Vladimir Putin attends an extended meeting of the Board of the Ministry of Healthcare and Social Development
16 march 2012
Vladimir Putin’s address:
Dear friends and colleagues, first of all I would like to thank you for your work in this highly responsible, important and sensitive area. I am perfectly well aware how difficult it is working in the social sphere. It entails having constant, daily contact with people; this is particularly true of your colleagues on the ground. It is the most difficult, most sensitive and most important work because it affects millions and millions of our fellow countrymen. The social sphere is important precisely because it is rightly seen as an indicator of the government’s viability and its accountability to society as a whole and to specific individuals in particular. We have chosen an active policy of social development as a priority and never retreated from this principle even during the most difficult periods in our recent history.
We have achieved some significant results, but our main success story has been the positive demographic trends. Let me begin with this topic. The natural decline in the population has fallen by 86.3% since 2000. Life expectancy in Russia has gone up by almost five years within a fairly short period of time – and this is a good indicator – it currently stands at just over 70 years (70.3). The birth rate has risen by almost 45%, while infant mortality rates have declined. These are certainly positive indicators but we all understand that this is still not enough, because what we need is a sustained natural increase. Much remains to be done in this sense, although other countries facing the same problems as Russia are unable to match even these demographic indicators. But let me repeat once again that this is not enough.
Substantial increases in investment in healthcare and support for families, mothers and children has been one of the main reasons behind these results. Over the last 12 years, federal spending on healthcare has increased by 30 times to 0.5 trillion roubles in 2011. This is without question a very significant increase.
But as you may know, the quality of social services cannot be measured solely in terms of federal spending. The main criterion is how people feel about it. People in this country place high demands on the social sector. It is undoubtedly the most important area of work in the social sphere and we will continue focusing on it. But the public wants us to address an even more ambitious task, that of securing the quality and content of social services so that they match the standards of the economically advanced countries. We need to create a truly comfortable living environment for people, one that is conducive to achieving self-fulfillment, having a large family, and bringing up children.
We know what needs to be done in this area and how to go about achieving it. The majority of voters supported the transformations in the social sphere that we proposed. To be sure, we have to continue our activities in all directions so that we can form a consolidated, truly modern social space that revolves around individual interests and requirements as well as those of the family.
Our federal and regional programmes of support for families with children have proved to be highly effective; they must definitely be continued, though we also need to take additional steps in order to promote them still further. A particular focus has to be placed on the regions, where the demographic situation is still unstable. I am primarily referring to the Far East, the Volga Area, and the European part of the country. The specialists in this room know what I am talking about. I mean the Volga Area to an extent, northwestern Russia and central Russia.
Benefits for families with incomes below the regional average will be introduced in these constituent entities following the birth of their third and each subsequent child. I would like to ask the Ministry of Healthcare and Social Development, jointly with the regions, to submit to the government your proposals for implementing this programme, which should be launched early next year.
On the whole, I would like to emphasise that our demographic policy is now at the stage where the greatest effect can be achieved through direct targeted measures in specific regions, taking into account regional specifics, traditions, and patterns of family life. In some constituent entities, this will mean providing plots of land to families with many children; in others, additional benefits; in still others, housing; and somewhere else – a combination of all these measures.
However, as you probably know, my meetings with people, especially in the regions, show that not everything is fine, at least not everywhere. I feel uncomfortable when people say: “Does the government want to support large families or not?” This means that the necessary measures are not being promoted efficiently enough in the given region and that we should highlight this issue. I am asking the Ministry of Healthcare and Social Development to help determine the priorities of the regional demographic programmes.
Life cannot be comfortable without major improvements in the healthcare system. As you know, we have drafted the necessary legislation and now we should focus primarily on the efforts to complete the modernisation of healthcare facilities, including the introduction of current information technology.
People, especially old people and people with disabilities and with rare diseases, often complain about the inadequate provision of medicine. We must ensure that this process works smoothly so that people will not feel humiliated when asking for what is theirs by law.
Of course, a decent salary for specialists is one of the key factors of a higher quality of medical and all other social services. By 2018, a doctor’s salary should be two times higher than the average pay in a given region. Salaries were raised in many regions after we launched these modernisation programmes. This growth must continue throughout this year. According to the ministry’s preliminary data, salaries in this sector should be increased by 20%-25% on average.
I would like to stress that we must first of all help those who are ready to work honestly and efficiently and to improve their qualifications, which is why allocations for monetary incentives and additional benefits should be increased faster than basic pay. I am asking you to take this into account when laying out a programme for improving the system of compensation in the public sector. These programmes should be prepared without delay.
Ladies and gentlemen, the priority goals for the coming years are to reduce poverty and expand the middle class. Of key significance are a new quality of employment and a fair evaluation of one’s contribution as social mobility mechanisms. We must plan a trajectory of personal success in which everyone will have an opportunity not only to work in one’s profession but also to make a good career by improving one’s qualifications. This fully applies to people with medical conditions. I am asking the Ministry of Healthcare and Social Development to work along with the other ministries, agencies and public organisations to determine what else should be done to enhance the effectiveness of our employment programmes for people with disabilities, including employment at federal and municipal agencies. I know from my own experience that when people with disabilities are offered decent jobs they sometimes work even more efficiently than people without any medical problems. They set a high value on their jobs.
One more direction on our social agenda concerns pensions and the creation of conditions to ensure a high quality of life for senior citizens. We are currently discussing a long-term strategy to develop Russia’s pension system. Developing an effective strategy is a crucial socioeconomic goal and one of our priorities. What should its key elements be?
First, we must provide incentives for those who would like to continue working after reaching the retirement age. I am asking you to work along with the Pension Fund to create a mechanism for increasing postponed pensions, payable upon retirement. The logic is that people with a longer employment history should receive a larger pension, which would be absolutely fair.
Our second basic goal is to further develop all the elements of the pension system, including pay-as-you-go, funded and voluntary contribution components, in order to guarantee the interests of current pensioners and those who are only working for a pension.
We must also guarantee the safety of pension accruals and increase the profitability of their investment. Therefore, I am asking you to consider measures to further develop the funded component of pensions when drafting a long-term strategy to improve the pension system.
Of course, we will continue to raise pensions. I’d like to remind you that retirement pensions were raised by 7% on February 1, 2012, and will be raised by 3.4% on April 1. Overall, pensions will be increased by more than 10%, which is slightly higher than we planned when we prepared the 2012 budget. It is not substantially higher, but still.
Also starting April 1, social pensions will be increased by 14.1%, which is also a higher increment than that which is required by law. That is, the inflation rate last year was below the forecasted figure that was used for compiling the federal budget. However, since we have already included a 14.1% increase in the budget expenditures, we decided yesterday – along with two ministers, including the minister of finance – to leave it as is, so the increase will be 14.1% this year. The size of monthly benefits will increase 6% – I am referring to individuals entitled to various social benefits.
Colleagues, I am confident that civil society itself should be the most important participant in social reform – that is, the people themselves. Here are some specific issues:
We need to establish the most favourable conditions for non-profit and public organisations working in the social sphere, as well as for church organisations of all faiths that are engaged in social services. I met with the heads of the traditional churches active in Russia recently, during the election campaign. They all seemed eager to serve people. They are willing, you see, and this is in fact something that the activities of these traditional churches are aimed at. They also know how to do this, but we need to help them. Governmental and non-governmental, not-for-profit organisations that provide social services, should have equal rights, including the right to government financing, state resources and state orders. These rights should be real and effective and not declarative. I would like you to closely examine the Russian and foreign experience of public-private partnerships in the social sphere. We need to make this the top practice in implementing our social policies.
I also believe that the key social policies and decisions need to be adopted after public consultations. We have accumulated very useful experience in business associations evaluating the regulatory effect of legal acts and their influence on the business climate. It is even more logical that this public audit practice be applied to social projects. We need to develop an appraisal procedure to evaluate the social effect of the legal acts regulating issues that concern families, motherhood, childhood, healthcare, the environment, education and upholding morality.
The public must certainly be directly involved in evaluating the performance of the main social institutions in Russia. Therefore, I consider it necessary that we work out certain criteria for the effectiveness of social services and use them as the basis of an independent appraisal system. This system should be jointly developed by representatives of the government, professional associations, public groups, and most importantly, the public. This could be done through social networks and other public communications systems, so I would like to ask the Agency for Strategic Initiatives to join this work because it has some experience in this area.
An appraisal system will also require professional self-evaluation tools, based mainly on ethical codes. Professional associations and self-regulatory organisations should be responsible for the job of drafting these codes. I believe that trade unions should get involved in this work. New requirements should be made not only for the quality of services and specialists’ work, but also for the social infrastructure. We need to modernise all public and social services including hospitals, outpatient centres, preschools, schools and social welfare centres. They should comply with modern standards of comfort, design, energy efficiency, safety and accessibility, including for people with special needs.
We need to look closely at both national and international experience and use the best practices as the basis for standard projects to be introduced across Russia.
In conclusion, I would like to emphasise the fact that people’s attitudes and their judgment of the government’s effectiveness and responsibility depends on how soon and how well we attain the goals set, as they mainly have to deal with you and your colleagues at their local services. This is how they will evaluate our ability to perform our mission as a social state.
Finally, although we still have a host of problems to be address, I would like to thank you for your work. It was a large effort, and you have been effective in many ways. Thank you very much, and take care.
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Vladimir Putin’s closing remarks:
Thank you very much. I would like to say a few more words before I leave. When I tour regions I visit major federal medical centres or major social centres in the regions. A network of high-tech medical centres, such as perinatal facilities, that has been emerging recently is particularly impressive and gives you a sense of pride that such facilities and services exist… I know our health workers dislike this word “services” but let’s still use this bureaucratese. Indeed, they give you a sense of pride because they do not just match the world level but exceed it in many cases, and this is obvious. I’m referring to both the level of specialists and the equipment at these facilities.
At the same time, when I visit, say, typical district or municipal institutions – not only medical institutions, but any social facilities – I understand how much we still have to do, because our social sphere requires a lot of attention, to put it mildly. I’d like to draw your attention to the fact that we are continuing to discuss delimitation of responsibilities and in this context we must think about enhancing the responsibility of all government bodies for resolving social issues at the federal, regional and municipal level. I’m referring to the need to enhance responsibility to the people in general. This is the first point.
And now the second point. Nothing is more routine than what you are doing, with the exception, say, of cardiologists and oncologists, to name a few. Let me repeat that this is routine work but nothing is more important than what you are doing. It is for this reason that I expect dedicated, active and effective work from you. I wish you success. Thank you very much.