Internally Displaced Persons and People with Illnesses Cannot Be Deprived of Declarations

At the same time, this is not about new regulations but about a mechanism that has existed in Ukrainian legislation for several years. Under what conditions a doctor can initiate the termination of a declaration, how this procedure takes place, and what it means for patients will be discussed further in the article.

In which cases can a doctor initiate the termination of a declaration

According to the explanation by the Ministry of Health, a primary care doctor has the right to apply for the termination of a declaration only in two cases. The first is if the patient systematically does not follow medical prescriptions or the doctor's recommendations. The second is if the patient systematically violates the internal rules of the healthcare facility.

At the same time, the legislation establishes an important restriction: the declaration cannot be terminated if this may pose a threat to the life or health of the patient or the safety of others. Thus, this is not about the doctor's right to refuse any patient at their own discretion, but about exceptional cases when normal interaction between the parties becomes practically impossible.

How the procedure takes place

A doctor cannot independently terminate a declaration. First, they must submit a written application to the head of the medical institution indicating the reasons for such a decision. After that, the head of the institution verifies the circumstances provided and assesses whether there are grounds for terminating the declaration. Only after making the appropriate decision is the information transmitted to the National Health Service of Ukraine.

The declaration ceases to be valid 10 calendar days after the NHSU receives the notification from the medical institution. In addition, within three working days after the termination of the declaration, the healthcare facility is obliged to inform the patient via the contacts provided during the signing of the declaration.

When a doctor does not have the right to refuse a patient

The Ministry of Health emphasizes separately: there are circumstances that cannot be grounds for refusal to conclude or renew a declaration. In particular, a doctor does not have the right to refuse due to: the person's place of residence or registration; status as an internally displaced person; age or gender of the patient; social or financial status; presence of certain diseases; lack of a passport if another identity document is available.

The only legal reason to refuse signing a new declaration is exceeding the recommended number of patients a doctor can serve.

Fact check: have new rules appeared

After the Ministry of Health's explanation was published, messages began circulating on social networks that doctors allegedly received new powers to terminate declarations with patients. However, an analysis of current legislation shows that this is not true. The doctor's right to initiate the termination of a declaration is provided by the Procedure for Choosing a Doctor Providing Primary Medical Care, approved by the Order of the Ministry of Health of Ukraine dated March 19, 2018, No. 503 since the introduction of medical reform. Thus, the Ministry of Health has not introduced any new grounds for terminating declarations.

In fact, the ministry only reminded citizens and medical workers about the existing procedure.

What changes for patients

In reality, nothing fundamentally new is happening for most Ukrainians. The Ministry of Health has not introduced new grounds for terminating declarations but only reminded about a mechanism that has existed for several years. As before, a patient can change their family doctor, therapist, or pediatrician at any time without explaining reasons. For this, it is enough to sign a new declaration with another doctor—the previous one will be terminated automatically.

The right of a doctor to initiate termination of a declaration in exceptional cases remains unchanged. However, they cannot do this unilaterally. Previously, many patients believed that a doctor could simply "refuse" a person at their own will, but in reality, the procedure involves several stages of verification and approval.

The obligation of the medical institution to inform the patient about the termination of the declaration also remains unchanged. Moreover, termination does not occur instantly—there is a legally established period between the decision and the actual termination of the declaration.

It is also important that, as before, a doctor does not have the right to refuse a person due to place of registration, status as an internally displaced person, age, gender, social status, or presence of certain diseases. Thus, no new restrictions have appeared for internally displaced persons, pensioners, or other categories of patients.

The main conclusion for citizens is that the right to primary medical care remains even if the declaration is terminated. If cooperation with one doctor ends, the patient can choose another specialist and sign a new declaration. Therefore, this is not about depriving a person of access to medical services but about regulating relations between a specific doctor and patient in cases where further interaction becomes impossible.

Note that recently, choosing a new doctor can be done through the Patient's Cabinet.

What questions may arise in practice

Despite the existence of the legislative mechanism, certain questions remain open. In particular, normative acts do not contain a clear list of actions that would be considered "systematic non-compliance with medical recommendations." This means that each specific situation will be assessed individually by the head of the medical institution. Similarly, controversial situations may arise in practice regarding whether there are sufficient grounds for terminating the declaration. That is why the final decision is not left solely to the doctor but involves additional control by the institution's management and the NHSU.

Lawyers note that if a patient disagrees with such actions, they can file a complaint with the head of the medical institution, the NHSU, or defend their rights in court if they consider the decision unjustified.

Thus, the Ministry of Health's explanation does not change the rules of the game for patients and does not grant doctors new powers. The mechanism for terminating a declaration at the doctor's initiative existed before but is applied only in exceptional cases and goes through several stages of verification. For most Ukrainians, this means only one thing: the right to freely choose a doctor remains unchanged, and access to primary medical care cannot be restricted due to place of residence, displaced status, or other social circumstances.

At the same time, the story with the Ministry of Health's explanation reminds us that the declaration between a doctor and a patient is not only a guarantee of receiving medical services but also a mutual responsibility of the parties. The patient has the right to quality medical care, and the doctor—to respect for their professional activity and adherence to established rules. It is precisely the balance of these rights and obligations that forms the basis of the mechanism actively discussed in society today.

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