Opening Address at the Session of the State Council Presidium on Increasing the Availability and Quality of Medical Aid 2005-10-11 23:30:28 Penza President Vladimir Putin: Good afternoon dear colleagues! Increasing the availability and quality of medical aid is on the agenda of today's session of the State Council Presidium. Let me point out at once that this is not merely a question of sectorial policy. This is a key condition for improving citizens' quality of life and as a final result, increasing their business and public activities. In general I think this is simply strengthening the country. I think that it is obvious to all of you that we expect solving this problem to be quite difficult. Despite the positive tendencies that have already been described, modernization of the system of public health servies has not taken place. The legislative base has not sufficiently developed and, first and foremost, state guarantees for medical aid and the mechanisms by which they will be financed have not been determined. It is necessary that we fundamentally update the whole system. I expect that the priority measures of one of our national projects will act as an important impulse towards this. The 2005 Address contained its basic provisions and the concrete actions that will take place over the next two years were laid out at a meeting with Cabinet Members and the Heads of the Federal Assembly in the beginning of September. Let me remind you that I am referring to strengthening primary medical care, developing medical establishments' material and technical bases, expanding disease prevention and increasing the volume of high-tech medical aid. And establishing a new wage system must accompany all of these measures. As a result, the availability and quality of medical aid should significantly increase. And the goal is that people feel appreciable results in all of these areas. Speaking very literally, it is necessary to decrease hepatitis by three times, to reduce the number of HIV infections by a thousand people per year, for example, decrease measles by ten times, and to prevent the development of birth defects in children, which are connected to infectious diseases. I also expect that the number of people who will receive high-tech medical aid paid for from the federal budget will increase. Therefore the period during which patients wait for diagnoses must decrease, and the arrival of first aid vehicles must be more effective. There must also be more general practitioners, and this is especially important in rural areas. Just now I mentioned high-tech aid, which is currently being received by only ten percent of those who require it. This is absolutely inadmissible and certainly, in the near future, we must increase this number many times over. The prospective federal budget for 2006 (and it is undergoing the second reading) provides that the Government fully finance these actions. Now these federal measures require active and interested support. We must develop and implement together a common programme of action that is unified at the federal, regional and local levels. I will emphasize that such consolidating efforts are absolutely necessary today, and should take place in the following way. First, already on January 1, 2006 in every Russian region there should be a precise plan for how these stipulated measures will be implemented in each town and city. Secondly, I am waiting for comprehensive measures on providing resources to our own regional and municipal health services programmes, and first of all guaranteeing free medical aid and indexing the salaries of public health employees as foreseen by the budgetary process. I wish to draw your attention to the fact that the means from the federal budget – I simply want to emphasize this – do not replace regional and local expenditures on health services. Federal resources constitute additional money. And I ask that this be monitored together with the presidential plenipotentiary envoys to the Federal Districts. They have already received the relevant orders. My dear colleagues, I am very much afraid that our measures towards accomplishing priority national tasks, including in the field of health services, be perceived by the authorities as a way to redirect regional and municipal resources. Nobody should be able to say: aha now we are receiving federal resources, and therefore we can conserve our own resources and spend them on something else. No way! I emphasize that these means are allocated in addition to those that must be allocated by the regions and municipalities. In connection with this I ask that all heads of regions work at creating budgets for 2006, 2007 and 2008 as publicly as possible. As publicly as possible. I ask the representatives of political organizations, political parties, civil society organizations and media to pay special attention so that our financial plans both at the regional and municipal levels are as transparent and as clear as possible for people. So that the people concerned can track how much is spent on public health services in a given region or a given municipality yesterday, today, tomorrow, last year, this year, or in the next two to three years. That it is clear who spends money and for which purpose. I am very worried that money that appears in regions and municipalities may be spent on something that at first glance seems necessary, on some kind of construction or so-called investments, but that is not one of our priority tasks. Certainly, in some circumstances such investments are both legitimate and necessary. However I wish to emphasize once again that all investments and capital spending should take place after not only professional, but also public scrutiny. Because we all know what this could lead to; nobody ever compares the proportions of cement and sand that are incorporated into the base. I emphasize that very little time is left for organization. The regional and municipal budgets for 2006 are being accepted and it is very important that we do not leave out anything now. And finally, there is an extremely important question. As a whole, we must use the opportunities to implement the national project's priority measures to modernize the system of public health services as a whole. We are now allocating significant resources to this sphere, resources which should create an additional impulse for fundamental changes within the branch, first of all to create a full value legislative base and to introduce modern principles of work in the national public health services. The question of accepting basic laws has been raised not just in this year and has already been postponed more than once. The time for delays has completely been exhausted. I consider that both the Government and the Federal Assembly should pass these necessary laws as soon as possible. It is time to comprehensively define citizens' rights to guaranteed free medical aid, the rights that governmental organs and medical establishments should rigorously provide. Some words on the system of obligatory medical insurance. Its legislation has also not been duly developed. I know that the members of the working group have a number of proposals regarding the ways to replenish OMS funds and finance various establishments. We will discuss them in detail. Therefore the financial and economic tools are important more as a means to accomplish the main task, the task of providing citizens with accessible, high-quality medical aid. All innovations should be directed towards accomplishing this task. I would like to close the opening address on this point, and suggest we start discussing today's theme. I give the floor to Vasilii Kuzmich Bochkarev.