President of Russia Vladimir Putin: Ms Skvortsova, have you got any good news for us?
Healthcare Minister Veronika Skvortsova: Mr President, I would like to tell you about the results for 2014, but I want to begin by mentioning a decrease in the death rate among mothers, children and infants in this country.
2014 was marked by the fact that along with a small number of other countries we managed to meet the fourth and fifth United Nations Millennium Development Targets by reducing the child mortality rate threefold and the mortality rate among mothers by 4.5 times.
Vladimir Putin: Was this after we adopted international standards?
Veronika Skvortsova: Yes, since the adoption of international standards in 2013, we have reduced the death rate to 8.2 per 1,000, and in 2014 to slightly over 7 per 1,000, and in the first two months of this year, the figure is 6.3. This is a more than 20 percent reduction compared to 2012. We have actually reached our national minimum in both the maternal and infant death rate.
This is primarily due to the development of a well-operating three-tier system. On your instructions, we have already started building additional perinatal centres. This year we are to commission two perinatal centres ahead of schedule – in Nizhny Novgorod Region and in Belgorod Region. The other 30 will be commissioned next year.
The second area I would like to speak about is the development of preventive healthcare. As before, we are working in two main directions here: a mass preventive care strategy aimed at promoting healthy living, health screening and regular medical check-ups.
We have already made significant progress in promoting healthy living: the adoption of the anti-tobacco law made it possible to introduce in 2014 the second package of limitations, which has resulted in a 17 percent reduction in the number of smokers since 2008.
Vladimir Putin: 17 percent? That is a significant number.
Veronika Skvortsova: Yes, and at the same time we have seen a decrease in the number of alcohol abuse cases, while per capita alcohol consumption has gone down by almost one third in the same period.
Vladimir Putin: And the number of people doing sports has grown.
Veronika Skvortsova: Yes, by almost 2.5 times.
We have paid special attention to increasing regular medical check-ups, and over 40 million people have already been covered in 2014. The most important thing is that these check-ups are becoming more detailed.
We have increased cancer detection rate from 50 to 70 percent compared to 2013, that is in one year. This is a very good achievement especially for the types of cancer that are not visible to the eye. Up to 70 percent for gastric, intestinal and prostate tumours.
Most importantly, with this proactive approach, we have increased the rate of early detection – at stages I or II. The detection rate was 72 percent in 2014. We have managed to save 15,000 young women with stage I and II breast and reproductive system cancer alone.
We continue our efforts in this area and 2015 will be primarily dedicated to adjusting risk factors of cardiovascular diseases within the framework of the National Year for Combatting Cardiovascular Diseases.
The third area where we can report positive results is healthcare in rural areas and the development of primary medical assistance. For many years, we observed a reduction in the number of rural first aid stations, paramedic centres and various rural outpatient clinics.
In one year, we built 328 paramedic centres and first aid stations, and about 700 rural outpatient clinics and general practitioners’ offices. As a result, the number of rural outpatient facilities has grown by more than 3,000 since 2011, with the number of various rural hospitals going up simultaneously – from local and regional to inter-municipal medical centres. In 2013–2014, their numbers exceeded 3,000 for the first time.
At the same time, I would like to note that in the same period of time the life expectancy of rural residents went up by 1.5 years, while the death rate has dropped by almost 3 percent.
Vladimir Putin: The current average national life expectancy is 71, isn’t it?
Veronika Skvortsova: The national life expectancy is 71. For women it has grown in the past year to reach 76.5; however, for men it is still rather low at 65.3. This is an 11-year difference.
Vladimir Putin: …and 71 is the average.
Veronika Skvortsova: Another important achievement is a sharp, almost 40 percent increase in the scope of high technology medical assistance achieved in only one year, in 2014. This was made possible by the decision made a year ago to transfer 459 high technology treatments to the basic Comprehensive Medical Insurance programme.
Mr President, I would like to draw your attention to the fact that regional facilities have already completed 80 percent of this work. Their number has grown since 2011 more than three-fold – 3.4 times to be exact. The overall number of facilities providing high technology assistance is now 657.
Vladimir Putin: Is that in the regions or total?
Veronika Skvortsova: This is the total number. There are 461 in the regions, compared to 135 in the past. Such an increase in the infrastructure capable of providing high technology medical assistance made it possible to sharply reduce the waiting time for high technology treatments: from 93 days for both adults and children in 2009, to 41 days for adults and 35 days for children in 2011, and 21 and 14 days, or 3 and 2 weeks respectively in 2014. A very significant reduction. There is practically no waiting time for high technology treatment now.
I would also like to draw your attention to the fact that we were happy last year that rural residents accounted for 25 percent of all patients receiving high technology medical assistance, while this year the number is 26 percent. This actually corresponds to the share of rural residents within the total population.
Vladimir Putin: I would like to hear how you asses the overall funding of healthcare after the Government substantiated and amended the budget for this year and the planning period.
Veronika Skvortsova: This year our funding has gone up by more than 200 billion rubles. This is not only sufficient to reproduce the scope of medical assistance provided last year, but also gives us an opportunity to expand, provided we manage to keep down the prices of medications and medical implants.
Vladimir Putin: The Government has resolved to increase funding in this area, I mean medications. Are you receiving the money?
Veronika Skvortsova: Currently we do not need this money, so we have set it aside for now. We have stabilised the situation. Retail prices for vital medicines have gone up by 6.6 percent since the year began, while for hospitals the growth is 3 percent. I would like to note here that the main hike occurred in January, while in February we already observed a drop, and in March there was no sharp increase. The most important thing is that we have observed a negative tendency in the prices for non-vital medicines, meaning that in March they were lower than in February.
We are trying to maintain direct contacts with both producers, key wholesalers and the association of pharmacies and pharmaceutical organisations. The pharmaceutical organisations, for example, have decided to freeze prices.
We have our resources and so far, the prices for vital medicines are within the limits set by the Government. Together with the Prosecutor General’s Office, we are actively conducting inspections in the regions. In March, we exposed 15 violations of the law, when prices had been raised by 15–16 percent above the limit set by the state. In such cases, we simply launched legal proceedings.