 2014, 95% of all money spent by the state on treating cancer patients was won by six companies, four of which orbit one person - Petro Bagriy, who is associated with deputy Oleh Musiy.”

Musiy himself denies communicating with representatives of the pharmaceutical business and says that he will not be voting for Suprun’s appointment as minister solely because he is an opposition deputy and does not vote on personnel issues on principle.

Citizenship Issue

Among Mosiychuk’s reasons for demanding Suprun’s removal from the ministry is her alleged dual citizenship. Poroshenko granted the U.S.-born doctor Ukrainian citizenship in July 2015. According to the Ukrainian law, after a new citizenship is acquired, the person needs to renounce their non-Ukrainian citizenship within two years. But this law has loopholes, which many people in Ukraine use to their advantage.

Suprun's press secretary Natalie Usatenko told Hromadske that Suprun had taken "all the necessary steps to revoke her U.S. citizenship." She further clarified that the acting Health Minister had written a declaration renouncing her U.S. citizenship.

According to the Ukrainian State Migration Service, the next step after writing such a declaration is to "return the passport to the corresponding foreign authority and to stop exercising the rights of a citizen of that country." However, Usatenko could not clarify whether Suprun has taken this step.