Doctors were diagnosed with a lack of money

From 2023, the government will introduce monthly bonuses in the amount of 4.5 thousand to 18.5 thousand rubles for about half of the healthcare workers. This money will be received by 379,000 doctors, 725,000 employed as nurses and 65,000 nurses. Surcharges make it possible to bring the salaries of doctors closer to the targets of the May decrees, but do not relieve the authorities of the need to develop a unified approach to wages in healthcare. At the same time, representatives of trade unions of medical workers report that the choice of categories of recipients of additional payments and the future method of their registration “raises questions.”

Within the next month, the government will adopt the documents necessary for the introduction of a new system of federal additional payments to doctors, said on Thursday, December 8, the head of the Ministry of Health, Mikhail Murashko. “Draft documents have already been prepared, and it is planned that payments will begin on January 1,” the minister said. Earlier, Vladimir Putin, at a meeting with members of the Human Rights Council, said that he had instructed the government to assign additional payments to doctors working in primary health care in central district hospitals, district hospitals and in the ambulance system from 2023. The President noted that “if it takes some time for bureaucratic decisions,” then “all the same, all technical issues should be closed in the first quarter,” and the accrual of payments should be issued retroactively from the beginning of the year.

Later, Deputy Prime Minister Tatyana Golikova explained that 379,000 doctors, 725,000 nurses and 65,000 junior staff will receive additional payments in 2023.

Doctors in central district and district hospitals will receive an allowance of 18.5 thousand rubles. per month. Primary care doctors – 14.5 thousand rubles, ambulance – 11.5 thousand rubles. per month. Nursing staff of district hospitals will receive 8 thousand rubles, their colleagues from primary care – 6.5 thousand rubles. The allowance for paramedics and ambulance nurses will be 7 thousand rubles, for junior medical staff – 4 thousand rubles. Also, ambulance paramedics working on calls will receive an additional payment of 4.5 thousand rubles. In total, 152.4 billion rubles are provided for these purposes in the budget of the Mandatory Medical Insurance Fund for 2023, the Deputy Prime Minister specified.

It should be noted that although the payments will cover only about half of the workers employed in the healthcare system (in total, according to Rosstat, there are more than 2 million of them), they are likely to bring the salaries of doctors closer to the target levels. For the industry, as you know, the requirement of the May 2012 presidential decrees still applies, according to which the regions are required to maintain the level of salaries of doctors, middle and junior medical staff in the amount of at least 200% of the average for the subject of the Russian Federation. According to Rosstat, according to the results of the first half of this year, in the Russian Federation as a whole, the salary of doctors was 191% of the average Russian (95.3 thousand rubles against 49.6 thousand rubles), nurses – 96.4% (47 thousand rubles). rubles against 49.6 thousand rubles), the youngest – 81% (40.2 thousand rubles against 49.6 thousand rubles).

At the same time, introducing such surcharges, the government is likely to face certain difficulties at a time when they will need to be combined into some kind of unified approach to wages in health care.

This should happen after 2025 – it was until this date that the pilot project was postponed, the purpose of which will be the introduction of common wage standards in public medicine (see “Kommersant” dated October 9, 2021). Vladimir Putin once again reminded the government of the need to eventually develop a unified approach to the government on Wednesday.

“The introduction of new targeted benefits, and this is how the decision on payments should be called, was not discussed by representatives of the trade union with the relevant ministries,” Mikhail Androchnikov, deputy chairman of the trade union of health workers of the Russian Federation (part of the Federation of Independent Trade Unions), told Kommersant. He added that questions are raised both by the choice of categories of recipients of additional payments, and the future way of their registration. Andrey Konoval, head of the Deystviye medical workers’ trade union, spoke in a similar way – he emphasized that payments can be considered as a temporary alternative to OSOT, since salary increases are necessary for all healthcare workers, and not just representatives of certain categories.

Anastasia Manuylova