But they blame Grigory Yavlinsky for this

Press Release, 15.12.2017

The Ministry of Healthcare of the Sverdlovsk region published their response to criticism by Grigory Yavlinsky, which he voiced at a press conference of the politician during his visit to Yekaterinburg on 12 December.

Regional officials were offended, in particular, by Yavlinsky’s words concerning the reduction of healthcare expenditure in the region: “Only in the last year, healthcare expenditure in the Sverdlovsk region fell almost twofold – from 39.8 to 20.4 billion rubles,” Grigory Yavlinsky said. “And the region is ranked 72nd out of total 85 for such an indicator as the share of ambulances arriving to patients within 20 minutes”.

The presidential candidate also cited other figures: since 2012, the number of hospitals in the region had decreased by 14 per cent, and hospital beds by 11 per cent. According to Yavlinsky, these indicators characterise not so much the poor performance of the Sverdlovsk Health Ministry as the general deplorable state of healthcare and all social sphere in the country. To change the situation, it is necessary to change the system of distribution of tax revenues between the federal centre, the regions and the municipalities, Yavlinsky said.

However, the Ministry of Healthcare of the Sverdlovsk region refuted Yavlinsky’s arguments. Konstantin Shestakov, Press Secretary of the Ministry, wrote on his Facebook page that in 2016 the region spent 58.4 billion roubles on healthcare, and in 2017 (according to the plan) it should spend 61.8 billion roubles, i.e. by 5.7 per cent more.

According to Shestakov, “for the nine months of 2017, ambulance arrived to patients within 20 minutes in 335,839 cases (88.3 per cent of the cases). Given that the target value of this indicator for 2017 is 88.1 per cent.” The Press Secretary did not mention the reduction of hospitals and beds at all.

According to the Yabloko’s Expertise and Analysis Department, the information provided by the ministry is erroneous. “One can invent different figures for internal use in the region,” says Ivan Bolshakov, head of the department and member of the Federal Bureau of the party. “But the figures fixed in the documents and the official statistics transmitted to the Federal Treasury and Rosstat (the Russian Statistical Agency) contradict the statements by the [regional] Ministry of Healthcare.”

The information provided by Yavlinsky on healthcare financing in the Sverdlovsk region concerns only the expenditures of the regional budget. According to the law of the Sverdlovsk region of 06.06.2017 No. 58-OZ “On the execution of the regional budget for 2016”, the expenditures under the section “Healthcare” amounted to 40.047 billion roubles.

According to the law of the Sverdlovsk region of 19.12.2016 No. 131-OZ “On the regional budget for 2017 and the planned period of 2018 and 2019” (as amended on 03.11.2017 No. 106-OZ), the expenditures under the section “Healthcare” amount to 20.363 billion roubles.

The cut of expenditure amounts to 49 per cent.

But even if we take into account both the consolidated budget of the region and the territorial fund of compulsory medical insurance (which, apparently, the regional Health Ministry had in mind), the healthcare expenditures in the region fell anyway.

Tatyana Golikova, Chair of the Audit Chamber, indicated that in November 2017 (basing on the results of the nine months of 2017), healthcare expenditures were reduced in the consolidated regional budgets in Russian 84 regions and demonstrating a drop by 42.9 per cent. And the Sverdlovsk region was not the region showing a rise of funding.

According to the Federal Treasury as of November 1, 2017, the consolidated budget of the Sverdlovsk region and the territorial state extra-budgetary fund totaled 64.276 billion roubles, while implementation of the consolidated budget of the Sverdlovsk region and the budget of the territorial state extra-budgetary fund for 2016 amounted to 82.951 billion roubles. This is a decrease by 22.5 per cent.

Also it should be noted that the budget of the territorial fund of the compulsory medical insurance of the Sverdlovsk region consists by 98-99 per cent of the federal money in the form of subsidies from the Federal Compulsory Medical Insurance Fund.

According to the Rosstat official data, for the past five years, the number of hospitals in the Sverdlovsk region have declined by 14.1 per cent (or by 26 institutions), the number of hospital beds by 11.6 per cent (or by 5,000 beds) and the number of medical and obstetrical stations by 3.6 per cent (or 21 institutions in the rural areas).

According to the RIA Rating agency, the Sverdlovsk Region is ranked 72nd as of the share of ambulances arrivals to patients within 20 minutes and 67th in terms of the number of doctors per 100,000 residents.

The low efficiency of regional healthcare is also confirmed by another ranking compiled by the Higher School of Healthcare Organisation and Management, where the region is ranked 75th demonstrating a drop by 12 points against 2015.

Трагические истории о ситуации с невыездами скорой помощи в Свердловской области не раз доходили до федерального уровня. Подтверждения, например, здесь, здесь и здесь.

Tragic incidents when ambulances in the region refused to go to the patients have repeatedly raised by the mass media on the federal level. The confirmations, for example, are here, here and here.

https://ria.ru/incidents/20171206/1510326075.html

https://rg.ru/2015/03/04/skoraya.html

https://www.vesti.ru/doc.html?id=339946&cid=1

“The situation with healthcare in the Sverdlovsk region is not rosy,” Ivan Bolshakov noted. “Instead of justifications and disputes about the calculations, the authorities of the Sverdlovsk region should have raised the issue of insufficient funding of healthcare before the State Council or the Federation Council seeking provision of the required funding from the federal centre on the proper level; in particular, through a fairer redistribution of tax revenues. This is exactly what Yavlinsky said, describing the situation in the field of healthcare,” Bolshakov stressed.