Decision of the Board of the Ministry of Health of the Russian Federation: Tasks for the Periods 2001-2005 and 2006-2010
Decision of the Board of the Ministry of Health
of the Russian Federation, March 20-21, 2001, on
Progress in Implementing the Concept for Development of the
Healthcare System and Medical Science:
Tasks for the Periods
2001-2005 and 2006-2010
(EXCERPT FROM PROTOCOL NO. 6)1
The Board of the Ministry of Health of the Russian Federation notes that the past decade has been characterized by complex socioeconomic, political, and demographic changes in the country, which have altered the fundamental character of the activities of medical organizations and have raised a number of challenging new problems for the sector.
Negative changes affecting the status of public health and the need to adapt the existing healthcare system to real current conditions made it necessary to adopt a conceptual document to reflect the governing principles for further development of the healthcare system in Russia. Such a document was in fact produced in the form of the Concept for Development of the Healthcare System and Medical Science in the Russian Federation, which was approved by Government Resolution No. 1387 on November 5, 1997.
The Concept is aimed at maintaining and improving the health of the people and reducing direct and indirect losses to society by decreasing illness and mortality rates.
The first stage of fundamental measures to implement the Concept concluded in 2000. The majority of planned measures were carried out. This made it possible to ensure stable funding for healthcare institutions, improve the efficiency of resource utilization, and reduce the deficit in the Program of State Guarantees for Providing Free Medical Care to the Population.
In the aim of improving the system for healthcare standardization, metrology, and certification, the Russian Ministry of Health and the State Committee for Standardization and Metrology (Gosstandart) have created the Interagency Coordinating Council. A program for the development of patient management protocols is being implemented successfully, and another program has been approved for the training of specialists in the fundamentals of healthcare standardization.
Work has been initiated to standardize medical services and regulate the provision of medications, equipment, and other medical products to hospitals and clinics.
The introduction of new medical technologies, despite financial resource constraints, has substantially increased the volume of unique types of medical care delivered to the public. For example, the number of heart operations involving the use of artificial blood circulation has doubled, while the volume of aortic-coronary shunting operations has increased by a factor of 2.5. The number of patients on hemodialysis has doubled, kidney transplants are up by 50 percent, and marrow transplants have increased tenfold.
Measures to implement several federal targeted programs, including Urgent Measures to Fight Tuberculosis, Diabetes, Vaccine Prophylaxis, Anti-HIV/AIDS, and others, have been developed and approved and are currently being carried out.
In 2001, plans call for the adoption of targeted programs on arterial hypertension, oncology, and sexually transmitted diseases. Programs are also being worked out in the areas of child health and the development of the sanatorium and health resort sector. In 2002, a unified comprehensive program on preventing and combating diseases of a social nature will also be prepared.
Despite insufficient financing, the potential of the medical science sphere has been maintained successfully. In recent years, Russian scientists have developed new technologies for diagnosing and treating oncological diseases and surgical pathologies with the use of plasma streams, ultrasound, lasers, and photodynamic therapy. Active efforts are under way to use genetic engineering technologies in the treatment of a number of serious diseases.
Achievement of the strategic goals of state healthcare policy depends to a decisive extent on how well the healthcare system can be managed. In order to facilitate implementation of the Concept, the Ministry of Health has established a Council on Regional Policy and placed Health Ministry representatives in the
various federal districts. The Ministry is creating district healthcare coordination councils and has reorganized itself to bring its structure into accord with the goals and objectives assigned to it by the government.
All of the aforementioned points make it possible to conclude that the Russian Ministry of Health and healthcare organizations of the various component entities of the Russian Federation have done a great deal of work within the Concept framework to maintain accessibility and volumes of healthcare services rendered to the population.
At the same time, despite the significant amount of work that has been done and financial resources that have been invested in healthcare, the necessary return has not yet been received and the measures that have been taken have not had an effective impact on public health indicators. Reform of the sector has been unacceptably slow. This situation urgently demands changes in basic objectives and approaches to the further development of healthcare in the country.
The Board has decided:
to deem it necessary to continue reshaping the healthcare system within the framework of Government Resolution No. 1387 of November 5, 1997, on Measures to Stabilize and Develop Healthcare and Medical Science in the Russian Federation and to set the following top priority objectives for the period up to 2010:
reducing the rate of premature death (from cardiovascular diseases, accidents, injuries, poisonings, and malignant tumors)
fighting diseases of particular significance with regard to the country’s demographic situation (diseases threatening infants and maternal reproductive health as well as diseases affecting the elderly)
fighting diseases representing a special threat to the health of the nation as a whole (tuberculosis, HIV/AIDS, drug addiction, alcoholism, sexually transmitted diseases)
creating a real mechanism for providing resources for priority objectives in the development of the healthcare system
developing disease prevention measures and a system for active health maintenance and restoration for the healthy population
promoting an expanded understanding among the population of the value of health and a corresponding reflection of this understanding in people’s behavior
ensuring comprehensive development of medical science and cutting-edge medical and information technologies
meeting the needs of the population in terms of medications and medical products
shaping the medical-social insurance system
determining price policy in the medical services market
instituting a system of professional malpractice insurance and increasing the level of social protection afforded to medical personnel
shaping the medical rehabilitation system and developing sanatorium-and health resort-based forms of treatment
expanding organizational and legal forms of healthcare organizations and optimizing the nomenclature of medical specialties
SOURCE: Ministry of Health (2004c).