Anrei Lebedev, Tatiana Yefremenko
‘Rossiyskaya gazeta’ of 4 December 2007:
http://www.rg.ru/gazeta/rg/2007
(FEDERAL NEWS) ‘Russia should hurry up to sign and ratify the UN Convention on Rights of Disabled People’, was the opinion of Alexander Klepikov, First Deputy Chairman of the All-Russian Society of people with disabilities (RSPwD), on the International Day of the disabled, yesterday.
How can we solve the problems people with disabilities have, and advocate their rights?
According to Alexander Klepikov, First Deputy Chairman of the RSPwD, there have been increasingly more funds spent on the disabled but, oftentimes, these efforts are dissatisfactory. Meanwhile, the social welfare mechanism as ever looks humiliating to disabled persons. For instance, if a prosthetic device needed, formerly one had to approach one officer, but now four officers have to be visited.
The results of the monitoring held by RSPwD in 42 Russian regions revealed that people in 30 regions had found the social provision mechanism worse, and in other 10 regions they spoke of no improvements at all.
‘In his wish to get medicines at discounted rates, the disabled person, who enjoys entitlements, faces lots of problems’, said Klepikov. ‘Few drug-stores release medicines for prescriptions. Sometimes, a medicine is on sale but not available since the quota of discount release is over.
More than often, disabled people have to queue for long. Alexander Lysenko, leading federal expert of the EU and Russia’s cooperation programme on disability, stated that ‘the government is able to provide disabled people only with two-thirds of the prostheses on demand’.
‘As for the bit about a disabled child, his prostheses need be changed more often as he grows. An example is the child with a lost lower limb; unless his prosthesis is regularly changed, he will unlearn to walk’, he goes on to explain.
Another problem is means of transportation the government allocates for disabled persons. The waiting list has expanded to 140 years. And still, the public transportation is almost inaccessible.
‘Today, financial management principles have been used to deal with social issues’, told Mikhail Osokin, Chairman of the Vladimir region RSPwD branch. ‘The funds originally appropriated for medicines are spent on purchasing food, because this money assistance for a disabled person is small (a 1st category (note: severest) disabled person gets only some 4,000 rubles (€111)). As this money is insufficient, disabled people have to refuse the medical assistance and do without it.
With the Law about the monetization of entitlements for the disabled people passed, the laboring ability of a person must be determined now, too. If a person normally has the third degree of laboring ability, and then, gets the second (note: less severe) one, he loses some 1,500 rubles (€41.5). Given that, it is more than often that, for instance, getting a prosthesis device fixed results in lowering the degree.
‘The government reckons: If a person is an amputee, then, in theory, he is able to work’, says Alexander Lysenko. ‘But at the same time, other difficulties the person will face are not considered (note: employers do not wish to employ the disabled). Sometimes, a person’s laboring ability degree is determined zero (note: working ability is not restricted), and with this in place, he receives no monthly money benefits from the state’.
‘I have a friend, who used to be an aviator’, Alexander Klepikov went on. ‘Formerly he was slightly deaf and had a 60 percent laboring ability, and now physicians diagnose near anacusis, but his laboring ability remains just 50 percent’.
The laboring ability degree is determined by the Medical and Social Disability Commission.
‘It takes them thirty minutes to have a disabled person examined. As for me, I was given the due certificates, and that was it’, Alexander Klepikov said.
‘And, as ever’, Mikhail Osokin maintained, ‘90 percent of disabled people on finishing school will not graduate from a higher education institution. An entry in their documents will state ‘can’t be taught’’.
There would rather be more chances to solve these difficulties provided Russia signed and ratified the UN Convention on Rights of Disabled People’.
Recall that the Convention was approved by the UN back on 13 December 2006. One of the Convention main advantages as compared to similar documents is its provisions are compulsory and not recommending in nature. As for today, there are 118 nations to have signed the Convention and eight more to have ratified. Russia, according to Klepikov, is still delaying to sign it, while calculating if it is able to meet the requirements the document includes.
Meanwhile, Alexander Lysenko, leading federal expert of the EU and Russia’s cooperation programme on disability, pointed out that neither do other countries ensure the rights for the disabled on the level the Convention provided for. ‘It should be accepted as a document with future prospects’, Lysenko demanded.
‘We are to step forward by signing the Convention as soon as possible’, Klepikov stated. ‘I believe that neither additional financial investments nor any minor amendments to regulatory enactments can help resolve the system crisis we are facing. Big reforms are necessary’.
Irina Nevinnaya
‘Rossiyskaya gazeta’ of 14 December 2007:
http://www.rg.ru/gazeta/rg/2007
(FEDERAL NEWS) The first results of the work on the strategy of healthcare development in the Russian Federation for 2009 to 2019 are expected in February 2008, Vladimir Starodubov, deputy Healthcare and Social Development minister, was quoted as saying yesterday.
‘The strategy must include all the key points as to organize the medical assistance in the nation,’ the deputy minister recognized. ‘This is both the financing of healthcare and ensuring the accessibility and quality of the medical assistance, and cooperated advocacy of physicians and patients, and insurance of the professional responsibility of physicians’. Those were the conclusions Vladimir Starodubov drew, based on the results of the public hearings that had been organized by the healthcare committee at the Public Chamber of the Russian Federation.
The major difficulty of the work to do is to make not a declaratory instrument but a really feasible programme for the Russian medical profession development. Meanwhile, the experts have not got a definite and common stance on this yet.
Thus, moving away from the ‘socialist-like’ budget financing policy and substituting it with insurance schemes have brought no substantial positive effect in Russia. Insurers themselves acknowledge it. Insurance companies in developed countries do not simply pay the job clinics do, but they are also the main tool to control, on the one hand, the quality of the assistance rendered and, on the other, the efficiency of financial expenses. Well, our insurer is actually a ‘cashier’, whom the money stream goes through; and, that’s it.
The efficiency of the Russian medical science is an individual topical issue. Inequality in accessing qualified specialists, not to mention new technologies to treat diseases, equals that of Third World countries.
Allocation of funds for separate stages of rendering medical assistance is another topical issue. As known in Russia, 60 percent of all expenditures goes to the hospital care, that is, once the patient is seriously ill. This figure is twice as much as that in developed countries. The first step to strengthen prophylaxis activities and to intensify the practice of ‘timing control of the disease’ making it a task for a district physician only, has informed the national project ‘Health’. Today it is important to secure and develop this line of activities.
What is significant is that presumably odd problems must be considered for the conception, which is being developed. ‘Today there is not so much as an abstract of the document, so the ministry is open for any proposals’, Starodubov was quoted as saying.
The transit to the practice of planning budget expenses for several years ahead requires the clear and prompt definition of the branch needs. It is especially so, as the healthcare is still behind of the GDP growth pace, despite a significant increase in the state financing of the healthcare system.
