![Visiting a hospital of the Mat i Ditya [Mother and Child, MD Medical Group] private clinic chain. With the Group’s Chairman of the Board Mark Kurtser (right) and Acting Governor of the Moscow Region Andrei Vorobyov.](http://static.kremlin.ru/media/events/photos/big/6XgWAFBAYPTmulbyUXFkGnvZW27t91EM.jpeg)
![During a visit to a hospital of the Mat i Ditya [Mother and Child, MD Medical Group] private clinic chain. With Acting Governor of the Moscow Region Andrei Vorobyov.](http://static.kremlin.ru/media/events/photos/big/oT22E0xyJQ1EMpS2WMoSB2wvsrBhrCev.jpeg)
![During a visit to a hospital of the Mat i Ditya [Mother and Child, MD Medical Group] private clinic chain.](http://static.kremlin.ru/media/events/photos/big/IgmRJ5RcOFzudahdu2ku7TOCN3uFyQLJ.jpeg)
![During a visit to a hospital of the Mat i Ditya [Mother and Child, MD Medical Group] private clinic chain.](http://static.kremlin.ru/media/events/photos/big/wUEE4gJvAK4Bq4cKAjTTEoCYnVfAgOmp.jpeg)
President stressed the need to further support programmes for large families, in particular the provision of land plots for housing construction and payment of maternity capital.
The Government has been instructed to promptly adopt measures to simplify the adoption of orphaned children by Russian citizens.
During the meeting, the President also announced that he had signed the Executive Order that increases payments to non-working parents raising children with disabilities.
Before the meeting, Vladimir Putin visited a hospital belonging to the Mat i Ditya [Mother and Child, MD Medical Group] chain of private clinics. This multipurpose medical facility offers outpatient and inpatient medical care to children and adults.
The medical centre’s main departments include paediatrics, obstetrics and gynaecology, traumatology and orthopaedics, and rehabilitation. The President viewed the surgery unit and visited the children's consultative and diagnostic department.
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Opening remarks at a meeting of the Council for the Implementation of Priority National Projects and Demographic Policy
President of Russia Vladimir Putin: Good afternoon, colleagues,
Together with members of the Council for the Implementation of Priority National Projects and Demographic Policy, various public figures, and experts, today we will discuss Russia’s demographic situation. This is a fundamental issue for almost any country, something that is particularly true in our case. As you know, it is a very acute question for Europe, for many European countries, and in our case it can be formulated as follows: either we will exist or we will not exist.
Not long ago, some experts believed that it was impossible to increase birth rates with government support. While government support has not played an exclusive role, it has been significant; this much is obvious. Some international experts, including those employed by the UN, predicted very hard times for Russia. According to predictions UN experts made in 2000, Russia’s population should have shrunk to 133 million people by now. They actually predicted that we were faced with irreversible extinction. We did not allow ourselves to become disheartened by such forecasts. We launched comprehensive demographic projects and, as you know, today Russia’s population numbers 143 million people. Ten million more than what those very experts predicted. Ten million new lives – that is a success.
Over the past seven years the natural population decline decreased by 264 times: it went from 687,000 people in 2006 to 2,600 in 2012. Along with this, last year we recorded natural increase in six consecutive months, from July to November.
Russia’s birth rate has continued to grow even against the backdrop of economic crisis, and the number of second and third births has increased too. The percentage of second births rose from 30-some percent per year in 2007 to 36.6 in 2012, while the percentage of third ones passed from 7.6 in 2007 to 10.8 in 2012.
At the same time we see serious demographic challenges in the decades to come. We will have to address them in difficult conditions. But I am deeply convinced that our dynamic, goal-oriented measures to support families are precisely what our citizens expect from us today.
The love for children and the absolute value of a large family are deeply ingrained in our culture. Let me recall that in the early 20th century Russian families, both noble and peasant ones, had on average six or seven children. Today in Russia one mother has less than two children. But sociologists confirm that a significant number of our citizens would like to have three or more children in the family. In rural areas the desire to have and raise children is particularly pronounced. Incidentally, in Russian cities only five percent of families have three or more children, while this increases to thirteen percent in rural areas.
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We must create the conditions for millions of Russian families to be able to make their desires and dreams about children a reality, and to remove the obstacles that prevent them from having and raising children. The solutions to these problems should determine the future content of our demographic project. The Council for the Implementation of Priority National Projects and Demographic Policy should be responsible for supervising and coordinating its key aspects.
I note that one of the major factors contributing to the increase in the birth rate in recent years was growing incomes of Russian families in general and the decreased risk of the so-called family poverty when the birth of a child reduces the family’s welfare significantly.
We must continue our efforts to improve family incomes in Russia, to create high paying jobs and raise wages in the public sector. I want to draw the attention of the Russian Government and the Governors that these tasks are set out in the May Executive Orders and must be executed.
We will continue to provide additional support for women with children and for large families. Let me remind you that the lump sum payment at the birth of a child is over 13,000 rubles [$400]. The maternity and birth monthly allowance equals in most cases to 100% of the mother’s average earnings in the preceding two years. However, it does not exceed a certain amount, which is set at 40,600 rubles. But in most cases the allowance amounts to 100% percent of the earnings in the preceding two years, as I said.
Our dynamic, goal-oriented measures to support families are precisely what our citizens expect from us today.
In addition, starting this year, 50 regions with an unfavourable demographic situation will receive funding from the federal budget for the new benefits to families that have the third child and subsequent children. On average, this benefit which is called the child’s subsistence rate amounts to 6,000 to 7,000 rubles a month. The amount is not the same in all regions because it is calculated depending on many factors. A further 13 regions will pay out these benefits out of their own budget.
Now on the maternity capital programme. This year, it will be raised to 408,000 rubles [$13,500]. This measure has already demonstrated its high efficiency, but now we must make it more effective and more targeted.
Let me remind you that the initial maternity capital programme runs out in 2016. That means that all the families that have the second and subsequent children before and during 2016 will receive the maternity capital, according to today's law, but not after that. We must consider the programme’s future together, what can be done after 2016.
We have repeatedly stated that the demographic situation depends on how each particular region helps mothers and supports large families.
The majority of regions have introduced the regional maternity capital, although unfortunately its size varies from region to region, and sometimes significantly, by several times.
It is clear that regions’ opportunities are different but, nevertheless, considering the effectiveness of maternity capital, I would like to ask the regional leaders to consider what can be done in this area to improve the situation.
We must create the conditions for millions of Russian families to be able to make their desires and dreams about children a reality, and to remove the obstacles that prevent them from having and raising children.
Now about housing, which is one of the key issues in demography. Families with three or more children and young families must have access to effective tools to improve their living conditions. It was decided previously – as you know, there were many different solutions, but one of them was to provide families after the birth of the third child with land plots for housing development. That was the right decision and a very good measure, but, unfortunately, it is not very effective because, in the end, what families need is housing and not just a site. We have discussed this issue many times. Of course, it would be good to get a land plots in a good location as well – the family could sell it and raise some money this way, but what is even more important is to build a house. Therefore, the plots that are allocated to families should not be just bare land but, as an option, we should consolidate the land, development and infrastructure projects and launch integrated housing projects.
For example, families that have received free land could combine their resources and form housing construction cooperatives. In such cases, regions must provide assistance with the engineering infrastructure, which will be cheaper if we are not talking about a residential development with several houses than for a separate building. The Russian Housing Development Foundation could prepare the necessary project documentation free of charge. Moreover, this could involve both low-rise construction and apartment buildings.
In addition, in cases involving this category of people, the Russian Housing Development Foundation could select companies that would be willing to build quality homes at the lowest fixed price. Bearing in mind the scale of development, the companies stand to make a healthy profit. Together these measures will significantly reduce the price of housing. I ask you to consider these and additional steps in the near future together with the regions, and generally thoroughly consider all of these issues in order to promote the widespread implementation of these ideas.
With this aim in mind, the regions must adopt amendments to their legislation to ensure that young and large families can buy housing at a fixed price: currently such programmes are already working successfully in 18 regions of the Russian Federation. To make sure that regions have available land resources, we must actively transfer unused federal land to their ownership. We know which ministries and agencies are holding these lands and we have talked about it many times. They must give up this dog-in-the-manger attitude. We must help regions to address acute social problems, particularly in the housing sector.
We must also offer families a wide range of options to address the housing problem, including the provision of social rent housing, special benefits, and so on.
We must continue our efforts to improve family incomes in Russia, to create high paying jobs and raise wages in the public sector.
Colleagues, it is clear that one of the key issues, and we have repeatedly returned to it, is to help women combine motherhood and employment, and that might mean working from home, flexible working hours, retraining for a new career and professional development, including distance learning. These are the solutions proposed by the Government and I consider them effective on the whole. We must promote them more actively together with the regional authorities. These measures are particularly relevant for women who are raising their first and second child aged 1.5 to 3 since the benefits provided during this period are quite modest.
The State Duma has already considered in the first reading the amendments to the Labour Code governing distance employment. I would like to request the State Duma to accelerate the adoption of this law. As for distance learning, this form of education is already enshrined in the new law On Education.
Next. We have agreed that the regions will allocate sufficient resources for professional training programmes for young mothers. What do we have in reality? In practice, all regions have reserved budget funding for these programmes, but some regions have substantial allocations that will be sufficient for this purpose while many regions, unfortunately, or at least some regions have planned allocating 10,000 rubles [$330] per person. What’s that? That is called a sham. I instruct the regional leaders to devote attention to this and Presidential Envoys to carefully monitor what is being done in this respect. Who are we deceiving? Ourselves? Why should we do this?
The efforts must proceed systemically in all these areas. We must involve employers and sectoral associations, public associations, employment centres and employers, and together develop retraining programmes, create databases of jobs that offer flexible hours and encourage businesses to create such workplaces for women.
The maternity capital programme has already demonstrated its high efficiency, but now we must make it more effective and more targeted.
Naturally, we must address the problem of kindergartens and expand the network of preschool institutions, including by promoting private, family kindergartens. Some regions already have such programmes. There is virtually no difference now in the fees parents pay for municipal and private kindergartens. It is important that new law On Education allows for the development of this sector.
A number of regions have radically reduced kindergarten waiting lists for children aged 3 to 7. I am pleased to name those regions: they include the Moscow Region, Samara Region and Perm Territory. However, there has been no progress in a number of regions, including the Kursk and Orel regions, and a number of other regions.
Unfortunately, many regions still have no free places in kindergartens and no money to build new ones, or at least that is what their budget looks like. At the same time the private sector is not creating any competition for the state sector because it is not developing at all. It is considered [by local authorities] a troublesome business that is of little interest. But that is wrong. It is the most important task that is to be addressed today. But it seems much more profitable to get federal subsidies and then distribute these resources.
I want to stress once again that the success of the demographic policy depends on the concerted, focused efforts by the authorities at all levels.
I ask the Government of the Russian Federation, in conjunction with the regions, to review the effectiveness of the measures implemented both at the federal and regional level, and I ask the regions to monitor what is happening in municipalities. Please complete your analysis of the situation over this year and submit your suggestions on what other solutions are required to reduce the differences between regions regarding the main demographic indicators.
The next item on our agenda today is medical care for pregnant women and children. We have managed to radically reduce maternal and infant mortality and our maternal mortality rates approach the western European figures.
You are all aware that the maternal mortality rate has fallen to nearly zero in the areas where new perinatal centres and maternity hospitals have been built. For example, I recall that two new federal perinatal centres have been built in recent years (one of them is ready and the other is nearly completed) and 22 regional perinatal centres were built with the active support of the federal centre.
Last year we adopted the World Health Organisation’s recommended standards of registration for infants with a very low birth weight. This was a difficult decision but it was absolutely correct, although it did, to some degree, ”spoil“ our statistics indicators, but we must proceed from the reality of modern life and introduce the very latest standards to ensure the life and health of our citizens, including the youngest of them. We have just visited such a centre and saw how it is organised. I must say that the standard of care is equally high in the regional and federal perinatal centres.
One of the key issues is to help women combine motherhood and employment, and that might mean working from home, flexible working hours, retraining for a new career and professional development, including distance learning.
We must continue improving the material and technical standards of maternity hospitals, children’s health clinics and hospitals, and women's clinics.
I also ask the Healthcare Ministry, jointly with the Government’s economic bloc, the Finance Ministry, to draft and submit the programme for further development of perinatal centres in the coming years. I would like you to raise this issue in your discussion today and to make proposals.
As I said before, modern perinatal centres should be established above all in those regions that need them and have the required human resources. The Healthcare Ministry must establish a training programme for health professionals to be employed at maternity hospitals and kindergartens.
Today I want to raise another sensitive issue. You know, you probably also receive such letters because you all work in institutions or organisations that have immediate contact with people, and what particularly worries people about the issue we have gathered today to discuss is that in small towns, in rural areas maternity and obstetric centres are being eliminated.
We had proceeded from the assumption that their network would expand within the broader framework of healthcare modernisation, and that their quality would improve. Nevertheless, people write to us about the fact that, on the contrary, their number is decreasing. I understand what the idea is to establish better-equipped centres, both county and intercounty ones. The idea is good, but we must proceed from daily realities. We should look at the conditions of road networks, see how transport connections work, determine whether the women who need them can reach these newly created centres. If they can not, then for whom is this being done? I would ask regional governors to investigate this as carefully as possible. We are to take decisions that are feasible and acceptable to our citizens. The Government jointly with regional authorities should elaborate criteria concerning access to healthcare services in both cities and rural areas.
An extremely important issue that we also have to address today, one which has recently been actively discussed in society at large, is the fate of children without parents. I have already said that such children should find a family here in Russia, their homeland, receive education and, if necessary, medical treatment here.
We must address the problem of kindergartens and expand the network of preschool institutions, including by promoting private, family kindergartens.
Today I signed a presidential executive order that provides for a significant – more than four and a half times – increase in social payments to non-working parents raising children under eighteen with disabilities, or Group 1 disabled individuals [with lasting since childhood health problems] regardless of their age. Such payments will now amount to 5,500 rubles [$180] per month, and will apply from 1 January 2013. This is in addition to a given child’s social pension, which is also increasing. Along with this non-working parents or people who have adopted a child with a disability will not have to gather their documents and travel back and forth between different institutions. Local branches of the Pension Fund will execute and make payments automatically.
In addition, the executive order I just signed instructs the Government to simplify as much as possible procedures for Russian citizens wishing to adopt orphaned children. The Government has already made a number of decisions to this effect, but several serious problems remain unsolved. We are to remove all obstacles that prevent individuals who wish to adopt a child into their family from doing so.
As it stands, Russian citizens can be refused adoption if their house does not meet sanitary and technical regulations and standards. At first glance, this is both logical and right: if housing conditions are poor, a child should not live there. But the problem is that these standards, those that apply specifically to adoption, do not yet exist. Construction regulations exist, but there are none yet relating to adoption. We must either remove this clause or introduce the straightforward standards and requirements.
A large, traditional family must once again become a national symbol. And we have to enlist the efforts of the state, society, religious organisations, national culture, and all concerned Russian citizens in accomplishing this task.
Documents required for adopting a child in one region are not always recognised in another. Yet we live in the same country. I would ask all those who can influence this situation to take the necessary decisions as quickly as possible. The validity term of the papers required by the social institutions on guardianship for granting the right to adopt a child differ. This is unacceptable, the situation must be changed as soon as possible, otherwise citizens have to collect documents from and submit papers to the same legal instance several times.
At the federal level there are no set procedures and timeframes for citizens to take a child into their family. I would ask the Government of the Russian Federation to resolve all of these problems as soon as possible. It is important that as many children as possible who don’t have parents, could find a new family, and for this we must develop not only the institution of adoption, but other forms of family care too, including fostering.
In Russia foster care is a very good form of supporting and bringing up children. It is not a new phenomenon; it is well-known and already used in Russia. We should support and modernise this practice. Foster care in a substitute family must be actively developed. This form of care is particularly in demand for children with disabilities and those older than seven.
Problems in providing high-quality healthcare for disabled children still persist today. People who are not able to resolve many important issues concerning their child’s welfare make the difficult decision to abandon their child. For this reason, families that have children with disabilities, as well as those that want to take in a child, particularly one with disabilities, must be sure that the child will unquestionably receive all the medical care he or she needs. They must be sure that they will not have to ask friends and relatives for money support [to cover medical treatment], nor will they have to abase themselves in queues [in offices of social institutions]. Instead, they will benefit from free and readily available necessary assistance, including medical assistance.
I would ask the Government of the Russian Federation to establish a clear, detailed procedure for providing disabled children with medical care, as well as to resolve all issues associated with the social, psychological, educational, legal and medical support for families that adopt children or raise them, both children with disabilities and orphans generally. In turn, regions should also provide support mechanisms to such families.
Besides, we must understand that most orphans have parents that are still alive. Unfortunately, child abandonment thrives in Russia. Therefore we must do everything we can to support the families who find themselves in difficult situations. The effectiveness of public policy is not measured by how many parents are deprived of parental rights, but rather by how many families were saved and able to go back to living a normal life.
A large, traditional family must once again become a national symbol. And we have to enlist the efforts of the state, society, religious organisations, national culture, and all concerned Russian citizens in accomplishing this task.
Let’s start our discussion.
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