What is behind the hasty liquidation of MSEC and will the “fixers”, exorbitant bribes and disabled prosecutors fade into oblivion?
First - 6 million dollars in the bed of the head of the Khmelnitsky MSEC, then - a story with fake disabilities for prosecutors. The most daring corruption scandals around MSEC - medical and social expert commissions that assign disability - have reached their climax, writes hromadske. After this, a wave of searches and arrests of regional MSEC officials swept across the country.
Prices for fictitious disability certificates in schemes to evade mobilization, according to police, reached 10, or even 16 thousand dollars. Sometimes they also made money off veterans for “increasing” their disability group.
Finally, the president decided to show the public “hard and fast” solutions. After a public “debriefing” at a meeting of the National Security and Defense Council, the Prosecutor General paid with his position. And MSEC should eventually cease to exist altogether.
Why was the reform actually slowed down before this? What will happen now instead of the infamous organ? And most importantly, will this help eliminate corruption in an area where the sale of disability certificates is on stream?
This has already happened
The emotional reaction and fundamental decisions of the president at the National Security and Defense Council evoke a feeling of déjà vu. More than a year ago, the head of state initiated verification of all the findings of military medical commissions and MSEC against the backdrop of scandals and hundreds of searches. However, we have not yet seen either the results of these checks or systemic changes, in particular in the system of medical and social expert commissions.
“There were many meetings of the National Security and Defense Council with very bright formulations that did not end in anything. A year ago, at a meeting about corruption in the VLK, there were also a lot of cool, beautiful words - and zero results for the year. I just hope that this will be different,” says Vitaly Shabunin, head of the Anti-Corruption Center, in a comment to hromadske.
This time, Prosecutor General Kostin bore political responsibility and resigned. What cost him his position was a scandal with the same Khmelnytsky prosecutors, who, as it turned out, were all applying for disability at the Khmelnytsky MSEC and in return “did not notice” the corruption there. After this, the UCP promised to undertake checks of all prosecutors.
At the same time, the question of the responsibility of the Minister of Health remains open, because the reform of MSEC depends on the Ministry of Health.
The Ministry of Health announced a large-scale reform of MSEC more than a year and a half ago. At the same time, Minister Lyashko spoke about a “new model for confirming disability” starting in 2024, and from 2025, these commissions, according to him, could cease to exist.
The Ministry of Health began to quarrel only after a new public flogging. The minister admitted that “the results for him and society are insufficient,” announced a number of dismissals and even reported on three rounds of inspections in a year: they say that more than 90 thousand medical expert cases were reviewed and almost 19 thousand were processed in criminal proceedings.
Although, judging by the response to journalists’ requests, only 74 cases resulted in the cancellation of MSEC decisions.
A decision in the heat of the moment: is it possible to implement?
The latest decision of the National Security and Defense Council, which Vladimir Zelensky immediately put into effect by his decree, contains a dozen “hard and quick decisions” against corruption in MSEC. In particular:
- monitor the implementation of last year’s decision of the National Security and Defense Council on checking all decisions of the MSEC dated February 24, 2022;
- within a week, create working groups that will check the decisions of the MSEC to determine the disability of officials. 3 months in advance - report on the results of the inspection;
- within 2 weeks, prepare a plan for digitalization of all stages of MSEC;
- conduct an audit of the accrual of disability pension payments to civil servants within a week; develop a bill to revise the system of such charges;
- within a month, develop and submit for consideration to the Verkhovna Rada a bill that reforms the system of medical and social examination in Ukraine and provides for the liquidation of MSEC from December 31, 2024.
As in last year’s decision of the National Security Council, quite ambitious deadlines are specified here. Lawyer Vladimir Romanchuk doubts the quality of their implementation.
“Everything is going on specifically, in my opinion, from the moment that the Ministry of Health, together with the State Bureau of Investigation, the SBU, and the National Police must create joint groups within a week to check the motivation of MSEC decisions. Okay, what if they can’t implement it on time? There is no certainty who should answer for this. I hope that there are some postscripts, instructions and closed protocols to this decision of the National Security and Defense Council,” says Romanchuk.
“And regarding the audit of pension payments to government officials: check all government employees in Ukraine in a week? These are hundreds of thousands of people. To check the legality of the accrual, you need to find orders, acts on the accrual of specific amounts, and check the grounds. It's a lot of work. But here they say to do it in a week. I believe, of course, in the best, but I am preparing for the worst,” the lawyer continues.
It may not be so simple with proving the fictitiousness of disability certificates for prosecutors who were hunting for high pensions. According to the former chief military prosecutor and acting. Prosecutor General Viktor Chumak, it will be extremely difficult to prove fraud in this case.
“If a prosecutor has a disease diagnosed during MSEC, from which he can theoretically be cured, then in principle it is very difficult to prove that this is a fake, made intentionally,” Chumak said on Radio Liberty. “Unless one of the doctors or prosecutors will cooperate with the investigation, which I very much doubt.”
Liquidation of MSEC: what next?
In the near future, the Ministry of Health should develop a bill that, in particular, provides for the liquidation of medical and social expert commissions from December 31, 2024. The key to this story is the digitalization of processes, says Shabunin.
“The liquidation of MSEC itself does not eliminate the need for the state to determine disability. Especially during the war. Therefore, the key is not the elimination of MSEC, but the digitalization of processes. Because this is the only thing that can change this hell that exists specifically in this public service,” he believes.
According to Prime Minister Denis Shmygal, after the liquidation of MSEC, a “digital transparent European model” will be introduced in Ukraine. The Minister of Health was given until November 1 to submit all necessary bills for consideration by the Cabinet of Ministers.
Due to the fact that there were more questions than answers, the Minister of Health Lyashko himself subsequently went to a briefing - explaining the essence of the reform, why it was delayed and what will happen instead of MSEC.
“We are doing everything possible so that on January 1, 2025, MSEC as separate legal entities cease to exist. We transfer this function to cluster and supercluster hospitals. The Ministry of Health has identified these hospitals in each region, which ensure accessibility for the patient,” Lyashko convinces.
According to him, processes should be digitalized thanks to the Electronic Health System, to which all cluster and supra-cluster hospitals should be connected.
“This will allow us to clearly track the time, the identity of the doctor, the diagnosis he makes and on the basis of what research. We will clearly see the vertical, who, where and at what stages made mistakes. As the practice of digitalization of the VHC has shown, we can automatically track abnormal things or diagnoses associated with a hospital or with a specific doctor, and work proactively so that there are no potential corruption abuses.”
In addition, as Lyashko said, they plan to abandon not only the name, but also the very concept of “medical and social examination”. They want to replace it with “assessing a person’s functioning and identifying his needs.” The Ministry of Social Policy, the Ministry of Economy and the Ministry of Education should participate in such an assessment - offering, for their part, retraining, assistance with finding a job, and the like.
“At the final stage, this will make it possible to offer not additional payments, but compensators that can return a person to society and be socially and economically active. This is the essence of the reform from the medical side,” Lyashko said.
The minister admits that the launch of the reforms was delayed. However, he promises that in two months they will make up for everything. It turns out that a political decision was needed to speed things up.
“Political decisions have been made - I think we will succeed,” Lyashko added.
