Translated material
Operational confusion
The Academy of Medical Sciences is in no hurry to hand over its institutes to officials
The optimistic mood of the ideologists of the national project “Health”, who recently summed up the results of the first year of its implementation, may be spoiled by another high-profile scandal. The leaders of the Russian Academy of Medical Sciences (RAMS) seem to be preparing a new attack on the head of the Ministry of Health and Social Development, Mikhail Zurabov. The confrontation between representatives of medical science and officials, which is entering an active phase, may boomerang on the national project. At least in that part of it, which should make complex and expensive medical interventions accessible to the majority of the population. The fact is that the ministry’s priority project provides for the provision of such assistance both on the basis of new high-tech centers (seven of them should be built within the framework of the project) and on the basis of already existing scientific institutes. Why should these institutions, some of which are directly subordinate to the Ministry of Health and Social Development, and some are subordinate to the Russian Academy of Medical Sciences, be transferred to the jurisdiction of the newly created Federal Agency for High-Tech Medical Care. The new structure was created by presidential decree of June 30 last year, but has not yet begun full-fledged work. The agency, which currently exists primarily on paper, is headed by the Vice-President of the Russian Academy of Medical Sciences and the head of the Endocrinology Research Center Ivan Dedov, whom, as they say, Mr. Zurabov wanted to see at the head of the “profile” academy.Formally, a federal agency is being created to more effectively manage property and clinical sites. Of course, no problems arose with the transfer of research institutes assigned to the ministry to the agency, but no one is in a hurry to hand over medical academic institutes “to good hands.” The academicians very clearly demonstrated their attitude towards the ideas of the ministry at the last presidential elections of the Russian Academy of Medical Sciences - the minister's protégé was given a ride, preferring the famous oncologist Mikhail Davydov to the country's chief endocrinologist. But until recently, this confrontation was largely behind the scenes. And last week, Mr. Davydov launched a serious offensive. At a conference where the fate of Russian science was discussed and where many high-ranking officials were present, he said that the trend of bureaucratic pressure on science that has emerged in recent years gives rise to serious concerns.
“This situation has arisen because the ministry says: we don’t need the academy,” says Mikhail Davydov. According to him, officials are trying to usurp science: “By presidential decree, an agency was created that completely duplicates the functions of the academy. A recent government order ordered the transfer of three medical centers to the agency, although it has not even worked a day.” The head of the Russian Academy of Medical Sciences also especially emphasized that the Academy is 80 scientific institutes, and “severing each fragment from this system that has been in place for 60 years is fraught with disastrous consequences” both for science and for the ordinary patient. Academician Davydov is confident that the project that the current government is promoting as the introduction of innovative technologies in medicine is, in practice, purely commercial and leads to an even greater involvement of doctors in the world of financial transactions. Mikhail Davydov voiced his complaints against the relevant ministry in the presence of the Chairman of the Federation Council Sergei Mironov, whose support the head of the Russian Academy of Medical Sciences is now trying to enlist. People around Mr. Davydov express the opinion that if it is not possible to “defend the academy” with the help of administrative resources, the leadership of the Russian Academy of Medical Sciences may go to court.
The split is also growing within the ranks of the academy itself. The heads of the three research institutes that Mikhail Davydov spoke about are not at all upset about the upcoming reassignment. And they have already publicly declared their desire to come under the wing of the new agency. Of course, this is the Endocrinological Research Center - the patrimony of Mr. Dedov, the Institute of Surgery named after A.V. Vishnevsky and the Scientific Center for Obstetrics, Gynecology and Perinatology. By the way, there was a hitch with the last one. The head of this famous center, Vladimir Kulakov, addressed President Vladimir Putin with an open letter at the end of last year, in which he complained about the machinations of his colleagues and about the obstacles from the Russian Academy of Medical Sciences, which prevented the center from changing its parent organization.
The actions of the “schismatics” are also supported by some other academics, including those who hold high administrative positions today. “For some reason, it is not customary now to remember that from 1945 to 1991 the Academy of Medical Sciences was part of the Ministry of Health, and yet all the significant scientific discoveries were made precisely during these years,” an academician of the Russian Academy of Medical Sciences and the head of the federal agency told Vremya Novostei for Health and Social Development (Roszdrav) Yuri Belenkov. He is confident that unified management of all scientific centers is simply necessary, since at present scientific research is not coordinated in any way. “If the confrontation continues, everyone will lose, and first of all the state, because overlapping programs will inevitably appear that require budget funding,” Mr. Belenkov believes.
Academician of the Russian Academy of Medical Sciences Sergei Ternovoy, head of the Department of Radiation Diagnostics at the Sechenov Medical Academy, does not see anything seditious or harmful for domestic medical science in the reassignment of scientific institutes. “This is nothing new, much less dangerous. More than ten years ago, Evgeniy Ivanovich Chazov withdrew his cardio center from the subordination of the Russian Academy of Medical Sciences, after which real prosperity began there,” he shared his thoughts on this matter with Vremya Novostei. The position of the leadership of the new federal agency on this dispute was not publicly announced; Ivan Dedov officially refused an interview.
In such a situation, the emphasis in the implementation of the national project will have to be on newly created clinics to provide high-tech medical services. And their construction, apparently, is behind schedule - in any case, not a single building was built last year. Even the competition to determine the general developer was held with a serious delay, in November 2006, and not as originally planned - in May. The winner was the company SE VO Technointorg, which should supply ready-made modules to Russia from Germany for the construction of medical centers. According to plans, this should happen no later than mid-summer of this year, but responsibility for work on the zero cycle lies with the authorities of the regions where these clinics will be built - Krasnoyarsk, Krasnodar, Astrakhan, Khabarovsk, Penza, Cheboksary and Moscow. Despite the fact that with such a distribution of roles the risk of delay only increases, Roszdrav is quite optimistic. In any case, in a conversation with a Vremya Novostei correspondent, Mr. Belenkov assured that the new centers will accept the first patients at the beginning of 2008.
According to the head of Roszdrav, an equally serious personnel problem has already been resolved. “A list of all directors of the new centers has already been compiled, the number of staff is known and a complete financial plan for salaries has been presented. In the next two weeks, all centers under construction will be assigned to the leading scientific institutes of our country,” Roszdrav told Vremya Novostey. Thus, the supervising institutes will supply new centers with personnel (even a rotational method of work for surgical teams from Moscow is possible), as well as train employees at their base. Thus, the Institute of Cardiology, which is headed by Yuri Belenkov, has already begun training with surgeons from Penza. But it’s worth making a reservation - only the research institutes of the Ministry of Health and Social Development are recognized as such “cartridges”. Scientific institutions existing under the auspices of the Russian Academy of Medical Sciences share their experience with regional physicians as part of their programs, and not as part of a national project.