Russia lacks social system infrastructure
There is no social system infrastructure in Russia, say experts
A discussion on “What kind of social infrastructure do we need?” took place at the Forbes Forum of Philanthropists and Patrons held on 2 March. These centred on what changes to social policy are needed to fully support families with children, people with disabilities and the elderly.
An effective support system for families with children
In Russia, around 70,000 children live in orphanages and 600,000 are with foster families. Approximately 189,000 pass through social rehabilitation centres and shelters every year. The country spends 97 billion roubles annually on providing care for orphans, with 43 billion set aside in subsidies for disadvantaged families. These figures were quoted by Elena Alshanskaya, President of the Volunteers in Support of Orphans Foundation.
“The fact that we are spending so much to make children unhappy is ridiculous. We need a completely different social policy, i.e. a system that provides wide-ranging and effective support for families with children”, said Alshanskaya.
Elena explained that certain conditions had to be created to ensure that families are not forced into crisis, i.e. by providing employment opportunities for parents and care for kindergarten and school children. Professional and accessible help for addicts is required given that most parents of children living in institutions use alcohol or take drugs.
“We could end up with a tiny number of children in need of a new family, much less placements in State institutions”, said Alshanskaya.
The rehabilitation system: From cradle to grave
Russia is 40 years behind other countries in terms of rehabilitation mainly because of a lack of long-term social programmes. In addition, there are no integrated services that can provide modern rehab therapy.
“Our government is not interested in quality”, says Ekaterina Klochkova, a physician, physiotherapist and CEO of the Physical Rehabilitation CSO. “There is a list of social services that are available to people with disabilities. For example, a family with a disabled child can have a consultation with a lawyer once a year and can access a service for collecting items to send a child on holiday on 14 occasions. This is absurd and it’s the same with everything”.
Klochkova said that CSOs are the main drivers in the rehabilitation field. All successful examples of palliative care, help for the elderly and post-operative rehab have come from ideas from CSOs.
“By bringing together all the money that is spent on rehab in Russia, you could create a system for everyone in need, from new-born babies to the elderly. You have to learn to plan and spend smart”, said Klochkova.
Competition in the geriatric care sector
There are nearly three million elderly people in Russia who cannot survive without help. A fifth of them need hospital care while 80% require home help.
“In other parts of the world, geriatric care systems are created by the State in partnership with business and not-for-profit organisations. In this respect, we are light years behind other countries. What will it take for the sector and quality of life for the elderly to change? We need three things: supply, demand and money”, said Alexey Sidnev, CEO of Senior Group, a network of geriatric centres.
Sidnev explained that there are currently only 300,000 hospital beds, although the demand is much closer to 660,000. “What’s more, most of these 300,000 date back to the 1960s. This proves there is no infrastructure”.
Sidnev stressed the need for competition in the care sector but that the State was limiting its scope by “kicking out the non-State suppliers”. He also highlighted the necessity for splitting the functions of implementation and monitorig. “Right now, the State sets the rules of the game, provides services and pays for them. It’s like playing football with the referee on the opposing team”, he added.
Demanding a high quality of life
Sidnev stated that it costs four million roubles to create one space to care for an elderly person. Having an infrastructure alone is not enough – you have to pay your staff.
“It’s very hard to convince the State of the need to invest in quality of care in old age. We therefore have to create a need and understanding among people about quality end-of-life care. Only when the public recognises its importance will the State start paying attention. At present, general awareness in society is sadly lacking”.
Alshanskaya also stressed the need for an overall improvement in the quality of people’s lives. “This is a key requirement that demands investment at both State policy and business level. So far, the State has become used to working based on numbers”, she said.