Annual Report of the Council for Social Protection
At its final meeting of 2008 the Council for Social Protection reported on progress made over the past year and announced its plans for 2019.
Palliative Care and Bone Marrow Donors
Access to pain relief for people with serious health conditions continues to be one of the main problems facing the medical profession and the pharmaceutical industry. Petr Rodionov, Director General of the Gerofarm Group of Companies, stated that every year around 600,000 people in Russia require some form of palliative care, half of whom are cancer patients needing pain relief medication.
Rodionov commented on a scheme that the Council had established to improve access to drugs and psychotropic medicine for people with serious health conditions. It had led to a four-fold increase in the number of analgesics dispensed to patients in 2018 compared to 2014. Nevertheless, he said that much of the demand for pain relief remains unmet, with only around 30% of people receiving the appropriate medication. The situation in the regions of Vladimirsk, Vologodsk and Tver is even more critical. As yet, there is also no effective system for accurately calculating the number of people who require pain relief and palliative care.
Rodionov believes there needs to be a major review of current legislation and is calling on the Ministry of Internal Affairs and the Ministry of Justice to decriminalise the supply of drugs for medical purposes. He wants the number of prosecutions to fall dramatically and for doctors to be given the right to prescribe drugs for pain relief, albeit within very strict guidelines. Nyuta Federmesser, Founder of the Vera (Faith) Foundation for Hospice Care, has discussed this problem with President Putin.
Tatyana Golikova, Deputy Chairman of the Russian Government on Social Policy, announced that the government has proposed a bill to change public health policies, to create a system for recording the number of patients needing palliative care either in their own homes or dispensed at clinics. The bill is currently being considered by regional authorities and is expected to have its first reading in the Russian Parliament at the start of January. Golikova said the aim was to pass the law in the shortest timeframe possible.
Rodionov is also calling for a change in the law in relation to bone marrow donation, to increase the number of potential donors. At any one time there are up to 10,000 adult patients and 1,200 children waiting for a bone marrow transplant. Only 10-15% of adults are getting the treatment they need and around 40% of children.
Changes are being introduced to support the older population. In the past year six of the regions have launched a system of long-term care for the elderly. The move was instigated by the Strategic Initiatives Agency, the charity Joy in Ageing, the Ministry of Labour and the Ministry of Health.
Yelizaveta Oleskina, Director of Joy in Ageing, explained that the system aims to allow elderly people to continue to enjoy social interaction, to have access to education and employment and to be able to choose where they receive the assistance they need.
Maria Morozova, Director General of the Timchenko Foundation, added that the system aims to produce the kind of conditions that will allow as many people as possible to enjoy an active life in old age.
In the first instance, the changes are designed to increase public awareness of the support available to the elderly. Many are denied assistance simply because they do not know they are entitled to it or they do not know how to access it. The regions that took part in the pilot project were able to trace the people who required help using the records of clinics and hospitals and as a result 1,660 new claimants came forward.
In addition, the changes are intended to improve access to support through the use of functional diagnostics. In the regions where the new system was piloted, claimants (21,000 people in all) were divided into different categories according to their level of need; 10% of them were in the category requiring the most intensive support. The changes helped to identify unmet need but they also had the advantage of raising the activity levels of some elderly people, by guiding them into education or some form of employment or encouraging them to socialise with others. Day services were also introduced, including day centres, social and medical facilities and training sessions for people caring for elderly relatives.
In the course of 2019 Joy in Ageing will continue to provide these services in partnership with other NGOs, including the Centre for Medical Teaching and the two charities, Vera and the Way of Life. Maria Morozova added that a protocol explaining the concept of active ageing will be published by March 2019.
Children and Young People with Disabilities
A pilot project on assisted living for people with disabilities is currently underway. It is aimed at helping people with mental disabilities to access social services, education and rehabilitation at locations close to their homes. Three centres have been established to date. Yelena Klochko, Head of the Russian Organisation for the Parents of Disabled Children, believes the law should be changed to ensure that all disabled people are given the assistance they need with their living arrangements and employment opportunities. Klochko said that new measures were also needed to improve education for young disabled people living in psychoneurological boarding houses. According to the Ministry of Labour, there are 4,000 disabled people between the age of 18 and 23 who have never received any kind of schooling.
Children’s Home Reforms
Public institutions for orphaned children are in the process of reorganisation. The changes are designed to ensure that children who do not live with their natural parents should be placed in children’s homes for only a limited period of time, until they can either be returned to the family home or a new family can be found to care for them.
Yelena Alshanskaya, President of the Foundation of Volunteers for Orphans, said that implementation of the reforms across the regions has been patchy; and the fact that three separate bodies are responsible for orphanages is creating considerable confusion.
Alshanskaya said that legislation in relation to social orphans also needs to be updated. Under Family Law, when a child is removed from the family home, the organisation assuming responsibility for his or her care has seven days in which to submit the necessary documentation. Simply presenting documents describing the support the family has received to date is not sufficient to justify the removal of the child from the family home or any other kind of restriction on the rights of parents. Alshanskaya stated that current legislation is not effective in this regard.
NGOs and their social services
Alexandr Spivak, Chairman of the National Foundation for the Protection of Children, reported that its board members had been running training programmes to advise on the provision of social services and offer solutions to the problems encountered in the regions. He said there had been a marked increase in the number of NGOs providing social services in recent years, and funding for it remains a problem. In some regions the board members uncovered cases of poor budget planning and frequent delays in the issue of payments, with some organisations refusing to make any payments within the current financial year.
Public Service Advertising and Professionals in NGOs
Yelena Topoleva, Director of the Agency for Social Information (ASI), reported that in the past year the Russian Public Chamber had set up a special coordination council to focus on the difficulties NGOs were facing in advertising their services in the media. Working with the Ministry of Digital Development and Mass Marketing, the council had established commissions to place advertisements on main TV and radio stations. Information about the NGOs is now available on their websites as well. It was, however, discovered that certain TV networks were refusing to provide public information adverts free of charge while others would not disclose the names of the individual NGOs offering the service.
During 2018 ASI, together with the Potanin Charitable Foundation and the STADA Group in Russia, recorded a series called The NGO Professionals, in which the leaders of NGOs described the contributions they have made to the public sector. Topoleva said the aim of the project was to highlight the fact the many of the people employed by NGOs are not volunteers. The project was mostly targeted at young people, to show them that working for an NGO can be an important part of their career development. Topoleva said that the changes are already having an effect, as recruitment agencies are beginning to work with NGOs and are offering training for professional qualifications.