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Russian public health system experiencing serious issues

Non-central regions lack more than 120 billion rubles for providing free medical treatment.

Former Public Health Minister Tatyana Golikova, now as Audit Chamber head, has addressed the situation in the department she previously headed expressing concern that it might worsen from January 11, 2014, Nezavisimaya Gazeta writes.

Speaking at the State Duma lower house of the Russian parliament, Golikova stated that the quality and availability of medical assistance would decrease dramatically next year. It will happen because the budget for the next three years envisions health care funding by the Compulsory Medical Insurance Fund.

A year ago, the Finance Ministry published the main budget policy guidelines for 2013 and the period from 2014 to 2015. Expenditure on health care this year has to decrease by 8.7 percent while in 2015 it will plunge by 17.8 percent. Within three years, health care will lose 21.9 percent of funding in real terms.

Golikova said straightforwardly that the mechanism to transfer money from the budget to the Compulsory Medical Insurance Fund had not been created yet. Public health facilities, including the leading hospitals in Moscow and St Petersburg will be worst hit by the transfer of funding, she warned.

Tremendous funds allocated for health care have "dissolved in the dark," Nezavisimaya Gazeta writes. The Audit Chamber checked the effectiveness of the use of funds for the program of state guarantees in free medical assistance in 2010-2012 and reported in its findings "systemic problems" with the availability of such medical assistance and provision of medicines.

At present, regions lack more than 120 billion rubles for providing free medical treatment. This figure was cited by President Vladimir Putin at a meeting of the presidium of the State Council in July.

Moscow shut down hospital # 45 (planning to establish a pay neurology center there instead), hospital # 47 for urology patients where a rehabilitation center for athletes will be opened and hospital # 60 (which was sold to a pay gastroenterological clinic). A similar process is gaining momentum in regions, according to activists of the Deistviye /"Action"/ independent trade union of hospital workers. Last year, the Kirov and Tula regions shut down five hospitals each, while the Orenburg and Ryazan regions shut down three each.

Amid the claims about the authorities' efforts to preserve free medicine, the process of shutting down public health facilities and replacing them with pay medical centers is underway, the newspaper notes.

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