The Object Will Retain Its Medical Focus

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The Object Will Retain Its Medical Focus
The Object Will Retain Its Medical Focus

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The object will retain its medical focus

The scandal around the Moscow maternity hospital No. 10, which was closed by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, is gaining momentum. Nobody is going to eliminate them, the other day the newly minted chief specialist of the Department of Health for deontology and part-time business trainer said that it was impossible to keep the maternity hospital in this building and promised to organize gynecological care at home.

"The object will retain its medical focus"
"The object will retain its medical focus"

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The scandal around the maternity hospital No. 10 in the Moscow district of Zyuzino, closed by Rospotrebnadzor until the "elimination of violations", is gaining momentum. It seems that no one is going to eliminate them: there are no official documents in this regard, and the leadership of the head institution is busy with the employment of the employees who have been left without work. The newly minted chief specialist of the city health department for professional ethics and deontology and part-time business trainer, who came to the last meeting with doctors and residents of the district, said that it was impossible to keep the maternity hospital in this building, and even promised to organize gynecological care at home. The independent trade unions of medical workers believe that the second wave of "optimization" is underway in the country.

Standard reception

On November 22, the Zyuzinsky District Court suspended the activities of all departments of maternity hospital No. 10 (a branch of the Family Planning and Reproduction Center), with the exception of the antenatal clinic. The court ruled to eliminate the violations of the sanitary and epidemiological regime discovered by Rospotrebnadzor within 90 days. The next day, the doors of the emergency department were sealed. At this time, most of the maternity hospital workers were sent to forced downtime with the retention of 2/3 of their wages. In a word, it is quite a standard technique for closing a medical facility.

Residents of the district spoke out in defense of the maternity hospital, and independent municipal deputies from the Zyuzino Headquarters stated that the violations revealed were only a pretext, and the Moscow authorities were going to completely close the maternity hospital located on land of commercial interest. Indeed, the medical complex at 22 Azovskaya is located next to the metro, parks and a pond. The Health Department indignantly denied the assumption of infinity, but did not add clarity about the fate of the maternity hospital. The official replies of the department only vaguely say that "the object will retain its medical focus." And this does not mean at all that the “object” will not change its profile and will generally remain in the system of budgetary medical care, the maternity hospital defenders fear.

This is the second attempt to "optimize" the only maternity hospital in the district, where 126 thousand people live. In 2014, the hospital managed to defend. But now the authorities are determined: the equipment is being taken out of the maternity hospital, the antenatal clinic, to which the sanitary services had no complaints, is already being transferred to polyclinic No. 84. And in the parent institution - the Center for Family Planning and Reproduction (CPPR) - they almost openly talk about the need to merge medical institutions.

Funds for overhaul are not pledged

At a team meeting held on January 30, the chief physician of the TsPSiR Oleg Latyshkevich explained that the planning solutions and ventilation of the building built more than 65 years ago do not meet modern requirements, it is possible to eliminate sanitary and epidemiological violations only through major repairs. But this year no budget funds have been allocated for it. In addition, according to the head of the TsPSiR, the maternity hospital should be located on the territory of a multidisciplinary hospital, so that in case of complications the woman in labor and the child would not have to be transported to another institution.

As for the staff of the maternity hospital, then, according to Latyshkevich, those who wish are transferred to TsPSiR, where there is still a fairly large number of vacancies in all specialties. Doctors were offered to retrain for other, more popular, medical specialties. Those who found another job were fired by agreement of the parties with the payment of two average monthly salaries.

In response, the doctors of the maternity hospital offered to compare the effectiveness of maternity hospitals in multidisciplinary hospitals and in detached maternity hospitals. The fact is that all statistical indicators at the maternity hospital №10 are higher than the average in Moscow. In 2018, not a single child died in intensive care - all children born in serious condition were cared for, the staff of the maternity hospital emphasize.

No one argues with the need to repair and modernize the hospital, doctors say. But last year money was found for three expensive elevators, car washes, oxygen supply for children's intensive care. And if desired, it will not be difficult to fulfill the requirements for heating, ventilation, microclimate and air environment of the premises presented this time. The maternity hospital defenders said that they are launching an independent examination of the building and will work to ensure that a clear timetable for eliminating violations, if any, is found.

Gynecological care at home

Apparently considering that the obstetrician-gynecologist and chief physician Latyshkevich did not cope with his task of enlightening the team, the health department sent a professional negotiator to the next meeting - an expert on customer service and employee motivation, the general director who has multimillion-dollar contracts for "consulting" with the Moscow MFC consulting company "Strategic solutions", Maxim Nedyakin. Not long before this, the "expert practitioner in trade, procurement and negotiation management" (as stated on his personal page on the Moscow Business School website), who had no medical education, was appointed chief freelance specialist in professional ethics and deontology of the city health department… Head of the Department Alexey Khripun signed Order No. 70 on February 4, 2019.

The newly minted representative of the department immediately said that it was impossible to keep the maternity hospital in a building unsuitable for a medical facility, its closure was aimed at increasing the "cost efficiency of the budget", and the employees had nothing to worry about - they would all be employed. Everything will be fine with the residents of the district, whom Nedyakin even promised to organize the provision of gynecological care at home. But this time no agreement was reached either.

Heavy artillery

According to the organizing secretary of the Moscow city organization of the Interregional Trade Union of Health Workers Action, Alexei Gusev, “earlier the participation of special consulting services (whose services, presumably, cost a lot of budget money) in the closure of Moscow hospitals and polyclinics was only a hypothesis, now it can be taken as a fact ". He recalled that this practice came to Russia (along with the health care optimization policy) from abroad. In the United States in particular, starting in the 1980s, the authorities began to involve consulting agencies to close and reduce medical facilities.

According to Semyon Halperin, president of the League of Doctors' Defense, the “professional negotiator” was sent to the hospital to defuse the situation. “Business coaches are people who can talk to anyone, they are released against the outraged crowd, and they resist it. Apparently, this is how they imagine medical ethics in the department, - Halperin told Mednovosti. - But the main task of a business coach is to teach marketing, how to fulfill financial plans . Such specialists are hired in order to motivate doctors to make money on patients, train them on how to increase the average bill, how to offer additional services to patients.… Such trainings are conducted in commercial medical institutions, and now they will appear in state ones. Of course, medical ethics in this sense is a perversion. But this is one of the results of optimization in healthcare."

As for the situation around the hospital itself, according to Halperin, these are still ongoing privatization processes in the country. “When industrial enterprises were privatized in the early 90s, this was also explained by the need to improve efficiency and unite efforts of the state and business to reach the level of developed countries,” recalls Halperin. - When everything was divided between several clans, the factories went under the hammer. Now we have neither factories nor engineers, and history repeats itself in the social sphere. But since the social sphere is legally prohibited from privatization, new options have been invented - concession, public-private partnership, which translates into pumping budget funds into private hands."

We will defend the maternity hospital

Anastasia Vasilyeva, chairman of the interregional Alliance of Doctors, is confident that the maternity hospital defenders will be able to defend it. “I am a doctor and I understand perfectly well that the modern requirements that the maternity hospital must meet differ from the conditions that exist here today. Nobody objects to making the hospital more modern and better. But flow ventilation, due to the absence of which the maternity hospital is now being closed, is available only in three clinics in Moscow, in particular, in the commercial EMC, - she told Mednovosti. - A business coach was sent to the last meeting, who was supposed to convince the team that resistance was pointless, but he didn't succeed.We will try to get the department to stop fussing at last, and to provide us with a clear schedule of repair work, and the exact date of opening the hospital. The population, doctors, trade unions, municipal deputies have united here, we have already discussed options for mass actions, strikes. And I have no doubt that we will be able to defend the maternity hospital that the district needs”.

By the way, there are such precedents in the country, recently it was possible to stop the closure of the maternity hospital in the Kirovsky district of Kemerovo. According to the Action trade union, residents of the right-bank part of the capital of Kuzbass knocked out of officials a promise not to close the only maternity hospital in this part of the city. It happened at a meeting with the vice-governor of the Kemerovo region and the head of the health protection department. About 300 people took part in a spontaneous protest near the district administration building, and an hour later a delegation of officials from the regional government arrived at the protesters.

Second wave

According to Vasilyeva, there is a second wave of optimization in the country, this is being discussed in all regional branches of the organization, where doctors of various specialties are increasingly entering. Again, there is not enough money for health care, in particular, for the May salary decrees, says Vasilyeva. The first thing that was done to optimize these costs was to transfer nurses all over Russia from junior medical staff to cleaners. Another way to save money is to get doctors, such as radiographers, to sign additional agreements in which they agree to cut vacations and premiums for harm.

“But this is still not enough. Therefore, again, health workers are massively reduced, hospitals are enlarged and liquidated. We were in the Novgorod region the other day, where they have already closed all feldsher-midwife stations and small hospitals, leaving only large hospitals in Novgorod and Borovichi. And now they began to reduce the ambulance, for example, in the city of Okulovka, out of four cars, only two were left. It turns out that one takes the patient to Novgorod, the other leaves for Borovichi, and the city is left without an ambulance,”said Vasilyeva.

There are enough "hot spots" in the capital. So, the Moscow Eye Hospital in Mamonovsky Lane is going to be taken out of the building that it has occupied since its foundation in 1826. “Even then, when the Center for Eye Medicine, the Moscow Eye Hospital, was de jure attached to the Botkin Hospital, it was clear that she would be evicted from the Center, someone needed the land where the eye hospital is located for construction. And so it happened. It is unacceptable. Many visually impaired patients know "by touch" this road, the change of place will tragically affect the possibility of treatment ", - said the deputy of the Moscow City Duma Elena Shuvalova, who initiated a round table on this topic.

Mednews will follow the development of events around the capital's maternity hospital No. 10 and other optimized medical facilities.

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