Russians want NGOs to control the work of medical institutions

From NGOs operating in the healthcare sector, Russians expect, first of all, control over the work of medical institutions. This is the opinion of 48% of participants in a survey conducted by the Higher School of Economics. Another 46% of respondents talk about the need to protect the rights of patients. We are talking about the activities of non-governmental organizations that, in particular, organize vaccination campaigns, provide psychological assistance, help ensure access to medical services for low-income groups, and participate in the fight against pandemics and epidemics such as HIV/AIDS. Experts with whom Kommersant spoke point out that the non-profit sector cannot play the role of “supervisory authorities”, and explain the request from the population by complex legislation in the field of health care: the patient does not know what he is entitled to expect under the law.

The Center for Research on Civil Society and the Non-Profit Sector of the National Research University Higher School of Economics, as part of an all-Russian population survey, asked the opinion of more than 2 thousand Russians over 18 years old about the current situation in the healthcare sector and found out how, in their opinion, non-profit organizations (NPOs) and volunteers can help improve it . 43% of respondents considered the state of the healthcare sector to be satisfactory. Almost the same number – 42% – are bad. Only 13% of Russians rated it as good, the remaining 2% found it difficult to answer. The results, we note, generally do not contradict the results of a survey by the social design center “Platform” and the company “Online Interviewer” (see “Kommersant” dated December 18, 2023): 44% said that they were “rather satisfied”, and 54% “rather satisfied” dissatisfied,” answering a similar question.

Almost half of HSE respondents (47%) believe that the activities of NPOs in the field of healthcare are especially necessary in our country – more than in any other area. At the same time, only 16% of respondents believe that NPOs actually work there. First of all, the population expects representatives of the non-profit sector to monitor the work of medical institutions – this option was chosen by 48% of respondents. 46% believe that NGOs can protect the rights of patients.

Director of the Center for Research on Civil Society and the Non-Profit Sector, Irina Mersiyanova, says that similar questions were asked to the leaders of NPOs. It turned out that they see the protection of patients’ rights as the key task, and the control that citizens talk about is only in third place in importance for them. The second is information about the quality of work of medical institutions, which citizens, on the contrary, do not consider a priority. Ms. Mersiyanova emphasizes that, in general, NGOs play an important role in ensuring accessibility, quality and equality of healthcare for all members of society. Thus, she notes, NPOs can provide medical care in places where it is unavailable or insufficiently accessible. Representatives of the non-profit sector conduct prevention programs and raise awareness of healthy lifestyles, organize vaccination campaigns and other educational work. They provide psychological assistance, support medical institutions in purchasing equipment and medicines, and help organize access to medical services for low-income groups. NGOs, continues Irina Mersiyanova, play an important role in the fight against pandemics and epidemics, such as HIV/AIDS, malaria, and tuberculosis. They provide legal assistance and represent the interests of patients before medical institutions and government agencies.

Director of VK social projects and head of “VK Dobro” Alexandra Babkina adds that in health care issues, the NPO plays the role of an expert and partner. A good example, she says, is the work of the Vera Hospice Foundation, which lobbies for changes in the provision of palliative care to people across the country. Peer consultant programs (people who have experienced a particular disease) in oncology are being developed at the Alexandra Foundation, and among people with HIV – at the E.V.A. Association, continues Ms. Babkina. “It often happens that a non-profit organization pilots a new medical program related to assistance with various diseases, as it closely interacts with those who need help. For example, the “Life as a Miracle” charity foundation, thanks to communication with the parents of several young patients with liver diseases and doctors, managed to find a “gray area” in the diagnosis of complex liver diseases. As part of the Hyperammonemia project, the foundation equips hospitals with special devices for measuring ammonia in the blood of children. This helps doctors identify elevated ammonia and prescribe the correct treatment in a timely manner,” she says.

General Director of the Tinkov Family Foundation Konstantin Tikhomirov says that the organization cooperates with more than 70 clinics throughout Russia: “Together we identify areas in which we can help, complement and strengthen each other. We helped with the purchase of expensive equipment for regional clinics, made major repairs, and now we train and improve the qualifications of middle and senior medical personnel.” However, Mr. Tikhomirov emphasizes that non-profit organizations cannot be a “supervisory body.” Hematologist, medical expert of the Tinkov Family Foundation Andrei Abrosimov points out that NPOs (both targeted and systemic) cannot monitor the quality of medical care – this is not enshrined in the current regulatory framework. But NGOs have more important tools: “Practice-oriented education of medical personnel can improve the quality of medical care not for one, but for thousands of patients.”

Lawyer of the “Need Help” Foundation Konstantin Vorobyov points out the complex legislation in the field of healthcare – the patient can hardly independently determine what he has the right to count on according to the law. Therefore, he points out, citizens welcome the activities of NGOs to protect the rights of patients in hospitals and boarding schools, and they, in turn, “act free of charge and independently of government agencies and the management of medical institutions”: “The latter often interfere with the work of NGOs and strive to complicate it, since each the identified violation of patient rights is a potential problem for the hospital.” However, co-chairman of the All-Russian Union of Patients Yuri Zhulev emphasizes that “the task of NGOs is not to punish someone, but to prevent conflicts.”

In this regard, it is appropriate to recall the recent amendments to the law “On Psychiatric Care”: Art. 38, which describes the state’s obligation to create independent services for the protection of the rights of people with mental disorders. Instead, legislators proposed expanding Art. 46: the rights of patients can be protected, for example, by regional and federal officials, but they are required to agree on the conditions for visiting the patient with the head of the medical institution.

Natalia Kostarnova