The surgical department at the hospital in Domanivka may be left without funding

In the Domanivka community in the Mykolaiv region, discussions have taken place on how to save the surgical department of the local general hospital, which is at risk of losing funding from the National Health Service of Ukraine (NHSU) from 1 January 2027.

The issue was discussed during a meeting of the education committee of the Domanivka Settlement Council, according to NikVesti.

It was noted at the meeting that, due to uncertainty regarding staff contracts, employees had already been warned about possible changes to working conditions and redundancies.

«We have warned this team about possible changes to working conditions and potential redundancies, so that this does not come as a surprise to anyone and so as not to breach the law. But the crux of the matter is that the young staff decided to come and ask what to do next, because they will not be staying here,» said a representative of the Domanivka Hospital.

It was noted that the current local programme to support the continuous provision of specialised inpatient medical care remains in force until 31 December 2026. In December, the hospital plans to resubmit documents to the National Health Service of Ukraine (NHSU) to conclude contracts for medical packages. However, the results of the contracting process may not be known until January or even mid-February. Consequently, at the start of the year, the hospital may find itself without a signed contract and, therefore, without funding from the National Health Service of Ukraine (NHSU) for the surgical department’s operations.

One of the reasons for this problem is the National Health Service’s requirements regarding the number of operations performed. As explained during the meeting, according to the National Health Service’s response dated 28 May 2026, in order to conclude a contract for surgical care packages, the hospital had to have carried out at least 300 surgical operations between 1 January and 30 June 2025.

According to the electronic healthcare system, the Domanivka Multidisciplinary Hospital carried out 317 operations during this period. However, during its automated monitoring, the National Health Service excluded 42 cases, attributing this to the specific nature of the algorithms used. As a result, only 272 procedures were counted — fewer than the set threshold.

Furthermore, according to hospital representatives, between 1 July and 1 November 2026, the hospital received 107 warnings from the National Health Service of Ukraine.

The hospital notes that some of the operations actually carried out by medical staff are not counted towards the required target. At the same time, the hospital continues to enter information about them into the electronic system, even though these procedures are not reimbursed by the National Health Service.

During the discussion, the chairman of the village council, Viktor Vlasiuk, noted that they are not opposed to keeping the surgical department open, but cannot simply allocate funds from the local budget without proper legal justification.

«Who is against us having a surgical department? I’m all for it. Just provide the mechanism,» emphasised the community leader.

He explained that the local support programme had been designed to last for six months as a transitional period, whilst the hospital adapted to the new funding conditions. It is now necessary to determine the legal basis on which the community can support the department’s operations if the National Health Service does not enter into a contract with the hospital.

According to the community leader, maintaining the surgical department may require around 8 million hryvnias. This is a significant burden on the local budget, which has limited own revenue and is already funding a range of other social needs.

«Even if we cover the costs from 1 December through to January, that will amount to, roughly speaking, 500,000 hryvnias. This could constitute a misuse of the community’s funds. And if this extends into February, the figure will rise to 1.5 million hryvnias. A mechanism is needed,» he noted.

The hospital management has considered various options for retaining specialists, including the possibility of transferring surgeons and trauma specialists to work at the polyclinic, and anaesthetists to other posts. However, the hospital fears that such an option would not allow them to retain the team.

«They are young people; they won’t work in non-surgical roles. We could then lose even this surgeon or trauma specialist from the outpatient clinic, because they’ll move to the city. They need to perform operations; they need surgical practice,» explained representatives of the medical facility.

The hospital also considered the possibility of temporarily limiting its services to emergency surgical care only. However, medical staff pointed out that even in such a scenario, issues regarding patient admission, their subsequent care, dressings and payment for medical services would remain unresolved.

Following the discussion, the participants agreed to explore possible funding mechanisms for the surgical department. The hospital is to prepare its proposals and cost estimates, in particular regarding the cost of running the department, opportunities to raise funds from other local authorities, and the expansion of fee-based services.

There are also plans to draft a letter from the settlement council session to the National Health Service of Ukraine (NHSU) and other relevant authorities, requesting a review of the contracting situation and asking that the actual work carried out by the Domanivka Hospital be taken into account.

It should be noted that Mykolaiv City Hospital No. 4 has introduced new methods of surgical treatment for ear and sinus conditions. Thanks to modern endoscopic equipment, doctors can perform complex operations without external incisions and combine several procedures under a single anaesthetic.

It was also reported that a new magnetic resonance imaging (MRI) scanner has come into operation at Mykolaiv City Hospital №4. In the first two months, over 900 scans were carried out using the machine, including 69 for military personnel.