Transcript of the beginning of the meeting:

Vladimir Putin: Mr Sobyanin, you and I met this spring to discuss the modernisation of Moscow’s healthcare system, right? At that time, we agreed that the city is home to numerous major federal medical centres of a prestigious, world-class caliber. However, many other municipal, district, and territorial hospitals and outpatient clinics have accrued a number of problems, and Muscovites can see this every day. This year, we are to spend over 104 billion roubles on medical equipment purchases for the regions. How much is stipulated for Moscow?

Sergei Sobyanin: 23 billion.

Vladimir Putin: In fact, 23 billion roubles is quite substantial even for Moscow. The conduct of auctions and tenders and attaining an optimal balance between price and quality is the challenge. I know that Moscow has conducted auctions and tenders and is largely completing such work. On the whole, over 93,000 units of equipment will be installed in clinics over the country – an impressive amount. For Moscow, the number is also large …

Sergei Sobyanin: It runs into the thousands.

Vladimir Putin: Into the thousands. What are the results?

Sergei Sobyanin: This 23 billion includes 50% of federal funding and 50% of municipal allocations. Indeed, this is a very serious crucible for us. We have prepared for it in the most arduous manner and have probably delayed the conduct of tenders to some extent because we had prepared so meticulously and had assessed all the related technical documents and tenders. We have sent letters to all the manufacturers inviting them to bid on the tender. General Electric, Siemens, Philips, Toshiba, and others have received such letters. We have allowed all prospective bidders to take part. Each tender involved nine bidders. We have conducted two major tenders worth 3.8 billion roubles in primary value. The budget’s maximum prices were even higher. After trading, we obtained a price 45% lower than the initial budget price. 

Vladimir Putin: Does this mean that you saved about two billion roubles?

Sergei Sobyanin: Yes, we saved 2.1 billion roubles. Prices have plunged virtually fourfold on municipal purchases since 2008. We have not made any purchases since then. The prices were half as much as the ceiling prices stipulated in the projects’ budget. After this, we cut the starting prices, in addition to the budget ceiling prices, which helped us save about 45% on equipment purchase. Moreover, this is very complicated high-tech equipment used for magnetic resonance tomography (MRT), computer tomography and angiography. I repeat, this is the most expensive equipment, which is why we made such careful preparations. I think it is fantastic that we are using the funds that we saved to buy additional equipment for outpatient clinics – specifically those outpatient clinics whose development is lagging – as well as diagnostic centres, which are at the forefront of medical science. Overall, we believe that if we maintain this trend, we will save at least 30% on equipment and will be able to reinvest the funds we saved into healthcare.

Vladimir Putin: This is excellent experience. Unfortunately, these bids and auctions have not yet been held in many regions. Our colleagues are still only getting ready to start. I would like to ask the Healthcare Ministry to speed up their work with their colleagues in the regions. If some of them don't work out, I will ask you – this is not a joke – to hold bids for them and to use the funds that we allocated for the regions on these regions, using the experience you have accumulated. This could even be easier to do in Moscow.

Sergei Sobyanin: We are ready to provide the trading platform for this, as well as our experts and consultants; we could sign an agreement to hold these bids. We have the experience and we have set the requisite standards.

Vladimir Putin: Of course. Procrastination in other regions is due to our colleagues' alleged lack of understanding of the existing guidelines. The guidelines you set are very good.

Sergei Sobyanin: Moreover, we have plans for maintenance repairs at 1,500 medical facilities and capital repairs at 100 facilities. We have completed maintenance repairs at 200 facilities, and capital repairs at several others. It took us quite a long time to prepare the necessary documents, but we have, in principle, created a certain trend. We have a clear-cut schedule and can monitor our progress. I think that the two-year programme that we outlined will be fulfilled, and as a result there will be no obsolete medical equipment in Moscow’s outpatient clinics and hospitals, which is what matters.

Vladimir Putin: This is good. The main thing is to start repairs on time, especially capital repairs. This is an opportune time for capital repairs.

Sergei Sobyanin: We have launched 100 projects and are concluding contracts for more, which means that we will soon start work on them too.

Vladimir Putin: How will these changes influence the salaries of medical staffs?

Sergei Sobyanin: We have made a decision within the programme to allocate 8 billion roubles to hospitals in addition to the approved budgets. This will allow us to increase the salaries of medical staffs by at least 10%, which in principle isn't bad. We are trying to keep pace with the average wage growth in Moscow. We made that decision recently, just last week in fact, and we will now work actively to implement it. Importantly, we have established a link between allocations and the quality of medical services at outpatient clinics and hospitals. Part of the money will be used to shorten the wait for high-tech specialised medical operations, which used to be a problem. So part of the funds will be invested in that area, coming back in the form of salaries and medicines.

Vladimir Putin: Good. We all remember last summer very well: smog in Moscow, wildfires and peat fires. We agreed that you would develop working relations with your colleagues, including as regards the forest belt. Have you done this? How is your joint work proceeding?

Sergei Sobyanin: Mr Putin, we have held serious discussions about this issue with Boris Gromov (Moscow Region Governor) and have sent you a letter requesting that jurisdiction over the forest belt be turned over to the regional authorities. The issue is that the Federal Agency for Forestry, which was put in charge of the forest and the forest belt, is applying the same norms to it as in the Far East and Siberia, even though the forest is located at the centre of a huge agglomeration with a population of 20 million people, and experiences a major impact from human activity. Therefore, we need completely different norms and funds for protecting it, using it, and in general controlling the situation.

This is why we sent you that letter, and you have issued the necessary instructions to the Federal Agency for Forestry. We are working with them and have already signed an agreement with them on the free transfer of the forest to Moscow for an indefinite period. Moscow will take over 30,000 hectares of forest, which is two and a half times more than we currently have within Moscow boundaries. This year we will allocate 500 million roubles for marking boundaries, registration and inspection of the forests, so as to prepare for their use next year. We will assume full control of the forest belt on January 1, ensuring its development, protection – including from fires – and sanitary control. We will allocate about 1 billion roubles towards this purpose. This is dozens of times more than the Federal Agency for Forestry could spend. For these reasons, I think the situation will improve significantly. At the least, we will clean the forests of garbage and start improving them. The most important thing is to prevent the illegal seizure of forest plots, unlawful construction of dachas, and so on. This is very difficult to control when there is so much pressure on the controlling agencies.

Vladimir Putin: Good.