President of Russia Dmitry Medvedev: Colleagues,
Today’s State Council Presidium meeting is about social policy for senior citizens. We have been working on this matter for a while now, and I have been keeping the issue under my personal control. Over the last month alone I held several meetings in various parts of the country. I visited regional social service provision centres and veterans’ rest homes, and met here with social workers too. The situation in the regions is varied, and you know it well, especially the regional governors present. In some regions things are better, and in others worse. But it is clear that all regions have work to do in this area. At today’s meeting we will take specific decisions and I will issue the relevant instructions following all of our work at the end of the month.
I already said that care for senior citizens is one of the state’s absolute priorities. We must not forget that senior citizens make up a large share of our population. Using the current definition we have more than 30 million senior citizens, and this is one in five of our people or even more.
Experts predict that over the next decade the number of pensioners will increase. This is to be expected given that we are trying to increase life expectancy in general. In particular, the number of people over 80 will increase. We need to do everything possible to give them better living conditions, whether in the cities or in rural areas, and ensure that they are part of normal life.
I already noted that we have made progress of late in improving our senior citizens’ situation. Pensions have been increasing every year, although of course they still seem smaller than they should be in general. We decided to include in fuller measure years worked during the Soviet period when calculating pensions. Today there are no pensioners with an income below the subsistence level, though some pensions are still very small of course. This is just the first step in developing the pension system. We will take further steps in the future, but they will require separate discussion.
The state of medical care and the situation on the pharmaceuticals market are a crucial factor for senior citizens’ health and bringing down the death rate. It is extremely important to maintain a normal level of service and stable prices and ensure a full range of medicines. In this respect the state purchase system for medicines needs to work as effectively as possible. At the moment this is unfortunately not always the case. Artificially putting up the prices for medicines is amoral, not to say criminal. We also need to examine thoroughly the situation with provision of medicines within the framework of the regional programmes in place around the country. The regions themselves must get the system of registration and payment of benefits to people into order too. This is a very important task and in most cases remains to be organised in satisfactory manner. As has been said before, the pharmacy network also needs to be expanded, and more active effort must be made to develop the sale of medicines at rural paramedical centres, making use of the provisions making this possible, which came into force on September 1. We also need to make it easier for senior citizens to obtain prescriptions and organise a convenient system of home delivery of medicines. This is something I discussed during my visit to Kozelsk.
It is very important to organise these kinds of possibilities for people with limited mobility and people living in remote settlements and rural areas. Pensioners in such places are in a most vulnerable situation because of the low level of everyday and social services. These people also need to have the chance to receive everyday social services and medical services with the help of mobile brigades, new social technology and telecommunications technology.
Coming to another important matter, we have more than 4,000 social institutions around the country. They vary in the quality of service they provide, but waiting lists for live-in facilities such as rest homes and care centres for the elderly and similar facilities are not growing any shorter, and yet these facilities often leave much to be desired, to be frank. Of course there are some facilities offering high standards – the ones the bosses usually visit to see how things should be working. But there are others that present an awful sight and that require urgent work to improve the situation. I am not talking about any luxuries here, since this is not possible at the moment, but they must have all the basics at least, whether in towns or rural areas, whether in new buildings or buildings built in the 1930s, say. We need to move senior citizens out of dilapidated facilities and get them into modern buildings. All the more so as when I visited these places I saw how people are very thankful for any help. They are extremely thankful for things that really they should not have to thank us for. In other words, they are very grateful for any kind of attention that comes their way.
Along with the traditional nursing homes we also need to develop the senior citizens’ care centres, veterans’ rest homes, and small-scale homes that have started to appear of late. We have seen examples of these kinds of facilities, including in Kursk.
I want to note once again that care for the elderly must not be just a formality, but the subject of our constant attention. We have become much more attentive towards our youth of late, and it has become prestigious to help children. Practically everyone realises now that this is a priority for the country. The federal and regional authorities, the business community, and public groups all understand this. But working with the elderly is not yet fashionable in our country. This is not something that receives much public attention. But we realise that this is no less important than paying attention to the future generation.
We also need to look at organising leisure activities for senior citizens. There are a number of interesting ideas. One such idea mentioned recently was that of social tourism. We need to offer preferential conditions at sports and health facilities, including in educational establishments. I know that some regions already have experience in these areas, and this is the kind of practice we need to spread.
Another subject related to social services for senior citizens is the social workers themselves. We realise that how they work, how they understand their work, and their social status all have a big impact on our senior citizens’ wellbeing. But frankly, as we have already discussed here, even their wages differ significantly from one region to another. In a number of cases wages in some regions are below the set subsistence minimum. But we must remember that these are the people looking after our senior citizens. We need to give them moral and material incentives. Their number also includes people who do not ask for much, people for whom this work is a vocation. We realise how difficult this job can be, how hard it can be to work with the elderly, help them, provide them with the services they need. And so we need to raise this profession’s prestige. When I met with social workers here we agreed to organise a national competition for the ‘Best social worker’, just as we do for school teachers.
We also need to develop specialized knowledge about aging and include gerontology and geriatrics in the relevant universities’ curriculum. We need to make practical work with senior citizens part of students’ study programmes. This would also help to improve the quality of social service agencies’ personnel.
Non-commercial organizations are starting to take part in providing services to senior citizens in many places, and in some cases business organizations are also getting involved. But this is a subject that we need to work on separately, including through public-private partnerships and partnerships between the state authorities and the public.
Provision of housing and utilities services for senior citizens, especially for those living in their own apartments and houses, is one of the most complex and sensitive issues. This will be the subject of separate work. I will work on it over the coming month and we will hold a State Council Presidium meeting on the subject at the end of November.
Finally, in the area of legislation, it is clear that we need to develop and improve it. This is also something we could discuss, along with the drafting of the new law on social services, which will concern not just senior citizens but everyone in our country.
These are main areas for our work.
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We spent a month working and this has been useful in enabling us to assess the current situation, identify the biggest problems, and evaluate our possibilities. We do not have super possibilities at the moment, but there are things we can do. The situation is not as bad as it sometimes seems, and there are things we can achieve by, for example, distributing existing resources more rationally, and ensuring a more targeted approach. I fully agree with this. It may sound paradoxical, but the demand to standardise benefits and the demand for a more targeted approach actually mutually complement each other. We simply need to get our priorities in the right order.
I will sign the various instructions that come out of these discussions. I have already made some changes along the way during the discussions, but these are big plans, serious ideas, and we need to ensure proper organisational support for them, and financial too where necessary, despite the current difficulties.
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We need to examine the current situation and come up with new forms of work. There are programmes that were approved a long time back and must go ahead whatever the case, and I do not even want to hear anything otherwise. This concerns the programme to provide housing for all Great Patriotic War veterans for example. The money has been provided already, but there are some problems at local level. Discuss this with the Regional Development Ministry, come up with some schemes, but that this must go ahead is not open to question.
I also agree with what was said in particular by the representatives of public groups, and namely that we cannot always place the whole burden for caring for senior citizens on the state. Our country and people have changed greatly, and people of all ages must realise that caring for the elderly is not just the duty of the ministers here today, or of state funds, but of all of society. It is the task of public groups and business too. I said at the start and I say again now that it is easy to ask for money from business for young people and children, but no one gives money for the elderly. It seems they all think they will never grow old themselves one day. We need to change our thinking in this area. This thinking is rooted in a number of traditions. It is time to leave these Soviet traditions behind and return, perhaps, to the traditions we had in our society further back in the past, including religious traditions, because our country’s religious traditions made care and respect for the elderly an unquestioned priority. Of course, the situation with living standards in general is also a factor, but whatever the case, our laws on charity activities and philanthropy should be suited too to the support needs of our senior citizens. This is just as much a priority as helping our young people and children.
We have worked quite hard. There will be many instructions, and I will give them a final review and issue them soon.
Thank you, everyone.