Physicians in Tatarstan asking to introduce regional ‘Covid-19 allowances’
The Republican Trade Union of Medical Workers has proposed to introduce a regional premium of 25% of the salary
After the transition to a new order of federal “Covid-19 payments” to Russian physicians, the Tatarstan trade union of healthcare workers appealed to the government of the republic for support. The Committee of Trade Unions proposed to introduce regional compensation surcharges of 25% of the salary and extend them to those who work on the front line — employees of ambulance stations, paramedics of therapeutic areas and other medical workers. In the conversation with Realnoe Vremya, the head of the trade union, Gulnar Khusnutdinova, did not name the necessary amount of expenses but hopes that the republic will not leave doctors.
Federal payments withdrawal syndrome
The Tatarstan committee of the trade union of healthcare workers undertook to “beat out” compensation payments to medical workers from the republican budget in return for federal “Covid-19" payments cancelled from July 1. The thing is that against the background of the improvement of the epidemiological situation in Russia it was decided to leave an allowance of 25% of the salary only to some physicians working with Covid-19 patients. Previously, this payment was received by all healthcare workers in contact with patients with infectious diseases.
Gulnar Khusnutdinova, the head of the trade unions of medical workers of the Republic of Tatarstan, sent an appeal on the need to introduce monthly regional premiums to doctors who provide care to COVID-19 patients with the support of the branch union. The letter is addressed to Prime Minister of the Republic of Tatarstan Aleksey Pesoshin and Minister of Healthcare of the Republic of Tatarstan Marat Sadykov. She confirmed the information about this in a conversation with Realnoe Vremya.
The appeal expressed concern about the deterioration of the financial situation of physicians in connection with the termination of federal “Covid-19" compensation payments. “To prevent violations of workers' labour rights and prevent social tension in the collectives of medical organisations”, the Tatarstan trade union asked the Prime Minister of Tatarstan:
“To consider the possibility of financial support for medical workers engaged in providing care to COVID-19 patients and equalising the amount of compensation payments for all categories of medical workers who are involved in the fight against the new coronavirus infection," the authors of the letter write.
25% of salary or compensation for “harmful conditions”
According to Gulnar Khusnutdinova, the trade union asks to introduce additional payments of 25% of salary for the republic's physicians, which corresponds to the recommendation in the Decree of the Government of Russia No. 1268 “On the procedure for providing compensation payments to certain categories of persons at risk of contracting the new coronavirus infection”. This guidance was given the regional authorities on July 15 of this year. On the same day, additional social guarantees for doctors were suspended, which were provided under three decrees of the President of Russia (dated May 6, 2020 No. 313 “On providing additional insurance guarantees to certain categories of medical workers”; dated July 30, 2020 No. 487 “On Amendments to the Decree of the President of the Russian Federation dated May 6, 2020 No. 313 “On the provision of additional insurance guarantees to certain categories of medical workers”; dated February 1, 2021 No. 60 “On additional state guarantees to certain categories of citizens”).
The cancellation of additional payments from July 1 was explained by “the stabilisation of the epidemic situation caused by the spread of the new coronavirus infection (COVID-19), and the transfer of medical workers to a regular scheduled work mode”. According to the federal trade union of medical workers, the cancellation of the federal package of payments was made unexpectedly, without consultation with trade unions, and the funds for the payment of compensation allowances were not included in the budgets of the constituent entities of Russia.
The head of the Tatarstan republican committee, Gulnar Khusnutdinova, confirmed to Realnoe Vremya that “the guidance was given by the federal authorities, and the regions will have to pay”. It is for this reason that the trade union had to make the request to the government of Tatarstan. According to her, the sources of compensation payments were not provided for in the estimates of income and expenses of industry institutions, so the republican committee asks for additional allocations from the republican budget (for the execution of the decree of the Government of the Russian Federation No. 1268 as of July 15, 2022, — editor's note).
“A difference of 20 times is a mockery!”
The head of the trade union did not name the total amount of additional expenses to be found in the republican budget but noted that regional premiums are likely to be lower than federal ones. According to her, so far it has been a significant component in the earnings of medical workers: “Someone received an additional 70 thousand rubles a month (these are those who worked in the red zone of hospitals), someone — 7 thousand rubles, someone — 1 thousand rubles. It depended on how much they worked. Not everyone was paid the same payments. It was a fixed amount of premium, and it was different.”
Mikhail Androchnikov, the deputy chairman of the Russian Medical Workers' Union, spoke much more specifically about the problem. According to him, “if before the cancellation of 'Covid-19 payments' a doctor working on the payroll in the Covid-19 department received 77-110 thousand rubles in different periods, now the payment to a doctor faced with coronavirus is 4,5 thousand rubles. A difference of 20 times is a mockery! The phrase “thanks to the doctors” is implemented. Thank you, and nothing else.” Will doctors want to risk their health in the red zone with such a low premium? The question is important on the eve of a new wave of coronavirus, which is now gaining strength.
Ambulance left overboard
To prevent medical workers from quitting in the autumn, the Tatarstan committee of trade unions proposes to expand the list of physicians who are entitled to regional compensation payments. According to the head of the trade union, Gulnar Khusnutdinova, in the appeal to the government of the Republic of Tatarstan, the authors of the letter proposed to include in the list:
- ambulance station workers, including drivers;
- medical workers conducting pathoanatomic studies;
- medical workers of diagnostic services, including clinical diagnostic laboratories;
- narrowly focused specialists of inpatient and outpatient level;
- paramedics of therapeutic sections of polyclinics and paramedic-obstetric stations involved in providing medical care to patients with the new coronavirus infection.
She did not specify the total number of categories of doctors who can be covered by regional allowances.
At the same time, she stressed that the trade union returns to medical workers what has recently been unfairly taken away from them. According to her, in the new federal regulations, ambulance was removed from the list of medical institutions who are entitled to “Covid-19 payments” and these doctors were also excluded from the list of positions. “That's why we wrote: return the ambulance and return these posts," Gulnar Khusnutdinova said. Presumably, the final list of medical institutions will include inpatient hospitals specialising in the treatment of patients with pneumonia and coronavirus infection, polyclinic departments dealing with viral respiratory infections and influenza, home care teams.
“Chief physician has to take it away from someone in order to give it to someone”
The main purpose of the appeal is to achieve an increase in the wage fund for each medical institution, otherwise the aggravation of social tension in the collectives is inevitable, the leader of the trade unions of medical workers of the Republic of Tatarstan noted. The thing is that now the salary fund of the institution is distributed among the entire team, and after the federal recommendations on the introduction of a 25% premium, chief physicians will have to redistribute funds in a new way, which means that some part of the team will lose money.
“As a result, we want to have a salary fund added to us 'to the top'. And if they don't, then the question arises where to get the money for the premiums. The chief physician has to take it away from someone in order to give it to someone. It turns out, as in the famous saying: “you pull a blanket over your legs, your shoulders open”. Therefore, it is imperative that funds be added from the regional budget," Khusnutdinova summed up.
The average salary in the healthcare system of Tatarstan is 45 thousand rubles, and for doctors — 83,2 thousand rubles, Gulnar Khusnutdinova clarified. This corresponds to the presidential May Decrees, according to which the doctor's income should be 2 times higher than in the region. “The average salary of doctors in Tatarstan is 43,2 thousand rubles, so we maintain this bar of 80 thousand rubles," he said. “I think that the parameters of the roadmap will be maintained," the trade union leader believes.
There has been no response to the appeal yet. How doctors' salaries may change after the initiative, the trade union has not yet said:
“We can't say how much, because neither I nor the Ministry of Healthcare of the Republic of Tatarstan knows, everything is calculated. Firstly, the methodology of how to count premiums is not defined. It is unclear whether they will count shifts or for a month. Secondly, it is unclear how many healthcare workers will be covered by payments," she said, adding that she hopes for “one option”, but “still the situation is difficult”.
Regional allowance was given to doctors in Novosibirsk
The appeal of the Tatarstan trade union to protect the interests of medical workers was made in early August, that is, a month after the Russian government ordered the cancellation of federal “Covid-19 payments” to doctors across the country. In other words, the reaction to the deterioration of the financial situation of healthcare workers followed immediately but has not yet brought results.
“The salary amount must correspond to the employee's qualifications, quality and working conditions. This is important for strengthening the human potential of our healthcare," Raul Khalfin stressed.
In Siberia, a “Covid-19 premium” of 25% of the salary was introduced, and the salaries themselves have also been indexed by 10% in Novosibirsk Oblast. “The increase in the incomes of medical workers was the result of negotiations between the minister of healthcare of the region and the chairman of the Novosibirsk regional organisation of the trade union," the union said in a statement.
Now Tatarstan doctors have to wait for the decision on regional allowances to be made. At the request of Realnoe Vremya, the Ministry of Healthcare of Tatarstan reported the following:
“In accordance with the Decree of the Government of the Russian Federation dated 15 July, 2022 No. 1268 “On the procedure for providing compensation payments to certain categories of persons at risk of contracting the new coronavirus infection”:
— special social payments to medical and other workers providing medical care for the diagnosis and treatment of the new coronavirus infection (COVID-19), carried out through the Social Insurance Fund of Russia, have been suspended since 15 July, 2022;
— compensation payments in the amount of 25% of the salary of medical workers providing medical care for the diagnosis and treatment of the new coronavirus infection have been established since 01 July, 2022.
Currently, an order has been prepared by the Ministry of Healthcare of the Republic of Tatarstan on approval of the list of medical organisations providing medical care to patients for the diagnosis and treatment of the new coronavirus infection (COVID-19).
The Ministry of Healthcare of the Republic of Tatarstan has sent an appeal to the Cabinet of Ministers of the Republic of Tatarstan on the introduction of appropriate amendments to the Resolution of the Cabinet of Ministers of the Republic of Tatarstan dated 25 April, 2012 No. 323 “On the conditions of remuneration of employees of medical organisations subordinate to the executive bodies of state power of the Republic of Tatarstan and certain non-standard institutions subordinate to the Ministry of Healthcare of the Republic of Tatarstan” regarding the establishment of compensation payments in the amount of 25%".