The lethal outcome of Russian medicine: doctors quit, patients die

The Health Foundation, having studied the statistics of the Ministry of Health, released data on the growth of nosocomial mortality in Russia. Over the year, it grew by 5, 5%. Mortality growth was noted in 79 regions. The fund also reported an increase in hospital admissions in the country. This means one thing: there are more patients, but their treatment has become worse.

Two scandals shocked the medical community in just the past week.

In a maternity hospital in the Stavropol Territory during a cesarean section, a 24-year-old woman in labor died. Seeing that the patient’s condition began to deteriorate sharply, the doctors of the Andropovsk regional hospital together left the operating room. The 72-year-old doctor retreated first, citing pressure. Her younger colleague simply did not want to take responsibility – especially since there was not her change. She urgently needed to leave for family reasons. As a result, 24-year-old Diana K. found herself in the operating room alone, with an overdose of injected drugs. The result is tragic: having lost more than one and a half liters of blood, the girl died. Sanitation, rushing to the dying, could no longer help. Her child survived.

In one of the hospitals in Tyumen, a pre-investigation check is also carried out on the fact of refusal to provide medical care, the website of the RF IC in the Tyumen region reports. In this hospital, a woman with Quincke's edema, a severe allergic reaction that paralyzes breathing and can be fatal, was denied hospitalization. The ambulance managed to deliver the woman to another hospital and managed to save her.

What happens to the doctors who took the Hippocratic oath and pronounced the words: "I direct the regimen of the sick to their benefit in accordance with my strength and my mind, refraining from doing all harm and injustice … May I, indestructibly fulfilling the oath, be given happiness in life, transgressing and giving a false oath, let it be the opposite of this?"

“The system is just crashing. Every day in public health some kind of emergency. If earlier small incidents happened, now everything is progressing. The Ministry of Health practically does not manage anything. Each region creates, in essence, its own health system, by virtue of its capabilities. At one of the meetings, the president was surprised: why in the neighboring regions the prices for the same medicine differ 59 times. It’s just that the regional pharmaceutical lobby does business on certain drugs. According to our survey, 83% of patients stated that it was difficult or impossible to get the necessary medicines. Liberal principles and market relations in medicine – this is unacceptable! ”, – said“ NI ” Head of the Patients League, Alexander Saversky.

As for the "separate Ministry of Health in each region", the system operates like this. “Regional medical institutions must earn at the rate that the regional MHIF arbitrarily sets. That is, the state does not directly finance medical facilities, everything is decided by local MHI funds, which, through the tariff policy, reduce subsidies. There are glaring facts: in the Kuzbass at the beginning of the year, the total accounts payable of state medical institutions amounted to about 1 billion 700 million rubles, in the Murmansk region – about 700 million tons. The result is a lack of specialists, a lack of drugs, a lack of reagents for tests and examinations, without which it is impossible to make a correct diagnosis, ”NI said. co-chairman of the Interregional Trade Union of Health Workers "Action" Andrei Konoval.

Last year, above the national average, mortality was registered in hospitals in 45 regions of Russia. The highest rates are in the Leningrad Region, the Republic of Karelia and in the city of Sevastopol. They are followed by Tula, Tver and Yaroslavl regions. There are many reasons. One of them is the lack of doctors and their overload. Somewhere there is a reduction in rates, somewhere the doctors quit themselves. For example, the other day, on the website of the Russian Research Center named after Blokhin, an alarming message appeared: "At the moment, there is a planned reduction in vacant (not occupied) rates. At the present stage of development of medicine, these rates are excessive to provide medical care to the population. ”

The situation with the mass dismissal of surgeons in the Urals has already turned into a scandal of an all-Russian scale. It became known that the Nizhny Tagil hospital number 1 immediately leave six surgeons who are dissatisfied with the size of the salary and processing. Earlier it was reported about the mass dismissal of surgeons in another, Demidov city hospital. They are considering dismissing the surgery of hospital No. 4. In connection with this, a special hospitalization plan was introduced in the city, and doctors dissatisfied with their salaries said they were ready to go to work at the supermarket even as cashiers. "We drew attention to the information that appears from there. This, of course, is mainly a question for the serious reaction of the regional authorities, regional authorities, and, of course, the Ministry of Health," RIA Novosti quoted the words of Dmitry Peskov.

Surgeons from Nizhny Tagil hospitals massively filed for dismissal.

What happened in Nizhny Tagil? According to URA.RU, the surgeon of the city hospital №1 of Nizhny Tagil Nikita Zotov said that the salary of leaving doctors is only 22 thousand rubles. He stated this in a video published on the youtube channel "Ilya Tagilchanin." “The salary is about 22 thousand. We make money mainly on duty, ”the surgeon said. Also, according to him, the Labor Code of the Russian Federation is violated in the hospital. “We are now coming to work during the day, working, moving smoothly to night watch. Although the code only 12 hours you can work without a break. That is, we work a day and then another half a day, ”said Zotov. In what condition will the surgeon operate after working for another 5 hours after the night shift? What will happen to the patient who falls under his knife?

NI has already reported a catastrophic shortage of doctors in the regions of Russia. The shortage of doctors in the Altai Territory is recognized even by the regional Minister of Health. According to official figures, the number of doctors there is 48.5%, and that of mid-level specialists is 60.8%. In the Novosibirsk Region, 2,000 doctors are lacking, including 400 doctors and 1,500 mid-level specialists. Claims were also to a lack of equipment, drugs. “Everything was ignored. Totally. We cannot agree with this, ”summed up Prosecutor of Khakassia Alexander Kondratiev.

Additional shifts, processing, night shifts – all this leads to a drop in the quality of medical care.

“Save on everything. Now the "Italian strike" of the ambulance is taking place in Karelia, before that the ambulance workers went on strike in Penza, Orel, Tolyatti. Reduce the number of fast-assisted brigades, as part of the brigade – 1 person, people work "to wear and tear". In medical facilities, the situation is no better. Officials report on the "high" salaries "of medical staff and doctors, not mentioning that these salaries are the result of processing and additional duty. In some regions, doctors work 300 hours a month. According to the standard, the norm is 160-170 hours per month. There is simply no one to close bets. Specialists flee from public clinics to private ones, change professions, the remaining employees work "for wear and tear". Our union has evidence that doctors in some regional medical institutions took 8-10 night shifts by the 5-day working week in the hospital. That is, 10 times a month the doctor worked for 32 hours to earn his 20-30 thousand rubles! Worst of all business with salaries in the North Caucasus. According to our data, in Dagestan, for example, 15,000 rubles of "incentive" are regularly deducted from the salaries of health workers for not fulfilling the plan for medical examination and vaccination of the population. And how to drive people by force for medical examination and vaccinations? Lack of nursing staff is a special article. There are hospitals where one nurse serves 35 instead of the prescribed 15 beds. What quality of treatment can we talk about here? Fatigue, disappointment and, as a result, inattention to patients, ”he said. co-chairman of the Interregional Trade Union of Health Workers "Action" Andrei Konoval.

In some medical facilities, a nurse is required to provide assistance to 25-35 patients.

There is another reason for the professional mistakes of doctors. By order of the Russian Ministry of Health, new rules have been approved: the internship has recently been canceled. Now graduates of medical universities can go to study to obtain a narrow specialty only in residency. However, very few people have a chance to get there: the number of budget places is minimal, mainly tuition in the specialty is paid. So soon our medicine may even be left without surgeons, ophthalmologists, gynecologists, dentists and other specialists. The expert’s forecast is not encouraging: “There will either be an outflow of future doctors abroad to study in a particular specialty, or graduates of medical universities will begin to replenish commercial structures, and hospitals will focus exclusively on providing therapeutic care,” our source in the Ministry of Health said.

“I spoke recently in a district clinic of one of the regions with a leader. I asked the question why in the state clinic people can not be treated for free. The answer to me was the official's endless surprise. Thus, the Constitutional right to receive free medical care is violated everywhere. The system is collapsing. There’s virtually no medicine or treatment according to certain standards, ”said NI Alexander Saversky.

Underfunding of healthcare in Russia has long been no secret. Now it takes 3-4% of GDP, while even in Eastern Europe – more than 5%. But not only money matters. The profession of a doctor devalues. She ceased to be a symbol of humanity and humanity. “The collapse process has gone too far.”, – says Alexander Saversky.

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