President of Russia Vladimir Putin: Mr Roshal, I know that a congress of the National Medical Chamber has got under way. This is your brainchild, and you have always raised many issues. What is the key, the main aspect of this session?
President of the National Medical Chamber Leonid Roshal: First, I would like to thank you for finding time in your busy schedule to meet and have a serious talk about healthcare problems.
Vladimir Putin: I am glad to see you.
Leonid Roshal: Usually, we have a frank talk, unvarnished, normal. But you yourself probably need it just as much, don't you?
There has not been a congress like this in Russia for a long time. The congress is organised by the National Medical Chamber in cooperation with the Ministry of Healthcare. As many as 2,500 doctors from Chukotka to Kaliningrad gathered in the hall. We received your greetings. Thank you very much.
You know what we decided to do – that at the end of each report there must be a concrete solution, concrete proposal on how to implement it, and the people should evaluate it. In other words, today we are shaping a common opinion of civil society in this regard.
Today, the National Medical Chamber can truly represent our entire medical community. Doctors in all 85 regions of our country voted to join the National Medical Chamber. We have a very simple goal, namely that there should be more good doctors in Russia, that is all. But modest as it is, this goal is hard to achieve.
These are not just words: we have around 280 reports here. Let me show you the programme of the congress. It is very serious. And the issues that have been raised are not banal. Simply, we gave the people a chance to speak. This is very important today.
But of course, there are the regular problems as well: personnel, financing, training.
Vladimir Putin: Still, in terms of substance, what do you think is most important at this congress?
Leonid Roshal: I would say that it is personnel.
Vladimir Putin: Personnel?
Leonid Roshal: Personnel. Both in terms of numbers and professional skills.
As far as numbers go, we can do nothing; this is up to the state. Since the distribution of graduates was cancelled in 1990, as you and I have repeatedly discussed, there has been no influx of fresh blood. But as regards professionalism, we are responsible for this. We want to assume this role and build up a structure. We do not just want to, we are already doing it. We are currently working out professional standards: what each doctor must do at his or her job, what he or she must know, master and do. Professional standards are being used as the basis for new educational standards.
Together with the Ministry of Healthcare, we have conducted accreditation. Representatives of the National Medical Chamber headed accreditation commissions in all regions and administered exams. In cooperation with the Ministry of Healthcare, we changed the structure: educational institutions teach, while admission into the profession is given by a professional organisation.
We signed an agreement with the Ministry of Healthcare, which enabled us to create, basically for the first time in Russia's history, a state-civic model of professional activity management: the Ministry's orders go through the National Medical Chamber prior to being signed, we send them out across the country, collect opinions and then come to the ministry and say “This is good” or “This needs to be changed,” “We disagree on that point.” So, in fact, we gave the ministry a shoulder to lean on. Now, if a law or a resolution comes out and something is wrong with it, people say, “What has the National Medical Chamber been up to?”
As regards the development of clinical recommendations and protocols – this work will be seen through to the end.
The main thing is the protection of medical staff and the status of medical staff. We have created a unique system of independent professional expertise, when a corresponding commission is headed not by a doctor but by a lawyer or a judge, and identifying information is removed from documents, which we send from Moscow, say, to Vladivostok or St Petersburg and so on. And these commissions do not always take the doctor's side. But doctors, the medical community must be protected.
We are now working together with the State Duma on criminal liability. Attacks on medical professionals – ambulance staff, doctors – have doubled over the past year. Unlike other professions, we say that it is not just we who suffer, patients suffer as well. If there is just one doctor at some hospital who has been beaten, who will provide medical assistance? If there is just one doctor or paramedic in a certain district and they are unable to do their job, who will? And we say that, of course, greater liability is necessary.