Ayrat Farrakhov: “The basic principles of the law on public procurement do not work in the case of medicines”
According to the deputy of the State Duma, it is necessary to radically change the law on competition in order to improve the provision of medicines to beneficiaries
In the past year, the State Duma deputy from Tatarstan and ex-minister of healthcare of Tatarstan, Ayrat Farrakhov, received 3 times more appeals from voters. In part, this growth is due to the coronavirus pandemic — people reported problems by phone and online, wrote in social networks. As a result of these appeals, the plans for 2021 have been formed, in particular, regarding changes in legislation. Ayrat Farrakhov told in the author's column written specially for Realnoe Vremya what bills, co-authored by our parliamentarian, have helped make life easier for businesses and what initiatives are going to be worked on this year.
We are not the authors of the new bill, we are its agents
“Deputy” — translated as “appointed” from Latin, that is, a person appointed by the people to represent their interests in power. Concrete results and assistance are expected from the envoy. The year 2020 was a very difficult year, and there were a lot more appeals from voters, in particular, to me — more than three times compared to previous years. However, the growth is probably due to that it has become easier to contact — by phone, online, by e-mail, through the State Duma website, in person — in social networks. The natural result of these appeals are plans for the year 2021, in particular, plans for changing our legislation.
In 2020, nine bills were adopted, which I co-authored.
Recently, for example, a draft bill has been adopted in the third reading, which I was instructed to work on by the president of Tatarstan, Rustam Nurgalievich Minnikhanov. The bill is somewhat indicative because the work on it went exactly as I think is most correct. It was proposed not by deputies but by those who appointed deputies to power.
In May, we met with entrepreneurs — representatives of small and medium-sized businesses, and at this meeting, one of them asked to relieve them of the obligation of annual audit of financial statements. An audit costs from 60 to 100 thousand rubles, this is an additional cost, and for small businesses — every penny is important.
Now they do not need to conduct this audit — only large companies with revenue exceeding 800 million rubles a year have the obligation. I am particularly pleased that the authors of the new bill were, in fact, entrepreneurs themselves, and we only helped them to implement it.
And there were many such bills last year. The issue with the parents of disabled children was successfully resolved following a very heated meeting in Tatarstan, and one of the issues that they raised was the discrepancy between the real needs of disabled people and the standards established by the federal ministry of labour and employment for rehabilitation funds — diapers. For example, diapers were two times less than necessary. I made a request to the minister of labour and employment — as a result, the standards for absorbent underwear and diapers were significantly revised.
I am very proud that the nine bills I worked on have already been adopted. Next year, there are seven more bills in the first reading stage, and 15 more have been proposed but not considered.
Plans are based on personal appeals
In 2020, I had 96 meetings with voters, during the year I received 752 people — in person and remotely. In total, I received 1,212 requests, 427 of them through the official portal of the State Duma, 496 — through my social media accounts and personal electronic form, and 289 — during a personal reception. It is these appeals that formed the basis of plans for the next year.
The most relevant issues during the year were drug provision and the provision of technical rehabilitation facilities for disabled people — this is 45% of all issues. Probably, this figure is due to that many people associate me with my previous work and still perceive me as a representative of the healthcare system.
Appeals related to housing and utilities issues, deceived shareholders, infrastructure — 18%. Issues of pension provision — 15%. And 12% are the initiatives that need to be promoted. That's like the bill I mentioned earlier. Another 10% are requests for help — money, repairs, and so on.
The deputy has two tools — the legislative initiative and the request. Nine hundred and forty-five requests to federal and regional ministries and departments were prepared. We have already received positive responses and solutions in 58% of cases. The rest are in process — they are very complex, one year was not enough to solve them.
I also have plans to adjust the tax and budget legislation. Our economy needs substantial support. Small and medium-sized businesses are being in a very difficult situation, many entrepreneurs openly talk about their plight. Therefore, it is very important to adopt laws that are aimed at supporting the business environment, reducing taxes and ensuring that entrepreneurship develops. It provides the main budget revenues, which means that it creates a basis that will allow raising pensions, building roads, kindergartens and schools.
If the competition bill does not work when purchasing medicines, it should be changed
I head the working group in the State Duma of Russia on improving the provision of medicines. Now all medicines for beneficiaries are purchased under the bill “On the contract system...” (44-FZ). The effectiveness of drug provision depends on how it prescribes the rules of competitions and supplies.
We are currently preparing about a hundred amendments to this bill — so that the money that the state allocated for the purchase of medicines is used more effectively.
For example, we are not satisfied with that the main criteria under the current law are the presence of competition and price reduction. We understand that it is not always possible to buy a good medicine for the lowest price. That it may not be suitable for a particular person. And that sometimes there are situations when there is no competition and can not be. When, for example, a single manufacturer has brought a super-modern medicine to the Russian Federation and will buy it at the price that they set.
The basic principles of the bill on public procurement do not work in the case of medicines, so it is very important to look for other options, use other tools and mechanisms.
Besides, there are new drugs that are not registered in Russia, which the parents of sick children prescribed from abroad, and you remember, there were lawsuits. We took part in this case, all criminal cases were cancelled, and medicines were registered in our country.
But now it is still necessary to make sure that these medicines are produced in our country — then they will become cheaper and more affordable. Now their prices are exorbitant, providing them to some patients, we limit others — the budget is limited.
Another important point: today there are such approaches to procurement, when the payment of drugs occurs only after the effect is achieved, when it is clear that the drug really helped, brought results.
Today's Federal Law 44 does not provide for this, and we want to make very serious changes to it, which primarily concern innovative drugs and are aimed at creating conditions in Russia for the production of such drugs, creating new places and supporting science.
And there is also an idea to introduce the concept of centralised procurement by law, as it is done in Tatarstan. We have a centralised warehouse — Tattehmedpharm, and large volumes of purchases allow us to seriously reduce the price of each package of medicine. By extending this principle to a number of subjects, such as the Volga Federal District, we would improve drug provision for all patients.
It's time to limit the spread of rumours about the harmfulness of vaccines
Experts and I are close to starting to draft another federal law. Statistics show that approximately 60% of people are not ready to be vaccinated against coronavirus. They are not that against — they have not yet decided, and they can be understood. There are also complaints about the state: there is a lot of closed information.
When there is no official information, people turn to social networks for information. And there is a huge amount of fake information that vaccinations — vaccines are the causes of disability, autism, and so on. And the most dangerous thing is that this information is often massively distributed by people who have the right to medical activity — doctors.
But since there is not enough government information, people use these scientifically unsupported rumours to make decisions. There have already been many cases when the refusal of measles vaccinations led to that people became disabled. But what if people do not get vaccinated against COVID-19, get sick and get severe complications?
The essence of my idea is to limit false information on the Internet by law. We have recently made a decision requiring social networks to block unreliable, socially dangerous information, for example, on child suicides, child pornography, and it works. In the same way, I believe we need to approach unconfirmed information on vaccination — this is really socially dangerous information!