Became known the details of the new system of salaries of medical workers
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Each region will have its own coefficient.
The introduction of a new wage system in healthcare, which health workers across the country have been waiting for for many years, was announced by Minister of Health Mikhail Murashko. True, the system will now work only from 2025. The minister clarified that while it is being tested in several regions of the country, the transition to it for everyone will take place “taking into account their experience.” “MK” learned what lies at the heart of the new system, why the transition to it took so long and what to expect for medical workers in the future.
Experts have been talking about the fact that the current system of remuneration in healthcare, to put it mildly, is imperfect. Andrey Konoval, the head of the Deystviye medical workers’ trade union, told MK that today each region sets the salary of medical workers and a list of compensation (for harmfulness, night work) and incentive (for qualification, category, quality of work) payments. As a result, the salaries of doctors differ in regions sometimes up to 10 times. In one subject of the Russian Federation, the same specialist can receive 8,000 rubles, in a neighboring one – 15,000, and somewhere else – 35,000. It happens that in the same region salaries differ by 1.5 times. “The industry is underfunded, salaries leave much to be desired, they save on them. Although I believe that a doctor, wherever he works (in Kamchatka, in the Urals, in Moscow), if he works according to uniform medical standards, should receive the same. The rules must be the same. But today, the highest salaries are in Moscow and St. Petersburg, where doctors from neighboring regions are trying to get a job, exposing local medical facilities and reducing the availability of medical care there, ”says Andrey Konoval.
The task of the new system is to introduce uniform rules for the country, according to which the amount of salaries and a list of incentive and compensatory allowances, as well as the procedure for their formation, are established. Salaries will vary by position and will also depend on the coefficient of regional differentiation, which is tied to the median salary in the region. For the 12 poorest regions, the coefficient is 1, for Moscow – 3.6. And although under the new system the salaries of doctors in Moscow will still remain much higher than regional salaries, they will still rise throughout the country as a whole. “If in 2021 the salary of a nurse in the Kurgan region was about 6,000 rubles, then according to the pilot project, it should have increased to 13,000,” explains Konoval.
The pilot project to launch the new system in 7 regions was supposed to start on July 1, 2022, a separate Government Decree was adopted on this occasion, with a detailed breakdown of all new salaries and payments. A “road map” was also adopted, according to which in 2024 the system was to be implemented on a national scale. But… The project did not start. And on July 5, 2022, the authorities suddenly announced that its start was postponed to 2025.
And if we go a little deeper into history, then the President gave the government an instruction to develop and transition to a new sectoral wage system back in the fall of 2019. It was supposed to start operating in 2020, but first its implementation was postponed to the end of 2021, then to July 1, 2022. Now we have to wait until 2025. “That is, this is not news at all – the fact that the implementation of the system is postponed only to 2025 was reported more than a year ago. And now for some reason it has been passed off as something new. And it is not clear what kind of pilot projects in the regions Minister Murashko is talking about. All projects were supposed to be launched a year ago, but were cancelled. Today, there are no pilot projects in the regions in this area. No new research is needed to implement the system: all the experience has long been studied, all the data has been collected. And so it is possible to explore until the end of the XXI century, – says our expert. – One gets the feeling that, constantly postponing the transition to a new system, the government simply finds reasons not to fulfill this order of the president, it is not interested in it. Now they do not seem to cancel it, but only postpone it for an indefinite period. I would not be surprised if in 2025 it is moved to 2027 or immediately to 2029. And it’s very bad. Because with all the minuses associated with the huge difference in salaries, the new system nevertheless led to the equalization of the level of payment in different regions. In general, salaries should increase by several times for both junior and middle medical personnel. And doctors have been waiting for this reform for a long time, we talked about the need to switch to it back in 2012. And in 2019, we really hoped that the authorities responded to the protest speeches of doctors in a number of regions, and then simply began to push back the implementation of the system. I think that today there is a serious request for such a reform both from medical workers and from society, which is facing a total shortage of medical personnel in the regions. Now, it turns out, until 2025 the situation will degrade.”
Experts believe that by postponing the introduction of the system for 2 years, the government is postponing the solution of one of the main health problems for at least four. The price of the issue is actually not so high: according to the government itself, the implementation of a pilot project in 7 regions would require an additional 3 billion rubles a month from the federal budget. There are 85 regions in the Russian Federation, therefore, the total additional costs for the implementation of the system would require about 440 billion a year.
…Recall that, according to the May 2012 presidential decrees, it was supposed to raise the salaries of doctors to 200% of the average salary in the economy. Meanwhile, not so long ago, social activists said that so far the salaries of most doctors and nurses in Russia have not reached the level that was set by the May decrees. It was planned to achieve such results by 2018, but, according to 75% of respondents, their income has not grown so much by the end of 2022.
Newspaper headline:
Doctors are asked to be patient
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