Marsel Minnullin: ‘Not a single chief doctor was fired to my will or some kind of conviction’

“This is a lever to reduce mortality”

Most of the meeting was devoted to medical examination, which is carried out within the framework of the Healthcare national project. According to the Ministry of Healthcare of Tatarstan, today almost 900,000 people out of 1.2 million scheduled for examination in 2024 have undergone it. For comparison, by this time last year, a little more than half a million people came to polyclinics for preventive examinations with a plan of 800,000.

Every fourth person (224,016 Tatarstan citizens) was sent for further examination. In seven months, doctors identified 74,500 diseases — every 12th resident of the republic learned about their illness for the first time. Cancer is among them — from January to July, 841 new cases were found in Tatarstan residents. The good news is that most of the primary cancer diagnoses (78.2%) were made at an early stage. The prognosis of treatment in such cases is more favourable.

“Such measures as medical examination, follow-up, periodic examinations are the basis of preventive medicine. This is a lever to reduce mortality," explained Tatarstan Minister of Healthcare Marsel Minnullin.

A frequent complaint of patients is why so few tests are prescribed during the medical examination? The minister responds to this complaint that their list is standardised. But there is a nuance:

“I am absolutely confident and guaranteed that this list is sufficient to identify certain changes. General blood analysis, biochemistry, urine analysis — we can already see, for example, what kind of lipid background a person has. If a person over the age of 40 has elevated cholesterol, then we understand that he is at risk for diseases of the circulatory system," explained Marsel Minnullin. At the same time, he recalled that these diseases have been leading the top causes of death worldwide for many years. Tatarstan is no exception.

In addition to the main tests, once every three years during the medical examination, patients undergo basic oncological screenings: for colon cancer (all), prostate cancer (men), cervical and breast cancer (women).

“But we understand that a man may develop prostate cancer within a year and a half. Most likely, an approach will be introduced with more frequent implementation of these tests — perhaps, every two years," the minister added.

Another problem of the primary level is a difficult quest with an appointment with a narrowly focused specialist.

“Yes, this deficit really exists, but we are working on it. The regulations on scheduled consultations are in the basic law “On Health”, according to which a person can expect scheduled care for two weeks. It is unlikely that patients wait a month and cannot get to a specialist," the minister said confidently. “But we understand that this is the Achilles heel.

The Ministry of Healthcare is trying to solve the problem of routine examinations by narrowly focused specialists: for example, in Tatarstan polyclinics, a separate reception of patients undergoing medical examination has already been organised. They do not go in a common queue, but in a separate stream.

“To my will or some kind of conviction, not a single chief doctor was fired”

Another of the discussed situations is the high-profile dismissals of chief doctors.

“To my will or some kind of conviction, not a single chief doctor was fired” Indeed, there are head doctors with good self-criticism who come and say: “We can't keep up with the pace and would like to work as regular doctors.” In fact, there haven't been many replacements. In two years, we have rotated eight people out of 115 medical organisations in the republic," the minister clarified.

All retired chief physicians are provided with an alternative:

“Therefore, absolutely no one is offended here. And if you ask, those who wished to leave the post of head were absolutely satisfied. No one says that a monster minister came and started waving a saber.

According to him, all replacements are forced.

“The man himself came and said, “I'm tired, I want to live in peace.” Indeed, the life of a chief is hectic, because you have to think and take care of a lot. First of all, this is the population, this is the quality of medical care, medical examination. Now it is the main resource that can — and will! — lead to the fulfillment of the priority task — to reduce overall mortality," explained the head of the ministry of healthcare.

It should be noted that today Marsel Minnullin appointed two new chief doctors: Ildar Rakhimullin is appointed head of the Almetyevsk Central District Hospital, Ravil Shageev is appointed head of the Leninogorsk Central District Hospital.

“Just imagine: out of ten women who come to terminate a pregnancy, six continue it”

The Federal Ministry of Healthcare has established a norm for abortions: according to the department, 30% of women who come for termination of pregnancy should change their minds.

“Last year we did not reach the 30% threshold," stated the minister of healthcare of Tatarstan. “Since the beginning of the year, we have implemented a good project — the republican crisis pregnancy centre was established with branches in inter-district centres. Obstetricians-gynecologists and psychologists work with a woman by a special methodology.

The project does not require additional expenses from the budget. Marsel Minnullin says the results are already there:

“In fact, we are now not 30%, but 64% efficient. Just imagine: out of ten women who come to terminate a pregnancy, six continue it.”