Russian Healthcare Ministry has released a report on the state of healthcare in the regions. In 2018 the number of doctors in Russia increased by 0.07 percent, a total of 404 specialists. However, their number has simultaneously declined in 54 territories of the Russian Federation.
The largest exodus of totaling almost 60% of all regional medical staff was registered last year in the east-Siberian region of Buryatia. In absolute terms, the number of health workers decreased from 3,673 to 1,499. The second highest losses sustained were in the Novosibirsk region -- a decrease by 58 percent, with only 4,600 doctors of the previous 11,000 doctors remaining. Along with it, the number of doctors in Russia increased in 2018 on the whole. The increase was recorded in 31 regions. The most significant one was in Khakassia, where the number of medical specialists increased by 313 percent (8,476 doctors). The increase in the Omsk region was slightly less remarkable at 303 percent. Almost 33,000 physicians work there now. In general, the data on the outflow of doctors from primary care are comparable with the data on the healthcare system in general. The outflow of primary care workers occurred in 46 regions last year. The Novosibirsk region and Buryatia have become the “leaders” here too, with an outflow of 60 and 61 percent respectively. Healthcare Minister Veronika Skvortsova alleges that the outflow of doctors in a number of regions was related to the relocation of specialists to neighboring regions. People are changing their place of residence in pursuit of better social conditions and higher wages. Russian President Vladimir Putin has previously stated the need to provide decent wages for Russian doctors to motivate them. He said it would be impossible to settle the personnel problems plaguing the Russian healthcare system without resolving this issue. In his May 2018 decrees, President Putin instructed the government to ensure that doctors' wages should increase by up to 200 percent of the regional average. In a number of territories of the Russian Federation, this task was accomplished not by increasing salaries, but by using incentive payments. Earlier, Skvortsova told President Putin that the Healthcare Ministry was working together with the Ministry of Labor on a bill that would standardize the requirements for remuneration in the medical field. The Ministry summed up the results for six months that demonstrated that the percentage of the base salary made up less than 30 percent of doctors’ incomes in some regions. Data presented in August by the Federal Service of State Statistics showed that doctors’ salaries had not been raised to the target level in 24 territories. Among those failing to meet the targets are the Murmansk, Tuva and Ingushetia regions. By the end of the year the ministry expects proposals for the modernization of health care in the regions. It is planned to start implementing the programs from the second half of the year. Preliminary estimates place implementation costs at 50 billion rubles. The ministry views the failure of regional medical institutions to comply with the ministry’s requirements because, which report to the regional authorities, as the main obstacle on the way to standardization. Earlier in October, Skvortsova criticized the practice of paying higher salaries to medical directors than to rank-and-file physicians, which is common in some regions. She also made a reminder that the ministry had developed an optimal wage structure. However, despite recommendations by the ministry it is not observed at the local level. It is noteworthy that there were a number of strikes by medical professionals this year, which were covered at the federal level. Thus, in September, physicians at the traumatology and neonatal departments of Hospital No. 6 in Perm a work-to-rule strike. They were joined by emergency doctors from the Petrozavodsk hospital and by the stuff of four departments of the regional children's hospital in Veliky Novgorod. All of them protested against low wages and excess hours “for a pittance in unbearable working conditions.” At the end of September, four employees acting on behalf of all 26 doctors of N.N. Blokhin Russian Cancer Research Center threatened resignation because of “unfair” wages and “management pressure.”