Modern priority national health projects. The main priorities of the national project “Health

National project in the healthcare sector implies the development of primary medical care(including family medicine), increasing the staffing level of primary health care, transitioning to new forms of remuneration depending on the volume and quality of medical care provided, strengthening the material and technical base of medical institutions.

Based on the network schedule for the implementation of the Federal National Project “Health”, the “Plan for the implementation of the national project in the field of health care in St. Petersburg" The Health Committee held training seminars with heads of district health departments and chief doctors of hospitals and administrative institutions to study materials and explain decisions of the Board of the Ministry of Health and social development. On its basis, corresponding plans have also been formed in each administrative district.

In accordance with the main priorities and objectives, the Health Committee created working groups to monitor the implementation of each direction and prepared a draft Government resolution St. Petersburg on the creation of a Coordination Council headed by the Vice-Governor St. Petersburg. An Agreement between the Government was prepared and signed St. Petersburg and the Ministry of Health and Social Development of Russia on the procedure for implementing the National Project “Health”.

The basis of the national project in the field of healthcare St. Petersburg measures were taken to develop primary health care, including:

increasing the level of remuneration for local general practitioners and pediatricians, general practitioners (family doctors) and nurses working with them.
additional training for doctors in the specialties of “Internal Medicine”, “Pediatrics”, “General Medical Practice (Family Medicine)”. One of priority areas implementation of the national project consists of training and retraining of general practitioners, local therapists and pediatricians. IN St. Petersburg a Territorial Register of general practitioners, local therapists and pediatricians, nurses, obstetricians-gynecologists, neonatologists, anesthesiologists-resuscitators, midwives and children's nurses of antenatal clinics, maternity hospitals (departments) and perinatal centers city and regional health care institutions.
carrying out measures for the prevention, detection and treatment of a number of diseases (HIV infection, hepatitis B, rubella, etc.),
carrying out additional immunization within the framework of the National Preventive Vaccination Calendar. To carry out immunization, the size of the city's population to be vaccinated according to the national calendar plan has been determined, as well as the population to be subject to additional immunization against polio, rubella, hepatitis B and influenza.
carrying out medical examinations of the working population under additional programs. The main objective of medical examination is the early detection of diseases of the cardiovascular system, tuberculosis, oncological diseases, diabetes mellitus, degenerative-dystrophic diseases of large joints and spinal pathology. A computer program for monitoring medical examinations of the adult population is currently being implemented.
additional payment for primary health care provided to working citizens and non-working pensioners. In accordance with the instructions of Roszdrav, preparations have begun for the conclusion of agreements between the chief physicians of the APU and the health workers involved in the implementation of the project. These additional agreements will be executed on the basis methodological recommendations Ministries. The Committee issued an order on the procedure for additional cash payments within the framework of the national healthcare project. According to the approved Plan, the Health Committee, together with the Compulsory Medical Insurance Fund, will monitor the results of the activities of the APU in accordance with the established indicators of the volume, results and quality of medical care. The next most important section of the work is equipping the APU with diagnostic equipment. The procedure for equipping medical institutions in the city with diagnostic equipment and ambulances has been determined.

National health project for St. Petersburg it is planned to improve the provision of high-tech medical care to the population, including:

modernization of existing federal specialized medical institutions (FSMU),
improving the organization of providing high-tech medical care (transfer of the Federal Medical Service to government order, introduction of the “Registration Sheet”, development of standards for high-tech medical care). The concrete result of the activities implemented within the framework of this task should be to strengthen the preventive focus of healthcare, prevent morbidity, increase the level of satisfaction of the need for high-tech types of medical care. To quickly resolve issues of providing the population with high-tech medical care, committees of the Committee and federal institutions health care for the selection and referral of patients to expensive types of medical care.
specific measures aimed at achieving the goal of improving the health of children and mothers in St. Petersburg:
introduction of new organizational resource-saving, perinatal and reproductive technologies;
expanding the medical examination of children, conducting mass examinations of newborn children for hereditary diseases; For the section of the national project concerning the detection of congenital pathology, contingents have been identified for the examination of newborns for galactosemia and adrenogenital syndrome. Every year it is necessary to examine about 92 thousand newborns, taking into account repeated clarifying studies. In accordance with federal program To conduct a mass examination of newborns for the early diagnosis of galactosemia and adrenogenital syndrome, it is planned to provide the biochemical laboratory of the Medical Genetics Center with the necessary additional equipment and appropriate sets of reagents at the expense of the Federal budget.
development of perinatal care and specialized high-tech medical care for mothers and children;
introduction of the “Birth certificate” in state and municipal institutions health care, providing medical care to women during pregnancy and childbirth. To implement the birth certificate program, a surname electronic register of obstetricians-gynecologists, neonatologists, anesthesiologists-resuscitators, midwives and children's nurses working in 49 outpatient and 16 inpatient hospitals has been prepared government institutions obstetrics.

The main tasks for the implementation of the priority national project “Health” for 2012.

1. Continue the implementation of all main directions of the priority national project “Health”.

2. Ensure immunization of the population St. Petersburg in accordance with the plan in 2012, paying particular attention to:

completion of vaccination against hepatitis B in 2011 and ensuring the implementation of the vaccination plan for the decreed contingent for this year
-immunization against measles for at least 60 thousand people.

3. Continue additional medical examination.

4. Carry out measures for the prevention and treatment of HIV infection and viral hepatitis, including in patients with tuberculosis combined with HIV infection.

5. Continue measures aimed at reducing maternal, infant and perinatal mortality.

6. Implement the development of new directions to promote a healthy lifestyle among citizens St. Petersburg.

7. Improve the work of regional vascular centers for the provision of medical care on the basis of hospitals subordinate to the Health Committee, commissioned in 2011.

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Project goals

Strengthening the health of citizens
Increasing accessibility and quality of medical care
Development of primary health care
Revival of preventive health care
Providing the population with high-tech medical care

Main directions

As part of the development of primary health care, the following activities are envisaged:

training and retraining of general practitioners
increase in wages medical workers primary care medicine.

From January 1, 2006, local therapists, local pediatricians and general (family) doctors are paid an additional 10 thousand rubles, and nurses working with them - 5 thousand rubles.

Since July 1, 2006, emergency medical care personnel receive incentive payments in the amount of: 5,000 rubles. for doctors, 3500 rub. for paramedics and 2500 rubles. for nurses.

strengthening the material and technical base of emergency medical care

As part of providing the population with high-tech medical care, it is planned:

improving the quality and volume of high-tech medical care
construction of new medical centers and training of personnel for them (the construction of 15 federal medical centers is planned).

Federal Centers for High Medical Technologies

As part of the national project, it was envisaged to build 14 federal centers of high medical technologies in Russia in the regions, of which:

Besides regional centers, the Federal Scientific and Clinical Center for Pediatric Hematology, Oncology and Immunology was built in Moscow (opened in 2011).

Financing

In 2006, for the implementation of the project from federal budget and state extra-budgetary funds allocated 78.98 billion rubles. Besides, additional funds were allocated by the subjects of the Russian Federation and municipalities. In 2007, it is planned to allocate 131.3 billion rubles.

Expenses associated with the implementation of the project are planned for 2007-2009 in the amount of 346.3 billion rubles.

Immediately after the launch of the national project, it became clear that during its development the financing of several important expenditure items was not taken into account. For example, incentive payments received by medical staff, contrary to Art. 139 Labor Code not included in average earnings and, therefore, these payments did not affect the amount of “vacation” and “sick leave”. In this regard, the Ministry of Health was sent great amount requests from both regional healthcare managers and ordinary employees. The first person to achieve justice on this issue was therapist Anatoly Popov from the Vladimir region.

The issue of the so-called “northern bonus”, which is a significant part of the salary of the population of the northern regions, was much more difficult to resolve. This bonus should apply to all types of income, regardless of its source, but none of the budgets provided funds for these purposes. In a number of regions, after medical workers appeal to the courts, the debt on “northern bonuses” for incentive payments is reimbursed only to those who apply to the court for this. Health authorities continue to challenge court decisions, with varying degrees of success, according to which employers were ordered to pay the arrears of the “northern bonus.” Problems with financing continued in 2008 and 2009; some of the costs were shifted to the shoulders of regional, city and even municipal authorities, which did not contribute to achieving the project’s goals.

Implementation results

At the beginning of July 2007, 5,834 doctors had undergone training and retraining (2,939 in the specialty “Internal Medicine”, 2,298 in “Pediatrics” and 597 in “General Medical Practice”). In the first half of 2007, more than 150 thousand medical workers (more than 70 thousand doctors and 79 thousand nurses) received additional cash payments for total amount more than 6.6 billion rubles.

At the beginning of July 2007, 3,267 units of diagnostic equipment were supplied to the regions (512 sets of laboratory equipment, 71 ultrasound machines, 788 X-ray machines with 443 developing machines, 438 pieces of endoscopic equipment, 465 electrocardiographs and 550 fetal monitors). It was planned that in 2007, 375 children's clinics would be equipped with modern diagnostic equipment.

At the end of 2009, life expectancy in Russia increased to 69 years. In February 2010, Deputy Prime Minister of Russia Alexander Zhukov stated that increasing life expectancy is a success of priority national projects.

Criticism

Despite the good intentions of the curators of the national project, it was not possible to significantly change the situation in healthcare. Some experts call the national project “Health” a failure.

There was no one to work on the supplied equipment, Consumables ran out quickly, and the quality of the equipment itself leaves much to be desired.

Against the backdrop of optimistic reports from the ministry on the successes of the national project, deputies of the State Duma stated that the situation with drug supply and staffing medical facilities leave much to be desired.

The General Prosecutor's Office and local prosecutors regularly report numerous violations related to the implementation of the project. The most common: untimely payment of health workers, downtime of equipment, improper expenditure of budget funds. In 2009-2010, the Accounts Chamber, during an audit of the Ministry of Health and Social Development, headed at that time by Tatyana Golikova, also revealed violations during the construction of federal centers of high medical technologies, the financing of which was carried out as part of the implementation of the national project “Health”. From the results of a journalistic investigation conducted by employees of the Reuters news agency, it follows that 48 million US dollars from the project estimate were spent on the construction of a palace near Gelendzhik, which is considered the property of D.A. Beskaravaina.

Sources

Perestoronin, Alexander. The Federal Center for Neurosurgery in Tyumen will accept patients in 2011 (Russian), M.: RIA Novosti (August 18, 2010). Retrieved February 8, 2013.
In Novosibirsk, the Federal Center for Neurosurgery (Russian) received its first patients, M.: Channel One (December 5, 2012). Retrieved February 10, 2013.
Chukhacheva O. Neurosurgery Center: the first operation took place // Tyumen News: newspaper. - Tyumen, April 27, 2011. - No. 70 (5278).
In the Chelyabinsk region, vacation payments are being delayed for health workers (undefined) . REGNUM (August 8, 2007). Retrieved August 14, 2010.

(2015 results)

In 2015, within the framework of the priority national project “Health,” funds in the amount of 1,438.6 million rubles were invested in the region’s healthcare, of which: 1,243.7 million rubles came from the federal budget and the social insurance fund; 194.9 million rubles - from the regional budget. The implementation of the activities of the priority national project “Health” was carried out within the framework of the state program Russian Federation“Healthcare development” for 2013 – 2020 in the following areas:

Development of primary health care and improvement of disease prevention

As part of the National Preventive Vaccination Calendar, 2,689,598 people were vaccinated; according to epidemic indications, 271,966 people were vaccinated, which made it possible to maintain epidemiological well-being in terms of infections controlled through vaccine prevention, and to avoid group and outbreak morbidity among the population of the Rostov region in 2015.

At the expense of the federal budget, vaccines worth 286,998.4 thousand rubles were supplied to the region, which is 38.6 million rubles more than in 2014; 44,647.1 thousand rubles were allocated from the regional budget for these purposes. , 34,647.1 thousand rubles were financed. Failure to fulfill the plan is due to the termination of a contract in the amount of 10.0 million rubles due to the supplier’s failure to meet delivery deadlines due to lack of certificates.

The complex of organizational, treatment-and-prophylactic, sanitary and anti-epidemic measures implemented in the region makes it possible to timely identify those infected with immunodeficiency viruses, hepatitis B and C and provide the necessary medical care. In 2015, 652,076 people were examined, which is 8.4% more than in 2014. 2,269 HIV patients received free, expensive antiretroviral therapy. In 2015, innovative methods of HIV prevention were applied using television and radio channels with a total coverage of more than 95% of the population of the Rostov region.

From the federal budget, test systems and antiretroviral drugs were purchased in the amount of 230,771.9 thousand rubles, and 10,690.5 thousand rubles were spent on preventive measures. 31,091.1 thousand rubles were allocated from the regional budget for the purpose of combating HIV infections.

Activities aimed at identifying tuberculosistreatment of patients with tuberculosis

Thanks to a systematic approach, including measures to prevent the spread of tuberculosis, its timely diagnosis and treatment, it is possible to annually reduce the incidence and mortality from tuberculosis. In 2015, according to operational data, the incidence of tuberculosis was 39.6 cases per 100 thousand population, mortality from tuberculosis was 15.1 cases per 100 thousand population (2014 – 16.8).

The number of people examined for tuberculosis using fluorography in 2015 was 1,823,062 people, which is 78,201 more than in 2014.

For financial support of re-equipment medical institutions of this profile and procurement of antibacterial anti-tuberculosis medicines(second row) in 2015, 206,167.0 thousand rubles were allocated from the federal budget, and 6,636.0 thousand rubles from the regional budget.

Increasing the availability and quality of specialized, including high-tech, medical care

Since 2014, the capabilities have been expanded financial security provision of high-tech medical care at the expense of compulsory health insurance. In 2015, 7,190 people received high-tech assistance as part of the financing of the “Health” national project (from all sources of funding - 16,304 people, in 2014 - 13,119 people). The availability of specialized medical care for children in the region has increased. 2,468 children were treated (2014 – 1,955 people).

The provision of high-tech medical care was carried out in 17 medical institutions of federal, regional, municipal subordination, and private forms of ownership. Over the years, the main development in the region has been in those areas that directly affect the medical component of demographic indicators. These are cardiac surgery, obstetrics and gynecology, oncology and traumatology-orthopedics.

Table. Growth individual species high-tech medical care

	Stenting	Endoprosthetics

In 2015, new profiles of high-tech medical care were introduced in the Rostov region: transplantology, rheumatology, endocrinology, pediatric ophthalmology, pediatric traumatology and orthopedics, pediatric otorhinolaryngology.

For these purposes, 36,060.5 thousand rubles were invested from the federal budget, and 122,540.4 thousand rubles from the consolidated budget of the region.

Improving medical care for women and children

In 2015, funding in the amount of 522,731.0 thousand rubles was planned from the social insurance fund to pay for medical care provided to women during pregnancy and childbirth; as of 01/01/2016, coupons in the amount of 473,033.0 thousand rubles were paid.

Prenatal and neonatal diagnostic and audiological screening activities continued.

Prenatal diagnosis was carried out on 33,001 pregnant women who were registered before 12 weeks. Screening coverage in the first trimester was 85.6%, which is 11.2% more than in 2014.

50,000 newborns were examined for galactosemia, 6 cases were identified, for cystic fibrosis – 50,591, 5 cases were identified; adrenogenital syndrome – 50,694 children, identified cases – 8; primary hypothyroidism – 51,069 newborns, identified cases – 9; phenylketonuria – 50,650 children, identified cases – 10. The number of children who underwent audiological screening is 50,016, children with hearing impairment were identified – 9.

As a result of the implemented set of measures, it was possible to improve the annual target values of infant mortality indicators. Infant mortality decreased by 16.5% compared to 2014 and, according to operational data, amounted to 6.6 cases per 1000 live births.

Many activities previously included in the national project “Health” were implemented in 2015 as part of the State Program for the Development of Healthcare until 2020. In the main significant areas, separate agreements were concluded to co-finance the subject’s expenditure obligations from the federal budget. Some of the activities were financed from compulsory health insurance.

Formation of a healthy lifestyle

More than 648 events in the movement for a healthy lifestyle were held in 55 territories of the region. Quiet Don– health to every home!”; 11 off-site events within the framework of the project “Your health is in your hands - Enlighten yourself!”; 7 specialized events within the framework of the project “Let's maintain health in the workplace”; 55 events within the framework of the projects “Donors of the Don”, “Dance for Life”, “Everything That Concerns You”, volunteer events “Healthy Start” and “Youth Against Drugs”.

In total, 721 events were organized in 2015 aimed at promoting a healthy lifestyle.

14 adult and 6 children's health centers continue to operate in the region.

In 2015, 81,478 people were examined, of which 32,440 people (39.8%) were considered healthy.

As a result of the work carried out in the region, according to operational data, a decrease in the level of consumption was noted alcoholic products per capita by 6.9%, a decrease in the proportion of smokers by 23.5%, a decrease in the proportion of patients with drug dependence syndrome who are under supervision and in remission for 6 months or more by 23.2%.

Carrying out medical examination of citizens and children

In 2015, medical examination of the population continued using funds from compulsory health insurance.

It was planned to examine 400 thousand people insured under compulsory medical insurance, over 18 years of age; as of 01/01/2016, 405,235 people (101.3%) were examined.

As of January 1, 2016, out of 7,510 orphans subject to medical examination in state institutions, 7,611 children were examined. Of the 7,390 orphans under guardianship, adopted, 7,390 children were examined.

Carrying out medical examinations and medical examinations of the population, including rural residents and children, contributes to the early detection of diseases, pathological conditions, and risk factors for their development.

Measures to improve the provision of medical care to patients with vascular diseases

The provision of medical care to patients with vascular diseases is carried out in the regional vascular center on the basis of the State Budgetary Institution RO ROCHB and in 3 primary vascular departments on the basis of municipal treatment and preventive institutions (Basic Hospital No. 2 in Rostov-on-Don, State Emergency Hospital in Taganrog, State Emergency Hospital No. Kamensk-Shakhtinsky).

In 2015, a number of targeted activities were carried out for the early identification of patients with risk factors for cardiovascular diseases, the initial stages of circulatory diseases, timely placement of them on “D” - registration and training for residents of the region healthy image life.

Training was organized for pre-medical and primary health care specialists in modern methods of recognizing and providing emergency assistance patients with acute coronary pathology and cerebrovascular accident.

At the level of municipal medical organizations, routing plans for acute vascular accidents in institutions at the intermunicipal and regional levels have been developed, agreed upon with the Ministry of Health of the Rostov Region and approved by the heads of municipalities, with the use of thrombolytic therapy, if necessary, both at the prehospital and hospital stages. This made it possible to significantly reduce mortality from acute myocardial infarction and acute cerebrovascular accidents, including through the timely use of high technology coronary stenting, coronary artery bypass grafting and neurosurgical interventions for hemorrhagic strokes.

The creation of a regional register of patients with acute cardiovascular pathology has significantly increased the number of cases of delayed surgical interventions aimed at the secondary prevention of recurrent cardiovascular accidents.

As a result, according to operational data, a decrease in the indicator “Mortality from diseases of the circulatory system” was achieved - 617.3 cases against the target of 753.4 cases per 100 thousand population, which is significantly lower than the Russian average level - 631.8.

Measures to improve the organizationoncological care to the population

Re-equipment was completed in 2015 medical equipment five regional oncology centers (Rostov-on-Don, Shakhty, Novocherkassk, Taganrog, Volgodonsk). Funded drug provision, implementation preventive measures enterprises, organization of training and retraining of medical personnel, allocation of medical organizations premises necessary for providing medical care to patients and their repair.

As a result of the implementation of the above measures in 2015, according to operational data, the number of deaths from malignant neoplasms decreased to 164.9 cases per 100 thousand population (2014 - 174.4), the number of people who lived 5 or more years from the moment of clinical diagnosis increased , the number of patients diagnosed in the 1st and 2nd stages of the disease.

Activities aimed at improving the organization of medical care for victims of road accidents

Thanks to the well-established mechanism for the interaction of all services in providing medical care to victims of road traffic accidents, there is a tendency to reduce the number of deaths at various stages of medical care. There are consistently no victims of road accidents on the M4-Don highway who died during transportation by emergency medical teams. With the target indicator set " road map"mortality from road traffic accidents" - 10.3 deaths per 100 thousand population; in 2015, according to operational data, the figure was 7.3 (2014 - 9.3).

Plans and tasks for 2016

In 2016, within the framework of the “Health” national project, the provision of medical care to women during pregnancy and childbirth will continue. Funding in the amount of 488.1 million rubles is planned from the Social Insurance Fund. All main activities of the PNP “Health” are included in the state program for the development of healthcare until 2020.

The national project “Health” is one of the 4 priorities of the state’s socio-economic policy, announced in 2005. Declaration of priorities that recognize health, education, housing and Agriculture, indicates that a person, the quality and conditions of his life determine the purpose and content today government activities. From the point of view of economic development, this indicates that solving such problems at this stage is both necessary and possible. From the point of view of economic theory, priority national projects demonstrate the implementation of the principle of election in the economy.

The national project “Health” identifies from industry-wide tasks and problems those that, firstly, cannot be solved without government support; secondly, they require coordination of intersectoral connections; thirdly, they bring novelty and scale effects of general social, national significance.

The goals of the national project “Health” include the following:

Improving public health;

Increasing accessibility and quality of medical care;

Strengthening the primary health care system;

Strengthening the significance and effectiveness of preventive measures both in the structure of health factors and in assessing the performance of a doctor;

Providing the industry with high-tech means of providing medical care;

The implementation of the national project “Health” is focused on 20 years (until 2025), step by step, through targeted programs and subroutines. Since 2007, such targeted programs must be drawn up for a period of 3 to 6 years. All national projects began to be implemented in January 2006.

At the first meeting of the Council for the Implementation of Priority National Projects (December 7, 2005), V.V. Putin noted that the projects do not replace planned work and on a much larger scale than stated in the projects. About 800 billion is planned for all projects. rubles, and about 180 billion rubles for their implementation. These amounts also only supplement the planned financing of industries. Subsequently, during a period of economic crisis, in 2009 it was announced at the government level that budget cuts would not affect the financing of the “Health” national project.

For creating economic conditions implementation of the priorities of the national project “Health” since 2007, the government has indicated a transition to single-channel financing. Such financing involves the use of a per capita principle in budget allocations, which economically allows for wages in medicine to be based on quality, for results, including prevention, communication between hospitals and clinics.

At the stage of discussion of the national project “Health” in 2005, questions were raised about the legal support for reforms in health care, and the need for laws “On compulsory health insurance” and “On state guarantees of medical care in the Russian Federation”.

The plan for general socio-economic development for 2008 until the current year 2010 identified 5 goals of the Government of the Russian Federation related to the implementation of health care priorities:

1. Improving the demographic situation and the situation of families with children, as well as children in difficult life situations. This goal requires the creation of favorable conditions for fertility and raising children. Provisions on maternity capital and assistance to maternity institutions are already in place here.

2. Improving the well-being of the population, reducing poverty and inequality in monetary income of the population. In this direction (in 2006), a “pilot” project was developed to increase wages doctors (10 thousand rubles) and nurses (5 thousand rubles). The result was expected to attract specialists to primary care (and this happened) and increase their number from 0.2% of the number of graduates to approximately 10% already in 2006.

3. Improving the quality and accessibility of medical care, drug provision, especially for low-income groups of the population, ensuring sanitary and epidemiological well-being.

In the implementation of the 3rd goal - improving the quality and availability of medical care - the main lever of economic properties is increasing the efficiency of the health care system.

In accordance with the decisions of the President and the Government of the Russian Federation in this direction, the following is provided:

Completion on the basis of standardization of financing processing, first of all, for inpatient medical institutions with a focus on the final result with a phased transition to predominantly single-channel financing;

Determination of sources and procedures for financing such a transition in pilot areas;

Development of a mechanism for interaction between the entire line of executive power in healthcare management.

4. Increasing system efficiency social protection And social services, first of all - elderly citizens and disabled people.

5. Promoting productive employment of the population, ensuring the protection of citizens’ rights in the field of labor.

To summarize, we can say that in economically Priority in the implementation of the national project “Health” for the period until 2010 were measures to improve the quality of medical services and relate to the following:

Focus on the final result of medical care, ensured by the phased transition of medical institutions to single-channel financing in the compulsory medical insurance system;

Financing of inpatient care based on standards for the quality of care provided;

Financing of outpatient care on a per capita basis;

Reform of remuneration based on the final result, for which it is necessary to ensure that the volume of medical care is taken into account and its quality is assessed.

All of the above concerns the main socio-economic issues of reforming the industry, highlighted in the national project “Health”.

There is also a group of questions that have arisen in connection with the implementation of such a project and concerning the lack today in the Russian Federation of a system of primary training, retraining, and advanced training of personnel in the field of legal, organizational support for public health protection and the implementation of comprehensive socio-economic programs, projects and reforms.

This circumstance proves from a new perspective the need for an economic component in the training of medical specialists to professionally resolve issues rational use industry resources, interest in the consumer and economic results of their work.

Project goals

Strengthening the health of citizens
Increasing accessibility and quality of medical care
Development of primary health care
Revival of preventive health care
Providing the population with high-tech medical care

Main directions

As part of the development of primary health care, the following activities are envisaged:

training and retraining of general practitioners
increasing the wages of primary care medical workers.

From January 1, 2006, local therapists, local pediatricians and general (family) doctors are paid an additional 10 thousand rubles, and nurses working with them - 5 thousand rubles.

Since July 1, 2006, emergency medical care personnel receive incentive payments in the amount of: 5,000 rubles. for doctors, 3500 rub. for paramedics and 2500 rubles. for nurses.

strengthening the material and technical base of emergency medical care

As part of providing the population with high-tech medical care, it is planned:

improving the quality and volume of high-tech medical care
construction of new medical centers and training of personnel for them (construction of 15 federal medical centers is planned).

Financing

In 2006, 78.98 billion rubles were allocated from the federal budget and state extra-budgetary funds for the implementation of the project. In addition, additional funds were allocated by the constituent entities of the Russian Federation and municipalities. In 2007, it is planned to allocate 131.3 billion rubles.

Expenses associated with the implementation of the project are planned for 2007-2009 in the amount of 346.3 billion rubles.

Immediately after the launch of the national project, it became clear that during its development the financing of several important expenditure items was not taken into account. For example, incentive payments received by medical staff, contrary to Art. 139 of the Labor Code was not included in the average earnings and, therefore, these payments did not affect the amount of “vacation” and “sick leave”. In this regard, a huge number of appeals were sent to the Ministry of Health both from regional healthcare managers and from ordinary employees. The first person to achieve justice on this issue was therapist Anatoly Popov from the Vladimir region.

The issue of the so-called “northern bonus”, which is a significant part of the salary of the population of the northern regions, was much more difficult to resolve. This bonus should apply to all types of income, regardless of its source, but none of the budgets provided funds for these purposes. In a number of regions, after medical workers appeal to the courts, the debt on “northern bonuses” for incentive payments is reimbursed only to those who apply to the court for this. Health authorities continue, with varying degrees of success, to challenge court decisions, according to which employers were ordered to pay the arrears of the “northern bonus.” Problems with financing continued in 2008 and 2009; some of the costs were shifted to the shoulders of regional, city and even municipal authorities, which did not contribute to achieving the project’s goals.

Implementation results

Life expectancy in Russia

At the end of 2009, life expectancy in Russia increased to 69 years. In February 2010, Deputy Prime Minister of Russia Alexander Zhukov said that increasing life expectancy is a success of priority national projects.

Criticism

There was no one to work on the supplied equipment, consumables quickly ran out, and the quality of the equipment itself left much to be desired.

Against the backdrop of optimistic reports from the ministry on the successes of the national project, deputies of the State Duma said that the situation with drug supply and staffing of medical institutions leaves much to be desired.

Sources

Links

National project "Health". Official website of the Council under the President of Russia for the implementation of priority national projects and demographic policy
News feed on the national project “Health” on REGNUM news agency

Wikimedia Foundation. 2010.

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