The problem of a shortage of medical personnel became acute for the first time during the pandemic, when the need for doctors increased sharply. But even now the issue with the lack of medical staff has not been resolved. How many doctors are lacking in our country and how quickly can this shortage be filled? aif.ru talked about this with Academician of the Russian Academy of Sciences, co-chairman of the movement «For the Saving of the People», full member of the Russian Academy of Sciences, Honored Scientist of Russia, Professor of the Moscow State University named after M.V. Lomonosov Sergey Kolesnikov:
— The «personnel» problem of health care is an old problem and has become even more aggravated in connection with the so-called «optimization» — a term that is in principle inapplicable to the social sphere. This is the concept of a market economy, meaning the maximum extraction of profit (i.e. replenishment of the pocket) at a minimum cost. And since most of our leaders come from a market economy, this seems natural to them.
As a result of such “optimization”, part of the district hospitals, a huge number of FAPs, the number of beds was reduced, the number of doctors and paramedical staff was almost destroyed as an “economically untenable” element of primary medical care, since, as it turned out, we supposedly have too many of them. compared to Europe. And all this happened against the backdrop of an increase in morbidity and, accordingly, an increased need for medical care.
As a result, according to various sources, the shortage of doctors in the country ranged from 50,000 to 100,000 specialists, and the shortage of nursing staff became even more tangible. The graduation of doctors and paramedical workers by universities and colleges did not make up for the loss of specialists due to natural causes and retirement.
The outflow of doctors from the «outback» is largely due to the wrong decisions of the country’s leadership, laid down in 2012. Then it was decided to increase the salary of doctors up to 200% (mid-level medical staff — up to 100%) of the regional average, which led to the migration of doctors from disadvantaged areas to megacities and prosperous regions of Russia.
In order to retain personnel, it was necessary to set salaries in scarce territories much higher than where there are enough doctors. This bug has not been fixed so far.
As a result of this «optimization» for 2015, according to the Accounts Chamber of the Russian Federation, 17.5 thousand settlements were left without primary medical care at all.
Since 2015, there has been an increase in student enrollment in universities from 41,000 to 64,000 (in 2020, for example, medical students increased by 50%) and nurses from 75,000 to 111,000 in 2020 (also by fifty%). But you need to understand that current students will graduate in 2023-26. And only after that we can expect an improvement in the personnel situation.
In 2022, despite the positive dynamics since 2016, the estimated shortage of doctors in the Russian Federation amounted to 26,451 doctors and 58,268 paramedical personnel (according to the Ministry of Health of Russia, information is contained in the draft resolution of the Government of the Russian Federation posted on regulation.ru «On Amendments in the state program of the Russian Federation «Health Development»»). One of the main reasons for the decline in staffing is the reduction of «covid» payments and labor migration of health workers from state healthcare institutions to medical organizations of private ownership (commercial).
But 6.2% of the employed (working) citizens of Russia work in the healthcare sector, that is, almost 4.5 million people. Of these, 87% work in the public sector (state and municipal) and only 11% in the private sector. So it seems not entirely correct to explain the shortage of personnel by the departure of doctors to the private sphere, as well as the decrease in covid payments (people do not go anywhere).
At the same time, it is indicated: in 2021, the staffing of outpatient medical organizations with doctors increased by 2.6% compared to 2020 and amounted to 82.5%, and the staffing of nurses — 85% (1.4% more than in 2020) , which can be considered a positive trend.
The opinion of the author may not coincide with the position of the editors