The doctors’ protests that dominated internal media headlines progressing this year might have slipped from the spotlight, yet a handful of determined Moscow doctors continue to battle the reforms that they contend have done their pursuit unfit with a so-called Italian strike, differently famous as the “work-to-rule” tactic.
“We go to work and do the job, the difference is we act in strict suitability with existent legislation,” Yekaterina Chatskaya, a doctor participating in the strike and a co-chair of doctors’ veteran kinship Deistviye (Action), told The Moscow Times in a new phone interview.
The Moscow health caring remodel launched final year shook the city’s medical village to the core. Leaked skeleton display that City Hall dictated to shut down 28 hospitals in Moscow and the Moscow region, laying off some-more than 7,000 medical staff, sparked large travel protests by doctors and nurses in November 2014.
The drastic cuts were indispensable to make the system work some-more efficiently, Leonid Pechatnikov, emissary mayor for social growth in Moscow, insisted at the time.
But doctors contend that distant from improving the medical system, the doctors who kept their jobs now have a bigger effort given of the layoffs, while salaries sojourn low — notwithstanding city officials’ claims — and working conditions have worsened.
Doctors are now compulsory to see some-more patients a day, yet spend reduction time on each of them, that mostly leads to them operative overtime, and through lunch and any other breaks. Dozens of Moscow doctors assimilated the Italian strike in March, anticipating to persuade the authorities to acknowledge the problem and do something about it.
Those holding partial in the Italian strike are refusing to work overtime unless they are paid for it, spending as many time with patients as they cruise professionally required and communicating all their complaints by central letters to their bosses, pronounced Chatskaya, a gynecologist at Outpatient Clinic No. 180 in northwest Moscow.
She pronounced she assimilated the union — and then the strike — out of pure despair.
“I saw no other option. we complained to my clinic’s administration mixed times about the conditions I’ve been operative in, yet to no avail. we was operative overtime so mostly that we literally had no other life,” she told The Moscow Times.
“It’s the only approach we can change the situation,” pronounced Albina Strelchenko, a physician at Outpatient Clinic No. 107 in northern Moscow who is also participating in the strike.
Among the strikers’ final are the hiring of more staff and an design comment of doctors’ workloads.
“It’s not so bad now given it’s summer, yet this open we had to work all day prolonged yet any time for breaks given there were so many patients,” Strelchenko told The Moscow Times final week.
It’s not usually the doctors who are suffering, she said. Patient visits were limited to no some-more than 12 to 15 minutes, that is not adequate for qualified medical care. “How can we assistance a patient in such a short volume of time?” Strelchenko said.
Taken for Granted
Another emanate that bothers the doctors is operative on weekends, with no saving days off during the week and no bonuses in addition to their salary — a clear defilement of Russian labor legislation, Chatskaya said.
“Once we non-stop my report on the IMIAS [Integrated Medical Information and Analytical System, the electronic complement by that all appointments at municipal clinics are made] and was repelled to see that the whole of my Sunday, from early morning to late evening, was booked,” she said.
“And no one had even worried to warn me that we was indispensable to work on Sunday, no one offering me additional income for it. So we kindly yet resolutely refused to do so,” she said.
Doctors are also approaching to participate in so-called mobile brigades that revisit patients at their homes, yet there is no authorised sustenance for them to do so, according to Strelchenko.
“Last week we saw that it was unfit to book an appointment with me on July 6 around IMIAS. we asked my administrator either that meant that we was due to work in a mobile brigade, and the answer was ‘yes,'” Strelchenko wrote on her Facebook page final week, adding that this kind of work is not stipulated in her agreement or any other paperwork. She has filed dual central complaints to the clinic’s administration about that, she said.
Under the reforms, metropolitan clinics launched a number of paid services, and doctors are underneath instructions to convince their patients to make use them, Chatskaya said. “But since should we convince people to use paid medical services if they have open health word that covers everything?” she said.
More Work, Same Pay
Some media had speculated that the aim of the layoffs enacted underneath the reform was to enable Moscow authorities to achieve the increase in the normal doctors’ income betrothed by Vladimir Putin shortly after he returned to the presidency in 2012. Putin pronounced that doctors should be paid at least twice the average income in the region, that in Moscow final year was reportedly around 56,000 rubles ($1,000).
But the striking doctors contend that notwithstanding the layoffs and introduction of paid services, they still acquire distant from what the president promised.
“We mostly hear officials contend that the average doctor’s income is 80,000-120,000 rubles [$1,428-$2,142 per month]. But at Diagnostic Center No. 5, for example, we haven’t seen a salary like that given 2013,” Anna Zemlyanukhina, a doctor at the evidence core in northern Moscow who is also holding partial in the strike, wrote on her Facebook page final week.
According to her, the average doctor’s income in the core of Moscow is now about 40,000 rubles ($714).
No Cause for Complaint
City officials contend there is no reason for the doctors to be displeasure or go on strike.
Shortly after the strike began, the head of the Moscow health caring department, Alexei Khripun, called it a “political provocation” and suggested the Moscow medical village as a whole did not support it. Pechatnikov, the deputy mayor for social development, concluded with him, observant usually dual doctors were holding partial in the strike.
An official ask for comment sent by The Moscow Times to the city’s health caring dialect went unanswered by the time of publication.
Lyudmila Stebenkova, conduct of the Moscow City Duma health caring committee, told The Moscow Times final week that the situation in municipal clinics had in fact softened in many ways, and there was no reason for the doctors to complain.
“We totally altered the way metropolitan clinics function,” pronounced Stebenkova, a deputy for the statute United Russia party. “Today clinics work according to the needs of the patients. Those who wish to work another approach should substantially cruise looking for a pursuit at private institutions,” she added.
On the theme of the many common complaint — studious visits being limited to 12-15 minutes — Stebenkova pronounced it was not a restriction, yet simply the gap between appointments in the IMIAS, and said it was adult to the alloy how many time they spend with the patient.
“Of march if the doctor decides to spend 30 mins with the patient, their subsequent appointment will have to wait,” she said.
It was not immediately transparent how a doctor would be means to see all the patients with appointments underneath her proposal, however.
Pressure From Above
When the strike began in Moscow in March, about 20 doctors from different metropolitan clinics upheld it, Chatskaya said. They were shortly assimilated by another 30 — yet not for long, she lamented.
“As shortly as we announced the strike and filed an official minute with the final [to the authorities], the sanatorium administrators started pressuring us into giving up,” the doctor said.
The head doctors of the clinics talked to strikers, perplexing to scare them or even buy them off, and in some cases they succeeded, Chatskaya complained.
By early Jul there were usually 15 doctors still on strike, yet the union co-chair expects the number to grow in autumn when people lapse from their vacations.
Complaints to the clinics’ administrators, doctors said, outcome in nothing at best. In the misfortune box scenario, doctors get blamed for the emanate they complained about or face retaliation.
Two weeks ago, The Moscow Times reported on the box of a immature dental surgeon, Ivan Stepanov, who was beaten adult by the conduct of his sanatorium and her deputies for filing a complaint to Moscow Mayor Sergei Sobyanin about restricting studious visits to 15 minutes. He was taken to a sanatorium with a suspected concussion and multiple injuries, usually to be liberated shortly after, notwithstanding the protestations of another alloy from the kinship who was present.
Stepanov’s box at first looked hopeless: Moscow health caring dialect officials claimed it was he who had started the fight and attacked the head alloy and her deputies. But 60 of his colleagues at the sanatorium stood adult for him and signed a petition opposite the head doctor, and she was dangling from work tentative an investigation. It was not immediately clear, however, either his strange censure would lead to any result.
Chatskaya also pronounced she had been persecuted for complaining about conditions. She pronounced she had sent a complaint to Roszdravnadzor, the state health caring watchdog, about not being means to refer one of her profound patients for an ultrasound given all the appointments were requisitioned adult for the subsequent dual weeks.
In mid-June, Roszdravnadzor officials wrote back — and Chatskaya was repelled to learn that an investigation had been launched into her for allegedly violating manners and not informing her profound studious about any state-funded options.
“I was summoned to a assembly with Roszdravnadzor, where they told me that the investigation into the conditions was over and had determined that we was to blame,” she wrote on her Facebook page after the meeting. “I consternation what kind of investigation they conducted, sine they didn’t speak to me or my patient,” she wrote.
Chatskaya told The Moscow Times she refused to accept the accusations and demanded that Roszdravnadzor officials at least speak her patient.
Two weeks later, on July 2, the doctor was entirely vindicated at another assembly with the watchdog.
“I consider it’s the media courtesy that did the trick,” Chatskaya told The Moscow Times after the meeting. “They were really respectful and friendly, listened to my arguments and to my patient’s story and let me go, dropping all the charges,” she said.
But the original problem — not carrying adequate ultrasound specialists in the sanatorium to accommodate all the patients — has not left away, she added, nonetheless the clinic hired one after she filed her censure and made the procedure of referring the patients by IMIAS technically simpler.
The war might be ongoing, yet the individual tiny battles won by Chatskaya and Stepanov give the strikers wish that victory — in the form of changes to the system — is eventually possible.
“I’m certain the strike will eventually assistance change things. We usually need to stick with it,” Strelchenko told The Moscow Times.
“Of march we wish for victory,” concluded Chatskaya. “But it’s not an easy win — it will take time for all these issues to change,” she said.
Article source: http://www.themoscowtimes.com/article/525461.html