Olga Borzova Takes Charge of the State Duma Committee for Health Protection.

RIGHT OF CHOICE: ‘LAW OF SERFDOM’ TO ABOLISH IN HEALTHCARE?

Rossiiskaya gazeta, #4581, 6 Feb 2008

(FEDERAL NEWS) Although the patient’s right to choose a physician is recorded in the Health Insurance Act, practically, the enforcing of the law faces enormous challenges both explicitly and implicitly.

‘The patient should choose it himself, who treats him and where’, First Vice Prime Minister Dmitri Medvedev stated at a meeting of the presidium for implementing the National Projects. In the opinion of the chief monitor for the National Projects, it is the competition among clinics, which will be ensured by free application of insurance policies, and this will make it possible to promote healthcare services. The patient-pays-principle must redistribute financial resources among more or less successful medical treatment facilities, as well as more or less efficient physicians within a single clinic.

True, we have to think it over how to specifically launch this new mechanism, which requires a heavy (if not profound) restructuring of the compulsory medical insurance system.

To be honest, the patient’s right to choose a physician and the free application of insurance policies are formally at work; these are law-guaranteed. On the other hand, one can employ this right in practice very seldom.

According to Alexander Saversky, President of the League for Protection of Patients’ Rights, in 2006, there were over 100 thousand complaints received about healthcare professionals refusing to render assistance to patients, even though they had policies of the compulsory medical insurance, but which were registered with other medical facilities. Never ever was there a single case of a discontent patient who managed to convince the chief physician to change his (the patient’s) doctor. ‘Though, I say it again, the medical insurance law provides for this kind of change’.

The idea to make physician, mainly to interest him/her financially to, compete to treat a patient is not new at all. This principle had to serve as a basis for the birth-giving certificate: Each mum-to-be, each maternity patient brings net income to the clinic for women, which supervises her, and to the maternity home, where she delivers. In this connection, the Federal Service on Surveillance in Healthcare and Social Development acknowledges that maternity patients with positive background really tend to increase in number.

However, there are quite many obstacles, too. Thus, it is only big cities that can boast there are several maternity homes, which can compete with each other. To speak of the clinic for women, a walking distance factor counts in choosing an agency; a woman may want to have a highly-experienced professional supervise her but the professional can, if ever, have his/her practice in another part of the town.

In fact, the principle when territories are assigned to doctors in rendering medical assistance is a great hindrance in building competitive environment. ‘Sure, from the patient’s point of view, it is good that he can choose, for instance, a primary care physician’, Natalia Kravchenko, professor of the Healthcare Management Department at the Sechenov Medical Academy, comments. ‘But one needs to be fully aware of what difficulties may accompany this, too. Take organizational difficulties – as a doctor has more patients in the surgery than he is able to receive, and, financial ones – the more workload should be respectively paid. But what about rendering assistance in the home? Well, if we don’t follow the principle of settling a certain sub-district on a doctor, then, it has to be made clear, how he/she must work on call if this is the case’.

One has to keep in mind, as well, the factor of the subjectivity of patients’ evaluation. Patients pay more attention to the physician’s service quality, that is, how polite or attentive he/she is. However, the evaluation of the medical service effectiveness, that is necessary examinations or correct management of treatment in place, can be performed by professionals with certain expertise but never by ordinary patients.

‘This is why, - Alexander Saversky goes on, - we should develop clear standards and criteria to define the performance quality of a physician in particular and medical treatment facility on the whole. If we introduce such compulsory evaluation and, besides, make this statistics open, communities will have objective information that will enable them to make unbiased choices’.

Currently, the Ministry of Health and Social Development is working on a draft of the conception of the Russian healthcare development. Its goals have been stated and made clear-cut well enough: It is necessary that both physician and medical facility orient themselves on the eventual result, which is the patient getting well; and, their wages should reflect the efficiency of the eventual result. Given this, how to get this result with the least costs remains to be developed.

At One’s Own Will

 Young people are willing to spend their free time not entertaining themselves but helping their neighbour

Valentina Yaroslavtseva, Sverdlovsk region 

(REGIONAL NEWS) – Unpaid help to people is not out of the way nowadays. Recent sociological surveys conducted in the Sverdlovsk region revealed that quite a few young people are willing to spend their free time not entertaining themselves but helping their neighbour.

The researchers believe that it is quite logical. As a rule, the youth have more free time to spend, openness and intact desire to give a helping hand. People just don’t know what to begin with.

Noble hobby

Social project ‘An hour of care’ came to light in late December last year thanks to the spearhead consisting of fourteen young people. Project administrator Ilya Martirosyan recalls:

“First, friends of mine and I would simply visit boarding schools for orphans and homes for elderly, and we did all we could to help there. Then the idea struck us to tell about the project in public, so that all people wishing to take care of the elderly and children could do it.

We don’t render financial assistance as this is what numerous charity funds do. True, now orphan homes are well provided with practically everything – new furniture, toys and DVD-players. But children there, as well as the elderly, simply want to be attended and taken care of.”

So far, the voluntary assistance of project participants has lied in organizing subbotniki (voluntary actions to make a positive change in society usually with regard to environment), performance arts, conducting development games and events at orphan homes. ‘An hour of care’ collaborates with many public organizations and charitable creative groups; it also actively engages students of pedagogical and construction units in its activities. Sometimes the project officers recruit new volunteers outdoors.

“Quite recently, customers at the city mart have been asked to write a message for a kid at an orphan home,” Ilya goes on. “And, there was a response: we managed to collect some six hundred letters. Many people would leave their phone numbers in the messages so they should be contacted.”

Martirosyan admitted all the participants of the project would rather think what they do is a hobby without pursuing any political dividends, not to mention any personal profit.

Ticket to the future

Most people would like to volunteer in their impulse of altruism once or twice a year. But some are happy to volunteer on the regular basis. Such regular volunteer assistance is much more effective if it is well organized.

To achieve exactly this, the Volunteering Centre ‘Parus’ (Sail, - trans.) was established in the city of Yekaterinburg on the basis of the Youth Volunteering Organization ‘Druzhina’ (Retinue, - trans.) together with the Urals Institute for Social Education under the auspices of the department of youth in the Sverdlovsk region and the Yekaterinburg diocese.

The Centre’s main objective is to create jobs for volunteers at enterprises and organizations. For this purpose, they draw lists of both volunteers and the organizations that wish to accommodate them.

They are developing a shop for those wishing to help, who can then choose by themselves a job they would like to do. Head of the social projects at the Diocese Youth Department Ksenia Podymova goes on to explain:

“We seek our volunteers enjoy minimum working conditions. For instance, a girl who wishes to care of abandoned children in hospital must surely have a hospital attendant’s permit, then a hospital uniform, a special pair of shoes. What is also important is that a volunteer comes, of course, to volunteer his abilities unpaid, but I am confident that he or she must be rewarded in some way. We are here to cater for their transportation fees, connection services and food if necessary.

Today, the Centre ‘Parus’ has actively engaged over two hundred volunteers. They are mostly students. It is the second year that they conduct the interactive intellectual game ‘Learn the truth’. The centre accommodates its own membership clubs and holds thematic functions. Ms. Podymlova persists that a creative atmosphere like this helps bring more young people to volunteering activities.

An intelligent approach

It is a must for volunteering centre to give recruits some professional skills. If a volunteer wishes to work, for example, at an orphan home, he or she must have basic pedagogical skills and be psychologically competent.

The conditions created here encourage young people not only to help disadvantaged persons but also to acquire skills and working experience that may be very useful in their future.

‘Parus’ volunteers conduct development games and literature competitions at orphan homes, as well as art and theatre performances. In hospitals, volunteers help medical staff to take care of abandoned babies. Many of the young people collaborate with the Sverdlovsk regional centre for AIDS prevention. They are engaged in meetings with senior schoolchildren and peer students, as well as with the parents of HIV-positive children.

A new project is currently being developed, which is to help the elderly, who require care. There are immediate volunteers, who wish to deal exactly with lonely old people.

“By coming to help their countrymen on a rainy day, the young people learn to interact in society, get the first skills and working experience, and, last but not the least, they find like-minded friends,” the officers of different volunteering organizations confidently say.

SAMARA MS SOCIETY CONTRIBUTES TO THE WORK OF THE PUBLIC CHAMBER AT THE SAMARA ADMINISTRATION

http://ms.samaradom.ru

6 March 2008

(REGIONAL NEWS) – Today, 6 March, the first meeting of the Public Chamber at the Samara Municipal District Administration took place. This representative meeting had been set up on the initiative of Samara Head Victor Tarkhov. Among those who entered the Chamber were the representatives of public organizations, unions and associations, national and cultural centres. On behalf of the MS society, there will be Alexander Kozlov taking part in the work of the Chamber.

“The Public Chamber consists of most respected people in our town, who represent either big public organizations or areas of production, Victor Tarkhov explained. - No doubt, they are all good experts and high-skilled professionals. This gives me a hope that the work we started will go well. I am sure all the city dwellers will witness its fruit. However, the Public Chamber is not a place to solve conflicts but it is rather a constructive area, where similar situations are dealt with. Well, the municipal authorities and Public Chamber pursue the same goal that is Samara’s well-being, don’t they?”

The issues at the top of the agenda can be the most important ones in the city environment. As the meeting participants said it was important that, on the one hand, the authorities should hear citizens and, on the other, citizens should be aware of what the authorities do. Decisions passed at the Chamber are recommending in nature but they are compulsory for consideration of the Municipal Administration.

The participants elected Public Chamber Chairman. The position was entrusted to Alexei Dyogtev, the principle of school 58, who has a huge public work experience under his belt.

The next meeting of the Chamber will see formation of the permanent commissions: (i) expert and analytical one, (ii) for veteran care, (iii) for work with disabled persons, (iv) for family, children and gender development, (v) for culture, (vi) for national and inter-ethnic development, (vii) for youth development and health promotion, (viii) for advocacy of citizens’ rights, (ix) for ecology, and (x) for charity activities.

Office of information and analytics at the Samara Municipal District Administration.