Tatarstan health ministry: X-ray therapy equipment really becomes obsolete and goes down

Health Minister Adel Vafin about the army of oncology patients, his attitude to the appearance of fee-for-service medicine

Tatarstan health ministry: X-ray therapy equipment really becomes obsolete and goes down Photo: Oleg Tikhonov

To tell that 2017 became one of the successful years for medicine in Tatarstan, Tatarstan Health Minister Adel Vafin gathered journalists in recently opened Polyclinic No. 21 that became the biggest in Kazan. He talked about the repair of all polyclinics for kids and adults, mortality rate's fall and officially increasing the quality of medical care. Realnoe Vremya's reporter watched how Vafin started to call it 'recognised perfection' after the Republic Clinical Hospital got a European certificate and how caring about men's health he dedicated the next year in Tatarstan to it. Realnoe Vremya tells facts about the results of the press conference.

Large-scale update

Thanks to the programme approved by Tatarstan President Rustam Minnikhanov, 2017 became unprecedented in terms of modernisation of polyclinics in cities and districts of the republic. 3,9bn rubles have been spent in 74 facilities. It was promised all work was to end until the end of 2017. However, everything stopped a bit.

''Nowadays Almetyevsk has been completed, Nizhnekamsk has been completed. Naberezhnye Chelny is about to be completed, repairs in Kazan are finishing. Equipment is delivered and the personnel are trained,'' Adel Vafin said.

In 2017, a total of almost 6,5 billion rubles have been spent to update the technical and material base in the republic. To compare, the health minister presented data on expenditures for modernisation in 2011-2013 that were 10,9bn rubles. He also told about 4 billion rubles were planned to update 120 facilities in 2018, excluding federal money to repair polyclinics for kids.

In 2017, a total of almost 6,5 billion rubles have been spent to update the technical and material base in the republic. Photo: Maksim Platonov

Over 10k of new oncology patients and lack of equipment

The number of deaths from oncology has been reducing for the third year in a row in Tatarstan. In addition, cancer remains the second most popular death cause after cardiovascular diseases. Almost a quarter of one million people have been examined in the primary oncology rooms, more than 25,000 of which were sent for a clearer diagnosis. It was confirmed in 46,7% cases. However, complications arise while curing oncology diseases, mainly they are linked with a failure or lack of special equipment, as a result of which the patients' treatment schedule goes out of its course. One of the journalists raised this problem for the health minister. In particular, she told about the facts of failed X-ray therapy terms she knew about.

''We, of course, try to provide flawless work now, but the equipment is becoming obsolete, it works with a high capacity and really goes down and needs to be updated,'' the speaker commented

The minister answered the problem with the availability of X-ray therapy equipment affects all Russia. It is solved in Kazan by equipping the Nuclear Medicine Centre, creating E-Emission Tomography Centre and introduction of such a procedure as tomotherapy that is also an X-ray therapy. According to the country's task, 725 patients were to receive it. However, Vafin admitted the equipment went down.

''Secondly, we, of course, try to provide flawless work now, but the equipment is becoming obsolete, it works with a high capacity and really goes down and needs to be updated,'' the speaker commented.

He promised there would be an X-ray therapy in Almetyevsk next year by means of Tatneft. So part of the load of Kazan would be lifted. The north-east part of Tatarstan would receive therapy in Naberezhnye Chelny, according to the minister. The construction project of the X-ray Therapy Centre will go through a state expertise.

''The problem is really urgent and it will be a priority in updating the fleet of equipment in Kazan. Now we also prepared offers to expand public and private cooperation to increase the availability of this help in Kazan,'' Vafin noted.

More satisfaction in Tatarstan

Even if it seems the number of dissatisfied patients in polyclinics doesn't reduce, official digits on the population's satisfaction with the quality of medical care in the republic grow. According to Tatarstan's Statistics Service, the satisfaction level has risen from 72,2% to 75,5% in a year. In addition, the ministry of health's survey showed that as many as 80,1% of citizens who completed the questionnaire are content. But their number wasn't mentioned. This is why it won't be possible to conclude what part of the population is satisfied with medicine in the Republic of Tatarstan.

The Tatarstan Committee on Social and Economic Monitoring held another survey. Its results were identical with that of the Tatarstan Statistics Service – the survey showed same 75,5%.

In general, he called the situation with drug provision 'uneasy' and advised residents of Tatarstan not to rush and not to choose financial compensation instead of free medication

Tatarstan is against but can do nothing

Among other pointed questions, the health minister also had to answer for changes at the federal level thanks to which the list of free medications for the population has shrunk. Vafin focused that the position of Tatarstan was very active but 'the decisions that are made, unfortunately, are not always effective from a point of view of patients'', but they had to be fulfilled on the spot.

''Unfortunately, we have to fulfil this decision of the federal centre. We expressed our position to leave available medication right on the list of vital drugs,'' the speaker commented.

In general, he called the situation with drug provision 'uneasy' and advised residents of Tatarstan not to rush and not to choose financial compensation instead of free medication because if they have serious diseases, much money will be needed for treatment, and it won't be possible to return to the programme.

Argument in favour of fee-for-service medical care

Talks about fee-based medicine don't calm down at the federal level. Not only insurance companies and functionaries but also very Vladimir Putin started to support the idea of co-financing of medical services by citizens speaks about it. Answering Realnoe Vremya's question, Adel Vafin was on the Russian president's side, but in quite careful formulation.

''Technologies grow – today high-tech medical care can cost 1,5-1,7 million rubles. But we understand that our abilities are limited,'' the minister told. Photo: Maksim Platonov

''It is absolutely certain that the state guarantee programme needs to have limits. We need to guarantee the volume we can fulfil, we have money for. Technologies grow – today high-tech medical care can cost 1,5-1,7 million rubles. But we understand that our abilities are limited,'' the minister told.

He noted efforts of the country should be designed, first of all, to increase the availability of medical care for kids and old people whose number only grows. ''For this reason, the load on the country in this sphere of health will increase,'' Vafin said and offered the population to pay attention to their health more often and 'invest' in preventive examinations.

In hunt for medical tourists

The work on certification of medical establishments is separately done in Tatarstan. 12 regional medical centres got ISO 9000 international certificate. Another 6 establishments have EFQM now. The Regional Clinical Hospitable was last to get the certificate – it was given five stars, what Vafin proudly called 'recognised perfection'.

The First Medical Aid Hospital in Naberezhnye Chelny is preparing for reaccreditation of JCI next year. It is the only state establishment in Russia today to get this certification. It all is done also to develop medical tourism in Tatarstan, which is still a novelty.

''We think that the commonly recognised certification will enable us to really become full-fledged players of the medical tourism market,'' Vafin hopes.

Russia's own certification has been also introduced – it is called National Quality System. Four hospitals of which three are in Tatarstan got it now.

''We are raising the level of evidentiary medicine to a new stage,'' the minister commented. Photo: Maksim Platonov

Medicine becomes online

Tatarstan also continues purchasing expensive diagnostic equipment that, unfortunately, is not always used at work. For instance, 7 mammographs, 10 digital ergographs, 6 densitometers, 44 ultrasonic diagnostic apparatuses have been purchased.

''It all will work, and we plan to save every research, that's to say, we are digitalising all our diagnostic base, so that research could be given for a second opinion, consultation, analysis. We are raising the level of evidentiary medicine to a new stage,'' the minister commented.

By Maria Gorozhaninova. Photo: Oleg Tikhonov