State regulation of treatment and health institutions

Modern society is increasingly concerned about strengthening and protecting its health. The high potential of people's physical and mental activity is an immediate prerequisite for a fulfilling life. Medical and health tourism allows to maintain good health in comfortable and relaxed conditions, so its development in recent years has been extremely dynamic both on the domestic and international tourist markets. Medical tourism has acquired a global scale. However, the situation changed dramatically at the end of 2019 - the beginning of2020, when the coronavirus pandemic brought significant changes to the usual conditions of social life, which “stopped” a significant number of industries. The service and tourism sectors were the most affected by the pandemic itself and measures aimed at curbing the spread of the COVID-19 virus. In this regard, the issue of ensuring the development of both the entire tourism industry and certain types of tourism in the modern conditions of quarantine restrictions and the uncertainty of their implementation period is gaining special relevance.

Keywords: state regulation, medical and recreational facilities, problems of medical and recreational facilities.

Анотація

Добрянська Наталя Анатоліївна, доктор економічних наук, професор, завідувач кафедри туристичного бізнесу та рекреації, Одеський національнии технологічний університет

Лебедева Віра Василівна, доктор економічних наук, професор, професор кафедри туристичного бізнесу і рекреації, Одеський національний технологічний університет

Крупіца Ірина Вікторівна, кандидат економічних наук, доцент, доцент кафедри туристичного бізнесу і рекреації, Одеський національний технологічний університет

Домбровська Вікторія Миколаївна, здобувач ступеня магістр ДержавниИ університет «Одеська політехніка»

ДЕРЖАВНЕ РЕГУЛЮВАННЯ ЛІКУВАЛЬНО-ОЗДОРОВЧИМИ ЗАКЛАДАМИ

Сучасне суспільство все більше піклується про зміцнення та охорону свого здоров'я. Високий потенціал фізичної та розумової діяльності людей є безпосередньою передумовою повноцінного життя. Лікувально-оздоровчий туризм дає змогу в комфортних і невимушених умовах підтримувати стан здоров'я у належному стані, тому його розвиток останніми роками є вкрай динамічним як на вітчизняному, так і на міжнародному туристичних ринках. Лікувальнооздоровчий туризм набув глобального масштабу. Проте, ситуація різко змінилася наприкінці 2019 - початку 2020 рр., коли суттєві зміни у звичніумови суспільного життя внесла пандемія коронавірусу, яка фактично «зупинила» значну кількість галузей. Найбільш постраждалими від самої пандемії та заходів, спрямованих на стримування поширення вірусу COVID-19, виявилися сфери сервісу та туризму. У зв'язку з цим особливої актуальності набувають питання забезпечення розвитку як всієї туристичної галузі, так і окремих видів туризму в сучасних умовах карантинних обмежень та невизначеності терміну їх запровадження. Лікувально-оздоровчий туризм в Україні є складовою частиною державної політики стосовно національної системи охорони здоров'я. Мета державної політики полягає в ефективному використанні курортного потенціалу країни для оздоровлення населення, збереження генофонду та у відтворенні трудових ресурсів. Складність ринковихумов функціонування санаторно-курортних закладів спонукає до визначення ролі держави в їхньому розвитку. Державна політика України у сфері лікувально-оздоровчого туризму визначається Верховною Радою України і будується на принципах: законодавчого визначення умов і порядку організації діяльності курортів та санаторіїв; забезпечення доступності санаторно-курортного лікування для всіх громадян; врахування попиту населення на конкретні види санаторно-курортних послуг при розробці та затвердженні загальнодержавних і місцевих програм розвитку курортів; економного та раціонального використання природних лікувальних ресурсів і забезпечення їх належної охорони; сприяння перетворенню санаторно-курортного комплексу України у високорентабельну та конкурентоспроможну галузь економіки.

Ключові слова: державне регулювання, лікувально-оздоровчі заклади, проблеми лікувально-оздоровчих закладів.

Actuality of theme

The market of medical and health services is one of the most stable types of tourism markets of Ukraine and priority directions, which is most in need of support and coordinated development. Sanatorium-resort treatment is medical assistance carried out with a preventive, curative or rehabilitative purpose with the use of natural healing factors in the conditions of a stay at a resort or health-recovery area and in sanatorium-resort facilities. The Ministry of Social Policy constantly monitors the provision of sanatorium-resort treatment services by health facilities that have been selected by privileged categories of citizens to receive such treatment, namely, participants in the antiterrorist operation, persons with disabilities, and citizens affected by the Chernobyl disaster.

The scientific works of many scientists, namely M.V. Sabat [1], Yu.M. Kozoriz [2], I.I. Samoilova [4], N.M. Vlashchenko [5], M.V. Tonkoshkur [5], V.Z. Kholyavka [6], H.S. Leshko [6], O.M. Mochulska [6], A.O. Kukhtiy [6] and others. The above-mentioned scientists thoroughly considered the concept of medical and health services, but at the present time, the definition of their place and role in the issue of the development of medical and health services requires attention.

The purpose of the article

The article identifies factors that exert a key influence on the tourism industry in Ukraine attention is paid to the importance of infrastructure development, the need to complete the medical reform, as the basis for the functioning of medical and health tourism. The need to introduce service management in each segment of the tourism industry is substantiated as the most important condition for increasing the competitiveness of the tourism industry of Ukraine and its individual subjects on the European and world markets and, as a result, the successful attraction of foreign tourists.

Presentation of the main research material

service management tourism market

The market of medical and health services is one of the most stable types of tourism markets of Ukraine and priority directions, which is most in need of support and coordinated development. By choosing medical tourism, the client (patient) will be able to rest, receive treatment and improve their appearance at the same time. Medical spa and wellness centers offer clients health and rejuvenation programs, fitness centers, swimming pools, comfortable accommodation and healthy food, a unique combination of herbal infusions, phytobaths, yoga and meditation, as well as excursions, entertainment, sports recreation, festivals, gastronomy and oenotherapy, thalassotherapy and medotherapy, and this is not yet a complete list of services for those who want to be a tourist using the services of "medical tourism".

It is worth noting that the popularity of European countries among tourists is not the same. Most tourist flows are directed primarily to Western European countries. The tourism industry has always been characterized by rather ambiguous characteristics and opportunities. Tourism as a multi-sectoral and multifunctional phenomenon is characterized by the highest degree of elasticity from natural (ecological), general economic, social, and political changes in any country - a potential destination. Classic tourism, especially in the direction of visits to foreign countries by Ukrainians, tends to develop, and such a specific direction as medical tourism is rather difficult to perceive both by our compatriots and by foreign citizens who visit Ukraine.

Medical and wellness methods are traditionally divided into the main ones: climate therapy (treatment with the help of a favorable climate); balneotherapy (with mineral waters); peloidotherapy (mud), and additional: thalassotherapy (sea water); aerotherapy (mountain air); speleotherapy (microclimate of caves); phytotherapy (phytobaths, microclimate of phytocenoses, i.e., a collection of a certain set of plants).

Medical tourism is one of the types of tourism, according to which there is no unity among scientists in determining type-specific characteristics and classification features. The terminological confusion is explained, firstly, by the peculiarity of the domestic sanatorium-resort system, which has been preserved in its main manifestations since the Soviet period, and secondly, by the lack of a unified understanding of tourist terminology in the field of medical and health services on a global scale. According to A.M. Vetitnev, "sanatorium-resort care is a complex of medical, diagnostic and preventive measures, which are performed by specially trained personnel, in specialized resort institutions, with the predominant use of natural healing factors, for a certain contingent of patients, within the framework of state social programs on a free or discounted basis. It is a part of medical care, and by analogy with it, it can be considered both in a broader sense (as the provision of assistance to the population) and in a narrow sense (as the treatment of a specific patient)." In other words, operating with the concept of "help" means the state's duty to the population to preserve their health.

As far as health tourism is concerned, there is also no consensus on the term itself (healing, health, sports, rehabilitation, recreation, etc.) and the meaning of this concept. The majority of specialists are inclined to the fact that medical and health tourism should be defined based on the selection of its main components - medical and rehabilitation, valeological (health), and recreational. The first two components are medical in nature, and the third is characterized by recreation and entertainment services. Trying to provide a definition of health tourism, it is first necessary to define more clearly the terminology accepted throughout the world.

The development of state regulation of tourism activities in Ukraine is characterized by a gradual weakening, with the simultaneous expansion of contractual regulation at the level of a specific business entity and consumer. Under such conditions, the mechanisms of competition, self-regulation, the relationship between demand and supply have a decisive influence. [3]

Considering that the main motive of tourism production is profit, public interests without adequate protection from the state are relegated to the background. As a result, in Ukraine, the desire to abandon comprehensive control by the state, as an attribute of the administrative-command system, calculation on the self-regulation of society, brought with it the denigration of the importance of public interests, and the hypertrophy of private interests.

In this regard, V. M. Pashkov notes that "hopes for spontaneous market self-regulation have led to a decline in social protection of the population, which is particularly dangerous in such a socially significant area as the protection of the human right to health. Annex A reflects the approaches of scientists regarding the influence of the state on the regulation of the sphere of economic activity.

Thus, the application of the regulatory influence of the state in various spheres of public life is a strict necessity to protect the rights of consumers. This statement is especially relevant in the field of health tourism, in which the formation of a tourist product involves the provision of health and medical services.

The specificity of medical and health tourism is that the activity of organizing and ensuring the creation of a tourist product (tour operator activity), as well as the activity of providing medical and health services (medical practice), belong to the types of economic activity that are subject to licensing. This is primarily due to the high level of potential risks in the implementation of these types of activities, which necessitates the need for state protection of the rights of consumers of these services.

The purpose of licensing and other types of state control is the need to provide state guarantees, both to protect the rights of consumers of medical and health tourism in general, and to protect the rights of individual patients to life, health, and compliance with international and regional (European) standards for the provision of medical services.

The consequences of state control on the part of the bodies that regulate the activities of medical and health tourism are the provision of a law enforcement or law enforcement function in the form of administrative coercion, by deprivation of the right to implement the specified type of activity, and prosecution. In this context, Yu. A. Tikhomirov notes that "coercion acts as an important element of public power."

The study of the Law of Ukraine "On Tourism" shows that, in fact, along with the main means of regulatory influence of the state, which are listed in Art. 12 of the Civil Code of Ukraine, it also establishes other means of state regulation. Note that the means of regulating activity in individual sectors of the economy and on the markets of individual goods and services are basically the same as the general means of regulating economic relations. In particular, Art. 5, 17 of the Law of Ukraine "On Tourism" indicate that tourist operators must obtain a license for tour operator activities in accordance with the established procedure.

In addition, Art. 6 of the Law of Ukraine "On Tourism" establishes that "the implementation of state policy in the field of tourism is carried out, among other things, by:

1. licensing in the field of tourism;

2. standardization of tourist services;

3. determination of qualification requirements for the positions of tourist support specialists;

4. establishing a system of statistical accounting and reporting in the field of tourism and the resort and recreation complex;

5. organization and implementation of state control over compliance with legislation in the field of tourism".

According to Clause 6 of Art. 15 of the Law of Ukraine "On Tourism", "in order to ensure the rights and legitimate interests of citizens who are consumers of tourist services, tour operators and tour agents are obliged to provide financial support for their civil liability (a guarantee from a bank or other insurance (medical and accident) is mandatory and is provided by the subjects of tourism activities on the basis of agreements with insurers." Article 19 prohibits the provision of accommodation services credit institution) to tourists." Article 16 of the Law of Ukraine "On Tourism" regulates that "tourists' without a certificate of establishment of the appropriate category.