Healers of budgets

More than 312 billion rubles were spent last year on the implementation of the Healthcare national project. Using this money, Ministry of Health officials further reduced the bed capacity, did not succeed in solving the problem of staffing shortages, and also changed statistical indicators in their favor.

Judging by the reports, the Ministry of Health is working perfectly. As calculated by the Ministry of Finance, at the end of last year the department Mikhail Murashko spent the national project budget by 97.9%. In total, 312.4 billion rubles out of the planned 319 billion were spent on the development of domestic healthcare. At the same time, it was possible to utilize 100% of the allocated funds within the framework of projects to provide the healthcare system with qualified personnel, develop a network of national medical research centers, and introduce innovative technologies.

Why, then, in real life are there not enough doctors in hospitals, and innovative technologies are often only available for money?

Doctors with a C grade

The problem with the shortage of medical personnel has become so acute in recent years that even the Ministry of Education and Science has started talking about the controversial successes of the Ministry of Health in solving it. It turned out that applicants with obviously low scores are recruited for targeted training.

According to him, last year the average passing score for medical universities in the general competition was 77.03, while the passing score for target places was only 69.39.

However, poorly trained doctors are at least something. Many regional hospitals today do not even have such specialists. For example, in the city hospital of Verkhnyaya Pyshma, Sverdlovsk region, five pediatricians are seeing patients at 16 sites. Each doctor is assigned 1000–1200 children. There are no doctors at all in the hospital in the village of Yarega in the Komi Republic. There are vacancies for therapist, neurologist, radiologist, occupational pathologist and gynecologist.

In this case, where did the money from the federal project “Providing medical organizations of the healthcare system with qualified personnel” go? By the way, according to the target indicators of the program, by the end of 2023, the staffing of outpatient clinics with doctors should be 92%. Today, perhaps, even clinics in large cities cannot boast of such high rates.

Let’s draw – we’ll live

Target indicators that are inconvenient for the Ministry of Health can still be found in the public domain. Apparently, Mikhail Murashko’s subordinates simply did not have time to “tweak” all the federal programs included in the national project.

But information on mortality from strokes or objective data on cancer is becoming increasingly difficult to find every year.

The Ministry of Health began manipulating statistics back in the “Covid” years. In 2020, presumably, due to the unsightly mortality rates, the target indicators in the national project were noticeably changed for the first time. For example, instead of the planned 525 deaths per 100 thousand population from diseases of the circulatory system, there were 610 deaths. At the same time, apparently just in case, the indicators for future years were also increased. For 2021 – 600 deaths instead of the originally planned 505, for 2022 – 590 instead of 485, for 2023 – 575 instead of 465, for 2024 – 555 instead of 450.

The dynamics of mortality from strokes are no longer publicly available.

This is not surprising: mortality statistics from myocardial infarction have not met the planned indicators for four years now. Thus, in 2022, mortality from myocardial infarction, according to plans, was to be 33 people per 100 thousand population. In fact, it turned out to be 34.2 people. In 2021, there will be 38.3 actual deaths instead of 34.4 according to the planned indicator. In 2020 – 39.7 and 35.7, respectively. In 2019 – 37.3 and 37.1. In order not to spoil the picture completely, they apparently decided to hide the data on strokes.
In general, something incomprehensible is happening with the statistics of oncological diseases. Thus, in the passport of the federal project “Fighting Cancer,” the proportion of malignant neoplasms detected at stages I–II by the end of 2022 should be 59.6%. On the official website of the Ministry of Health itself, in a beautiful report, the figure is 59.3%. It would seem that it fits well into the planned indicators. However, medical officials apparently wanted to not only fulfill, but also exceed their goals, so the target figure was reduced to 57.9%.

From the Ministry of Health to court

Meanwhile, functionaries of regional ministries of health are developing irrepressible activity. The most scandalous cases could not be silenced: many officials became involved in criminal cases related to fraud, bribery and abuse of power. In total, at the end of 2023, the heads of 21 regional ministries of health did not sit in their chairs.

In January last year, personnel changes occurred in the relevant department of the Tambov region. New appointee Alexey Ovchinnikov replaced Marina Lapochkina, detained on suspicion of abuse of power. Reshuffles also occurred in the Ministry of Health of the Udmurt Republic. In the summer of 2022, the Minister of Health Natalya Yakimova left her post to head the Republican Medical College. Apparently, she agreed to such a reduction not by chance.

Later, the former official became involved in a criminal case in connection with abuse of power. According to investigators, Natalya Yakimova, as the head of the regional Ministry of Health, helped commercial structures close to her receive lucrative government contracts. In total, Yakimova, as the investigation believes, secured government contracts for the “right people” in the amount of more than 1 billion rubles.

A similar case is being considered today against the former Deputy Minister of Health of the Ryazan Region and ex-member of the Federation Council Irina Petina, accused of receiving bribes in the amount of 75 million rubles. Several episodes of the case concern the receipt of bribes from entrepreneurs when concluding government contracts for the supply of medical equipment.

The former Minister of Health of the Irkutsk Region is also accused of accepting bribes when concluding contracts for the supply of medical equipment. Yakov Sandakov. In addition, the former official is accused of negligence. The investigation claims that the head of the Ministry of Health did not ensure the supply of necessary medications for disabled children in 2021.

It is clear that, while engaging in fraud with government contracts, employees of regional ministries of health hardly have enough time to solve the problem of the shortage of doctors and hospitals. Not to mention monitoring the quality of treatment and reducing mortality.

Practice