Failure to pay premiums to health workers: mistakes? a misunderstanding? sabotage?



Failure to pay premiums to health workers: mistakes? a misunderstanding? sabotage?

Failure to pay premiums to health workers: mistakes? a misunderstanding? sabotage?


12.05.2020 21:20


They promise to pay the doctors in March in the coming days. Introduced in April, the new payment mechanism will work in mid-May

For more than a month now, Ukrainian doctors opposed to the coronavirus have been “fed with promises” regarding large additional payments for their work in March. And it’s not the first week – about a “worthy” bonus for April. However, as early as Tuesday morning, they settled completely with the heroes of the fight against СОVID-19 in only one area. And this, despite numerous signals and complaints, lively discussions in social networks and the media, persuasion and threats of “personal conclusions” from the leaders of the Ministry of Health, the Prime Minister and even the head of the state. Despite assurances that the central government transferred the funds necessary for field payments in mid-April. At the same time, no one can finally explain the reasons for this situation. Where is the “Bermuda Triangle” in which the state resource goes, who is really responsible for late payments and when will doctors be paid?

Supplements for March: “the three months promised are waiting”?

300% of the salary increase for medical workers who identify and treat coronavirus patients has been fully paid only in the Poltava region. This was announced on Monday by Minister of Health Maxim Stepanov. On average, he said, each doctor received 21,000 hryvnias. However, it turned out that even in this case we are only talking about a surcharge for March. In April, in the Poltava region, people received only 1.5 to 2.5 thousand hryvnia in bonuses from regional and local budgets. This is far from 300% of the salary on which the doctors based, rightly, on the basis of the results of the work of the second month of spring. Although the Minister of Profile has promised: “all health workers will receive the salary due to them as well as allowances”. And he repeated once again: those responsible for late payment will be punished.

1. The government’s position.

However, despite the fact that such threats do not sound the first time, deadlines for completing the task are delayed again and again. For example, exactly a week ago, Maxim Stepanov demanded that the March premiums be paid in full before May 8. After all, the necessary funds – as a state subsidy on the ground – were transferred a few weeks ago. As the Minister explained, on the basis of data from the regional health services on the number of doctors who oppose a dangerous disease in each region, the Ministry of Health has determined the amount of the subsidies. After approval of the calculations at a government meeting, the regions received all the necessary funds. In total, 905 million hryvnia. At the same time, approximately 5.5 thousand health workers involved in the fight against COVID-19 should receive a higher salary. In other words, we are talking about not more than 182 million hryvnia. The funds allocated from the state budget should therefore have been sufficient …

However, according to the government, local authorities have started to “get smart” on how to save on the resources received under the grant. In particular, in some places, payments to physicians have started to increase not for monthly salary, but for days of service or hourly work with patients with COVID-19. Since in many regions the first cases of the disease did not appear until the end of March, people received a “penny” – a few hundred hryvnia. Ideally, 2-3 thousand each. Such “mockery” against the backdrop of “thousands” of promises.

Failure to pay premiums to health workers: mistakes? a misunderstanding? sabotage?

Prime Minister Denis Schmigal and Minister of Health Maxim Stepanov

In addition, local officials have attempted to create additional bureaucratic barriers to payments. As Stepanov said, “they rushed to look for commas or extra dots in the documents.” In addition, as Prime Minister Denis Schmigal explained, local authorities were not guided by a government anti-coronavirus decree, but by a document from the Ministry of Social Policy dating from 2003. As if it were there was no quarantine and pandemic in the country.

2. The position of local and regional authorities.

At the same time, local authorities have “their own truth”. In particular, officials complain: payment deadlines are delayed due to the slow adoption (or deliberate blocking) of decisions to meet budgetary demands from the Treasury. In particular, as explained by the Chair of the Standing Committee on Budget, Finance and Regional Programs of the Vinnitsa Regional Council, Gennady Mazur, Government Decree No. 246, which defines the list of categories of health workers who are entitled to surcharges against coronaviruses, has not yet entered into force in early May. Consequently, the Treasury Department did not miss the payments concerned – due to the possible interpretation of these payments as a “misuse of budgetary funds”. In other words, even by having the necessary money in “subsidy” accounts, local government could only reward health workers from regional and community budgets until now. What they have done in certain regions – especially in the Vinnitsa region, Dnipropetrovsk, in the capital. But this resource is limited. As a result, the doctors had the impression of being deceived. Although actual payments of state funds in many areas only started in May.

For example, they insure in the Dnipropetrovsk region: they have already paid the acquired rights to local doctors. We are talking about more than 1.1 million hryvnia. And immediately, as soon as the Treasury has responded to the corresponding request, the money will go to the salary cards of the employees of health establishments, who in March were at the forefront of the fight against COVID-19 in the region . This was announced by the President of the Dnipropetrovsk Regional State Administration, Alexander Bondarenko. In addition, according to him, at the expense of the regional budget (2.4 million hryvnia), nearly five hundred medical workers were also rewarded for the month of March. Bonuses of “coronavirus” in the amount of 3 official salaries will be collected by 84 employees from three medical establishments: hospital No. 21 in the city of Dnipropetrovsk, hospital No. 1 in Kryvyi Rih and the regional center of emergency care and disaster medicine. Payments – for all days worked in March. Regardless of their number, doctors contacted patients with coronavirus.

3. Local action. Who is in the forest, who is firewood

But at the Kiev Regional State Administration, they report a slightly different approach (in the Kiev region, 2.1 million UAH have been allocated to six medical facilities where patients with COVID-19 were treated in March). But, according to the acting interim president of the regional state administration Vasily Volodin, doctors will receive a 300% surcharge for all working days from the start of quarantine until the end of March. In other words, payments in the Kiev region will obviously be lower than those in the Dnipropetrovsk region.

Meanwhile, in some areas where the coronavirus disaster has preceded everyone in the country and where a large number of health workers have joined the fight against the pandemic, they assure: in order to fully comply with the “standard” for the payment of three additional salaries in March, except for state subsidies, I also had to attract local resources. For example, as the head of the health department of the Ternopil regional administration, Vladimir Bogaychuk, said: “In March, 420 doctors helped patients with COVID-19 in the region. And in April during a session of the regional council allocated 1.7 million UAH. to pay them bonuses. Now allocated an additional 3.4 million UAH. Therefore, all health workers will receive the promised allowance of 300%. In addition, 2.3 million UAH. for an additional fee, doctors were provided from local budgets. “

Failure to pay premiums to health workers: mistakes? a misunderstanding? sabotage?

Vladimir Bogaychuk

Thanks to municipal allowances, it has been possible to considerably increase the salaries of medical staff, who oppose coronavirus in the capital. “Doctors working with suspect patients and patients with COVID-19 have received salary increases for their work since March 13. The city has established an additional nine official salaries. Thus, in March, doctors generally received 30 to 50,000 hryvnias, nurses – 25-30,000, junior medical personnel – 20 to 25,000 hryvnias. They will receive the same salary in April, “said Vitali Klitschko to the mayor of the city.

April payments are still delayed, but not for long

The government ensures that, unlike the “disaster” in March, there will be no confusion and transfer of responsibility with payments to doctors for April. After all, all additional payments will be made not through mediation of local budgets, but directly to each medical facility through the National Health Service. In general, they plan to spend almost 16 billion UAH for the corresponding needs.

Admittedly, they failed to reimburse doctors until the end of last month or in the first days of May (many hospitals pay salaries on 5-6). The reason is the same, “bureaucratic”. The decision on the new settlement procedure and the approval of the three main service packages to combat COVID-19 did not take effect until May 4. And even that is not all. “Due to certain procedures, this decree has only entered into force. And in fact, from that moment we can start the procurement process on the part of the NSZU. But first you have to get the so-called “specifications” for these packages to be coordinated from the ministry. If there are no delays, then in mid-May we can pay the institutions, ”said Natalya Ryabtseva, vice-president of the NSZU. According to her, in the future, the amount of doctors’ salaries will be fixed by the chief doctors of medical establishments. But the clarifications to the approved service packages contain a “strong recommendation” to spend the funding provided through the NHA primarily for the payment of salaries.

In other words, the subjective factor in the question of payments is again preserved. Therefore, there remains the risk of an unfair distribution of funds. But, unlike the current police history with the search for those responsible for the delay in payments to doctors, then the situation will be clearer: all the complaints are directed against the heads of medical establishments. And the government promises to react harshly to any harassment and violation. The Department of Health advises physicians who have not received the promised benefits to contact a special “hot” line now at 0-800-505-201.

Vladislav Obukh, Kiev

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