18 december 2010

Prime Minister Vladimir Putin meets with Health and Social Development Minister Tatyana Golikova

Mr Putin and Ms Golikova discussed the distribution of funds towards regional programmes for modernising healthcare.

Transcript of the beginning of the meeting:

Vladimir Putin: I know that you have conducted a series of meetings with your colleagues and drafted proposals for the allocation of funds under the regional programmes to modernise healthcare. What are these proposals?

Tatiana Golikova: In accordance with your instructions and under the leadership of Alexander Zhukov, we conducted an inter-agency meeting apropos of the methodology for distributing funds to the regions of the Russian Federation for programmes to modernise healthcare.

First, we came to the conclusion that the bulk of the 460 billion roubles devoted to this cause should of course be distributed immediately and that these sums – at the earliest possible time subsequent to their distribution – should be formalised and submitted for the programme’s approval in order to be implemented early next year. We have put together a small reserve in order to stimulate the regions – at their own request – towards the programme’s results. The distribution itself is based on the number of people living in a respective territory of the regions along with the cost of services. In other words, we followed your recommendation that in some donor regions such as Moscow and St Petersburg, the cost of living is higher, and, of course, so is the cost of medical care, so we have taken this factor into account. In addition, we considered the state of healthcare itself – the level of neglect, the condition of state institutions, and whether or not they require major repairs. Of course, I cannot help but mention that the methodology itself takes into account our intention that various quality indicators should improve through these programmes – among them, demographic figures, morbidity, and mortality rates in each respective region.

This set of indicators formed the basis for our initiatives, and we propose to adopt allocations for the territories accordingly. Certainly, there are some reasons for concern – no methodology is capable of accounting for all possible factors and contingencies. We have a remaining group of regions, for which we will have to apply special considerations. These include parts of the Central Federal District, such as the Kursk and Tambov regions and some regions of Northwest, such as Pskov, Novgorod, and Magadan, if we look further. I will not enumerate all such territories. I will, however, request your advice. Despite the fact that our methods are considered valid, we still need to approach these critical regions differently and view them in a special way.

Vladimir Putin: What is the total amount of funds that will be allocated to the regions for these purposes in 2011?

Tatiana Golikova: In 2011, 190 billion roubles from this funding as well as a small additional sum will be sent to the federal agencies participating in these regional programmes. And if all goes well and the 216 billion that we planned for 2011 in the Budget of the Federal Mandatory Medical Insurance Fund is fully met or exceeded, then, based on that performance, we will propose to distribute the remaining amount. In other words, we are hedging the macroeconomics a little.

Vladimir Putin: I see. What type of approval do you need for this initiative?

Tatiana Golikova: I would like it, if possible, to be an executive order from the federal government for the regions to proceed immediately and submit their programmes to us.

Vladimir Putin: Let's do the following. I think that the criteria you have chosen are appropriate: population, cost of services, and cost of living. But, of course, we need to look at the regions that need special support – by which I mean the need to improve what can be charitably described as the humble state of healthcare systems in these regions. Please provide a list of these regions and your suggestions for a calculated ratio to increase the amount of their received funds. This, of course – I agree with you – includes some regions of Central Russia, the Northwest, the North, and perhaps the Far East. Examine these closely, and make these adjustments in preparing the draft for the executive order.