What State Duma's autumn session preparing for healthcare
Boris Mendelevich about how Russia's State Duma plans to develop medical legislation this autumn
The autumn session of Russia's State Duma is already in full swing. The deputy from Tatarstan, Dr. Boris Mendelevich, in the author's column for Realnoe Vremya, tells about which draft bills related to health are going to be considered by the State Duma this autumn.
The budget of Healthcare project has to be sequestered
By tradition, the autumn session in the State Duma begins with amendments to the budget (budget adjustments 2019) and amendments for 2020 and 2021.
When discussing the situation with healthcare financing, we must take into account the new conditions — the pandemic of the new coronavirus. Now we can say for sure that it has divided the national health care into three stages — protecting people's health before the epidemic, at its peak, and in the post-epidemic period.
When the budget discussion started, I, as the head of the working group of the Duma Committee on Health Protection, which monitors and supports the implementation of Healthcare national project, immediately noted that funding for the national project has been reduced by almost 10%. But we all understand that this sequestration was a forced measure. It is due to the unprecedented costs incurred by the state in the fight against the coronavirus pandemic.
But it's not that bad. The Russian ministry of healthcare and the ministry of finance have already promised that if the economic situation changes, they will try to restore funding for the national project to the maximum possible amount within a year. For example, in her report, Deputy Minister Natalia Khorova noted that the health development programme reserves the resources that will be used to treat children with rare (orphan) diseases. This money will be used to purchase expensive medicines, equipment, medical devices, and perform high-tech operations. The amount of funds for this is planned to be enormous: for 2021 ‒ 60 billion rubles, for 2022 — 64 billion, in 2023 — 68 billion rubles. Besides, in 2021, additional funds in the amount of 1 billion rubles will be spent on specialised medical nutrition products for disabled children.
Putting the remuneration system of state employees in order
One of the main events in the legislative work of the parliament this autumn was the adoption of the bill in the first reading on September 23, which will allow the government of the Russian Federation to form common approaches to the remuneration system in various sectors of the public sector, including healthcare.
If the bill is finally adopted, the Russian government will have the opportunity to approve uniform requirements for the system of remuneration of state employees: set salaries, rates, the lists of compensation and incentive payments, and unify the conditions for their appointment.
This will eliminate confusion and free interpretation of the current rules (remember what happened in the regions with payments for doctors who worked with Covid-19 patients), and make the remuneration system more transparent. It is no secret that today there may be large differences in the salaries of the same specialists, not only in different regions of Russia but even within one and the same region.
The bill will create a single clear system in which the official salary will be determined — according to the deputies, it should be at least 70% of the salary. The system of allowances, compensation and incentive payments will have to be determined by the regulatory and by-law framework, depending on the sphere of professional activity.
Biosecurity, telemedicine, and more
There are more important bills in the field of human health protection that our committee is preparing this autumn.
- We take into account the amendments received and are preparing for the second and third readings of the draft law on biological safety in the Russian Federation — it was adopted in the first reading last December, when the first infection cases were registered in China.
- We are also continuing to work on changes to the law on telemedicine (I have already told Realnoe Vremya about it).
- Besides, we need to finish work on the draft bill that provides for a complete transition to electronic document management: we live in the 21st century, and paper document flow should be excluded from circulation as much as possible — it is too inertial and requires too much resources (both time and material).
- At the autumn session, we have planned to introduce a draft federal bill on professional associations of physicians: their powers should be expanded in terms of providing professional expertise.
- In October, in the second reading, the Duma should consider the draft bill of my authorship “On immunoprophylaxis”. It will give the opportunity to get free vaccinations according to the National calendar not only in public medical institutions but also in private and private-public ones. The main thing is that the citizen is attached to this medical institution. I emphasize again, vaccination is vital to preserve the health and quality of life of our citizens, as evidenced by the age-old medical experience of the whole world!
- A draft bill is being prepared to expand first aid, which should divide it into basic and extended — using medical devices and drugs.
- The Duma will consider a bill on remote medical examination of drivers. Here we need to take into account a number of important aspects: for example, improving the convenience of medical examinations should not allow people with diseases that do not allow them to drive safely.
- We will also work to simplify the procedure for informed voluntary consent of the patient. In some cases, a person cannot give it (for example, is unconscious or unable to understand the doctor's speech), and because of this, precious minutes are spent during emergency care that could save a person's life and health.
As a psychiatrist, I also plan to hold a round table discussion in November that will focus on the COVID-2019 pandemic and mental health. It is no secret that the period of self-isolation and anxious moods that have dominated society for more than six months have a serious impact on the psyche. We are talking not only about patients of psychiatrists, but also about healthy citizens, because the psyche is a very subtle and vulnerable structure. At the round table discussion, we are going to assess the situation on the impact of the period of self-isolation on mental health separately by population groups (school children, older generation, teenagers, and all of us), and consider the situation with the appearance of various phobias against the background of the pandemic. We once again will discuss the need to introduce a separate federal project with separate funding — “Mental well-being of citizens” — into Healthcare national project.
We have very serious plans. I hope that the second wave of coronavirus will not make any changes to them, and that we all have enough time, energy and health to implement them all!
Wear masks, use hand sanitizer!