It will be possible to manage a state or municipal medical institution until the age of 65. A draft law has been submitted to the State Duma establishing an age limit for chief physicians. Of course, they won't kick the chief doctors out into the street, according to the document, they will be offered another "qualified" position.
The opinions of experts are divided: some believe that such an approach will give a "green light" to the growth of young personnel. Others insist on the need to unify the rules and individual approach.
They want to adopt the law promptly: from July 1, 2017. At the same time, the authors explain that, firstly, a certain transitional period is envisaged: age leaders will not be removed from office for the next three years. In addition, the founder of a medical organization will be able to extend the term of office of the head physician up to 70 years, if requested by the general meeting of the staff of the medical organization. But, in fact, it may not last.
Similar restrictions have been in place for two years in the system of education and science: the same 65 years for university rectors and directors of scientific institutes. By the way, legislators use the exact opposite approach for leading positions in the civil service. Since January 1 of this year, the possibility has been introduced to extend the powers of up to 70 years for federal leaders, a bill is on the way for regional officials.
"Today, medicine is actively introducing innovative technologies need new specialists. Of course, the issue should still be discussed, but I support the direction itself, - Raziet Natkho, an expert of the working group of the ONF Social Justice, told RG. “If this is transferred to the chief doctors, I believe this will help to avoid situations where managers stay in their places and do not work effectively.”
Competent leaders in medicine are sorely lacking
At the same time, Larisa Popovich, director of the HSE Institute of Health Economics, recalls that according to the Labor Code, age discrimination is prohibited in labor relations. She is supported by the Vice-Rector of the Academy of Labor and social relations Alexander Safonov. In his opinion, it is possible to talk about age restrictions only if the health of the employee does not allow him to fulfill his official duties. "In all other cases, this is a restriction of rights," the expert is sure.
“I can guess what this initiative may be connected with - with the fact that a number of heads of medical institutions are trying to transfer leadership in them“ by inheritance, ”says Alexander Safonov. - But these sensational cases are isolated. So there is no need to shoot from a cannon "Probably, the rotation of personnel is really needed. But to judge whether a person can lead or not, it is necessary not in terms of his age, but the efficiency of his organization. If the medical institution works fine, if there are no complaints from the public, consumers of services , then why break it? But in order for the founder to be able to evaluate the effectiveness of the organization, it is necessary to develop clear criteria for such an assessment. "
You can't "purge" the medical staff so rudely, the head of the department of healthcare management is convinced State University Management, Professor, Honored Doctor of the Russian Federation Viktor Cherepov. “We have an extreme shortage of competent managers in medical institutions. In the regions, they are generally worth their weight in gold. I am a doctor who is 66 years old and is ready to work for another 20 years. a special, difficult profession," Viktor Cherepov told RG.
For heads of state medical institutions and their deputies, the age limit for tenure in office can be set at 65 years. In some cases, it can be extended to 70 years if such a decision is made at a general meeting of the organization's employees. The corresponding bill will be considered by the Labor Committee of the State Duma on May 25. The deputies are going to recommend to adopt it in the first reading. The government has already sent a positive response to the initiative, proposing to extend this rule to the heads of all federal and municipal state unitary enterprises regardless of their field of activity. If the bill is passed, the heads of the largest Russian medical centers can move to another job, "suitable for qualifications," experts say.
Amendments to Labor Code(TK) in January 2017 was introduced by a group of deputies from United Russia - the first deputy head of the faction Andrey Isaev, the first deputy chairman of the labor committee Mikhail Tarasenko and the head of the health committee Dmitry Morozov. Later, more than 30 deputies signed the document.
According to the proposed amendments to Art. 350 of the Labor Code, positions of heads and deputy heads of state and municipal medical institutions can only be occupied by doctors not older than 65 years. Those who have reached this age are offered to be transferred to another job corresponding to qualifications. At the same time, the founder of the organization can extend the term of work in his position up to 70 years, but only if this decision is made at the general meeting. The expiration date of employment contracts of deputies, according to the draft law, cannot exceed the term of office of the head of the organization.
For health workers who have reached the age limit at the time the law enters into force, a transitional period is provided. Their employment contracts will be valid until the end of the period specified in them, but not more than three years.
Chapter profile committee Yaroslav Nilov (LDPR) told Izvestia that the committee would support the initiative.
The rejuvenation of managerial personnel is certainly necessary. There must be movement career for young people. Otherwise, doctors will leave the Federal State Unitary Enterprises and Municipal Unitary Enterprises for commerce, - the deputy explained. - At the same time, you should not lose touch with experienced specialists. It is necessary to find such forms of interaction in which the stars of Russian medicine, if desired, will be able to continue to work effectively even after 70 years.
The government also sent a positive response to the bill. However, as pointed out in the Cabinet of Ministers, before its adoption, it is worth considering the issue of limiting the term of office for deputies. In the event of their simultaneous expiration with the head of the institution, the organization may be left without management personnel, the recall notes. The government proposes to remove this provision from the draft.
The government proposed to establish a similar age limit for heads and deputies of all state and municipal organizations“in order to ensure a systematic approach”. This was also pointed out by the co-executive committee on the federal structure and issues local government when considering the bill. Thus, age limits have already been set for rectors of universities, directors of scientific institutes and civil servants. It is necessary to extend them to all federal state unitary enterprises and municipal unitary enterprises, regardless of their profile, Irina Guseva (United Russia), the first deputy chairman of the committee, explained to Izvestia.
This will enable the personnel reserve to understand that there is an opportunity for growth, and the leader himself to prepare mentally and select successors. Although there are stars who, even at the age of 90, will give odds to the young, but there are only a few of them. They can always continue to serve as honorary presidents, conduct consultations and workshops, mentor and scientific work, to help young people, to stay in the team, but not to waste time and effort on administrative red tape, - Irina Guseva believes.
The bill was also supported by the co-executive committee on health protection. Such measures, noted in the committee, are aimed at the rotation of the leading personnel of medical organizations and will help attract the most qualified and promising employees to these positions.
If the bill is passed, another position suitable for qualifications may be offered to a number of heads of the largest Russian medical centers. For example, the director of the Scientific Center for Cardiovascular Surgery named after A.N. Bakulev Leo Bokeria (77 years old), head of the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky Mogeli Khubutia (70 years old) or the head of the Institute of Surgery. A.V. Vishnevsky Valery Kubyshkin (72 years old).
The first reading of the bill is scheduled for June. In the final reading, it can be adopted already in the autumn session.
According to the new bill, all chief physicians and their deputies over 65 years of age will be made redundant, regardless of work experience and recognition.
After reaching the age limit, managers will be transferred to other positions corresponding to their qualifications.
At the same time, the term of office of the head physician can be extended up to 70 years by decision of the organization's staff.
The law will come into force in October 2017.
Krasnoyarsk doctor Valentina Krasovskaya has been in surgery for more than 40 years. This year she celebrated her 90th birthday.
Even in retirement, the doctor continues to treat people: she runs 4 private clinics, which she opened herself 20 years ago.
Then she was 70 years old, which, according to the new bill, is already a prohibitive age for doctors.
“The main thing in the profession of a doctor is experience, knowledge, as well as attention and love for the patient, the desire to help him. It is impossible to dismiss people without an individual approach,” said Valentina Krasovskaya, Honored Doctor of Russia.
Valentina Pavlovna does not fall under the bill on the age limit, since it only concerns the chief doctors of state hospitals and clinics.
“Of course, a person ceases to be a specialist, becomes a manager, sometimes even an official. But nevertheless, this is a certain specific area, it must be taken into account. In healthcare, it is the continuity of knowledge that is especially important. There has always been a special attitude towards the patriarchs here, and rightly so,” said the director private clinic Maxim Tersky.
Often the chief physicians of hospitals continue to practice.
For example, cardiac surgeon Leo Bokeria, at the age of 77, heads the Scientific Center for Cardiovascular Surgery in Moscow and
From October 01, 2017, the age limit for managers is set medical organizations various levels.
On July 29, 2017, the President of the Russian Federation signed Federal Law No. 256-FZ “”. Article 350 of the Labor Code of the Russian Federation establishes features of labor regulation medical workers and now it is supplemented with new provisions.
The additions relate to limiting the age of tenure of heads of medical organizations. After the changes come into force, you can stay in the position of the head of a medical organization no older than sixty-five years.
The age limit for heads of medical organizations applies to:
- heads, deputy heads of medical organizations subordinate to federal authorities executive power;
- heads, deputy heads of medical organizations subordinate to the executive authorities of the subjects Russian Federation;
- heads, deputy heads of medical organizations subordinate to local governments;
- heads of branches of medical organizations subordinate to federal executive authorities.
If the age limit of the head of a medical organization is reached, then the following options are possible:
- the employment contract with the employee can be terminated
In accordance with Part 11 of Art. 350 of the Labor Code of the Russian Federation, the basis for terminating an employment contract with the head of a medical organization is the achievement of the age limit for filling the relevant position. - the employee can be transferred to another position
In accordance with Part 8 of Art. 350 of the Labor Code of the Russian Federation, heads of medical organizations who have reached the age of sixty-five years, to other positions corresponding to their qualifications. - term of office may be extended
In accordance with Part 9 of Art. 350 of the Labor Code of the Russian Federation, the founder of a medical organization has the right to extend the term of office of an employee until he reaches the age of seventy years. In order for the founder to accept this decision, representation required general meeting(conferences) of employees of a medical organization.
In accordance with Part 10 of Art. 350 of the Labor Code of the Russian Federation, the head of a medical organization has the right to extend the term of office of his deputy until he reaches the age of seventy years in the manner prescribed by the charter of the medical organization.
The age limit for heads of medical organizations is set from October 01, 2017. Employment contracts remain valid until the expiration of their terms, but not more than three years from the date of entry into force of the law, for the following managers:
- who have reached the age of sixty-five years on the day the law comes into force;
- who reach the age of sixty-five years within three years from the date of entry into force of the law.
The Zemsky Doctor program is looking forward not only to young specialists, but also to older doctors. The need for a mentoring program in medicine is also mentioned by the First Deputy Chairman of the State Duma Committee on Health Protection Natalia Sanina, and the head of the Central Research Institute for the Organization and Informatization of Health of the Russian Ministry of Health, and in the past the country's Minister of Health Vladimir Starodubov. Young and not even very experienced doctors need experienced assistants... Otherwise, what's the point in discussing the availability of treatment?
In the organisation medical care a completely different trend took hold. The law, signed by Russian President Vladimir Putin on Sunday, July 30, sets the age limit at 65 for heads of medical organizations, as well as their deputies and those specialists who manage branches of medical institutions. By decision of the staff of the hospital, medical center or clinic, the head physician may remain in office for another five years. For doctors who are already over 65 or 70 today, there is a three-year transition period.
Health improvement
The authors of the document were the head of the State Duma Committee on Health Protection Dmitry Morozov and deputies Andrey Isaev, Tatyana Saprykina, First Deputy Chairman of the State Duma Committee on Housing Policy Alexander Sidyakin and First Deputy Chairman of the State Duma Committee on Labor, social policy and Veterans Affairs Mikhail Tarasenko. The aim of the new legal act parliamentarians see the turnover of personnel and the improvement of the industry with its help.
What will follow the initiative, which should come into force on the first of October? Rejuvenated workforce and more modern treatments, or decapitated medical facilities and declining levels of patient care?
The list of doctors who will lose their posts in the coming years is, of course, impressive. Alexander Rumyantsev, Head of the Dima Rogachev Federal Research Center for Pediatric Hematology, Oncology and Hematology, Ivan Dedov, Head of the Endocrinology Research Center, Zurab Kekelidze, Director of the V.P. Gennady Sukhikh. In the same list - the director of the Scientific Center for Cardiovascular Surgery named after A. N. Bakulev Leo Bokeria ...
From Rector to Director
However, let's digress from the list of outstanding doctors - often not only the heads of medical centers, but also the country's main specialists in their field of medicine. The concept of the age limit is already in force in domestic legislation.
So, in accordance with part 12 of Art. 332 of the Labor Code in state and municipal higher educational institutions the positions of rector, vice-rectors, heads of branches of institutes are filled by persons under the age of 65, regardless of the time of conclusion of employment contracts, explains lawyer Tamerlan Barziev.
Article 25.1 of the Federal Law of July 27, 2004 No. 79-FZ “On the State Civil Service of the Russian Federation” also establishes the age limit for civil service - 65 years. In the original version of the document, however, there were no such restrictions: the article was introduced at the end of 2010 by Federal Law No. 317-FZ.
An adviser or assistant may, in certain cases, continue his work until the powers of his leader expire. But the leader himself can extend the term of civil service to 70 years. government agency or the person who appointed him to the post, comments Barziev.
Finally, on July 30, 2017, the President of the Russian Federation signed the federal law"On Amendments to Article 350 of the Labor Code of the Russian Federation, according to which employment contracts concluded with heads of medical organizations, deputy heads, as well as heads of branches of medical organizations that have reached the age of 65 years on October 1, 2017 or will reach this age within three years after that date shall remain in effect until the expiry of the periods provided for in such employment contracts, but not more than within three years from the date of entry into force of the Federal Law.
Age is not enough reason?
The legitimacy of labor restrictions by age was studied by the Constitutional Court back in 2006. In his ruling dated July 11, 2006 No. 213-O, he decided:
“The age limit when filling the positions of heads of departments in state higher educational institutions ... cannot be considered as a special requirement due to the nature of this activity, the characteristics of this type of work, and the fact of reaching the age limit in itself cannot serve as a sufficient basis for dismissal of the head department or prevent participation in elections for this position.
... The proclamation of the independence of universities in the selection and placement of personnel and at the same time their responsibility for their activities to the individual, the state and society suggests that when deciding whether a person whose age exceeds sixty-five years meets the necessary requirements for heads of departments, the opinion of the leadership of universities and their collegiate bodies should be of decisive importance.
However, "in general" the position of the Constitutional Court was ambiguous ... And today, all legislative norms on the age limit remain in force.
To give way to the young?
“Similar laws have long been in effect in relation to a number of public servants. budget institutions. The process of rejuvenation of the leadership should be. In universities and research institutes, this did not cause rejection. After all, there is both the position of the scientific director of the research institute, and the status of the president of the faculty,” comments Director of the National Research Institute of Public Health Ramil Khabriev. - Bad is the leader who did not give his subordinate capabilities to grow up, did not prepare a replacement for himself… Transferring knowledge is a natural human desire. And it is necessary that the head medical institution I thought about preparing a worthy replacement for myself.
Supporters of the new amendment to the Labor Code hope that it will motivate the heads of hospitals and polyclinics to be more attentive to junior specialists. And this will help medicine to rise to a higher level.
However, as the “children's doctor of the world” Leonid Roshal noted back in March: “At the age of 82, I decided to leave the position of director of the Research Institute of Emergency Pediatric Surgery and Traumatology. Found a decent replacement. But he still needs my help."
On round table ONF "How to overcome the staffing problem in healthcare", the doctor supported the proposal of Natalia Sanina and Vladimir Starodubov on a special mentoring program.
Big...fight?
“No matter how we treat famous doctors, they have enormous charisma, authority and decision-making experience. With their departure, a “big fight” of less charismatic and authoritative people will begin. Struggle, inertia, the search for a way out, the reaction of authorities at various levels, attempts to find a replacement, staff turnover due to unsuccessful decisions. Those whom the law will directly affect, their environment - and new ones, along with those whom they will bring with them, ”warns President of the League of Patient Defenders Alexander Saversky.
IN in social networks A fierce debate ensued around the new law. Some cite experience European countries, for example in Germany, where upon reaching the age limit, no head of a health care institution can retain his post: chief physician either retired or engaged in teaching activities. Others are perplexed: the director can be appointed to the position of supervisor - there he will be able to defend the interests of his medical center much more successfully.
Still others pay attention to personnel statistics: “In our country, district doctors are 76 years old, why do you think they work? Let's be honest. I don't know the figures for Moscow, but on the periphery the understaffing is 50 percent or more! In cities with a population of one million! The fourth, with bitter irony, proposes to introduce age restrictions for deputies of the State Duma. And also in some industries and institutions.
“They were over 65, but they invested so much in us ...”
Fifths are indignant: "One gets the feeling that this is a deliberate policy - to decapitate the country altogether, depriving it of valuable and thinking people!"
As noted doctor Lyudmila Fokina:“Those who made such a decision have no idea how long it takes a doctor to gain experience and have time to pass it on to the younger generation! And since medicine is a living science, the laws in it change exponentially. And every professional in medicine is an expensive "product". Practice and experience form high-class professionals! The older they are, the more they know, and therefore they can convey. I still remember Myasnikov, Vorobyov, Chazov, Struchkov, Petrovsky, Persianinov, they were well over 65, but they invested so much in us that this knowledge still “works”.
The problem is the organization!
“Only at this age all the organizational abilities of a person are revealed. And any chief physician or director is, first of all, an organizer. When the law comes into force, the level of medical care will fall even lower," warns Honored Worker of Science of the Russian Federation, Member of the Committee for Civic Initiatives, Professor Yuri Komarov. “It's not about clinical medicine. At the very least, it is developing, new methods and technologies are emerging. The problem is in the organization of medical care.”
The age of chief doctors is a private problem. The root cause of all the difficulties with the training of personnel and the organization of primary health care is the lack of order in healthcare, Yuri Komarov explains. Movement without a rudder is still only at the level of “general and whole” ...
Share your personal opinion and Deputy Chairman of the State Duma Committee on Health Sergei Furgal:“I think that the law is at least premature. And hurt a lot. In addition to Moscow, there are other regions where there are 2-3 doctors in district, city, and rural hospitals. If they are fired because of their age, there will be no one to replace them. Anarchy will begin. Any piece of legislation must be enforceable - and must improve the situation. And here the result will be the opposite: both the quality of medical care and its availability will fall throughout the country. An amendment on the age limit is not needed at all - healthcare needs to solve other, systemic problems. And the limitation in labor activity, in my opinion, there can only be knowledge and health.”
The circle is closed. Staff shortage, lack of conditions in which young doctors could live and work... By setting an age limit for doctors, does the country run the risk of losing not only the luminaries of medicine, but also medicine as such?
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