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Russia - Prime Minister Vladimir Putin meets with Minister of Healthcare and Social Development Tatyana GolikovaTranscript of the beginning of the meeting:
Vladimir Putin: Ms Golikova, at the beginning of the year you spoke a great deal about the healthcare modernisation programmme. I know that the ministry has been working closely with the regions on this issue. The funding for the programme is substantial: 460 billion roubles for two years, plus regional funding. The programme is complicated and its development was not easy. I know that the ministry rejected a number of proposals, and that the governors were directly involved in the project. Preparations have finished, summer has already begun, and we should start working locally. What is the current situation?
Tatyana Golikova: Firstly, Mr Putin, I would like to say that it really was a complicated process. However, to our relief, it is complete. All 83 programmes were accepted by the regions. All 83 agreements were signed by the regional authorities, the Federal Fund of Compulsory Health Insurance and the Ministry of Healthcare and Social Development. As you correctly pointed out, the Fund of Compulsory Health Insurance provided the bulk of the funding, comprising 460 billion roubles. But according to the executive order that we adopted at the beginning of the year, we will not distribute the total amount over the two years, but only 385 billion. A small part, 20 billion, has been allocated for federal institutions. The rest will go to regions that will successfully implement the programme. As of today, therefore, the federal part of the two-year strategy has been approved, to the amount of 385 billion roubles. The total healthcare modernisation funding is over 618 billion roubles.
Vladimir Putin: Does this include regional funding?
Tatyana Golikova: Yes, this is what I would like to point out. Around 114.6 billion roubles makes up the money from the regional budgets, while 118.8 billion comes from the regional compulsory healthcare insurance funds. It is therefore over 618 billion in total.
If we reward the regions for the successful implementation of their programmes, we will reach the sum you have mentioned. As far as children’s healthcare is concerned, we have allocated 163 billion roubles for it, which is 26.4% of the total funding.
Vladimir Putin: Initially, you said it would be at least 25%.
Tatyana Golikova: Correct.
Vladimir Putin: What is the state of rural healthcare?
Tatyana Golikova: Rural healthcare requires a considerable portion as well, as we recommended that the regions support the remote and under-populated villages first. I cannot tell you the exact figure at the moment but at least 10% should go towards rural healthcare.
Vladimir Putin: Do you think 10% is enough?
Tatyana Golikova: It should be, as village residents receive medical care from both rural and city healthcare. I’m talking about standard villages.
Vladimir Putin: You mean rural medical centres.
Tatyana Golikova: Yes. I should add that as of today the regions have received 66 billion roubles and started working quite actively in this direction. We are monitoring the situation and I would like to point out three types of work that are in progress. This modernisation programme (shows documents) is going on in the Republic of Tatarstan. These papers show how one of the local hospitals is being upgraded. We require all regions to provide status reports to us. Tatarstan is an advanced region, and it therefore looks very modern and European. It is an example of a successful project, implemented in stages, and now it is 2011. And here is an example from the Kemerovo Region. On May 20, they reopened one of the units in the Kemerovo City Hospital No.2. It looks like this (shows photos) It used to be the Gynecology Unit, and it looked like this.
Vladimir Putin: They kept patients in the hall?
Tatyana Golikova: That's only part of it! Now it looks like this (shows photos).
Vladimir Putin: This has been done as part of this programme?
Tatyana Golikova: Yes, it is already working. Here is another example from Kemerovo (shows papers), one in progress. It is a children’s outpatient clinic. It used to look horrible. Now the Children’s Unit looks like this.
Vladimir Putin: Ms Golikova, what can you say with regard to supervision? We agreed from the very beginning that implementation of the programme requires strict and constant supervision. The programmes have been developed, the funding has been allocated, but it is coming from the federal budget. We must make sure that money is coming from the regional budgets, too, in the required amount and in a timely manner. How is the supervision organised?
Tatyana Golikova: First, regarding the money, the law and government resolutions, which are clearly stated in the agreements, commit us to distribute the money every month, while the regions also fund the programme from their local budgets on a monthly basis, with a clear understanding as to which facilities receive the money.
Vladimir Putin: Who controls this?
Tatyana Golikova: It is easy for us to monitor this. General financial control is the duty of the Accounts Chamber, while the Finance Ministry oversees budget spending. Moreover, we have established an interagency workgroup that will be monitoring the programme on a monthly basis. It consists of representatives from the Federal Service for Supervision of Healthсare and Social Development and the Federal Service for Labour and Employment, as one of the components is standards improvement, which includes pay levels.
Vladimir Putin: Wage increases.
Tatyana Golikova: It is essential that this takes place. And thirdly, regarding regional compulsory health insurance funds: from June 1 onward, as most of the money will be distributed during this period, they must submit a monthly progress report on each region to the federal interagency commission for further consideration and instructions.
Vladimir Putin: I would suggest that they also submit relevant documents with their monthly reports.
Tatyana Golikova: Yes, very well.
Vladimir Putin: And I would ask you to make a monthly report on the situation in general.
Tatyana Golikova: Of course.