The Medical and Social Expertise (MSEK) has been one of the most controversial structures in the Ukrainian healthcare system for decades. It performed an important function of determining disability and the degree of disability, but at the same time had significant shortcomings, including a high level of bureaucracy and corruption. On November 20, 2024, the Verkhovna Rada of Ukraine supported in the first reading Bill No. 12178, which provides for the complete elimination of the MSEK and its replacement with a new system for assessing a person’s daily functioning. What does this mean for citizens, and will the new system be able to meet expectations?

Why was the MSEK liquidated?
The MSEK has long become synonymous with opacity and corruption. Hundreds of thousands of people were forced to overcome complex bureaucratic obstacles every year to confirm their right to receive a disability group. Determining the degree of disability was often accompanied by numerous additional requirements, queues, and bribes.

Many patients said that without a “reward” it was impossible to obtain the desired disability group or avoid re-passing the commission. The corruption component became so systemic that it actually undermined trust in the results of the examination. Moreover, the lack of clear assessment criteria created conditions for the subjective interpretation of each case.

The elimination of the MSEK is not just an attempt to replace one structure with another, but a fundamental step towards creating a more modern, transparent and fair approach to assessing disability.

What will replace the MSEK?
The new system is based on assessing a person’s daily functioning. This approach is aimed at objectively determining the level of life limitations, taking into account physical, mental, sensory and intellectual impairments.

Key innovations include:

Assessment in hospitals. Instead of separate expert commissions, all procedures will be carried out in cluster and supracluster hospitals. This allows using existing resources of medical institutions, reducing administrative costs.
Electronic data system. All stages of the assessment will be recorded in the electronic health care system. This guarantees the transparency of the process and minimizes the impact of the human factor.
Expert teams. Decisions on establishing disability will be made by temporary expert groups formed automatically based on the specializations of doctors and rehabilitation specialists.
Possibility of representation. The patient will have the right to involve his representative - a military lawyer or doctor, which will significantly increase the level of protection of rights.
The procedure will include several stages: from the patient's referral by a doctor to establishing the results, forming a rehabilitation program and monitoring its effectiveness.

Advantages of the new system
The main advantage is transparency. The electronic system allows you to avoid manual intervention in the process, ensuring the objectivity of the decisions made. In addition, the decentralization of the assessment significantly simplifies access to the service, as patients will no longer need to contact separate commissions.

A significant improvement is the video and audio recording of all procedures, which provides additional guarantees of patient protection. Meeting records will be kept for 10 years, which allows them to be used as evidence in the event of an appeal.

Another important innovation is the ability to monitor the effectiveness of compensators and rehabilitation measures. This approach is aimed not only at fixing problems, but also at solving them.

Possible challenges
Despite the obvious advantages, the implementation of the new system has its risks. First of all, this is the technical readiness of hospitals. Not all healthcare institutions currently have the appropriate equipment or software to work with electronic data.

In addition, there is a risk that old corruption schemes may adapt to new conditions. For example, delaying the referral of a patient for assessment or inadequate qualifications of experts may become new problems.

Another challenge is staff training. Doctors and rehabilitation specialists must undergo training to meet the new standards. This requires time, finances and clear planning.

We believe that the new system has great prospects. Its successful implementation will minimize corruption and improve citizens' access to essential medical services. However, this process must be supported by a clear plan and effective implementation, because the lives and health of thousands of people are at stake.

The elimination of the MSEC is a step forward in reforming the Ukrainian healthcare system. The new system for assessing a person's life limitations is aimed at reducing corruption, increasing transparency, and creating a more effective mechanism for protecting patients' rights.

However, like any large-scale reform, this process requires careful planning, state support, and active control by society. This is the only way to ensure real improvement in the situation, rather than replacing one bureaucratic structure with another.