"If you want me to deliver your baby, you have to pay $200." What to do if your doctor demands a bribe?

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Viktoriia Hubareva

The recurrent scandal broke out in the Mykolaiv region. This time, because of corruption in a maternity hospital. The Head of the NGO "Anti-Corruption Headquarters" Serhii Mytkalyk announced this in a post on Facebook:

"A local activist received a report of corruption and asked on social media if anyone else could confirm it. In response, 60 mothers who had faced a similar story wrote to him. The situation is complicated by the fact that some doctors say directly: 'If you pay, we'll discharge you,'" the post says.

It was a poll organized by local deputy Yevhen Notevskyi on Instagram. According to him, about 150 women told him they had to face corruption in the maternity hospital. According to the deputy himself, they all asked to publish their statements anonymously. However, to launch an investigation, it was necessary to draw up an official document, a statement of corruption:

"We barely managed to persuade 20 mothers to give a statement, and so that everything could be officially completed, and the guilty could be punished. I held a meeting with them, a closed meeting, and they shared their memories and recollections with me and then wrote statements," Yevhen Notevskyi recalls.

• "Piddubniak V. said: 'If you want me to deliver your baby, you have to pay $200′"
• "During my stay in the Pervomaisk maternity hospital of the Mykolaiv region, I came across corruption and a negligent, rude attitude towards the mother by the pediatrician Halyna Stanislavivna. This person didn't want to talk to the mother and was constantly being rude until the husband gave her money, 200 hryvnias. Then the attitude changed. Also, this person didn't want to discharge the child from the maternity hospital, the husband also paid money."
• "In a maternity hospital, a pediatrician doesn't discharge women until she's paid. The nurses told me: it's better to pay because she won't leave you alone."

This way, different women wrote about the same maternity hospital.

The same surnames were repeated in the statements: V. Piddubniak and H. Makovska, Hordiichuk. As Yevhen Notevskyi told us, Hordiichuk is a doctor, "a bribe-taker, and so is his sister. They're both doctors. She doesn't discharge moms, and he's an obstetrician-gynecologist and delivers babies for money. The head of this maternity hospital, Piddubniak, covers up their tracks. And this Piddubniak is the fellow sponsor of the chief doctor, who covers the entire gang up… Nepotism," he explains.

This problem isn't an exception, but a well-established scheme in maternity hospitals. The woman, who recently gave birth in the Kyiv maternity hospital №2, told Rubryka ​​that the delivery cost her a little more than 10 thousand hryvnias:

"You see, it's already accepted: it's easier to pay. We gave one and a half to two thousand to doctors, a little less to nurses and other medical staff. I also paid 2,000 hryvnias to the official charity account. It's not necessary, but they say you'll be treated better. I wanted to stay in a separate ward for one person. I was told that it costs 2 thousand hryvnias per day. But then they took only 2,000 hryvnias for three days of stay which I paid in cash, they didn't give me any documents," the young mother says.

She also added that the average check around Kyiv "for childbirth" is about a thousand dollars, and it happens in state hospitals!

Medical care during childbirth is a priority service, included in the program of medical guarantees. For each birth, health care facilities will receive UAH 8,136 from the National Health Insurance Fund.

The patient is free to choose a maternity hospital, regardless of the place of registration and actual residence. The hospital doesn't have the right to demand to pay any charitable contributions or medication packages. A young mother needs to take only private things for herself and the baby during the hospital stay.

Within the program of medical guarantees, these services are free:

• medical care during childbirth with the obstetric team (conducting uncomplicated physiological delivery, conducting complicated delivery, urgent or scheduled cesarean section);
• stay in a standard ward;
• anesthesia of surgical interventions at the direction of a doctor;
• monitoring the condition of the pregnant woman, parturient, and newborn (laboratory and instrumental examinations, consultations of doctors of other specialties if necessary);
• intensive care of the mother;
• stabilization of the newborn after childbirth and cardiopulmonary resuscitation (if necessary);
• metabolic screening in newborns;
• vaccination of the newborn according to the Calendar of preventive vaccinations.

Each of these services is paid for by the state at the expense of the National Health Insurance Fund, so the mother has the right to receive it in full. But there are also paid services provided in the hospital:

• more comfortable room
• improved nutrition
• additional services on request

So if you want to be in a more comfortable environment during childbirth, you'll have to pay for it, but the medical staff is obliged to provide you with a receipt and a check, and payment must be made through the cashier of the medical institution.

The patient's personal agreements with a particular doctor about childbirth are outside the program of medical guarantees and aren't provided in the "Medical care during childbirth" package. This is a personal decision of the patient.

Serhii Mytkalyk, the Head of the Anti-Corruption Headquarters, gave some advice on where to go and what to do if the maternity hospital demands finances:

The first piece of advice is to ask for a bill and a receipt to pay for these services when demands occur in the hospital because the receipt will contain information about what services you pay for. Most often, cash is demanded; most of this money doesn't reach the hospital. It's usually corruption.

"Indeed, although the Constitution guarantees free treatment in state and municipal institutions in Ukraine, there's still a list of services that are paid and set depending on the specifics of treatment. In fact, some services may require additional payment. But it needs to be done to the official account. Then we'll make the system as transparent as possible and minimize the risk of corruption," Serhii explains.

The second point is the doctor's refusal to discharge a patient until he/she is paid. Mytkalyk stresses that in this case, you need to refer to the existence of the doctor's protocol:

"It's a common practice to try to draw money out of parents so that they can get home faster. Don't agree to provide funds. The only legal reason to keep a mother with a newborn baby in the hospital is possible mother's or child's health problems. If their condition is normal, according to the protocol, there are no legal grounds to keep them. If the mother doesn't pay, sooner or later the doctors will conclude on the discharge. You may have to linger," he said.

The third piece of advice from the lawyer is that if you're asked for money, ask for a receipt and note that you'll give it to a lawyer so that he/she can check the legality of this payment. If a doctor or nurse cannot justify the demand to pay for the procedure, it's corruption. In this case, you need to:

• file with law enforcement agencies, call the police on 102, write a statement to the prosecutor's office or appeal to the deputy, which is also an effective mechanism in the fight against corruption.
• call the government hotline or the health department hotline at the hospital location.

"Usually, this complaint is properly processed and responded to," the lawyer says.

Concerning the alleged mandatory payment of charitable contributions, the head of the public organization emphasizes:

"Charitable contribution is one of the types of voluntary donation. If you want to pay, you pay. In Ukraine, it's common practice to negotiate with doctors in advance, for the doctors to demand additional funds, but, in fact, you can not do it if you don't have health problems. That is, when you call an ambulance, it brings you to the doctor on duty and no payments are made. If the doctor refuses to deliver the baby, it's Article 139 of the Criminal Code of Ukraine.

Mr. Mytkalyk also added that he hadn't heard of such cases when doctors refused to deliver a child, but if you find yourself in such a situation, you must call a police patrol.