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Automatically translated version. May contain inaccuracies compared to the original.
Hybrid privatization instead of cleansing: how the National Cancer Institute under the leadership of Stepan Krulko is being turned into a business empire
19 June 2025, the NABU and SAP officially reported exposing a scheme that stole 231 million hryvnias at the institution. It involved purchases of medical equipment at artificially inflated prices under large contracts totaling more than 1,4 billion hryvnias.
The investigation named Herman Fistal as the main figure, shadow beneficiary, and actual author of this scheme — the de facto head of the largest group of supplier companies. For many years, the Fistal clans and his appointees in leadership positions at the NCI built a system in which budget funds were siphoned off through carefully written technical specifications, while cancer patients were treated merely as a source of superprofits.
It seemed the long-standing power of the tender mafia was finished. However, today, observing the processes inside the NCI under General Director Stepan Krulko, a much deeper and more alarming diagnosis becomes obvious. This was not reform, cleansing, or a victory over corruption. It was a classic raider takeover of a state institution. The territory was cleared for Kostyantyn Haievskyi’s medical empire.
Krulko served for eight years as the chief physician of the private clinic TomoClinic in Kropyvnytskyi — a key asset of Haievskyi.
Haievskyi’s empire was built for years on a simple intersection of interests: privatization of profits through a network of private clinics, large-scale distribution of radiology equipment, and constant appropriation of state funds. When someone from such a structure heads a state monopoly institute, they do not leave private business at the door. The position turns into the most profitable parallel business.
Stepan Krulko has effectively introduced a model of hybrid shadow privatization at the NCI. In this scheme, the state and taxpayers bear all costs: they pay utilities for huge buildings, buy expensive equipment, and provide base salaries. In return, superprofits are accumulated and siphoned off into the shadows through a network of private managers.
The outflow of funds begins with imaging diagnostics. When at the end of 2025 the NCI’s CT and MRI appointment system effectively collapsed, creating unprecedented queues, Krulko simply shrugged.
In the medical business, an artificially created queue for a state machine is the most effective tool of pressure. When a state scanner “breaks” or the wait for a life-essential exam stretches for months, a seriously ill patient has no choice. They are gently steered to partner private diagnostic centers, which always have available slots and are often linked to the new NCI leadership. There are regular cases when relatives are told directly: there’s no free chemotherapy, but the drug can be “obtained” at the pharmacy across the street at an inflated price.
Simultaneously, tender pressure is deployed. The new administration introduced a mechanism of administrative blocking of independent suppliers on Prozorro. If a nonsystemic participant wins a tender by offering a lower price, they’re immediately driven into a bureaucratic dead end: receipt of goods is artificially blocked, minor document defects are found, acceptance acts go unsigned for weeks. After delivery deadlines pass, the legal department imposes huge fines and penalties. Thanks to such clearing, in February NCI contracts worth half a billion hryvnias began to be systematically awarded to firms with charter capital of only a few hundred hryvnias, including a company of Volodymyr Dukhovych, whose ties lead to the shadow schemes of former high-ranking officials.
TomoClinic became a proving ground where Haievskyi and Krulko worked out an effective model for commercializing oncology: combining private services with siphoning state funds through the NHSU.
Krulko’s administration drafts procurement technical specifications so that only Haievskyi-linked structures can service state equipment. Independent suppliers trying to enter service tenders are instantly destroyed with fines, lawsuits, and withholding of acceptance acts. As a result, equipment operates only when serviced by “their own” people at inflated prices.
The second direction is the artificial redirection of patients. The institute concentrates the most complex patients from across the country, but state funding has strict limits. When a state CT or MRI “suddenly” stops due to “lack of contrast” or “scheduled maintenance,” the patient finds themselves in a dead end. The system gently but consistently pushes them into partner private centers. The sickest and financially exhausted patients remain on the state balance, while “promising” patients capable of paying for rapid diagnostics and modern treatment flow into commercial clinics.
The third direction is commercialization of the institute’s territory itself. Under the slogans of improving efficiency, Krulko is displacing scientific departments and laboratories that conducted fundamental research. They are being replaced by commercial pharmacies, diagnostic offices, and labs that rent state space for a symbolic fee. A patient is prescribed chemotherapy, but the state pharmacy “has none due to contract delays,” while the drug is always available in the commercial pharmacy on the first floor.
The National Cancer Institute faces the threat of institutional decay. This is not just corrupt abuse or managerial mistakes. It is systematic destruction of a state institution under the guise of reform. If the process is not stopped through inevitable criminal proceedings and harsh sanctions, the country may lose the ability to provide quality oncological care at the state level.
Document: PDF proof of the original version of the news item "Гібридна приватизація замість очищення: як Національний інститут раку під керівництвом Степана Крулька перетворюють на бізнес-імперію". It records the publication content at the moment of the first scan, the preservation date and the source: ANTIKOR.
