Marina Gracheva

The host of the St. Petersburg hour of the Liberty Live program Tatyana Valovich: today we are visiting the Deputy Chairman of the Committee on Health, Head of the planning and economic department Marina Gracheva. Marina Ilyinichna, before we touch on such a complex and sick topic as financing urban healthcare, I want to offer you and our listeners to listen to a report, which will give an offer about which budget for St. Petersburg is drawn up in 2004. It is today that the deputies of the St. Petersburg parliament will consider it in the first reading, and in which it will be accepted, in particular, how city health care will be financed. Despite the fact that the budgetary committee of the Legislative Assembly recommended that the budget in the first reading, many deputies are unhappy that the budget for 2004 is again scarce, and it does not take into account important areas of social financing. The topic will continue Dmitry execution:

Dmitry execution: Chairman of the Control Chamber of St. Petersburg Dmitry Burenin called almost a 4-million-dollar budget deficit far-fetched, and also accused the administration of underestimating revenues and numerous violations in the formation of its expenditure part. The main conclusion of the head of the KSP: the budget has the same errors as in the last years, and the new governor needs to change the team of financiers. Valentina Matvienko herself immediately after being elected to the post of head of St. Petersburg, promised to double the city budget, from 80 to 170 billion rubles. However, while in the project the budget remained scarce. The deputy of the Legislative Assembly of the city, Mikhail Amosov, believes that the draft budget is not good. It does not take into account a number of positions: the surcharge of poor pensioners, insufficient financing of housing and communal services and other issues. Colleague Mikhail Amosova Natalya Evdokimova believes that the draft budget must be accepted in the first reading:

Natalya Evdokimova: I cannot say that the social sphere is offended. And most of all I am pleased that next year St. Petersburg takes obligations to pay suppuers to the state employees of St. Petersburg so that the lower level of salary is not lower than the subsistence level for the working population - 3100 rubles. There are some incomprehensibility related to housing and communal services. The norm on housing policy is not still satisfied, and we are going to correct it. There is something to correct, but this is what to correct, you can do the second reading. Everything related to the social sphere.

Dmitry execution: According to Natalia Evdokimova, plus the budget of 2004 - just his social orientation. In addition, according to the deputy, Governor Valentina Matvienko promised to add one and a half billion rubles to the revenue part of the budget, and by the second reading with the help of this money to close those holes that have in the main financial document of St. Petersburg, Valentina Matvienko began her first financial year in the office of the mayor with anything about fantastic increase in the budget, Which remained scarce, and with promises to deputies to find money in under -financed directions along the way.

Tatyana Valovich: Marina Ilyinichna, I know that you took part in the deputy hearings regarding part of healthcare financing. From this point of view, from the point of view of healthcare financing in 2004, do you have any complaints about the budget compiled?

Marina Gracheva: You know, everything that you said before is completely pure truth. Indeed, the budget has become more. If this year it was 4 billion, for next year 5 billion is expected, growth is evident. Unfortunately, they forgot to add that it is only on a wage. A billion, which is added mainly to wages. A number of steps in the city are really taken, which will allow you to increase the revenue part, from, let’s say, salaries to our employees, employees of the budget sphere, in particular, health care, but the healthcare budget is not only wages. This is the current content. These are our programs, these are our preferential medicines, this is our everything, everything that we encounter every day when we visit clinics, hospitals and our other medical institutions. What is the most acute that could be said now - programs. Indeed, there are programs. The programs were adopted in the form of laws, and now, as it were, it was questioned which law is more important, the budget law, or programs adopted in the form of laws earlier, which were financed from year to year. The money that was supposed to be allocated to these programs earlier went to separate, so-called targeted articles, and it was clear that such and such an amount goes to one program, for diabetes, such and such an amount goes to the drug addiction program, the other amount for emergency care, and so on. Now formally, the money is really allocated, it is, it is assumed in our budget, but, let’s say, from the budget text itself you can’t quite see where and in what form they should be directed. But the amounts are declared, and as it were, so to speak, if they are molested according to economic articles, and it will be seen that the allocation of a certain amount was supposed to be allocated for one or another - this amount remained. Therefore, the Health Committee retains the right to spend either for current content or to implement these programs. I think that the committee will still go along the second path. There is no such thing that there are no programs.

Tatyana Valovich: I see. There was simply such information that some targeted programs, such as, say, oncology, diabetes prevention, improvement of emergency medical care in St. Petersburg, and a number of others, the information funds voiced such information that from January 1 to December 31, 2004, the action of targeted programs worth more than 318 million rubles is suspended-what does this mean? Because the listeners immediately began to call and ask, but what is it, we will again be left without preferential medicines? We will not be able to get any and so scanty of the possibilities that diabetics or oncological patients use?

Marina Gracheva: You know, we are talking only about the draft budget. Indeed, in the appendix to the part of the budget law, there is such an application in which programs are named, the action of which seems to be suspended. But I say once again, the money is allocated for them, and the healthcare committee will try to go in line with the implementation of these programs, because, here you said, 318 million rubles, and there are about 11 programs. But there are three more programs that, in general, remained in the budget. As for benefits, benefits are not programs. This is a separate target article, separate money, 702 million, they are, and nothing will change here. That is, the benefits, expenses for benefits and medicines, as we have happened, will be carried out further.

Tatyana Valovich: And the increase in expenses for preferential medicines is provided in the new budget?

Marina Gracheva: Yes, but insignificant. If earlier, this article of expenses included two targeted articles: the implementation of the Federal Law on the Social Protection of Disabled and the Actually the Assignment of Medicines for Preferential Categories of Citizens, the first part has now gone to the Committee on Labor and Social Protection. Therefore, the money there will also be allocated for this. Our part, if this year was 655 million, for next year - 702 million. Therefore, the growth is, as it were, in the amount of 10 percent, another thing, there is enough this money or not.

Tatyana Valovich: Yes, inflation is happening.

Marina Gracheva: Yes, inflation is happening, this is true. If you need two billion, they gave 700 million, then it is clear, 30 percent, as they were this year, will be the next year, that is, this is the volume that can be spent on these purposes. But here there is growth, while in the rest of the budget expenditures it is insignificant. There are a lot of problems in the budget. This is not only benefits, this is not only programs. There are expensive types of treatment. There is generally the content of our institutions. Expensive types of treatment are so that you imagine such types of treatment as resuscitation of a newborn, hemodialysis, cardiac surgery, burn treatment, organs transplantation. The city of St. Petersburg, an extraordinary city, and it has a lot of modern technologies, but, unfortunately, the budget is not able to fully pay them.

Tatyana Valovich: That's just recently there was an appeal of doctors of the burn children's center of the first city hospital that they are not able to, they have minimal funds to maintain the condition of the child, but in order to cure him to the end they again turn to sponsors. In general, the city’s healthcare is formed, because, probably, from the federal budget, do you get something, how is this happening?

Marina Gracheva: Well, actually those institutions that are funded from the city budget, from the federal, receive very minor funds, only in the form of some additives for medicines, but very insignificant, but, mostly, this is our financing, it is the city, as a subject of the federation, and our money, which should, in general, fully ensure these costs. I would not say that there is absolutely not enough money, there is enough money for a certain minimum, although all expenses, covering their budgetary part everywhere, is provided by 40 percent.

Tatyana Valovich: Marina Ilyinichna, in one of our reports, which was dedicated to youth policy, it was said that the absence of one gives rise to a lot of problems, do you think you need youth political organizations?

Marina Gracheva: It is difficult for me to answer this question, and because I grew up at a time when there was a Komsomol, there was a pioneer organization, and I cannot say that these organizations gave me little life. They gave me a lot in my life. They helped me acquire new friends, to spend interesting a segment of life that coincided by age with participation in these organizations. Therefore, I think that we are needed. Another thing - in what form and what orientation they have.

Tatyana Valovich: That's the ideological orientation, what do you think, should it be or not?

Marina Gracheva: A small example. Recently, I was at the celebration of one anniversary of our institution, and I was completely surprised that there was already nothing, it turns out, there is amateur performances, and the guys are interested not only in politics that they are talking about now, and they pay a lot of attention, and believe that the youth should actively participate, and in addition - dances, various circles, all this exists. Therefore, I think that too politicized youth organizations may not be given the wrong push in the future idea of the world.

Tatyana Valovich: Yes, just with youth policy and the problem of drug addiction is very large, which now exists. Yesterday, this figure was voiced in the State Duma: about 4 million children and adolescents were accepted in Russia. In St. Petersburg, I know, there is a program for the prevention of drug addiction, how is it financed, is the committee this problem is engaged in this problem?

Marina Gracheva: He is engaged. This is one of the programs that remained, of 14 that are named in our budget. The initiator in general, the creation of this program is the administrative committee, before it was called the administration in the person of our former power. The program is very important, very significant. The Health Committee takes part in these programs in terms of assistance to our institutions, which this is what they devote all their main activities.

Tatyana Valovich: We have a listener's call. You are on the air.

Ekaterina Izotova: Good afternoon. Ekaterina Abramovna Izotova, free trade union "For justice". For two years, I have been struggling to return the programs to ensure the soft medicines of the blockade, so far, especially after the election in the SCS, these programs do not actually work. If one diabetes program works, this does not mean that people should not help but die.

Tatyana Valovich: Here is the question of our listener in blockade, is it really not financed, and this article is not laid down?

Marina Gracheva: Of course, there is no separate article on blockade. These are exactly our veterans, the same exactly people who have all rights in the category of citizens whom we call preferential. The acquisition of medicines, I already said 30 percent, but this does not mean that only one diabetes program. All other medicines are also purchased for all categories of citizens, in accordance with applicable law, and all those who are entitled to receive these medicines, they usually turn to clinics, and receive the right to receive these medicines. But I say once again, 30 percent of the amount that is, do not, of course, not fully purchase the required amount.

Tatyana Valovich: And what is the need for the city in general for financing, so that it does not arise constantly, that’s not enough for it, that’s not enough. You calculated this amount?

Marina Gracheva: Counted. This amount is 11 billion. This is precisely with regard to healthcare institutions that are subordinate to the committee.

Tatyana Valovich: Has half allocated for the next year?

Marina Gracheva: Yes, 5 billion.

Tatyana Valovich: We have another call of the listener, you are on the air.

Emilia Vasilievna: Hello, I am a former medic, now retired, 67 years old, I am Emilia Vasilyevna, I have long been interested in the following: there are many old people, disabled people, disabled people of varying degrees. I have known one woman-blocker 82 years old, there is a terrible wet of the legs, does not sleep, relatives are exhausted, it is impossible to hospitalize, no one comes to the house, and with great difficulty, two or three times, through the governor’s reception, well, beautiful people worked there

Tatyana Valovich: I see, this is geriatric help ...

Emilia Vasilievna: And how are policies used, if no one uses them, where do the funds laid down to everyone go?

Tatyana Valovich: So, geriatric care and, apparently, was meant compulsory medical insurance.

Marina Gracheva: What does it mean, the policy is used. You know that there are 5 million inhabitants in the city. The program of the territorial fund, and the budget - two sources of financing of our system, and say that if the patient does not go to the hospital, and he has a policy, his money goes somewhere for other goals - this is not there either. There are people, a large number of people are entering our hospital institutions, and so far I have never encountered special problems with hospitalization.

Tatyana Valovich: But the problems are that they really don’t take old people, they say, “you know, he will die anyway,” and leave it at home?

Marina Gracheva: This is better for doctors.

Tatyana Valovich: But financing is allocated?

Marina Gracheva: Financing in full - there is no such that the money is somewhere and they are sent somewhere, for other goals, if they are focused on healthcare, on medical care - they go there.

Tatyana Valovich: And what is control, why sometimes such, one might say, scandalous situations arise. Everyone is in hearing the situation with insulin. What is the control by the health committee for how those funds are used, even meager, but released for healthcare?

Marina Gracheva: If you are talking about medicines, then the passage scheme is known to everyone: medicines enter the city, then prescribe according to doctors, go to pharmacies, and so on, as they reach the patient. Here, of course, is tight control over the expenses of these funds, we are checked an infinite number of times. But there are no violations. It is not said about this, of course, that they should not be. We have healthcare, given that we have a crazy deficit, you ourselves understand, 11 billion, or 5, there is a difference, therefore, before sending funds somewhere, a rigid analysis is carried out, hard control over the expenditure of these funds. Then there is a treasury budget execution system. Therefore, here for other goals, except for healthcare, except for the aid of our residents, they simply cannot go - there is nowhere to go.