The meeting was attended by Prime Minister Mikhail Mishustin, Chief of Staff of the Presidential Executive Office Anton Vaino, First Deputy Prime Minister Andrei Belousov, First Deputy Chief of Staff of the Presidential Executive Office Sergei Kiriyenko, deputy prime ministers Viktoria Abramchenko, Yury Borisov, Tatyana Golikova, Alexander Novak, Alexei Overchuk, Marat Khusnullin and Dmitry Chernyshenko, Deputy Prime Minister – Chief of the Government Staff Dmitry Grigorenko, Deputy Prime Minister – Presidential Plenipotentiary Envoy to the Far Eastern Federal District Yury Trutnev, Presidential Aide Maxim Oreshkin, Minister of Economic Development Maxim Reshetnikov, Finance Minister Anton Siluanov, Minister of Industry and Trade Denis Manturov, Healthcare Minister Mikhail Murashko, Chairman of the Accounts Chamber Alexei Kudrin, Moscow Mayor and Head of the Working Group at the State Council of the Russian Federation on countering the spread of the new coronavirus infection Sergei Sobyanin, Head of the Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor) – Chief State Sanitary Doctor Anna Popova, and Head of the Russian Popular Front Executive Committee Mikhail Kuznetsov.
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President of Russia Vladimir Putin: Good afternoon, colleagues,
I have already talked to some of you today. I would like to greet those whom I have not seen today.
Today, as agreed, we will have to discuss the coronavirus response once again. Regrettably, the situation is far from simple. Therefore, we will talk about it in detail today. Anyway, this issue has been a priority of late, never leaving our radar. But, as agreed, today we will discuss it in detail.
I would like to ask Ms Golikova to be the first to speak. I would like to hear her views on the current situation with the coronavirus infection and her opinion and assessment of the latest developments.
Vladimir Putin: I would just like to say a few words in conclusion of our meeting following the reports we’ve heard and our discussion.
On the whole, the situation in the country is certainly not easy but it is under control. That said, in some of the regions of the Federation the situation is hard, let us be quite frank. The number of new cases of the disease is growing as we can gather from the figures. Unfortunately though, the number of serious complications is also on the rise. The most alarming factor is an increase in the death rate but we will talk about this separately.
The relatively low disease rates in other regions should not calm us down. On the contrary, this may question the quality of diagnostics, timely detection of the disease, organisation of out-patient observation and the efficiency of home treatment. I would like to ask colleagues both in the Government and the regions to pay special attention to this.
I would like to address the regional governors. We have repeatedly mentioned the regions of the Russian Federation during our meeting. Colleagues, you have received broad powers for implementing anti-pandemic measures. And nobody has relieved you of personal responsibility for the adopted measures– I really do hope that they were adopted on time – or, unfortunately, not adopted at all in some cases.
Needless to say, nobody must try to embellish the situation in any case. Feigning the impression that everything is perfectly normal is absolutely unacceptable. Rosy reports or attempts to hush up the truth are totally useless both here, in the centre, and in the regions.
Today, our colleagues from the Russian Popular Front (ONF), Mr Kuznetsov, said that in many regions people are experiencing a shortage or even absence of the required medicine at chemists (we have discussed this as well), and that people have to wait for a doctor’s appointment or the arrival of an ambulance for a long time. There are quite a few cases when people in a serious condition are left at home although they should have been taken to hospital in line with all indications. These facts are also mentioned in the ONF reports.
The job of all regional governors, your teams, and colleagues is to promptly and consistently resolve the emerging problems on a daily basis, and I would say, even hourly basis, and to monitor all areas of countering the pandemic and key issues of the performance of medical facilities.
Importantly, this applies both to the treatment of coronavirus patients and scheduled medical aid to chronic patients. Let me repeat: if there are setbacks, please respond immediately and remedy the situation without any further delay.
An absolute majority of our doctors, paramedics, medical nurses and ambulance workers are most certainly carrying out their duties courageously – we have heard about this and seen such examples today. They are working professionally, doing everything possible and even impossible, in other words, all they can, and they are even risking their lives to help people. As Mr Kuznetsov so rightly pointed out just a moment ago, they continue doing their jobs even when they catch the disease themselves. It is inadmissible that their colossal efforts and all their hard work are debased by managerial confusion and the local officials’ inability to act coherently and in a coordinated manner so that they have everything they need. We must respond to the requirements of our medical professionals without further delay.
Here is one important thing that I would like to emphasise separately. Back then we approved special payments for the medical workers who are directly providing medical assistance to coronavirus patients.
Pressure on our medical workers has not eased off, as we are all aware, and on the contrary is even increasing. And so these payments must continue. At the same time, the doctors and medical nurses – I know that the Prime Minister has discussed this matter with the medical community, with its representatives – asked for the procedure for calculating these payments to be made more equitable and clear.
In this connection, I would like to remind everyone that a new format of payments to doctors and other medical workers has now been approved as of November. These payments will be based on the number of shifts during which the recipients provided medical assistance, notably diagnosing and providing treatment, to coronavirus patients. This is what the Government has agreed upon with the medical community. Therefore, I would like to ask the Government and the regional authorities to take a serious a responsible attitude to the introduction of this mechanism.
I would also like to ask the Government, based on the current situation and in connection with the approaching end of the fiscal year, to consider measures of additional assistance to the regions. We have discussed this more than once, and some decisions have already been made. We have agreed just now what else can be done, that is, transfer additional funds for payments to medical workers who are dealing with coronavirus patients.
As we know, medical institutions are doing much work that is not directly related to treating patients, and medical students who are brought in by medical institutions are doing some of it. Among other things, this made it possible to free up experienced specialists to work in the red zones.
The students who can work effectively should be incentivised. I propose – I know that the Government has worked on this – providing additional payments until the end of 2020 to medical school students who are not actually employed by clinics or hospitals, but, as part of their practical training, are helping patients. Medical college, residents and post-graduate students in medical specialties should receive payments in the amount of 10,000 rubles a month, and medical school students 7,000 rubles.
Of course, volunteer support for medical workers is much needed now, which has already been mentioned today more than once. This work is already underway as part of the We Are Together campaign. It has been going on successfully for a long time now. I want regional and local authorities to provide necessary assistance to volunteer organisations, including the provision of communications equipment and premises. The initiative and sincere impulse must be heard and supported in every way.
An open and candid dialogue with people without rumours or any sort of speculation is as important now as ever. The decisions must be explained clearly, professionally, competently and in detail not once or twice, but on a continuous basis with the use of all available information resources. It is important to let people know how to protect themselves and their loved ones, and what to do if a person falls ill, how and where to get timely help or professional advice, and where to go in case of a problem.
This is especially important for the people who receive treatment at home. They should not be left alone with the illness.
I would like to mention one more important issue in this context. I know the Government has already sent 5 billion rubles to the regions. As we have discussed, this money is designed to provide home patients with free – let me emphasise the word, “free” – medical services and free medications.
I have to say that the regions are using the funds too slowly. This is absolutely inexcusable. This is inexcusable in any situation but all the more so now. Colleagues, I am primarily addressing the regional governors now, it is necessary to do everything you can to provide medications for the patients at home.
I am instructing the Government to analyse the current state of affairs in each and every region and send additional funds to those places that are short of medications due to the increase in the number of home-treated patients.
I would like to emphasise again: access to free medications must be funded in every region regardless of the number of patients.
But money is not the only problem. In some cases the warehouses simply do not have the required medications. I heard what Mr Manturov said but it is still the task of the Government and the Ministry of Industry and Trade to take measures that will enable companies to promptly increase the production of problem medications. Again, I heard what the Minister said, but I hope all this will be carried out. And the main thing is not just to produce and purchase the necessary medications, it is important to make sure they reach those who need them, that all patients receive them as soon as possible and immediately after they are diagnosed. And, once again, these medications must certainly be free of charge.
That said, I understand that many regions have budget difficulties at the end of the year. I would like to ask the Finance Minister (Mr Siluanov, I am talking to you) to monitor the budget performance in each region of the Federation for the next six weeks. I know the methods but we will not talk about them now. Let’s assume they are correct and fair, but you and we know that…
All right, I will not go into details. I will simply draw the attention of the regions to the need to fully fund all social commitments and payments, as well as the expenses linked with the functioning of the healthcare system and other vital areas.
Mr Siluanov, please review the situation in every region. I would really appreciate your work on this. I know there’s a lot of routine work at the Finance Ministry but this is especially critical now.
And I ask the Government to render financial support to those regions that are really in need of this support regardless of formal circumstances, formal indicators, so that they are not faced with a dearth of funds. Already this week, the regions that are having revenue problems should receive the amount that we all know well – 80 billion rubles – intended to balance their budget.
At the same time, the distribution methodology – we have talked about this – is based on a shortfall in revenue. Let us not go into the details now. I am just drawing your attention to it. Mr Siluanov, you know what I am talking about. We should not forget that there are regions that had a low, very modest level of revenue even before the epidemic. And please refrain from references to their formal shortfall in revenue. They did not have revenues, nor do they have them now. They lack oil and gas and are unaffected by the decline in oil prices. But the situation is as acute as it was previously. There are current pressing financial problems. Please take this aspect into account.
Generally, let me draw your attention to this. Right now we should do all we can to rule out a situation where the regions, to cover the deficits, to repay the budget and commercial loans, will have to repeatedly seek the “high-cost” resources on the market, at commercial banks, and thereby divert funds from the social and economic development goals.
In conclusion, I would like to reiterate this. The regions have been given the broadest possible powers to implement COVID-19 response measures. And they should and will be made to report. But no one has relieved the federal agencies, the Government, of their responsibility either.
The Government’s Coordinating Council, the Emergency Response Centre, and the State Council Working Group – all of them should work, all agencies should keep the situation under their unfaltering watch. Their mission is not just to analyse the regions’ moves and take them into account, but to maintain, to pursue the general, clear-cut and effective policy of coordinated steps.
To do so, it is important to see and understand the real picture. I hope this is so. This is what we did today. It is necessary to continue to study the situation thoroughly, to take timely and well-grounded actions in each region and to help our colleagues in the regions in terms of resources, finances and personnel and in general with organising this work, and to encourage best practices. Today, we talked about Kurgan, which receives medicines, as they say, on an as-needed basis. Why not extend this practice to other regions? It is important to consult our colleagues and come up with the best solutions for each problem.
To improve the efficiency of fighting the coronavirus at all stages, it is imperative to take advantage of the experience of our leading companies, such as Rosatom and the Federal Centre for Lean Manufacturing Competences, as well as the potential of the country's leading research and medical institutions.
This includes setting up call centres in the regions, which we just covered, let's not forget about this, logistics, ambulance and emergency services. It is necessary to rationally distribute the work between the laboratories, computed tomography units and so on, and to finally put in place a system of convenient and patient-friendly doctor appointments at medical institutions. Colleagues, please make supporting the regions in these matters a priority for the coming months.
Let me stress again: inefficiency and sluggishness are unacceptable. Preciseness, efficiency and effectiveness in supporting and protecting people are the key criteria at all Government levels. Please keep this in mind and act accordingly.
Colleagues, the situation really is under control. We went through this in the spring, and we now know what to do and how to do it. We have established work procedures, and vaccines will soon become available. There is enough information on what to do and how to do it when it comes to treating the coronavirus infection. We have a whole new toolbox and new possibilities now. There is no room for error.
Many thanks to everyone. I look forward to this joint work with a good that the people are expecting from us.