The Center for High–tech Medical Care is the first of fifteen
Tatiana Bateneva, "News of Science"The year 2008 should become a milestone in our healthcare - four newest centers of high-tech medical care (VMP) out of the planned 15 will begin their work in the regions.
So far, only the center in Penza has started operating out of four first-born children.
Everything here is not like in our usual hospitals and even famous Moscow institutes and clinics. The modules from which the centers are assembled, as from children's cubes, were invented and made in Germany. Everything is already installed in them and ready to receive patients. Operating rooms and offices are equipped with the latest equipment. Corridors and bathrooms shine with cleanliness. Workplaces are convenient for doctors and nurses, wards are for patients. But everything is modest, without pomp, marble and gilding.
The idea of building new VMP centers was not a whim of the high authorities, as many medical authorities believed and continue to believe. They should not just bring the most modern medicine closer to the residents of the regions, many of whom cannot afford to go to Moscow and St. Petersburg for treatment. The centers should become points of growth for a fundamentally different, new healthcare. Today, no one doubts that the existing is hopelessly outdated, has accumulated "mutations" and needs changes. VMP centers should master modern Western models of examination and treatment of many of those patients who will be helped only by complex and expensive surgery - on the heart, joints, brain and spinal cord. And there people do not lie in hospitals for months waiting for surgery, do not spend crazy money on "additional tests", do not suffer inconveniences in wards for six, etc. They are well and comprehensively examined in advance, then quickly and efficiently operated on, observed 4-5 days after the operation - and discharged. Either for further treatment in another hospital, simpler, or even home, under the supervision of a family doctor.
Such Western clinics work on a stream - expensive equipment must be loaded almost around the clock. Doctors of the highest qualification receive very good money in them. These are kind of "health factories" in which operations are worked out so that there are practically no errors or very few of them. We don't have all this yet, even in the best medical centers, of which we are rightfully proud.
According to the decree of the government, the first four centers - in Penza, Astrakhan, Cheboksary and Krasnodar - were supposed to start working back in 2007. Then the deadlines were postponed to 2008 - the approval of projects was delayed, other paper chores interfered. This year they should open the doors for patients.
How are things in the centers today?
Penza. The very first VMP center was commissioned by builders in January. At the same time, in the presence of distinguished guests - two presidents, the previous one and the current one - a large meeting on construction was held. They started operating here at the end of August. Today, at least 10 patients are hospitalized a day, so far only adults. Internal organizational models have been debugged: for example, the hospitalization procedure. Those who have ever been to the hospital know how sometimes this process stretches for hours. Here, the chief physician of the center Vladlen Bazylev, having played the role of a patient, himself was hospitalized with a chronometer in his hands. At first it turned out to be more than an hour, now it is no more than 30 minutes.
Astrakhan. The center was built, its official opening was timed to the beginning of October, the 450th anniversary of the city. But due to the installation of equipment, it was postponed until the end of the month. So far, only the polyclinic department is working, 531 patients are included in the waiting list. 44 specialists from other regions were invited, the region allocated housing for them.
Cheboksary. The delivery of the center has been postponed several times, the last one - at the end of October. The installation of modules was completed here in January. 48 doctors and 134 nurses were trained in St. Petersburg. A waiting list of patients has been formed. Now doctors invite them to the polyclinic department, which is already working, to prepare them for hospitalization.
Krasnodar. The construction of the center is nearing completion, although the deadlines have already been postponed, and also more than once. Finishing works are underway, landscaping of the territory with an area of 4 hectares has begun. A special commission is engaged in the selection of personnel.
Chelyabinsk. The zero construction cycle has been completed. The finished modules from which the center is mounted arrived from Germany at the end of August. Installation should take two months. At the same time, infrastructure is being built: a garage, a laundry room, a residential building, a hotel - something that is being built at the expense of the regional budget. The center is scheduled to be commissioned in December, and the first operations are scheduled for 2009.
Novosibirsk. According to the project, the center should be commissioned by the end of 2008. However, German manufacturers cannot deliver modules on time, so builders are not in a hurry here either, ending the zero cycle, which the regions finance and build according to the project. According to Pavel Nefedov, Director of the Capital Construction Department, if the modules arrive in November-December, the center will be put into operation next summer.
Kaliningrad. The construction of the zero cycle is coming to an end. The region has fully fulfilled its obligations, according to the head physician of the future center Vladislav Golikov. The delivery was scheduled for December 15, but the regional government doubts the reality of these deadlines. Manufacturers promise to start delivering modules no earlier than the end of November. There are recruitment problems. One operating team is formed from local doctors, the second chief physician plans to invite from Orenburg, where he came from himself. The others are also going to be invited, until it is decided from where.
What is slowing down the construction?
In fact, only one of the first four centers has started work this year, and it is unlikely that others will be deployed before the end of the year. If we summarize the stories of the chief doctors and experts, we can identify several important reasons for the backlog.
1. Module suppliers are slowing down - Cadolto (Germany).
2. Qualified personnel are hardly selected. Cardiac surgeons and anesthesiologists in the field - a big shortage. It's not easy to lure people away from the center. They are more willing to come from other regions, especially under the promise of housing. There is an acute shortage of qualified engineering and technical specialists for equipment maintenance.
3. There were difficulties with the registration of centers in the State Property Committee - the supplied modules were issued at customs as medical equipment. And the centers should be designed as real estate objects. Without this, it is impossible to obtain medical licenses. Without licenses, it is impossible not only to operate, but even to buy medicines, etc. Until the issue is resolved.
4. The law on medical equipment has not yet been adopted in Russia. Without it, it is impossible to build the right relationships with equipment suppliers. In particular, there are idiotic difficulties with the service - the millionth equipment is idle for weeks due to the lack of the necessary spare parts. And firm specialists arrive in weeks, or even months. And there is no legal ruling on them yet.
5. Regional healthcare systems sometimes sabotage the selection and referral of patients. It is unprofitable for them to give them away if they themselves conduct high-tech operations in the region and receive good funding for this.
6. The existing federal centers are also not enthusiastic about the construction of "competitors". There are cases when Moscow specialists, visiting the regions, frighten patients by saying that "they don't know how to operate in new centers, and they will shake a lot of money out of you." In fact, all operations in them will be free for patients, and there are many specialists from Moscow and other major cities.
Portal "Eternal youth" www.vechnayamolodost.ru20.10.2008