"Even those who arrived." Doctors do not go to the village, despite a million

The regions of the so -called "LPR", "DPR", the Kherson and Zaporizhzhya regions occupied by Russian troops will attract doctors to work in villages under the Zemsky Doctor and Zemsky Palesher programs, which have been operating in Russia for the past 10 years. The money was allocated by reducing the financing of the same programs in the "old" regions of the Russian Federation . The correspondent of North. Realia found out from rural doctors why they refuse to work in remote areas and do not want to participate in the "zemstvo" programs.

A pensioner from the Vologda village of Vokhtog, 70-year-old Natalya Rusina in mid-July 2023 fainted on the street. Passers -by caused an ambulance. A car quickly arrived at her, but without a doctor and paramedic.

- Neither a nurse nor a doctor was in this car. One driver. Who asked her: "Will you reach the car yourself?" She got up, the driver helped her sit down, and they left, ”said the witness of the incident. Doctors who were waiting for the victim in the district hospital could not be saved.

The friends of the deceased say that Natalya used to work on a wholesale base, retired and took up summer matters. The Department of Health of the Vologda Oblast confirmed that the ambulance car arrived without a resuscitation brigade.

- At this time, ambulance workers were involved in the provision of medical care to a child with appendicitis and a patient with a heart attack. The doctors team was preparing to accept this patient. Despite the full range of resuscitation measures, unfortunately, the woman could not be saved, the department said.

Vokhtoga is a woodworking working village 100 km from Vologda. For five thousand inhabitants, two ambulances work here. This complies with the standards of the Ministry of Health of the Russian Federation, which advises hospitals to hire at least one brigade for 10 thousand inhabitants. As the North. The former Vologda doctor Nikolai Muravyov said, when there are not enough paramedics, in emergency situations the hospital can use the so -called "hostess". This is a car driver who is usually on duty at the supply of food and linen, but in emergency cases can go after the patient.

- Once, one driver came to us too, God grant him health. The doctors were busy with heavier patients, but we were given the right help in the hospital, ”recalls Tatyana Vlasova, a resident of Vokhtogi.

According to doctors from other regions, their hospitals are also sent to the calls of "empty" ambulances.

Feldsher Alexei Bobrovitsky He graduated from medical college in Petrozavodsk in 2015. After receiving the diploma, he got a job at an ambulance station in one of the villages of the Leningrad region. Most often they went to accidents on the Moscow-St. Petersburg highway. There were not enough hands on the "home" calls.

- Where I worked, there were mostly traffic accidents: truckers who fell asleep at the wheel, and in the summer motorcyclists. And there, for the first time, I found out that drivers were sent alone to patients, because there are two paramedics at the next five settlements. If the paramedic left for a severe patient, then one driver goes and takes the patient to the emergency room, he is examined there. There are no people who want to work for that kind of money. The conditions are still okay - profit. And the fact that a penny is paid for this is serious. At that station they paid 15.5 thousand rubles, ”says Alexei.

After moving to St. Petersburg, the salary of Alexei increased four times-up to 60 thousand rubles. He did not participate in the "zemstvo" program, since, according to him, this is "not the best option, which you can spend time and effort."

"Zemsky Doctor" is a scam to enslave young doctors

In March 2023, the Government of the Russian Federation announced the redistribution of funds allocated for financing the Zemsky Doctor and Zemsky Feldsher programs, taking into account the territories of the so -called Donetsk and Lugansk People’s Republics, the Kherson and Zaporizhzhya regions occupied by Russian troops and later joined through the "referendums". The Russian authorities only in 2023 will allocate 185 million rubles for the payment of “lifting” money to doctors who will go to work in new regions: under the terms of the program, 1 million rubles are paid to doctors and 500 thousand rubles to medical assistants who move to rural areas for 5 years.

The Zemsky Doctor program has been operating in Russia since 2012, the Zemsky Feldsher since 2018. For almost ten years, more than 51 thousand health workers took part in them.

Every year, 5.9 billion rubles are allocated to the "zemstvo" programs. In 2023, after the occupation of Ukrainian territories, 21 Russian regions were cut by budgets for payments to rural doctors, it follows from the order of the head of government. North. Realia compared the expenses for the programs prescribed by the Federal Law " On the federal budget " on 2022 and planned 2023, and the expenses that were indicated at the disposal of the head of government of March 17, 2023.

So, for example, in the Leningrad region in 2023 they will be sent 11% less - about 111 million rubles. With this money, in the area where the authorities have been talking about personnel shortage in hospitals for several years , they could go to work for 14 doctors (or 28 paramedics) more than planned in 2023. Irkutsk region reduced funding by a third - up to 102 million rubles, the Lipetsk region by 2 times - up to 19 million.

Of the four occupied Ukrainian territories in 2023, the Kherson region will receive the most - more than 51 million rubles, which is comparable to the annual budget of the "Zemstvo" programs in the Pskov (45 million rubles), Kurgan (52 million rubles) and Vladimir (53 million rubles) regions.

The shortage of medical personnel in Russia (excluding the occupied territories), according to the calculations of the Ministry of Health of the Russian Federation, reaches 75 thousand people. Most of the doctors and paramedics are not enough in the villages, where doctors do not even remain with a million rubles received from the state. The main claims of doctors: low salaries, lack of social infrastructure for living and problems with the arrangement of hospitals.

- The Zemsky Doctor is a scam to enslave young doctors, since inherently it is a million loan with a period of payment of 5 years. Calculate the average salary of a novice doctor in Moscow and St. Petersburg, this is 80-100 thousand rubles per month. In one year, everything pays off without a program, ”says one of the employees of the St. Petersburg Medical University (at his request, we do not name his name and name of the university. - SR).

Many doctors refuse to participate in the program, without waiting for the end of a five -year contract, the study of the Higher School of Economics says . In the Voronezh region, for five years since 2012, 11% of doctors terminated the contracts with the Ministry of Health ahead of schedule. Doctors explained their decision with career growth in another organization, a change in marital status, the purchase of housing in another area, a small salary, and working conditions. The program is in demand in villages around large cities, but it does not solve problems of remote areas, the authors of the study say. They give an example that in the Tyumen region only 35% of doctors agreed to stay in the village after working out, and in the "complete" areas the number "remaining" reached 70%.

"There are no doctors for several years"

While the government redistributes the money intended for villages to the occupied territories, residents of Russia have been waiting for years for years when doctors will come to their small villages and begin to work.

In March 2023, residents of the rural settlement of Krasnobors in the Izhema district of Komi complained to the head of the region Vladimir Uybe that the feldsher-obstetric centers in the region are empty for almost a year. The district authorities cannot be involved in the work of a pediatrician and a dentist, and local pensyele doctors went to quarantine in the Pandemia of Coronavirus and never returned.

In November 2022, the family of doctors Alexei and Elena arrived in Krasnobors Rakins to participate in the Zemsky Feldsher program, but they left the village three months later.

“We returned all the money, we only have a small part for the time worked, the ministry was recalculated in the ministry,” said Elena Rakina North. Realiy. According to her, “this program is working,” but they changed their minds to participate in it for personal reasons.

Alexey Rakin says that he and his wife did not find a common language with the authorities.

"The reason for the hasty departure of the doctors we consider the unwillingness or inability of the Izhema Central District Hospital to solve problems related to organizational issues, as well as disrespect for our employees and the population of the region. We turn to officials from healthcare: do not accuse our doctors, whom we reasoned and look for the reason for their departure of their inaction. Otherwise, there will be beautiful, good solid ones. Faps, who needs them without specialists? " - The inhabitants of the village wrote in an appeal to the authorities.

- The paramedic in the village is such a responsibility, 24 hours a day as a soldier. You never know what where anyone has happened. They conduct reception, go on challenges, they have no cars. There are several kilometers between the villages, they should walk at night if the ambulance does not leave. This is gasoline or bus, time and money, ”says the municipal deputy Olga Chupova.

Chuprov is from the Krasnoborsky settlement. For the past three years, she has been trying to change the conditions of the Zemsky Feldsher program at the regional level to attract doctors of various specialties, such as dental doctors and laboratory assistants for blood sampling. Chuprova advocates reimbursing transportation costs if the doctor uses a personal car on the calls. But so far, neither regional nor federal authorities are responding to her appeals.

- The answer was everywhere that there was no compensation for such business trips. But if there is no such federal program, the region can come up with such a program. We turned to newspapers, on TV, to the Ministry of Health, to the head of the Komi, but this did not lead to anything: the doctors did not appear. Moreover, they say that it was decided to reduce bets that are empty. As I understand it, there is no bet - there is no problem, ”the deputy continues. - We have one paramedic retired and went on a watch. All this is very bad. There are no doctors for several years, even those who arrived are leaving. Now there are two places, they are called "millionaires", where they are ready to pay a million and provide housing. But they are free.

Krasnobor is located on the peninsula between the rivers of Pechora and Izhma. Before Syktyvkar - the capital of Komi - there is a year -round highway. Private houses for two thousand inhabitants stretched along the shore 12 kilometers. There are five villages with speaking names: this is a nativity scene, desert, diet (translated from Komi "Upper Island"), Krasnobors and Yurgenshar ("Copper Ball"). There is a kindergarten and a school. The deputy of the Chuprov says that in recent years young people are returning to the village, but everyone is traveling for 70 kilometers to be treated.

- Our population is already accustomed to - who is in IZHMU to treat teeth, some in Ukhta, who is generally in Syktyvkar. Take a vacation for this! They themselves solve their problems. Recently, the Minister of Health came to the district, but did not even meet people. By default, everything goes. “There is no money for this, we cannot, it is not provided by law,” says Chuprova.

"The program was disappointed"

The village of Bilutay is located in Buryatia, three hours from Lake Baikal and an hour from the border with Mongolia. 210 people live here - mainly of retirement age. Young people are trying to leave the village, since there is no work here: only personal farms of residents, paramedic obstetric center (FAP) and mail. Irina Lapteva came here in 2018, signing an agreement with the regional Ministry of Health under the Zemsky Paramedic program. Under the contract, Lapteva receives half a million rubles and has been working as the head of the FAP for five years.

- I will not deny, for the issued money for the first time they bought firewood, purchased furniture. I decided to participate in the program because I wanted to get experience in the village, moreover, they promised an apartment. The apartment turned out to be dilapidated, although it was better than none. But, unfortunately, the program was disappointed. The conditions for work are bad, there is no kindergarten in the village, ”she explains North. Realiy.

Bilutai is a steppe village. Historically, he was inhabited by the Old Believers, sent in the 18th century by the authorities from Moscow, Novgorod and St. Petersburg. This ethnographic group is called "family", as they were sent to Siberia by large families, unlike single convicts. The ancestors here resemble carving on wooden houses, traditional for Russian housing construction. In one of these houses, Irina allocated a two -room apartment. According to her, all lifting went to stove heating and traveling to the district center 80 km from the house.

- There is no car, there are no buses. You have to hire a local taxi driver for 2000 rubles in both directions. We have to ride five times a month, and everything at our own expense: we carry patients and tests, plus for seminars and conferences I leave. Cars, of course, are in the district center, but they are constantly busy. Not only I pay for work trips, but also many paramedics from other villages. And the salary is not large: from 20 to 30 thousand rubles, ”Irina continues.

Together with the newborn daughter, she moved to the village from the small city of Kyakhta. This is 100 km from Biluya. The daughter spent the first four years with her in FAP, since there was no one to leave the child with.

- For all the time, my patients have become like relatives for me. Of course, I will be bored, but this year my contract ends. I’m going to move to where there are more or less conditions for normal work and, of course, primarily a kindergarten, ”says the paramedic.