Any problems in the Russian economy primarily affect workers in the “budgetary” sector, most of whom are teachers and medical workers. Therefore, all fluctuations in the exchange rate of the national currency, a decrease in quotations for hydrocarbons, or unpopular steps in the international arena in foreign policy, entailing tougher sanctions on the part of other states, primarily affect the well-being of people who, due to the specifics of their work, cannot translate it into "commercial" channel.

The situation is aggravated by a relic from the times of socialism – the state’s declaration of free universal education and medical care.

Why wages are rising, but welfare is not growing

In Russia, in 2012, in the well-known “May” Decree of the President of the Russian Federation, an increase in wages for medical workers was declared for the period until 2018. Wages should rise to 200% of the regional average.

Economic development trends and high oil prices made it possible to build rosy prospects and make loud statements. But at the end of 2014 the situation changed dramatically. A protracted economic recession began. Along with it, inflation began to grow rapidly.

What they had managed to sell by this time over the past two years “dissolved” in the general rise in prices for absolutely all consumer goods.

At what cost does salary increase?

The main direction that the state has chosen to increase wages is “optimization”. New accrual - simply a fixed part of wages is increased due to a reduction in the number of workers and an increase in the load on those who remain working in the industry.

At the same time, we are not talking about increasing the total income of working medical workers, but only about increasing salaries. In turn, all existing bonuses are also being “optimized”: bonuses “for harmfulness” are being reduced, which can now only be claimed by those workers who work in workplaces with harmful factors, and not depending on the position held, bonuses for continuous experience work.

Other payments are transferred to the management of medical institutions, who independently decide who should receive additional remuneration and who should not.

Prospects for program implementation

The reform related to increasing wages for medical workers was planned in two stages:

• First stage was aimed at optimizing and increasing the efficiency of all medical workers. It's almost done.
• Second phase– the working conditions of the remaining workers must be changed in such a way as to achieve the promised wage increase to 200% of the average salary in the region. Problems arose with the fulfillment of this promise.

The only recent news is that from January 1, 2017, there are no plans to further reduce medical workers.

There is still a significant gap in the income levels of doctors of the same qualifications depending on the region.

Average salary of doctors in Russia (by district)

In average statistical terms, it turns out that the salary of a doctor working in the Yamal-Nenets Autonomous Okrug and the North Caucasus is 66,247 rubles. Averaged figures apply in the same way to employees of municipal and commercial medical institutions, the difference in salaries of which can vary by an order of magnitude.

The average salary of doctors in Russia increased in 2016, according to Rosstat, by 5.8% and amounted to 50.7 thousand rubles per month. It is noteworthy that in six regions, the indicator for which officials at all levels are persistently fighting under the supervision of the president, on the contrary, went into the negative. The situation with the earnings of paramedical and junior medical personnel is no better.

Average monthly wages of workers in the healthcare sector in 2015-2016, in rubles (Rosstat)

Let us remember: not long ago, officials boldly stated that in accordance with the “May” presidential decrees, doctors’ salaries would increase by 200% of the average salary in the country in 2017.

Real and target indicators of wage growth for various categories of medical workers until 2018, in%

However, it now turns out that this height will be attacked only in 2018. Deputy Prime Minister of the Russian Federation Olga Golodets recently announced that doctors’ salaries will be increased in 2017 in two stages and should reach 180% of the regional average by October 1.

Director of the Health Foundation, member of the Public Chamber of the Russian Federation Eduard Gavrilov: – Raising doctors’ salaries remains a sore point, despite the annual increase in funds allocated for healthcare. Thus, in 2011, a total of 1.93 trillion rubles were allocated for healthcare, and in 2015 – already 3.23 trillion. Why aren't wages rising? The regions urgently need to restore order in this area. Head of the Department of Economics and Management in the Social Sphere of the Institute of Industry Management of the Russian Academy of National Economy and Public Administration Larisa Gabueva: – The target indicators for salaries of healthcare workers are, of course, achievable, because those responsible for the implementation of government resolutions and presidential decree have no choice. Therefore, officials will report on their achievements. Another question is: at what cost will they be achieved. As you know, in most regional healthcare facilities, the path of optimizing staffing levels was chosen for this, naturally, downwards, so that the remaining doctors would have enough money to achieve these results.

The ratio of the average monthly nominal accrued wages of workers on average in the economy and in the field of healthcare and social services, in rubles and %

According to Rosstat, salaries of those employed in the healthcare and social services sector have grown at an accelerated pace since 2002, and without any shout from above. During the period under review, the indicator increased 21 times compared to 15.3 times on average for the economy. This made it possible to improve the ratio of the salaries of workers in this field and the average salary in economy: from 60% in 2000 to 82% in 2016.

Head of the design and analytical center of the Academy of Labor and Social Relations Anton Daletsky: – Rosstat statistics represent the “average temperature in a hospital.” Since it includes in the salary data not only doctors, nursing and junior medical staff, but also management personnel. Which, naturally, leads to an increase in the average. Plus, there are questions about the reliability of these statistics, since they are collected in health care facilities, whose managers do not want to lose their jobs. Therefore, there are concerns that salary figures are being inflated. In my opinion, without manipulating statistics, the indicators established by the “May” presidential decrees are clearly unattainable.

The ratio of the average monthly nominal accrued wages of workers on average in the economy and in the healthcare sector, in rubles and %

In the period 2009–2015, the rate at which wage growth in healthcare outpaced wage growth in the economy as a whole was noticeably less than in the period 2000–2015. The ratio ranged from 79 to 87%.

With regard to increasing wages by category of health workers, the implementation of the target indicators provided for by the road map is regularly monitored to ensure the achievement of the tasks set in the presidential decrees by 2018. Below are data by year of the reporting period (2013-2016) for various categories of employees.

As of January 1, 2016, 543,604 doctors and 1,309,846 medical workers with secondary vocational education worked in medical organizations of the Ministry of Health of the Russian Federation.

In some regions, doctors’ salaries back in 2014-2015 were twice the average. But there are very, very few of them, so even the aggregate indicators for the districts, not to mention the country as a whole, are not so optimistic.

Ratio of the average salary of doctors, paramedical and junior medical staff to the average salary in the economy
Factors influencing the level of remuneration in an institution, in terms of the average level of income of health workers in their main position, thousand rubles.

Head of the design and analytical center of the Academy of Labor and Social Relations Anton Daletsky:

– The data from our study are based on interviews directly with health workers, and communication often went beyond the scope of the study. Thus, we learned that the situation with part-time work among healthcare workers sometimes goes beyond the limits of reason. I understand that in order to survive, doctors have to take on additional wages within their healthcare facility and combine this work with private practice or in the field of education. But we are faced with outrageous cases where surgeons are forced to work as taxi drivers, and paramedics as hairdressers.

Distribution of income levels of health workers from various sources, rub.

The current regulatory framework prescribes methods for determining the salaries of doctors in Russia. The accrued amount consists of 3 parts: bonus for length of service, rate and compensation for harmful conditions. Subjects of the federation are given the right to establish additional payments to certain categories of medical workers. According to the current legislation, additional payment is optional. Appointed if appropriate financial resources are available in the budget.

The growth of salaries of medical workers in the period from 2013 to 2017.

From the moment an employee starts working, an employment or fixed-term contract is concluded with him. In some cases, we are talking about a collective agreement. The document specifies the salary of doctors and all the conditions that allow it to be changed in one direction or another:

• approved classifier of professions;
• developed professional standards;
• local government surcharges;
• RTC decision;
• gratitude or punishment received.

A separate resolution of the Ministry of Health of the Russian Federation determined the maximum salary for the management of a medical institution. The monthly salary of the chief physician cannot exceed eight times the salary of the employees of this medical institution. This formulation made it possible to eliminate the conflict associated with certain provisions of the Labor Code of the Russian Federation.

Watch the video: real salary figures for doctors.

Much attention is paid to the issue of accounting for experience. Thanks to this indicator, the salaries of doctors will be indexed in 2017. On the one hand, current regulations do not allow length of service to be taken into account as one of the grounds for increasing or decreasing wages. On the other hand, a special resolution of the Ministry of Health recommends taking into account length of service when assigning compensation payments in 2017 in Russia.

Thanks to this, employees of medical institutions in remote areas of the country received significant additional payments. It’s not just compensation for harm that’s at work here. The duration of work played an important role. The professional qualification group is taken into account. Each of them has certain requirements for experience, merit, scientific publications, etc.

Doctor's salary sheet with tax deduction

The better the doctor works, the more funds he will receive at the end of the month. This allows you to objectively assess the contribution to the work of the medical institution of each employee. Statistical information is analyzed monthly. The employee has the right to familiarize himself with it. If disputes arise that cannot be resolved at the level of the head physician, you must contact a specialized commission on labor conflicts.

Comparison of salaries of medical workers in major cities of Russia

Piece-bonus form of remuneration

The legislation of the Russian Federation allows the calculation of wages to medical personnel in a piece-rate format. In this case, you need to remember a number of legal subtleties. They were determined by a decision of the Ministry of Health of the Russian Federation and a resolution of the tripartite commission (RTC). The first rule says that it is possible to install this format without any restrictions.

This means that in addition to the basic salary, the employee has the right to work part-time in the same institution. Before signing an amendment to an existing employment agreement, it is necessary to ensure that the applicant has the appropriate qualifications. This rule is not mandatory if the applicant plans to engage in work not related to the provision of medical care.

The second rule requires compliance with the established methodology for the formation of piecework-bonus wages. Taken into account:

• actual cost of services provided;
• duration of the work performed.

Incentive and compensation payments are not taken into account. Regardless of the duration of the additional work performed, doctors are paid piecework within the framework of the next salary. Payment documents must indicate the timing of the work performed, the coefficients used and possible deductions.

An example of a pay slip for a surgeon in Russia

Calculation of brigade wage forms

In order to increase the efficiency of medical institutions, the Ministry of Health of the Russian Federation decided to change the form of remuneration for doctors.

Now the salary of an individual health worker depends on the performance of the team in which he works. The new technique is based on many years of medical experience.

Watch the video: The Minister of Health talks about the sources of increasing salaries for doctors.

Officials decided not to prescribe strict workload hours. This was done for reasons of common sense. Firstly, during the day it is impossible to predict how many calls will be made by patients. Second, the team will spend a different amount of time with each patient. This means that, again, standard hours are a very arbitrary indicator here.

The current legislative framework in the Russian Federation provides the following formula for determining the size of the brigade form of payment:

• A is the number of calls recorded in the reporting period;
• B is the population of the serviced area;
• C - duration of the reporting period (30 or 31 days depending on the month).

An approximate calculation of the indicator is performed as follows - A x B: C. 418 received calls are taken and multiplied by 1000 people living in this area. The resulting value is divided by the duration of the reporting period. The resulting value is used to calculate the brigade form of remuneration. From a practical point of view, this approach encourages the doctor to perform better.

The photo shows the average salaries of doctors in Ukraine

The presence of a direct relationship between efficiency and salary helps the employee to realize responsibility for his own future. However, there is a downside to the model. Skeptics focus on the possibility of being left without a salary at all. Let’s say a medical institution has carried out effective preventive work. The number of calls during the month is at a low level.

If we take only this formula as a basis, then the average salary of doctors in 2017 will be at a similar level. The Ministry of Health, understanding the significance of the decisions being made, left medical institutions room for maneuver. Medical institutions have the right to use complex methods for calculating wages based on actual conditions.

Many contemporaries are interested in their future in advance. Doctors are offered information about changes in their field. Of course, everyone knows about the difficult situation, about how much the data from government statistics differs from the actual salary levels. After all, in the first case, everyone became millionaires, but in practice they are trying to distribute their income, without hope of a holiday abroad. And all this despite the fact that at work you have to work for several people, carrying out all the responsibilities yourself. Moreover, this was introduced relatively recently. Against this background, it is worth considering whether there will be an increase in salaries for doctors in 2017.

Previously, narrow specialists practiced in their field in such a way that their qualifications were directly related to it. At all times, such duties were performed only by therapy workers authorized to refer patients to a specific referral specialist. To replace such a clear distribution of medical responsibilities, related specialties were invented. Contemporaries prefer family doctors, whom they completely trust with their own health and their loved ones. But for this, the specialists themselves now need to master the basics of all areas of medicine, gaining knowledge in universities over the course of a whole decade!

To justify so much time and painstaking work, healthcare workers simply need to see the increase in medical salaries in 2017 in Russia as a long-awaited change next year. Otherwise, from the crowds of people who want to learn and then treat people, only fragments of enthusiasts will remain. The state is not interested in making a profession unprestigious, so the time for action is set for the next year.

What has the government done for medicine?

The head of state made efforts to solve the problematic situation of health care creators. Now work is underway to bolster wages. Growth there is possible through titanic efforts and redistribution of financial budget resources. To do this, it was necessary to reduce cash flows to emergency care, as well as to those on whom disease prevention depended. In the second case, they stopped transferring funds altogether, but in the first, a third of the previous amount remained.

The receipt of funds for indexation is definitely guaranteed. This has been provided for by the government in advance. Although, based on the experience of the previous year, we managed to partially fulfill our obligations. But looking ahead from around the corner is not so comfortable. It is not yet clear what will happen to housing and communal services and prices in stores. After all, instead of the expected and financed 5.5%, the growth in total money turned out to be over 10%. So how significant the premiums will be remains questionable. Only the opinion of analysts will help make adjustments to the indicators. This is what the latest news presents to citizens about the increase in salaries for doctors in 2017 in Russia.
As for the execution of presidential decrees, there are some underwater formations. The actions of government members, operating with the income level of citizens, act in the form of stones. They simply underestimate it, which leads to a decrease in the percentage itself. Under the guise of “legal” actions, people receive distorted information, and with it less money. Receiving informal salaries is related to regional salaries. After artificially lowering the average level, 12 million workers receive the amount of funds annually. But when receiving money bypassing the tax budget, the budget experiences a certain shortage, which is illogical to allow at the present time.

The lack of a system for recording income leads to the summation of all indicators together. Behind this lies the possibility of global changes in the long term, but not the likelihood of recalculations with doubling of coefficients. According to expert groups working independently of the state, the time has not yet come when they will keep records of all types of income. This is likely only if the money turnover of the shadow market is revealed. In practice, such control remains elusive.

Again about medicine: how to raise the salaries of doctors?

The lack of optimism in the situation with increasing salaries led to the need to come up with something and do something. Thus, the head of the Ministry of Health voiced a proposal to introduce a new system with an increase in income, and as a result, an increase in the salaries of doctors. Often, specialists with equal qualifications and positions of similar level earn differently. This occurs in connection with the use of compensation determined according to the quality criteria of the activities performed. However, the management of medical institutions does not always have the experience to take a loyal approach to the assigned tasks. VJmetalas.lt metalinės konstrukcijos, metalo apdirbimas, metalo gaminiai ir susiję darbai http://www.vjmetalas.lt

With the most optimistic estimates, we can expect an increase in medical salaries by 55-60%. Otherwise, the increase will be presented in the form of bonuses and additional payments. But this time there is no need to expect any tricky personnel issues. After all, now everyone’s salaries are being recalculated, without job cuts. This is guaranteed not only because there will be no one to work for the benefit of medicine. In practice, those years have not yet passed when the effect after the layoff of thousands of employees is forgotten. Next year we should expect stability. Although it will be possible to think about normalization and positive changes no earlier than 2018. While the financial world is getting back in order, you can count on an influx of changes with improvements in all respects and think about what will happen to doctors’ salaries in the near future.

Salaries in medicine in monetary terms

All medical workers were divided into 3 categories:

• Juniors (nurses and laboratory assistants);
• Middle (pharmacists);
• Seniors (doctors, other employees with a higher education category, providing a range of medical services).

While there was no increase in salaries in the healthcare system in the Russian Federation in 2017, it is worth remembering the quantitative values. If you compare the salaries of the three categories with average incomes in the region, you can obtain the following data. Juniors in rank are content with 50 percent of the average income. The average earns almost 80 percent, and senior management receives one and a half times the average salary in the region.

As for the monetary indicator, the average salary according to statistical data is compared to 32 thousand rubles. It turns out that half of this amount is 16 thousand, and one and a half more - 48 thousand rubles. The average salary indicator is influenced by treasures in the capital and in the north, the maximum possible, but in the periphery one remains content with the minimum.

When comparing data from medicine with other areas of labor, indexing the salaries of doctors is simply necessary. After all, with negligible salaries, working with an increased workload is simply incomprehensibly difficult. After all, doctors from small towns do not have alternative options for conducting work. After all, the places of private hospitals are usually occupied, and only district clinics remain vacant.

In addition to all of the above, it is worthwhile to include the joyful news that a massive reduction of doctors in 2017 in Russia should not be expected. It is still too early to talk about the specific timing of recalculations; information should be expected later.

In 2016, medical salaries are considered one of the most discussed topics. It turns out that at the end of 2015, information appeared in the media that the 2016-2017 budget should be spent mainly on increasing salaries for public sector employees. Doctors also belong to this sphere of activity. Needless to say, before such a decision was made, the salaries of medical employees were more like a handout from the state. However, in the last few years, such a situation could at least be explained by the budget deficit. Now the problem has leveled out a little and everyone is very much concerned about the question of what the planned salary for doctors will be in 2017.

The main question of the day: will there be an increase?

If you trust government statistics from 2016, medical employees can easily be called the richest people among other Russians. Of course, none of them are millionaires, but the statement itself is worth talking about in more detail.

The wealth of doctors lies in the fact that even with a meager salary, these specialists continue to save thousands of people every day and agree to do their job no matter what. In addition, according to the new legislation, every day they have to fill out a lot of documents in strict reporting. Just a couple of years ago, everything was radically different: doctors were divided into several categories, each of which was responsible for treating a certain part of the body. Now a student has to spend 10 years of his life studying at medical universities. Moreover, such “students” need to know absolutely everything about the human body and all its diseases. Accordingly, such a specialist must simply know by heart how to treat any human disease. But is this possible? More precisely, shouldn’t such an intelligent and knowledgeable worker expect a good salary? Indeed, without this mandatory point, the prestige of any profession very quickly falls below the plinth.

At the moment, the entire field of medical employees can be divided into 3 main categories, each of which has its own salary level.

1. Junior staff consisting of laboratory assistants and nurses. Today, this category of medical employees has the lowest salaries. Want to know more about this? Please! Somewhere around 50% of the “minuscule” level.
2. Nursing staff, which includes pharmacists. The level of this category of workers receives a significantly higher salary - 80% of the previously indicated level.
3. Senior medical staff: doctors and other staff. Their salary reaches 1.5 times the average.

So should all these categories of doctors expect salary increases in 2017? If the reforms promised by the Russian government do take place at the beginning of the new year, then there will be an increase in salaries for employees in the medical sector - salaries will double compared to the initial stage. But can such wonderful assumptions be realized in the current reality?

Latest news regarding raising the “medical” fee

The following conclusion is no secret to anyone: the current situation in the medical industry does not look too rosy. However, recent media news predicts an increase in wages for all doctors from the beginning of 2017 by approximately 55-60%. Everything else will be given in various bonuses and additional payments - as usual. Despite such optimistic news, there is a certain amount of fear and even a catch in it. Why should you start worrying about your income now, although there are no obvious reasons for sadness yet?

The fact is that until this year, the average salary of a public sector employee was determined, calculated and issued based on data provided by the state employer. Starting from 2017, a doctor’s earnings will consist of the income received in commercial organizations (one of the points of medical reform). Of course, everyone understands perfectly well that doctors working in public clinics and hospitals receive much lower salaries than their commercial colleagues. If you simply take the income coming from private clinics and add them all up on paper, then the average salary in this case will increase significantly. But this is only on a piece of paper. In fact, there are no changes in this regard, and the usual average earnings will become even more average.

Of course, no one is going to argue with the fact that the income of a doctor working in a private clinic cannot be taken into account when calculating the average salary. But if you choose this path for the development of the situation, then the salary of a medical worker will forever freeze at the same level and will never increase. And no reform will help here.

Today, a very significant problem is the lack of professional personnel, especially in rural areas. As a result, innocent people suffer. I would like to believe that after the announced medical reform, the situation in the periphery will change for the better.

Where is the positive side in all this?

Despite the announcement that the average salary for doctors will increase in 2017, the news itself does not sound too optimistic. To slightly improve the mood of medical workers, it is worth announcing a new system for increasing salaries for doctors, which was recently proposed by the Ministry of Health.

According to the noted department, sometimes the incomes of doctors who have identical qualifications and occupy almost identical positions differ simply radically. And at the same time, the current remuneration system uses uniform standards. Why does this happen and how can we stop such inequality?

As everyone knows, a doctor’s income is greatly influenced by the level of compensation, the amount of which directly depends on the amount of work he performs. Nevertheless, the exact amount of this compensation is determined by management, which can sometimes show a degree of loyalty. As a result, we can only say with confidence that next year all doctors will be paid a 60% increase in salary. All other “additives” will be available in the form of bonuses and surcharges. This step will reduce the likelihood that the management of medical institutions will award different wages to people with the same positions.

In conclusion, it is worth encouraging health workers that there are no planned staff reductions in this area in 2017. It’s just that too much time has passed since the last wave of optimization, and yet thousands of qualified employees have lost their jobs. In general, next year will still not be very favorable for public sector workers, but in general the situation with the state’s economy is leveling out, so the situation should improve very soon.