Minister of Health and charities to work
together on a permanent basis

A
meeting to discuss the problems involved in financing medical treatment was held
at the federal ministry on 28 February. It was set up on the initiative of the
minister, Veronika Skvortsova, in conjunction with the federal government’s
Council on Trusteeship Issues in the Social Field and the Federal Citizen’s
Chamber Social Policy, Labour Relations and Quality of Life Committee. Deputy
ministers, assistants, departmental directors and other colleagues took part as
well. Representatives of the charitable congress, ‘Vse Vmeste’ (Everyone
Together) and of other funds came to discuss those problems that are acute with
Ms Skvortsova.

Discussion
at the meeting covered the issues relating to funds having to pay for treatment
provided for by law and also areas of health care not currently covered by
government commitments. For example, there are cases where patients need life
saving drugs that are not registered in Russia or simply more costly
non-generic drugs whose cost cannot be met out of budgeted resources. Budgets,
also, do not stretch to paying for finding a bone marrow donor who is not
related to the patient. In many clinics the technology for delivering
radiotherapy to cancer patients with precision is unaffordable not to mention
that the therapy itself has to be paid for. The rehabilitation process is
under-financed, and there are no payments for those who need a prolonged period
of treatment elsewhere than in their home town.

‘Just
let the government clarify which areas it cannot help with and we will try to
shoulder the burden’, suggested the director of the charity, ‘Zdes i Seichas’
(Here and Now) and member of Vse Vmeste, Tatyana Tulchinskaya. There is no
doubt that health care can ‘devour’ the GDP of any country. It is impossible to
get by without help from the charitable sector. Ms Skvortsova agreed and gave
an assurance that a list of areas had already been prepared and would be
finalised in conjunction with the charitable community.  Ekaterina 
Chistyakova, director of the charity, ‘Podari Zhizn’ (Give Life”) said
that the state procurement process meant that it was difficult to obtain on
time even those drugs that are provided for by law. The programmes co-ordinator
of the St Petersburg charity, AdVita, pointed out that the quotas and tariffs
were three or four times under-financed within the system of compulsory health
insurance. The executive director of the regional communal organisation,
Souchaste v Sudbe (Sharing in Fate) Aleksei Golovan, suggested that legislation
should be introduced enabling charities to fund advanced medical technology
collaboratively when exceptional costs are involved. An appropriate bill had
already been drafted by specialists.

For
their part ministry staff before and during the meeting expressed concern that
in many cases the treatment provided for by law did not materialise because of
malpractice by various participants in the process even though the funds had
been allocated. The charities agreed to inform the ministry of these cases
where possible. However, they did ask that the possible negative consequences
of complaining should be borne in mind. Cases had already been noted where good
doctors had been dismissed because they had turned to charities for help. Many
heads of clinics and health agencies in a number of regions saw this as an
adverse reflection on their ability to deal with problems themselves. The best
course was for the patients themselves to turn to the charities for help. In
the case of children’s homes and other residential establishments, however,
residents were at risk of failing to receive necessary treatment.

Ms
Skvortsova said that she was aware of these problems too. The minister agreed
that in all these situations it was necessary to proceed with care and refrain
from making things worse. She suggested that a first step towards dealing with
the latter problem would be to look at the possibility of calling a meeting
involving the charities and the heads of the health ministries in all the
Russian regions to talk about working together and to dispel the myths that
were current amongst regional officials and doctors.The meeting would touch on
problems of providing palliative care, of providing medical care in the North
Caucasus and several other regions, and also issues concerning the doctors. All
these items would be allocated to separate working meetings for discussion between
charity representatives and the minister. Ms Skvortsova expressed the hope that
meetings with the charities would take place regularly, at least once every few
months. In the second half of 2013 the ministry hoped that a hotline would be
available for patients and in the meantime information about difficulties with
treatment provided for by law would be collected via the charities and by
monitoring requests for help over the internet including open letters to the
minister. A special department had been set up within the ministry for this
work.

Ms
Skvortsova also proposed setting up a specialist group within the ministry
involving departmental directors, senior external consultants, members of staff
of the charities and other knowledgeable people. The working group would work
on the many substantive issues and on considering rules for joint working
between charities and the government relating to the arrangements for providing
treatment in cases where an urgent response was needed.

http://www.asi.org.ru/asi3/rws_asi.nsf/va_WebPages/788704E450433FC544257B1F003590EBRus