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Video: “Firing From Work Is The Last Defense Against Doctors. It Seems That We Have No Other Rights Left "
“Firing from work is the last defense against doctors. It seems that we have no other rights left "
Health care optimization has reached FMBA institutions. All surgeons are leaving the Medical Unit No. 72 of Trekhgorny, Chelyabinsk Region. The employees of the medical unit No. 94 in Peresvet near Moscow are also dissatisfied with the changes taking place. And these are just two examples of what is happening across the country: wear and tear, low wages and management's silence on problems are doing their job.
Photo: flickr.com /
Optimization of health care, taking place due to the intensification of the work of ordinary doctors, reached the departmental institutions of the Federal Medical and Biological Agency. According to media reports, all surgeons are leaving the Medical-Sanitary Unit No. 72 of the FMBA of the city of Trekhgorny, Chelyabinsk Region. The employees of the Central Medical-Sanitary Unit No. 94 of the FMBA in Peresvet, Moscow Region, are also dissatisfied with the recent changes. And these are just two examples of what is happening all over the country today: wear and tear, low wages and management's silence on problems are doing their job.
I spent the night at home only three days a week, the rest of the time I spent at work
The medical unit in Trekhgorny is the only hospital in the entire city with a population of 35,000. The surgeons made the decision to quit because of the intense workload and disproportionately low wages, said the head of the department, a surgeon with 30 years of experience Stanislav Redkin. According to him, the situation was aggravated in over the past three years. And today I have to work at one and a half or two rates a day, plus serve night shifts.
As the head of the department explained, salaries in the FMBA system remained at the level of 2009. “As the head of the department, my salary is 7800 rubles. This is the salary for which all other percentages are made: for length of service, for harm, for experience, for a category. The rest is various incentive payments, attempts to catch up with our salary level to the 200% prescribed by the president. Of course, they fail, because they have to pay too much. I can say by July: I worked for three, for three rates, for this I received 76 thousand rubles with accruals. I spent the night at home only three days a week, and spent the rest of the time at work,”Redkin said.
According to the head of the department, all of his colleagues wrote letters of resignation after coming out of vacation in September. “Yesterday the head of the medical unit reprimanded us for our lack of awareness, saying that our workload is small and the salary is quite high. They will solve the problem by trying to bring doctors on time, under fixed-term contracts, in order to close the holes,”Redkin said.
Later, the information about the mass dismissal of surgeons in the medical unit No. 72 was denied by the regional Ministry of Health. “The situation in the Trekhgorny medical unit (structure of the FMBA) is under the close scrutiny of the Ministry of Health of the Chelyabinsk region. We are in contact with the head of the medical institution, information about the mass dismissal of surgeons has not been confirmed,”the press service of the department said.
Employees of this medical unit have previously complained about meager salaries. According to doctors, their salaries are several times less than stated in the presidential decrees in May. Moreover, the incomes of the nursing staff are below the subsistence level. “Up to the minimum wage, we are paid three thousand, two thousand. They have no right to pay lower, - explained one of the nurses of the medical unit. - Everything works in a day, in two days. Back to work in the morning. We are not paid extra for overwork … We write everywhere … They wrote to the General Prosecutor's Office, to the governor, to the president. The answer comes from everywhere that our salary is normal."
According to the presidential decrees in May, the average salary of doctors in the Chelyabinsk Region should now be 62,502 rubles, nurses and orderlies - 31,251 rubles. But the staff of the medical unit in Trekhgorny assure that almost no one gets that kind of money. The salary for doctors there is no more than 7-8 thousand rubles, for nurses - 4400 rubles, for orderlies - 2,300 rubles. Moreover, the issue of salary is by no means idle: many allowances are calculated on its basis.
On a "bare" salary
The central medical unit No. 94 in the town of Peresvet, Sergiev Posad district of the Moscow region, serves 27 thousand residents, about 400 people work here. The staff of the medical unit invited the media to the reporting and re-election trade union meeting, as they are unhappy with the recent changes. The meeting was also attended by employees who are not currently in the union. Only the head of the medical unit did not come - despite an official invitation specially sent to him.
According to the doctors, the administration is forcing them, under the threat of dismissal, to urgently sign an agreement with new, completely unacceptable and illegal, from the point of view of the hospital staff, working conditions, arguing that it is necessary to pay off the hospital's debts.
According to doctors, from July 1, 2019, they have cut incentive payments, eliminated preferential length of service, removed all allowances and additional vacations. These changes are associated with the results of a special assessment of working conditions (SAWC), which took place at the medical institution at the beginning of the year. At the same time, the commission did not include either representatives of the trade union or heads of departments. In due time, people were not notified of the results of this assessment. Or it was done retroactively, as ordinary doctors say. “According to the Labor Law, we have the right to information, and all regulatory and local acts must be agreed with the trade union,” says Elena Mavrina, chairman of the Sergiev Posad organization of the trade union of healthcare workers of the Russian Federation.
Over the five years that have passed since the last such assessment, nothing has changed in terms of working conditions, doctors emphasize. And why the conditions were harmful, and now suddenly become not harmful, is unknown. In addition, doctors do not understand why, where the premium for harmfulness still remains, it is paid at the rate of 4%, while the agreement between the FMBA and the Central Committee of Trade Unions provides for an 8% premium for hazard class 3.1. Moreover, the hazard class in the departments of gynecology, surgery, intensive care (where work is associated with blood and possible infections) should be from 3.2 and higher. “But in response to a letter signed by about 50 employees, the authorities explained to us that we were working not with the infection, but with its source,” a doctor from one of the “harmful” departments told Mednovosti.
The management of the institution denies all statements of employees about the reduction of payments and threats.According to the head of the medical unit Vadim Perevedentsev, the assessment of conditions is provided for by law, and it was carried out by an accredited organization - Glavpromekspertiza. All payments due for harm, approved after the SAUT, are calculated and paid, insists the head of the medical unit. As for the 8% premium for harmfulness, then, according to him, this is just a declaration. The agreement is not valid, as the relevant law has not yet been adopted. “If the salary is small - and this is the case throughout the Federal Agency - then the additional payments are made up,” Perevedentsev believes. - I can give examples without names. Anesthesiologist-resuscitator - 77 thousand rubles have been accrued, 62 thousand to be paid. A local general practitioner - 52 thousand rubles accrued, 40 thousand to be paid. These are not managers, but ordinary doctors."
Ordinary doctors themselves say that citing these examples, the head of the hospital forgot to clarify that these charges were made for work at 2.5 rates during the vacation period. In this case, in fact, it was necessary to fulfill the duties of four doctors. The fact is that in the medical unit the emergency surgical and gynecological services have been reduced, and all problems that arise during off-hours have to be solved by the doctor on duty.
The hospital's nurses were also made redundant: now, in the departments of neurology, therapy and gynecology, their functions are performed by “cleaning staff” - the same people, only for a lower salary. “In a hospital it’s impossible to do without nurses,” says one of the doctors of the medical unit. - And these should not be employees of the "cleaning company", but full-fledged junior medical personnel. Many of our nurses studied specifically for this."
However, doctors near Moscow do not intend to surrender. In the past few weeks, the medical unit's union membership has doubled. The regional trade union of medical workers appealed to the Ministry of Health of the region with a request to cancel the decision of the SAUT and reassess the working conditions in the medical unit.
It is impossible to condemn people who quit their jobs without enduring such conditions
The federal agency remains silent on all these cases. Meanwhile, the Minister of Health of the Russian Federation Veronika Skvortsova accused the regional authorities of abuses in the formation of medical salaries. "The salary, that is, the guaranteed part of the salary, must be at least 55-60%, 10%, maximum 15% - compensation payments for night shifts, work on holidays, and so on, and no more than 30% - incentive payments", - the minister told reporters. According to her, pilot projects to determine the optimal pay structure for doctors were carried out back in 2014. At the same time, criteria were developed for incentive payments.
But while the Ministry of Health is developing criteria and method of recommendation, and locally they are looking for where to save money, doctors, nurses and nurses turned into cleaners are leaving the state health care en masse
And it is impossible to solve this problem at the level of chief physicians. They are the same hostages of the situation: they are required to raise their salaries, but they are not given money for this. It remains to either quit, or manipulate statistics and resist employees, turning into monsters in their eyes. According to Semyon Halperin, President of the League for the Protection of Doctors, all managers - from chief doctors to the Ministry of Health - are trying to report on the implementation of the May decrees on increasing wages. But in fact, in most cases, this is a fiction.
At the same time, no one cares that when a doctor works for wear and tear, patients suffer. And this is the situation throughout the country today. In reports about the wave of mass layoffs and "Italian" strikes of doctors that has swept over the past months, the entire domestic geography: Nizhny Tagil, Pyatigorsk, Irkutsk, Kachkanar, Penza, Orel, Tolyatti, Perm, Gagarin, Smolensk.
“The current system of remuneration in health care has led to the fact that in order to somehow survive, doctors have to take more and more part-time jobs. Today the situation has reached a critical level, and it is impossible to condemn people who quit their jobs because they cannot withstand such conditions. Firing from work is the last defense against doctors. It seems that we have no other rights left,”says Semyon Halperin.
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