Ukraine’s healthcare system is entering a new phase of governance transformation. The introduction of supervisory boards in hospitals is seen as one of the key tools for increasing transparency, strengthening strategic management, and ensuring accountability of medical institutions. In European countries, this model is not new. Supervisory or governing boards have long been a standard element of hospital governance, both in public and private sectors. Their main role is to separate strategic oversight from day-to-day operational management. This principle—dividing management and control functions—lies at the core of modern healthcare management systems.
In most European countries, hospitals operate under a model of so-called corporate governance in the public sector. This means that the director or hospital management is responsible for operational management, while the supervisory or governing board is responsible for strategic oversight. Typically, such boards perform several key functions:
It is important that the supervisory board does not interfere in the hospital’s daily medical or administrative activities. Its role is strategic oversight.
The composition of supervisory boards in European hospitals is usually multidisciplinary. They may include representatives of public authorities or the hospital owner, financial and management experts, healthcare professionals, representatives of the public or patient organizations, and sometimes academic experts. In many countries, there are clear requirements regarding the competencies of board members. For example, some members must have experience in financial management, corporate governance, health policy, or healthcare systems. This ensures professionalism in strategic decision-making.
In Western European countries, supervisory boards have long been integrated into hospital governance systems. For example, in Germany, public hospitals operate under a two-tier governance system: the management board is responsible for operations, while the supervisory board oversees strategic decisions and finances. In the Netherlands, supervisory boards have particularly strong powers: they appoint and evaluate the hospital’s chief executive and approve the budget and development strategy. In hospitals within the United Kingdom’s National Health Service (NHS), boards of governors or trust boards include representatives of the community, patients, and professional experts. Across all these models, the key principle is balancing professional management with public oversight.
The introduction of supervisory boards in Ukraine could become an important step toward modernizing hospital governance. However, European experience shows that the effectiveness of this model depends not so much on the mere establishment of a supervisory board as on how it operates. Several principles are particularly important:
Is the Ukrainian system ready for this?
The introduction of supervisory boards is an important step toward transitioning from an administrative model of healthcare management to a more modern system of corporate governance. However, this process will take time. It involves not only creating new governance bodies but also shaping a new management culture—one based on transparency, accountability, and strategic thinking. European experience shows that supervisory boards can become an effective tool for hospital development, but only if they are formed and operate on a professional basis. This will be the key challenge for Ukraine’s healthcare system in the coming years.
In most European countries, hospitals operate under a model of so-called corporate governance in the public sector. This means that the director or hospital management is responsible for operational management, while the supervisory or governing board is responsible for strategic oversight. Typically, such boards perform several key functions:
- approve the hospital’s strategic development plan;
- oversee financial performance;
- evaluate the performance of the hospital’s chief executive;
- ensure transparency in governance;
- supervise internal audit systems;
- ensure compliance with ethics and integrity standards.
It is important that the supervisory board does not interfere in the hospital’s daily medical or administrative activities. Its role is strategic oversight.
The composition of supervisory boards in European hospitals is usually multidisciplinary. They may include representatives of public authorities or the hospital owner, financial and management experts, healthcare professionals, representatives of the public or patient organizations, and sometimes academic experts. In many countries, there are clear requirements regarding the competencies of board members. For example, some members must have experience in financial management, corporate governance, health policy, or healthcare systems. This ensures professionalism in strategic decision-making.
In Western European countries, supervisory boards have long been integrated into hospital governance systems. For example, in Germany, public hospitals operate under a two-tier governance system: the management board is responsible for operations, while the supervisory board oversees strategic decisions and finances. In the Netherlands, supervisory boards have particularly strong powers: they appoint and evaluate the hospital’s chief executive and approve the budget and development strategy. In hospitals within the United Kingdom’s National Health Service (NHS), boards of governors or trust boards include representatives of the community, patients, and professional experts. Across all these models, the key principle is balancing professional management with public oversight.
The introduction of supervisory boards in Ukraine could become an important step toward modernizing hospital governance. However, European experience shows that the effectiveness of this model depends not so much on the mere establishment of a supervisory board as on how it operates. Several principles are particularly important:
- The success of a supervisory board largely depends on the competencies of its members. European practice shows that such boards should include individuals with real experience in management, finance, and healthcare.
- To avoid conflicts, it is essential to clearly define where the powers of the supervisory board end and where the responsibility of the hospital’s management begins. The board should oversee strategic issues but not interfere in day-to-day operations.
- European hospitals place great emphasis on the transparency of supervisory boards. This includes publishing annual reports, ensuring openness in decision-making procedures, and establishing clear rules for preventing conflicts of interest.
- In many countries, supervisory boards are supported by administrative and analytical resources—such as a secretariat or analytical units—which enables members to work with high-quality information and make well-informed decisions.
Is the Ukrainian system ready for this?
The introduction of supervisory boards is an important step toward transitioning from an administrative model of healthcare management to a more modern system of corporate governance. However, this process will take time. It involves not only creating new governance bodies but also shaping a new management culture—one based on transparency, accountability, and strategic thinking. European experience shows that supervisory boards can become an effective tool for hospital development, but only if they are formed and operate on a professional basis. This will be the key challenge for Ukraine’s healthcare system in the coming years.
