Transcript of the beginning of the meeting:

Dmitry Medvedev: Mr Roshal, I’d like to begin by saying that a new government has been formed, and the Ministry of Healthcare is now operating as an independent entity.

Leonid Roshal: Thank you for this.

Dmitry Medvedev: I’m glad that the medical community has the same attitude as me. The trade unions are also happy about this because now the Ministry of Labour is also independent.

But I’d like to talk with you not about the ministry but about the role that the medical community is playing in the operation of the medical system, broadly speaking, all over the world, because we are just about to take the first steps in this respect. We are overwhelmed by red tape; the bulk of decisions are made at the administrative level whereas we know that corporations often decide much more than regulatory bodies, although this is appropriate when they can do this in a civilised manner rather than uphold their corporate interests. How should we combine government policy with professional approaches of the medical community? I’d like to discuss this issue with you. You probably have something to say on this.

Leonid Roshal: You’ve touched on one of the central problems. We are travelling a very long, uphill road but we must walk it. In fact, we are talking about the self-regulation of professional activities.

Dmitry Medvedev: Yes.

Leonid Roshal: Healthcare ministries abroad are not involved in professional activities. They deal with funding, general issues and laws. These self-regulated professional communities are supervised by one body in each country – the chamber in Germany, the medical board in France, the associations…

Dmitry Medvedev: But by one body only, is this right?

Leonid Roshal: Yes, one body for the entire country and this is very good. As we see it, self-regulation means that the medical community is responsible for the work of every doctor. Today, the quality of work of any district pediatrician or surgeon or the performance of a hospital is the responsibility of administrators. Meanwhile, it is the medical community as a whole that must be responsible for it. I think we should strive for the following goal – every patient who comes to a doctor must receive a qualified answer to his or her question. These issues are linked with education – both at institutes and post-graduate studies and the development of the entire system, including remote and customised education. It doesn’t matter whether we have a point-based system or some other system for assessing the performance of doctors. Today we must create the conditions for them to study.

Dmitry Medvedev: Of course.

Leonid Roshal: Currently many people are dissatisfied with the healthcare system.

Dmitry Medvedev: This will always be so.

Leonid Roshal: But I want it to be less so…

Dmitry Medvedev: That would be good, but in general people all over the world are dissatisfied with their governments, healthcare systems, pensions and some other spheres because they directly affect their lives.

Leonid Roshal: Indeed, both people and doctors are dissatisfied with healthcare. You have questions about it as well, and the president does, too. It means that we must somehow resolve this problem. There are many issues related to personnel, social problems and the like, but what you have said is very important.

Dmitry Medvedev: You know, I’ve thought about corporate medicine, the medical community, medical self-regulated organisations and such organisations in general. They can only be effective when they have the right to put things in order in different spheres. This is true of the medical community as well. Its regulation will be effective only if it can evaluate the performance of a particular doctor.

In effect, when someone is banned from the medical profession in the West or some other countries, this means an end to practicing medicine, but the state does not have anything to do with it. It is not the state that is passing a verdict in a court of law: this doctor does not know how to treat or this judge is making wrong decisions. I think it is very important for self-regulated organisations, including medical ones, to have such rights. Do you agree?

Leonid Roshal: Absolutely. I think it is important to work on legislation. This can only be resolved legislatively. We hope for your support.

Dmitry Medvedev: All right, let’s work on this.

Leonid Roshal: Thank you.