Sunday, November 9, 2014

Cutting Medical Services!


By Stephen Wilson

(Moscow, Russia) - Over the past few weeks both teachers and doctors are taking to the streets in what observers state are unprecedented attended demonstrations against what many see as an attempt to commercialise both medical care and education. For instance, as many as 1500 gathered at a protest against cuts in education on the 11th of October, while a few hundred assembled at Lermontovskya Square on the 25th of October. However, on Sunday the 2nd Nov, at Suvorovskaya Square, an estimated crowd of between 5000 and 6000 health care workers took to the streets against 'the commercialisation of medical care. '

              What has largely provoked the increasing militancy of health workers is a leaked document of the local government which indicates a plan to close down 28 medical centres and 15 hospitals. There are also proposals to fire 1000 medical personnel. All those changes are being justified by the rhetoric of the need to 'modernise' medical services, 'make them more effective' and the need to 'optimise' scant resources. However, critics doubt the sincerity of officials and see it as an attempt by the local government to not only fully commercialise medical care but to grab lucrative real estate property where those 'ineffective medical centres' happen to be located.' According to Semyon Galperin, a neurologist at Hospital Number 11, 'All the hospitals in the centre of Moscow that occupy the most expensive plots of land, have suddenly been labelled 'ineffective'.' The hospital which he works at was merged with Clinical Hospital Number 24 as part of 'reforms'. As a result of
this merger salaries fell drastically from 60,000 rubles a month to 20,000 rubles (470 dollars a month). This case undermines a recently made ludicrous claim made by Deputy Mayor Leonid Pechatnikov, in a recent interview with Kommersant, that the salaries of full time doctors and teachers stands at 70,000 rubles. In fact, Moscow Deputy Mayor Leonid       Pechatnikov has even been offering a serious of interviews explaining the logic behind the reforms and attempting to refute some of the fears of the protesters. Unlike head educational officials, he has not kept arrogantly aloof from the public. In some interviews he explained that the leaked document was only a proposal presented by a consultancy firm and not a plan about to be imminently implemented.

              Plans are not always intentions. In fact, one wonders if the planning stage has long passed. When Second City Teachers spoke to a medical nurse, we attained the impression
that it was not so much a case of planned redundancies 'on the cards,' but worse; the cards are already being dealt out!

              Many medical care workers had already lost their jobs without much of a murmur or stir until the last few months. We also discovered striking similarities between how the cuts were being imposed at both medical centres and institutions of further education. For example, instead of 'closing' schools, they, like medical hospitals, were 'merged', instead of being made redundant, workers had their hours cut to such low levels it might as well have been disguised unemployment and the increasing commercialisation of services where free medicine or books were no longer available freely.

             I spoke to one young nurse, who we will call 'Nadia,' who works at Hospital Number 133 which is located in the Lefortovsky district in Moscow. She told me 'the managers       gathered us together and told us directly that if we were seen on any protest demonstrations we would be promptly fired'. I asked her ' Were you made to sign a document saying you promised not to attend any protest demonstrations?'

             'I did not, but I know that medical staff at another hospital were asked to do this. Nadia answered that that itself seemed to echo a strikingly similar process going on in education. Only the other day, a 17 year old student of Moscow's Institute of Architecture and Construction were asked to sign a statement promising not to attend demonstrations. 'The student, whom I won't name told me she never even bothered  to read the document before she signed it.

             'I'm not interested in politics anyway and I don't want any big problems with the authorities,' she told me.

             So the authorities are attempting to illegally scare away people from attending demonstrations despite the fact that Article 31 provided them with this right.

             Nadia told me of how the polyclinic she had attended had not only lost a lot of staff, but had been stripped of its former services. For instance, massage services as well as a
cardiac care for patients with heart disease was no longer available. Instead, patients had to make a long journey to a clinic near the end of the purple line. Within the locality, Nadia told me how Hospital 29 was closed as well as a maternity hospital within the vicinity of the Old German Graveyeard. Nadia stated 'Medicine is becoming increasingly unavailable to older people.'

             Nadia stated that many people lost their jobs not so much by being explicitly fired but being threatened with redundancy in the event of not voluntary resigning.

             'They don't immediately fire them but simply cut their hours until they are virtually underemployed or virtually almost unemployed.' So we have a disguised slow-motion         redundancy process which is similar to the kind being executed in the Institute of Power and Energy. By the way, it may be just a coincidence but this institute is located just a 15 minute walk away down the road from the hospital! Nadia told me 'Our wages have been cut       severely from as much as 30,000 rubles a month to 21,000. (525 dollars). We can also no longer earn extra money under a bonus scheme where we were entitled to extra cash if we, say, cleaned a ward or room'.

             We can see that two articles enshrined in the Russian Constitution; Articles 31 and 41 are being blatantly and shamelessly violated. While the former provides every citizen of the Russian Federation to gather peacefully at demonstration, the latter insists that all citizens have the right to medical care.

             According to Alexsandr Saverskii of "the League of Patients,'" The government is making the maximum effort to move away from a system of free medical care to paid.'

             The results of this transition (which did not begin in 2012 but as far back as the 1990's ) can be tragically horrific. Only two years ago, one of my students of English turned up at my lesson at The Family Club and bitterly told me of how a 17-year-old boyfriend had died after being knocked off his motorbike by a speeding hit and run driver. She told me, 'The ambulance refused to take him to hospital because he did not have medical insurance. It is disgusting. I cried for three days after I heard of his death.

             Natasha 's story reminded me of the days when Jim Vail and I worked in a Brotherhood where we helped the homeless. I remember having to argue with ambulance drivers on the need to take some sick patients to hospital. Many drivers were stubbornly refusing to take them for all kinds of reasons, such as 'he has no proper documents' or 'he is not a Russian citizen'. If the medical care system is further privatised, we will witness even more tragic deaths!

             The plight of medical care workers is very similiar to teachers.

              Both are being threatened with lower pay, redundancies and longer hours! This explains why unions such as 'Teacher' are forging links with medical care workers. If they don't demonstrate, they may lose their jobs, but if they don't dare to go on demonstrations, their jobs will still be endangered! Therefore, the best defense against redundancy is not avoiding protest, but in bravely embarking upon it. Teachers and medical care workers can't afford to be intimidated .

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