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Flurry Of Hospital Tours Heralds Russian Health-Care Revamp

A view of the hallway of the Voronezh city hospital
A view of the hallway of the Voronezh city hospital
Barely a month goes by in Russia without national television airing images of a high-ranking official touring a hospital.

Moscow Mayor Sergei Sobyanin was recently seen shaking hands with doctors at the capital's Botkinsky hospital, where he pledged to give the prestigious facility a complete facelift within the next two years.

In January, President Dmitry Medvedev visited a newly built clinic near Sochi, the site of the upcoming 2018 Olympic Games. In December, it was the turn of Deputy Prime Minister Aleksandr Zhukov to inspect a hospital in Naberezhnye Chelny, in the Russian republic of Tatarstan.

Prime Minister Vladimir Putin, too, has joined the trend. This week, he donned white doctor scrubs and visited a hospital in Moscow where he then held a meeting with top officials on modernizing the country's healthcare system.

But despite the doctors' best efforts to please their guest -- including a rare endeavor to clear the entire boulevard of snow -- Putin was not impressed. Turning to the cameras, he said hospitals in Moscow had been neglected for too long.

"There are many superb, good, modern facilities, both municipal and private. But the majority -- I want to stress this -- of medical institutions in the capital that are frequented by ordinary Muscovites clearly need serious attention from both city authorities and the federal government," Putin said.

$5 Billion Program

The recent flurry of official hospital visits and the accompanying pledges of financial help are viewed by many as a sign that Russian leaders are already gearing up for parliamentary and presidential elections, scheduled respectively for December 2011 and March 2012.

The Kremlin -- together with Moscow city authorities -- has announced an ambitious program to overhaul the capital's state-run medical facilities. Some 150 billion rubles ($5 billion) have been earmarked for the next two years.

Putin's visit to a less-than-glamorous Moscow hospital this week was widely interpreted as an effort to justify such massive spending of public funds.

His apparent displeasure with the state of the hospital could also have served as pretext for the Moscow mayor to get rid of Ivan Leshkevich, the deputy chief of Moscow's health department and the capital's chief pediatrician. Some observers say Leshkevich's removal from office, which came just one day after Putin's hospital visit, heralds a major reshuffle among Moscow's health-care bosses.

But the Kremlin's promises to revamp Moscow's health system have met a degree of skepticism.
Prime Minister Vladimir Putin (right) visits the regional Clinical Hospital in Ivanovo in November 2010

A previous initiative, dubbed "Health" and launched nationwide in the run-up to the last presidential election in 2008, has shown limited results.

"Such programs were very much welcomed by the population at first, [and] the government's increased attention to social problems was perceived as very positive," says Lev Gudkov, a sociologist at Russia's independent Levada polling center.

"But people were not satisfied with the implementation of these programs. More than half of the respondents we interviewed said they believed the money allocated to these programs was being spent inefficiently or embezzled."

Soviet-Era Health System

A recent Levada study showed that more than half of Russians believe the quality of health services in their country is worsening.

Critics say the government's efforts to refurbish hospitals, although a laudable first step, essentially fail to address the underlying problems plaguing Russia's Soviet-era health system -- lack of specialists, paltry salaries, or the ever-rising cost of medication, to name a few.

The campaign to rejuvenate Moscow's hospitals has also upset many Russians living in less privileged regions.

Aleksei Shabashov, who heads "Healthy Regions," a nongovernmental medical organization based in the central Russian city of Tver, says he doesn't understand why the authorities are "trying to create this oasis of prosperity when the rest of the country is in such difficulty."

"Gigantic sums of money are being poured into Moscow's health-care system; anyone living more than 100 kilometers away from Moscow finds it hard to comprehend such sums. We simply don't understand why we feel like we're in a different country when we drive 150 kilometers away from the capital," Shabashov says.

Despite the much-advertised "Health" program, a third of state hospitals in Russia remain severely rundown and as many as 46 percent have no central heating or running water, according to official figures.

The issue gained unprecedented attention in December when a provincial physician told Putin during a live call-in television show that an upbeat presentation of a hospital in the central Russian city of Ivanovo was faked.

Ivan Khrenov, a young cardiologist, said the hospital's administrators presented a deliberately skewed image of their establishment during Putin's nationally televised visit in November.

"Hospitals were urgently prepared ahead of your visit. A lot of equipment was brought in temporarily to the regional hospital and taken away after you left," Khrenov said. "Nurses were instructed to say that their salaries were 12,000 rubles [$410] and doctors were given receipts bearing the sum of 30,000 rubles [$1,020]. In fact, this is not true, we don't receive such salaries. My own salary is 3,650 rubles [$125], less than the subsistence wage."

Khrenov's claims, in essence, revealed nothing new. Russians are painfully aware of the dire conditions in state hospitals and local authorities have a well-documented history of throwing dust into the eyes of their Kremlin bosses.

His declaration, however, was a rare display of public discontent on Russia's pro-Kremlin national television.

Putin's annual call-in show is widely believed to be a meticulously orchestrated performance during which callers are selected to ask nonconfrontational questions. Khrenov himself later explained that he had written a letter to Putin after his November visit to the hospital and that an aide to the prime minister had then asked him to repeat his claims in a phone call during the show.

Whatever Putin's intentions were when he allowed Khrenov to publicly vent his grievances, the disclosures have sparked mixed reactions among the medical profession.

While many underpaid nurses and doctors hailed Khrenov as a hero, the Health Ministry angrily dismissed his allegations. The outspoken cardiologist was also promptly sued for libel by two Ivanovo hospitals. The cases were eventually dropped last month.

with reporting by RFE/RL's Russian Service

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