Ayrat Farrakhov on rating clinics: ‘Corruption risks are obvious’
Private clinics in Russia will begin to be awarded stars
“Today, these are already the main requirements for conducting private medical activities,” said Ayrat Farrakhov, a State Duma deputy from Tatarstan, commenting on the idea of creating a methodology for assessing private clinics in a conversation with Realnoe Vremya. A corresponding instruction was announced at a round table of the Federation Council Committee. We are talking about a rating similar to what is currently in effect for hotels. Read more details about the pros and cons of the initiative are in a report of Realnoe Vremya.
Increase in citizen complaints about private clinics
At the end of last year, during a meeting of the Federation Council Committee on Regulations and Organisation of Parliamentary Activities, Russia’s consumer rights and health care watchdogs and enforcement agencies were instructed to create a methodology for assessing private clinics. The initiative is connected with the growth of complaints from Russians about organizations, Izvestia reports.
Thus, in Russia, over the first 9 months of 2024, the number of complaints increased by 15.5% — to 13,800. Most often, they concerned the work of medical personnel.
It is specified that in the third quarter of 2024, the Russian health care watchdog conducted 1.4 thousand inspections, 12% of which were with private individuals. Almost every one of them (93%) showed that non-governmental clinics violate mandatory requirements. This is allowed by nine out of ten medical organizations, the document says.
The methodology for assessing private clinics will become a rating, similar to the one used to assess the activities of hotels. These can be either stars or letter values — A, B, C or other benchmarks.
“Now supervisory authorities are limited in their actions: for example, due to the moratorium on inspections, regulators cannot punish violators. Therefore, it is important to create a system of incentives for clinics that do not violate the rules. For a correct assessment, we need a methodology, which we are currently developing. It will be based on an assessment of compliance with mandatory requirements: the presence of a license, disclosure of mandatory information for consumers, as well as an analysis of the performance indicators of a medical institution — this is turnover, staffing levels, and so on,” Oleg Pavlov, head of the Public Consumer Initiative, told Izvestia.
“You can't replace ordinary market mechanisms”
The idea of introducing an assessment of private clinics is unpromising, Ayrat Farrakhov, a State Duma deputy from Tatarstan, expressed his opinion in a conversation with Realnoe Vremya:
“All clinics receive licenses anyway. Accordingly, if the state has issued a license for medical care, has not suspended the document, etc., then how should clinics be ranked by stars and letter values? By the presence of higher-level specialists? By the availability of equipment? Who will evaluate this and how?” the deputy asked. “In general, there are a huge number of questions.”
In addition, the idea is fraught with corruption crimes — “the risks are obvious here.”
“In my opinion, you can't replace the usual market mechanisms — this is competition, openness and word of mouth. Word of mouth brings people to good clinics. Assigning stars... We often have cases when people are not worthy of these stars. In my opinion, this will be another discrediting of the idea,” Farrakhov expressed his concerns.
“Government agencies can punish businesses anyway”
Another Realnoe Vremya expert, Ilyas Nuriyev, CEO of Nuriyev Clinic, also agreed that the idea is ambiguous. According to him, it is necessary for private clinics to be rated not by government agencies, but by professional associations.
Another argument in favour of the participation of public organisations in rating is that the opinion of patients is also important in health matters. However, they do not have the necessary knowledge, continued the Realnoe Vremya interlocutor. But professional communities have the necessary skills.
“The idea itself is not bad, but it should not be implemented by state, especially not supervisory authorities. They can punish businesses anyway,” Nuriyev provided another argument. “This should be done by associations of professional communities — we have some. Who, except for us, private individuals, can truly evaluate their colleagues and assign the required number of stars? By the way, the Association of Small and Medium Businesses of our republic could participate in this project.”
The director of the clinic also expressed an opinion similar to Farrakhov's point of view: the criteria that they want to take into account to assess the quality of medical organizations are already in the public domain. It is necessary to pay attention to other factors:
- compliance with clinical recommendations, treatment protocols, industry standards that all medical organisations are guided by;
- service indicators;
- additional obligations that the private clinic has assumed;
- speed and quality of eliminating identified deviations;
- feedback from patients, patient communities and word of mouth.
“At the same time, when a patient is dissatisfied with the clinic, it is not a fact that he will write a negative review. And vice versa, a negative review often does not reflect the true picture. Word of mouth must be taken into account, it still regulates the flow of patients. In addition, official statistics often do not show the actual level of the clinic. There is a lot of subjectivity here, the expert is sure.”