Transportation of patients in the ambulance Ministry of Health wants to give to outsource
The ministry assures that it will not affect the quality of medical care
The Ministry of Healthcare of the Russian Federation is finalizing a project to transfer the function of medical delivery and transportation of patients when providing emergency medical care to private companies. As reported in the department, it should be ready until June 14. In this case, as explained in the Ministry of Health, despite the fact that the transport service "ambulance" will be outsourced, emergency medical care for patients will remain free. However, experts believe that ambulance partnerships with private carriers require strict state control and that this issue should be worked out with due regard for regional specifics.
The representative of the Ministry of Health of the Russian Federation said that the transfer of transport services to ambulance outsourcing will not change the procedure for rendering medical assistance.In addition, the Ministry of Health denied the earlier rumors that a quota would be introduced in four ambulance calls per person per year.- The Ministry of Health of Russia does not plan to make any changes to the current legislation in terms of limiting the number of free calls to emergency medical care. Moreover, this initiative by the Ministry in principle is not considered as a possible option for changing the activities of the Emergency Medical Services, - commented in the department.
The Ministry of Economic Development of Russia criticized the draft Ministry of Health.
A representative of Minek said that the draft report of the Ministry of Health on this issue, which he submitted to the Ministry, does not contain the required analysis with relevant conclusions. In essence, the draft report is a synthesis of information from those indicated in the instructions of the President of the RF subjects involved in the project (Republic of Mari El, Chuvash Republic, Perm Territory, Arkhangelsk, Vologda and Kirov Regions), which does not answer the questions put in the President’s instructions. The office notedthat it is impossible to objectively assess the real state of the implementation of projects for the transfer of ambulances to outsourcing, the existing advantages, disadvantages, difficulties and risks of project implementation in the specified regions of the Russian Federation.
According to experts of the ministry, one of the key indicators of the analysis should be the comparable cost of the car-hour of car operation, however, according to the submitted materials, it is not possible to evaluate this indicator.
In addition, according to the Ministry of Economic Development, the Ministry of Industry and Trade of Russia, on behalf of the government, must execute an ambulance fleet renewal program. In this regard, it is necessary to allocate funds for the centralized purchase of cars. A list of suppliers of ambulance cars for 2016 should also be compiled, including Automobile Plant GAZ LLC, Ulyanovsk Automobile Plant LLC and Ford Sollers Holding, a joint venture company.
Thus, according to the Ministry of Economic Development, taking into account the planned update of the ambulance fleet and clarification of the list of auto suppliers, questions about the need to implement projects for the transfer into private handsfunctions for the provision of transport services in the provision of emergency and emergency medical care need additional study.
Eduard Gavrilov, Director of the Foundation for Independent Monitoring of Medical Services and Human Health Health, commented on the situation, saying that the Ministry of Health should show more common sense and concern for the population when fulfilling the presidential instruction than when planning the recent optimization of health care.“It is important for the ministry to involve experts in preparing a well-thought-out standard technical assignment for private carriers that takes into account all the risks of such cooperation and the experience of the regions accumulated over the past few years,” he stressed. - As this experience shows, in some regions a public-private partnership has made it possible to spend budget money more efficiently. For example, in five years of cooperation with a private company, Perm Region saved 120 million rubles in ambulance transportation.
But at the same time, the expert notes that budget saving is not always possible.“Thus, in the Stavropol Territory, the cost of services of private carriers turned out to be too high, which made the partnership unprofitable for the region,” he said.- There are other problems: for example, when the region changes the carrier after the tender, the previous one ends its “careless” term.
Eduard Gavrilov also noted that the worst development is not excluded: if a private carrier suddenly leaves the market (for example, in the event of bankruptcy), the region may remain without ambulance for a while.
In turn, the All-Russian Popular Front stated that the issues of transition to transport outsourcing to ambulance should be carefully worked out by the Ministry of Health, taking into account regional peculiarities. A member of the State Duma Committee on Health Protection, Raziet Natkho, who personally checked the state of ambulance stations in the regions, believes that the Ministry of Health needs to be attentive to details: in some areas, private companies bought just cars and not ambulances, so they had to be equipped with equipment And this is extra money from the budget. In addition, the deputy clarifies, the ambulance team is a team of professionals, and the driver can also be involved in an emergency situation in the process of hospitalization of the patient.“In the case of an ambulance car on outsourcing, the driver will work for a private company, and he may not agree to help the medical staff,” the expert believes. - Such cases have already happened in the regions where a pilot project is being run around.
Raziet Natkho also noted that ambulance cars for outsourcing can be effective in large cities.“In regions with difficult accessibility, this project may be ineffective,” she said. - Therefore, the Ministry of Health needs to work out this issue taking into account regional peculiarities.
The chairman of the Feldsher.ru ambulance workers' independent trade union, ambulance paramedic, Dmitry Belyakov, said he considers the transfer of ambulances to outsourcing to be not a good idea.“The ambulance, like the police, the firemen is an emergency service,” he stressed.
At the same time, the chief doctor of the largest private ambulance service in Russia, the general director of CORIS, Lev Averbakh, said that this idea is good, like any idea of outsourcing something to business.“Certainly, business will be more efficient in this matter,” he is sure. - Now the cars, their service, and insurance have risen in price.Therefore, in some regions such private owners simply will not be due to the high cost of this business. Since you need to take a loan for cars, you need a lot of cars (according to the standard - one car per 14 thousand people), they need to be serviced and loans paid. Therefore, everything will depend on the proposed tariffs by the state. With good fares, people will take it. In Petersburg, for example, everything is fine with this question.
Recall that the President of Russia instructed the Ministry of Health, together with the leadership of several regions and the Ministry of Economic Development, to analyze the experience of transferring to private organizations on a contractual basis the functions of providing transportation services in the provision of emergency and emergency medical care.
The first phase of the project was launched in 2012 in the Perm region, the Kirov region and Bashkiria. In 2013, the project for transferring ambulances to outsourcing was recognized as successful and launched in a number of pilot regions - in Astrakhan, Belgrade, Voronezh, Ulyanovsk, Ivanovo, Kemerovo, Moscow, Tomsk, Tambov and Nizhny Novgorod regions, as well as in Karelia, Mordovia and Chuvashia.