Despite numerous attempts to remedy the situation with medical salaries, in many regions they remain shamefully low. But on November 1, a pilot project to introduce a new system of remuneration in health care will be launched in the country. The corresponding decree was signed by Mikhail Mishustin. It is reported that the new approach will make it possible to level the situation with the salaries of medical workers, as well as to avoid a shortage of personnel in one region and an overabundance in another. As far as is achievable, “MK” found out.
It was planned to introduce equalization of salaries of medical workers throughout the country since the time of the May decrees, in order to somehow reduce the outflow of personnel from medicine. However, the situation has not changed yet. Today regional hospitals and polyclinics independently determine the size of employees’ salaries, and there are no uniform requirements for the appointment of incentive and compensation payments in the industry. As a result, depending on the medical institution, the salaries of medical workers of the same profile and qualifications may differ.
At the same time, experts say, based on one rate (that is, with the established normal working hours and without additional work load during the main working hours), the level of the average salary determined by the presidential decree is absolutely unattainable today for the vast majority of health workers.
As the co-chairman of the Interregional Trade Union of Health Workers Action, Andrey Konoval, told MK, the staff deficit has remained, but the social discontent of a significant part of health workers with their salaries is only growing. Even before the pandemic, a wave of medical protests swept across the country, including “Italian” strikes by ambulance doctors in several regions.
The authorities had to pay attention to this problem again: at the end of 2019, a number of meetings were held, following which the government was instructed to develop a new sectoral wage system, which was to be introduced in 2020-2023. But due to the pandemic, the timing of the start of the new reform was postponed for a year.
“In February 2021, another meeting was held with Putin, where it was recognized that the May decrees were implemented unsatisfactorily, and the government was entrusted with the task of collecting information on the real salary of each medical worker, the analysis of which was to be announced on April 20. Unfortunately, the results have not yet been announced, but we know that painstaking work has been carried out: each region was asked for the full amount of data on each type of remuneration (including incentive and compensation payments) to health workers. When the data is processed, we will see the real picture of how much doctors receive from us, ”says Konoval.
Starting from November 1, in seven regions (Belgorod, Kurgan, Omsk, Orenburg and Tambov regions, Sevastopol and Yakutia), a pilot project will begin to introduce an industry-wide pay system for health workers. The system itself, as Konoval notes, has not yet been fully developed, only the basic principles have been determined, which will have to be polished by August 31.
It is still clear that the salaries of medical workers will be calculated taking into account the coefficient of differentiation depending on the complexity of work, as well as the coefficient of economic development of the region (the size of the coefficients and the calculation methodology will be set by the government).
“Both the size of salaries and the size of basic payments will be determined not by the region, but by the federal center. But this does not mean that they will be the same in all regions.
Today, the federal center proposes to take as a basis a certain calculated value, which will be multiplied by the regional coefficient and the official coefficient. For the regional it is proposed to take the coefficient of economic efficiency of the region, which, in our opinion, is not entirely true.
Calculations have already been voiced that with this approach, the salaries of medical workers in Moscow will be 3 times, and in St. Petersburg – 2.5 times higher than the average in the regions. What does the economic efficiency of the region have to do with it? Why should a doctor from the hinterland receive less? We are not very happy with this.
Therefore, we propose to take as a basis the coefficient associated with the cost of living, and not with economic efficiency. The size of salaries, in our opinion, should be tied to the average salary in the country (in 2020, the average income was 41 thousand rubles): for doctors, the minimum salary should be at least 150% (at least 60 thousand rubles), for average medical personnel – not less than 100%, the junior has not less than 75%. For the calculated value, we propose to take a double minimum wage in the country. The minimum salary should be uniform across the country, ensuring a dignified existence for any doctor and nurse, no matter where they live, ”says Konoval.
There is still time to polish the “pilot”. It is assumed that the project will last until March 2022, and there the authorities will already determine the uniform requirements for the wage system for health workers throughout the country.
Doctors will recalculate salaries