An expanded meeting was held at the presidential executive office. The heads of state authorities and the Ministry of Health, parliamentarians, chief doctors of medical institutions of the republic were invited to the working discussion. The work of such a composition has become customary during the coronavirus pandemic and holding meetings of the Operational Headquarters on a systematic basis to make timely decisions aimed at preventing the spread of COVID-19 in this regard. Health care in general was discussed today. The main issue is system optimization. The need for it is long overdue, said Vadim Krasnoselsky, opening the meeting. Work in this direction is underway. There are changes. The noticeable reduction in the number of citizens' complaints about the quality of medical services is indicative. However, there are many problems in the industry. It is necessary to approach their solution in a comprehensive manner, the President considers.
The keynote speaker, Minister of Health Christina Albul, spoke about the low level of wages in the healthcare sector against the backdrop of a significant workload and the outflow of professional personnel as a result. If there were 1906 doctors working in the republic in 2017, then there were already 1669 in 2021. Another 142 doctors and almost five hundred nurses were minus for the eight months of this year. The head of the department noted that doctors received the so-called COVID allowances, with the retreat of the pandemic during the pandemic period, the income of medical workers again decreased. The economic situation does not allow us to count on a significant increase in wages in the short term. Kristina Albul recalled recent transformations. We are talking about the formation of a three-level model of the organization of medical care – a breakdown into local, inter-district and regional levels, each of which involves its own technical equipment and staffing. The question of the validity of the bed fund of hospitals remains relevant. The number of beds per 10000 people in Pridnestrovie is much higher than in Russia, Ukraine, Belarus, and Moldova. In general, 4250 beds have been equipped throughout the republic. The minister stated that the indicator of staffing for the same 10000 people in Pridnestrovie is much lower at the same time (when compared with the aforementioned countries). The situation is different in various medical institutions, but in general the area of medical institutions and the number of beds in the country are used in half. The state of affairs with maternity hospitals and departments is indicative. The number of births is calculated in dozens per year in some maternity hospitals, that is the material and technical base is used inefficiently, the staff loses their qualifications. The Ministry of Health considers it necessary to get away from the unreasonable increase of the bed fund. It is proposed to reduce the number of beds in some institutions and completely phase out inpatient services in others. The compactness of the republic makes it possible to concentrate the provision of medical care in the conditions of the functioning of the three leading centers of inpatient care. The polyclinic link will be strengthened in towns and districts at the same time, the activities of rural medical outpatient clinics and feldsher-obstetric stations will be activated. The mechanism is being worked on. A concrete reorganization project is being prepared. Proposals and the consequences of implementation will be discussed in the course of the next meeting.
Discussing the issue of increasing the salaries of health workers, they talked about various ways to achieve this goal. Among the working projects is countrywide, but insignificant increase in salaries, the launch of pilot projects based on one or two medical institutions, maintaining the existing size of the wage fund with the provision of the head physician with the right to change the staffing table and use the principle of piecework wages. The meeting participants discussed the pros and cons of all options. The President instructed to prepare calculations for each of them. The proposed innovations have two interrelated tasks: to strengthen the human resources capacity of the health care system and to improve the quality of medical services.
