Head doctors of public hospitals and clinics after 65 years of age will be transferred to other positions. The corresponding amendments to the Labor Code of the Russian Federation were approved by the country's President Vladimir Putin. As the authors of the initiative explain, it is more difficult for older specialists to understand modern medical technologies. Primorskaya experts propose to clarify the text of the document so that managers are replaced not just by younger colleagues, but by pre-trained personnel, Primorskaya Gazeta reports.
The President of Russia signed a law according to which the age of chief doctors in state medical institutions, their deputies, as well as heads of branches of such organizations cannot be higher than 65 years. Upon reaching this age, employees will be transferred to other positions in the same organization. Written consent will be required from managers. What to do if for some reason it is not possible to obtain consent is not specified in the law. At the same time, chief doctors will have a chance to save workplace up to 70 years of age, provided that the rest of the employees vote for it at the general meeting.
The law will come into force on October 1, 2017. After that employment contracts with chief doctors and their deputies who have already reached 65 years of age will remain in force, but only for the period specified in the document. That is, it will no longer be possible to renew such an agreement. The transition period will end by October 1, 2020; after this date, there should be no chief doctors over 65 years of age in the country. This will give leaders three years to prepare successors.
According to legislators, the situation when senior positions in medical organizations are often occupied by elderly people acts as a brake on the career growth of their younger colleagues. That is why such a document was required. It is designed to stop the outflow of novice specialists from government institutions to private organizations, where it is easier for yesterday’s graduates to grow career ladder. In addition, medical equipment is constantly updated, modern technologies are being actively introduced high tech, and it’s easier for young staff to deal with them.
In Primorye, the average age of doctors is 49 years, the regional health department clarified. The average age of heads of medical organizations varies between 45-55 years. In total, more than 35 thousand employees are employed in public hospitals and clinics in Primorye.
The appearance of amendments to labor legislation is very timely, some chief doctors of the region are sure. It is indeed easier for young people to perceive changes in the industry.
Regulatory documents change so often that previous work experience sometimes even begins to get in the way, because you have to rebuild, noted the head physician of the Shkotovsky District Hospital, Mikhail Moldovanov. - Yet again modern technologies we regularly have to introduce, for example, telemedicine. Perhaps somewhere it is easier for young people to understand this.
The main thing is not just to remove the elderly chief physician from his post, but also to appoint a worthy successor in his place, employees of medical institutions emphasize. Otherwise, no positive changes can be expected from the entry into force of the federal law.
Training a chief physician is a slow and rather complicated matter,” emphasizes Dmitry Khan, head of the neurological department of regional hospital No. 1. - I don’t think that we have a huge number of people in the Primorsky Territory who could potentially become excellent managers of medical institutions. They need to be raised. Otherwise, nothing good will come of replacing an experienced and competent employee with another, younger one.
While the law has not yet come into force, it should be finalized, the chief doctors note. For current managers, it is worthwhile to state the obligation: starting from the age of 50 or 60, to prepare their successors.
I am not against the fact that young people are appointed to leadership positions, they have energy, modern knowledge, - emphasized the chief doctor of the Khasansky district hospital, Evgeniy Makhinya. - But it is very important that they can use their energy and knowledge correctly. And here they lack the most important thing - experience. As a rule, they do not have established communications. And a lot in the work of medical organizations depends on cooperation.
The “Zemsky Doctor” program is highly anticipated not only by young specialists, but also by older doctors. The need for a mentoring program in medicine is spoken about by the first deputy chairman of the State Duma Committee on Health Protection, Natalya Sanina, and the head of the Central Research Institute for Organization and Informatization of Health Care of the Russian Ministry of Health, and former Minister of Health of the country, Vladimir Starodubov. Young and even not so young doctors need experienced assistants... Otherwise, what's the point of discussing the availability of treatment?
A completely different trend has taken hold in the organization of medical care. The law, signed by Russian President Vladimir Putin on Sunday, July 30, sets the age limit at 65 years for heads of medical organizations, as well as their deputies and those specialists who manage branches of medical institutions. By decision of the team 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, a three-year transition period.
The authors of the document were the head of the State Duma Committee on Health Protection Dmitry Morozov, as well as 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 purpose of the new legal act parliamentarians see a turnover of personnel and the improvement of the industry with its help.
What will follow the initiative, which should enter into force as a law on the first of October? Rejuvenation of personnel and more modern treatment or decapitated medical facilities and falling levels of patient care?
The list of doctors who will lose their positions in the coming years is, of course, impressive. Head of the Federal Research Center for Pediatric Hematology, Oncology and Hematology named after Dima Rogachev Alexander Rumyantsev, Head of the Endocrinology Research Center Ivan Dedov, Director of the Federal Medical Research Center for Psychiatry and Narcology named after V. P. Serbsky Zurab Kekelidze, Head of the Scientific Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov Gennady Sukhikh. In the same list is the director of the Scientific Center for Cardiovascular Surgery named after A. N. Bakulev Leo Bockeria...
However, let’s digress from the listing of outstanding doctors - often not only the heads of medical centers, but also the country’s leading specialists in their field of medicine. The concept of an age limit is already in effect 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 not older than 65 years of age, 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” Russian Federation» also sets 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 authority of his supervisor expires. But for the leader himself, the term of civil service can be extended to 70 years. government agency or the person who appointed him to the position, Barziev comments.
And 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 who reached the age of 65 years as of October 1, 2017 or will reach this age within three years after the specified date, remain valid until the expiration of the terms provided for in such employment contracts, but no more than within three years from the date of entry into force of the Federal Law.
The legality of labor restrictions based on 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 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 itself cannot serve as a sufficient basis for dismissal from the post of 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 implies that when deciding whether a person whose age exceeds sixty-five years meets the necessary requirements for the head of departments, The opinion of the leadership of universities and their collegial 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.
“Similar laws have long been in force in relation to a number of government employees budgetary institutions. There must be a process of leadership rejuvenation. This did not cause rejection in universities and research institutes. After all, there is both the position of scientific director of a research institute and the status of faculty president,” comments Director of the National Research Institute of Public Health Ramil Khabriev. - A bad leader is one who did not give his subordinates the opportunity to grow, did not prepare his own replacements... Passing on knowledge is a natural human desire. And the head of the medical institution needs to think about preparing a worthy replacement for himself.”
Supporters of the new amendment to the Labor Code hope that it will motivate the heads of hospitals and clinics to be more attentive to junior specialists. And this will help medicine rise to a higher level.
However, as the “children’s doctor of the world” Leonid Roshal noted back in March: “At 82 years old, I decided to leave the position of director of the Research Institute of Emergency Pediatric Surgery and Traumatology. I found a worthy replacement. But he still needs my help.”
On round table ONF “How to overcome the personnel problem in healthcare”, the doctor supported the proposal of Natalya Sanina and Vladimir Starodubov about a special mentoring program.
“No matter how we feel about famous doctors, their charisma, authority and decision-making experience are enormous. With their departure, a “big fight” will begin between less charismatic and authoritative people. Struggle, inertia, search for a way out, reaction of authorities at different levels, attempts to find a replacement, staff turnover due to unsuccessful decisions. Those whom the law will directly affect, those around them - and new ones, along with those whom they will bring with them,” warns President of the League of Patient Advocates Alexander Saversky.
IN in social networks A fierce debate ensued around the new law. Some refer to the experience of European countries, for example Germany, where, upon reaching the age limit, not a single head of a healthcare institution can retain his post: the chief physician either retires or is engaged in teaching. Others are perplexed: the director can be promoted to the position of scientific director - there he will be able to protect 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 are working? Let's be honest. I don’t know the numbers for Moscow, but in the periphery there is a shortage of 50 percent or more! In cities with a population of over a million!" Still others, with bitter irony, propose introducing age restrictions for State Duma deputies. And also in some other industries and institutions.
Still others are indignant: “One gets the feeling that this is a purposeful policy - to decapitate the country altogether, depriving it of valuable and thinking people!”
As I noticed doctor Lyudmila Fokina:“Those who made such a decision have no idea how much time a doctor needs 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 medical professional is an expensive “product”. Practice and experience form high-class professionals! The older they are, the more they know, and therefore 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.”
“It is only at this age that all of a person’s organizational abilities are revealed. And any chief physician or director is first and foremost an organizer. When the law comes into force, the level of medical care will fall even lower, warns Honored Scientist of the Russian Federation, member of the Committee of Civil Initiatives, Professor Yuri Komarov. - After all, this is not a matter of clinical medicine. At the very least, it is developing, new methods and technologies are appearing. The problem lies in the organization of medical care.”
The age of chief doctors is a private problem. The root cause of all the difficulties with training staff and organizing primary health care is the lack of order in healthcare, explains Yuri Komarov. Movement without a steering wheel is still only at the level of “general and whole”...
He shared his personal opinion and Deputy Chairman of the State Duma Committee on Health Protection Sergei Furgal:“I think that the law is at least premature. And it will do a lot of harm. In addition to Moscow, there are other regions where there are 2-3 doctors in district, city, and rural hospitals. If they are fired due to age, there will be no one to replace them. Anarchy will begin. Any legislation must be feasible - and must improve the situation. But here the result will be the opposite: throughout the country both the quality of medical care and its availability will decline. The age limit amendment 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. Personnel shortage, lack of conditions in which young doctors could live and work... By setting an age limit for doctors, doesn't the country risk losing not only the luminaries of medicine, but also medicine as such?
Last week, the State Duma Committee on Labor, Social Policy and Veterans Affairs unanimously approved a bill according to which the heads of state and municipal medical institutions and their deputies should be people no older than 65 years. At the same time, for a manager, the tenure of office can be extended to 70 years upon the proposal of the general meeting of employees of the organization. As for deputies who have reached the age of 65, it is proposed to conclude employment contracts with them for a period not exceeding the expiration date of the powers of their immediate superiors.
Unfortunately, in some means mass media An incorrect interpretation of this document has emerged: supposedly many outstanding practicing doctors who are also heads of medical institutions will be fired. Actually in the bill we're talking about not about dismissing them from the profession, but only about releasing them from administrative and economic work: signing bills, repairing roofs and replacing sewer pipes in hospitals, solving other everyday issues.
Today, more and more new information Technology, and in these conditions it is advisable to ensure an influx of younger personnel into organizational work, including in the healthcare sector. And current leaders who have reached the age of 65 must be given the opportunity to concentrate on their medical and scientific activities, and on training students. They will be offered other positions corresponding to their qualifications. Transfer to these positions will be carried out with their written consent.
Similar norms establishing age limits exist for civil servants and managers scientific organizations and their deputies, for rectors and vice-rectors of higher educational institutions. Let me remind you that after the age limit for rectors was established, the position of president was introduced in many universities. Younger researchers began to be elected as rectors, former leaders became presidents: they could focus not on current administrative and economic work, but on the development of their scientific school, teaching, and so on. I think that a similar system can be introduced in the healthcare sector. This will ensure a smooth rotation of personnel in medical institutions.
This is especially important today, when many young qualified and talented specialists go to private clinics because they do not see prospects for career growth in state and municipal organizations and, as a result, work only for the more financially secure part of the population. Our task is to ensure that they provide medical care to all citizens of Russia.
Among other things, the proposed bill establishes continuity in the healthcare sector: new chief doctors of hospitals and clinics will begin their activities when their predecessors are still active and ready to help with advice. I will also note that for three years from the date the law comes into force, employment contracts concluded with the heads of medical institutions and their deputies will remain valid, even if these persons are over 65 years old. Three years, from our point of view, is sufficient time to prepare a worthy replacement.
This bill was supported by both trade unions and the government. We hope that The State Duma will adopt it in the first reading in June.
You can manage a state or municipal medical institution until you are 65 years old. A bill establishing an age limit for chief doctors has been submitted to the State Duma. Of course, the chief doctors will not be kicked out onto the street; according to the document, they will be offered another “qualified” position.
Expert opinions are divided: some believe that this approach will give a “green light” in the growth of young personnel. Others insist on the need for unification of rules and an individual approach.
They want to pass the law quickly: from July 1, 2017. At the same time, the authors explain that, firstly, a certain transition period is provided: senior managers 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 tenure of the head physician to 70 years if the general meeting of the medical organization’s staff requests this. But, in fact, it may not be extended.
Similar restrictions have been in effect for two years in the education and science systems: the same 65 years for university rectors and directors of scientific institutes. By the way, for senior positions in the civil service, legislators take the exact opposite approach. On January 1 of this year, the opportunity was introduced to extend the powers of federal leaders to 70 years; a bill is also on the way for regional officials.
"Today in medicine they are actively introducing innovative technologies, new specialists are needed. Of course, the issue should still be discussed, but I support the direction itself,” Raziet Natkho, an expert with the ONF Social Justice working group, told RG. “If this is transferred to chief physicians, I believe this will avoid situations where leaders sit too long and do not work effectively.”
There is an acute shortage of competent leaders in medicine
At the same time, Larisa Popovich, director of the Institute of Health Economics at the National Research University Higher School of Economics, reminds that, according to Labor Code, we prohibit age discrimination in labor relations. She is also 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 employee’s health does not allow him to fulfill his duties. job responsibilities. “In all other cases, this is a restriction of rights,” the expert is sure.
“I can imagine what this initiative may be connected with - the fact that a number of heads of medical institutions are trying to pass on the leadership of them “by inheritance,” believes Alexander Safonov. “But these sensational cases are isolated. So there is no need to shoot from a cannon.” by sparrows. Probably, personnel rotation is really necessary. But to judge whether a person can lead or not is necessary not from the point of view of his age, but from the efficiency of his organization. If the medical institution works great, if there are no complaints from the public, consumers of services ", then why break it? But in order for the founder to have the opportunity to evaluate the effectiveness of the organization, it is necessary to develop clear criteria for such an assessment."
Can't "clean" medical personnel so rude, the head of the department of healthcare management is convinced State University Department, 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 I am ready to work for another 20 years. It would be better to think about creating a reserve, specifically training young people, because management in healthcare is a special, complex profession,” Viktor Cherepov told RG.
The State Duma may set an age limit for chief doctors of hospitals. What do doctors themselves, whose professional experience is important in their work, think about this?
The State Duma is considering a bill to limit the age of heads of medical organizations. The amendments may come into force as early as June 1. Duma Committee on Federal Structure and Issues local government recommended their adoption in the first reading. What do doctors themselves think about this?
The director of the Sklifosovsky Research Institute, Mogeli Khubutia, for example, is now 70 years old. Leonid Roshal, President of the Research Institute of Emergency Pediatric Surgery and Traumatology - 83. Leo Bockeria, Director of the Bakulev Center for Cardiovascular Surgery - 77 years old. If the law is passed, then heads of state medical organizations who are over 65 years old should be fired. The restriction is extended to 70 years if the employees of the institution advocate for it. Here is the reaction of the director of the Russian Cancer Research Center named after N. N. Blokhin, Mikhail Davydov, who is now 69 years old.
Mikhail Davydov Director of the Russian Oncology Research Center named after N. N. Blokhin“We have a lot of examples where people older than this age work brilliantly, lead and are experienced professionals. Although such a template exists all over the world, in fact, it is the age limit for executive employees, so it is quite negotiable. I would still limit the age of chief doctors to 70 years. If an experienced leader, he will be in excellent shape until he is 70 years old, and, of course, he can be of great benefit.”
Deputies explain the idea by saying that staff rotation is necessary. Before this, the age limit had already been introduced for university rectors and heads of scientific organizations. By the way, there are no restrictions for the State Duma deputies themselves: Joseph Kobzon, for example, is 79, Valentina Tereshkova is 80. There are also heads of state who are already over seventy. And there are examples in business: 86-year-old Bernie Ecclestone, who led the world’s main auto racing for 40 years. But when there is no border, this can also be bad, comments Anatoly Makhson, former chief physician of Moscow Hospital No. 62.
Anatoly Makhson former chief physician of Moscow Hospital No. 62“There are other examples: he is already approaching 80 years old, perhaps he is no longer a leader, but he works, and when there are no boundaries, maybe this is not very good. On the other hand, when some kind of border is introduced, it no longer makes sense, because many of our leaders did what they did: suppose you know what it is, and so that you don’t have strong competitors, you can say, you mow down the competitors around you. This is also bad. If you know that you will leave at the age of 70, say, or at 65, then you need to prepare a successor, as before. But that's my opinion."
The bill clarifies that after reaching 65 or 70 years of age, a manager can be transferred to another position. A brilliant doctor is not always good leader, and the brilliant surgeon can continue to perform operations, comments Pavel Trakhtman, head of the department at the Rogachev Center for Pediatric Hematology, Oncology and Immunology.
Pavel Trakhtman Head of the Department at the Rogachev Center for Pediatric Hematology, Oncology and Immunology“A person, even if he is a big, big boss, cannot hold his position forever. He becomes washed out, he is no longer so eager to do something necessary and useful. Still, upon reaching a certain age, not everyone, it is clear that this does not happen to everyone, but still, the ability to work, performance, and mental functions decrease. If the manager knows that upon reaching a certain age specified by law - in Europe it is 65 years old, in Israel it is 65 years old, in the United States of America, in my opinion, generally 60 years old - he must leave the administrative post in government agency. Usually they all open their own private clinics and run them very well.”
Although even now no one is stopping the chief doctors, or rather their spouses, from doing this. For example, last summer Life.ru wrote that the highest personal income among the chief doctors of Moscow was that of the head of Dental Clinic No. 4, Manvel Aperyan. His wife, according to Life.ru, owns 40% in the private clinic Atri-Dent, and in 2015 the family earned 42 million rubles.
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