Kommersant: the government has prepared a reform of the calculation of salaries for doctors

Starting next year, an experiment with a new system of remuneration of medical workers will begin in seven Russian regions. It will cover 440 institutions and 170 thousand people. The government is seeking to reduce regional wage imbalances and bring the salaries of doctors, nurses and paramedics to a “common denominator”. According to preliminary calculations, the salaries of doctors will increase by 2-78%. The authorities promise that the reform will not lead to lower wages.

Ministry of Labor and the Ministry of Health formulated the main parameters of the new system of remuneration of medical workers, reported “Kommersant” with reference to the draft government decree. The Ministry of Labor confirmed to the publication that the document was developed jointly with the Ministry of Health, the Central Research Institute of the organization and health informatization (TsNIIOIZ), All-Russian Research Institute of Labor, the trade union of medical workers and representatives of the community.

The reform is planned to be launched as an experiment so far only in seven Russian regions (they are not specified) from the beginning of 2022. 440 medical institutions, employing 170 thousand people, will participate in the project.

Its main goal is to eliminate the existing huge difference between salaries of doctors in different parts of the country, as well as remove the link between income and workload … That is, the government wants to create a unified system for calculating wages for the whole country, when a high level of earnings will not be associated with high loads.

that now in Russia the salaries of specialists performing the same job are very different. Moreover, the difference is observed not only in different parts of the country, but also within one region. Differentiation was formed after the authorities gave the authority to form the salaries of physicians to the regional level. At the same time, in almost half of the Russian regions (40 out of 85), the salaries of medical workers are set directly by the chief doctors of health care institutions.

The final parameters of the reform are promised to be submitted for public discussion in the near future , however, it is already known that according to the new scheme, the salaries of doctors will be calculated based on three main indicators: salary, compensation and incentive payments. In this case, the salary will be calculated according to the new system, which also includes three parameters:

– the estimated value;
– the coefficient of differentiation depending on the position;
– coefficient of economic development of the region.

Estimated value – basic indicator the same for all regions, which will be equated to the minimum wage in 2022 (13.6 thousand rubles). The coefficient of differentiation (complexity) will be tied to the specific work that the employee performs. There are 16 job groups covering more than 200 types of work and competencies (all of them are approved by the order of the Ministry of Health dated December 20, 2012). For example, for an orderly, the coefficient will be 1, for a nurse – 1.35, for a primary care specialist – 2.23, and for a head of a surgical department of a hospital – 3.13 (maximum value).

The third indicator influencing the salary – the coefficient of economic development of the region – will be tied to the median salary of the subject of the federation. In the pilot regions, it will vary from 1 to 1.38, after the launch of the reform throughout Russia – up to 3.08.

The new system provides for a single list of compensation payments. There will be eight types of them, including a surcharge for night hours, work in hazardous and harmful conditions, the climate of the region. The size of these payments will range from 4% to 60% of the salary. A similar list was developed for incentive payments (16 types, from 10% to 60% of the salary), it included, for example, work in ambulance brigades, rural areas, mentoring.

Now the national average salary share in the salary of doctors is about 40%. As an interlocutor from the All-Russian Research Institute of Labor told Kommersant, after the reform, the share of salaries in the income of doctors will increase to 57% for doctors and up to 64% for junior and middle medical personnel. Incomes will grow most noticeably in regions where the salaries of medical workers are now understated.

The average salary increase for doctors will be 2-78%. According to the authors of the project, the new system should motivate employees to improve their qualifications, and not take additional shifts to earn more.

At the same time, the developers of the reform noted separately, that according to the new scheme, the salary of a medical worker cannot be lower than the amount that he receives now. According to preliminary estimates, the cost of salaries of employees of healthcare institutions in the pilot regions in the first quarter of next year will grow by 30% (9 billion rubles). If the experiment is extended for the whole of 2022, almost 28 billion rubles will be required. The Ministry of Labor proposes to fund the new system from the federal budget. An experiment on its implementation from May next year will take place in Yaroslavl, Nizhny Novgorod, Belgorod, Sakhalin regions and in Mordovia. The pilot project with teachers’ salaries, as in the case of doctors, is aimed at eliminating the current imbalance, when, depending on the region, incomes can differ fourfold.