The buildings haven't been repaired since Soviet times, the equipment's either old or non-existent, there are few specialists who have to work a lot and get paid little. Those are issues for Russian clinics and hospitals that were brought up today by Vladimir Putin. How do we make sure that the national healthcare project meets the expectations of the citizens? That was one of the key questions at the meeting held by the president. The state is investing unprecedented sums into medicine. This money must be spent wisely, said the head of the state.
National Projects Huge sums have been allocated for the development of healthcare, 1.4 trillion rubles ($21.2 billion) within the framework of the national project alone. 240 billion rubles ($3.6 billion) will fund the modernization of primary care facilities. It was noted at the meeting that more clinics are opening. Now, there are 60,000 of them across the country compared to 58,000 in 2014. It's a major achievement but about 500 villages with populations of 100-2,000 people are still out of reach of medical help. Within a year and a half, each of them will have a health post or a clinic with new medical equipment and a full complement of doctors and nurses.
Vladimir Putin: "People are still not satisfied with the level and quality of primary care. Patients rightfully complain about poor conditions, long waiting lists to see medical specialists, and a shortage of doctors. Medical workers, in turn, are unhappy with their wages and the high workload. We are trying to ensure that people who need medical care know that their doctor, their nurse, or the administrator at reception are always on their side and will do everything that needs to be done".
There's a nationwide shortage of doctors. Russia needs 25,000 more doctors and 130,000 mid-level medical personnel, nurses, and paramedics. Specialized doctors are also in great demand. Clinics, especially in small and rural towns, require renovation. It would be even better to move them to new buildings.
Veronika Skvortsova, healthcare minister: "The first issue is the shortage of medical workers at all levels, district doctors, specialized doctors, and middle-level medical personnel. The basic hardware is all worn out, including both buildings and equipment. There's also an issue with transport accessibility in remote areas of the country".
Here's the village of Bereznyaki in the Yelizovsky District, Kamchatka. It's not that far from the administrative center, but the old health post's building was crumbling. A mobile health post was immediately deployed. One can get a lung x-ray, women can have a check-up there, and one can have their blood pressure checked. In Sakhalin, doctors have to travel around villages. A mobile medical assessment. The locals look forward to every such visit and line up in front of the vehicle. Some of them couldn't get proper medical care for years. It's clear that such temporary measures aren't a full replacement. New medical institutions will be built over the next few years. Moreover, operating ones won't be closed down without a solid reason.
Tatiana Golikova, deputy prime minister: "Our current goal while preparing these principles is to avoid a situation where medical institutions in the regions get closed down without any reason. Unfortunately, that happens despite the fact that there's a legal provision prohibiting the closure or reorganization of institutions without the consent of the residents of the region where it's located".
Out of 1.5 trillion rubles ($22.7 billion) allocated for the national project, only a small part will fund primary care.
Vladimir Putin: "237.5 billion rubles have been allocated under two program. What percent is this? Fifteen, sixteen, seventeen percent, while the main measures under the healthcare program primarily apply to specialized and tertiary medical care".
- It just costs...
- Yes, it costs more. However, last year, there were 746.8 million visits for specialized care. There were 1.2 billion visits to primary care facilities over the same period. You see? It's almost twice as much. If primary care remains as it is today, the number of heart attacks and strokes will not decrease, because there is a breakdown in the primary care link of the chain, and this is the problem. Something doesn't seem to be working properly.
The president gave an example of one of the inefficient mechanisms.
Vladimir Putin: "I'll put it lightly, the payment of wages is organized poorly. Nationwide, we seem to have achieved the benchmark target which is 200% of the average wage in a region's economy. But this is far from the case everywhere. We are not even close to these numbers in small towns and villages".
After today's meeting, Putin gave instructions. The federal center plans to strictly monitor the payment of doctors' wages in the regions.
Tatiana Golikova, deputy prime minister: "We have a fixed payment structure: wages, compensations, and incentive payments. We want to prevent management from gaining full control over employees' wages. Reluctant to spend their entire payroll budget, they were allocating it not in favor of those who do all the work".
In general, the entire primary care system requires a serious upgrade. The president set a strict deadline for the draft principles.
Vladimir Putin: “I'm asking the government to draft the principles for upgrading primary care setting in the country by October 1st, 2019. Secondly, to initiate and organize the drafting of regional programs to upgrade primary care in the Russian regions. These programs must be ready and defended no later than July 1st, 2020. Thirdly, it is necessary to create mechanisms for monitoring the quality of these programs. Fourthly, it is important to oversee their implementation and execution. And finally, we need to work through and propose sources of financial support of all proposed activities. I'm asking you to begin immediately.”
The government promised to present the first proposals by the end of September.
Dmitry Petrov, Irina Vinogradova, Anton Kosimovich, and Oleg Shavyrin, Vesti, the Kremlin.
