ALMATY. June15. KAZINFORM /Yekaterina Ionova/ Draft State Program of healthcare development "Salauatty Kazakhstan" for 2011-2015 is being actively discussed in theregions, in medical and social organizations.  For the first time, the program provides for wide involvement of professional branch associations in its realization. President of the National Medical Association, PhD in medical sciences Aizhan Sadykova said it in an interview to Kazinform.   

What are the main directions of «Salauatty Kazakhstan» state program and what is its novelty?

For many years the state has elaborated and approved various healthcare development programs, but they were directed primarily on reforming the sector.  The current program has a strategic goal  which should help medicine overcome the difficulties. At present the discussions focus on how to provide conditions for rendering qualified medical care, what to do for people to engage them in prevention of diseases.

The program gives special attention to prevention of diseases. In your opinion, what must the state undertake in order to prevent diseases?

The most important thing is that the budget must envisage funds both for screening and certain treatment. We must teach the patients to be responsible for their health. There is a very good example in Russia: a woman not registered in hospitals till 12 weeks of pregnancy just does not get maternity benefits. Once got such a motivation all future mothers came to women's health clinics.   Besides, Russia allocated special funds to encourage doctors: if you treat a pregnant woman and everything ends well - you get a money prize.

In recent years particular attention is paid to material and technical equipment of the healthcare facilities and upgrading professionalism of medical workers...

Today, we face a serious problem connected with medical personnel that sometimes we wonder why so many hospitals are built if there is a shortage in doctors and other medical staff. Rural areas require urgent replenishment of personnel; there are no specialists with a narrow focus in many regions - dentists, anesthesiologists and intencivists, psychiatrists, phthisiotherapists and forensic scientists, laboratory technicians, psychologists.  Seriously there are issues of staff aging, because young doctors can not support their families with low salary, this money is not enough for raising qualification too. Thus, the new draft program shows the need to solve the issues like financial security and social protection of medical workers.

Does the program pay the same attention to the pharmaceutical industry?

Speaking about the development of domestic pharmaceutical industry, we must think about establishment of the Institute of Pharmacology and Toxicology.  If we want to launch domestic production we will need a special institution where the medicines will be tested and will undergo rigorous selection and control.  And for this we need an institution with a clinical base, where the patients will be under the doctors' supervision, a laboratory that will test effectiveness and safety of these medicines.  The companies which supply medicines or new methods of treatment to our market have to work closely with the Commissions on Scientific Research Ethics.  Such a commission has already been founded, but we must remember that scientific research should be conducted not only by the Ministry of Healthcare but also by other departments.

Are there any changes for our doctors in the program?

In accordance with the program, new information systems will be implemented. Today our doctors fill too many papers; there are many gaps due to the lack of a unified system. The hospitals must be provided with computers; we need new job positions, which will allow people without medical education to work in healthcare system. Thus it is possible to release doctors from paper work. 

A number of experts can be released through the introduction of paramedics' service.  For such kind of service it is necessary to develop regulatory framework, the curriculum for their preparation, consider the qualifications, job descriptions and qualification procedures. So, for example, the emergency doctors can be freed from the load.
This also relates to the medical managers - they do not have to graduate from the medical schools, the hospitals should be managed by the healthcare managers.  The same thing relates to the extra doctors, they also do not necessarily have a special education.  Social workers who can nurse critically ill patients can greatky help the doctors.  It is necessary to consider the mechanisms of motivation to attract volunteers.  For example, 9-11 class students, who dream of becoming a doctor, may be a volunteer.  But for this it is necessary to create legal and regulatory framework, which would offer them some incentives to enroll in medical school or college.  In the draft program there are a lot of such moments, which not only raise the issue, but also offer a real solution.

Did your association make any recommendations? 

Yes, we did, and we are very pleased that since our representatives have taken an active part in its development from the first days. The Ministry of Healthcare and its head have recognized us as partners especially in accreditation, licensing, attestation for awarding qualification categories, for conducting independent expertise while developing the standards - treatment protocols, diagnostics and rehabilitation. We must be among the  members of examination commissions because the medical associations must conduct rigorous selection. The rating of medical institutions must also be defined by the associations.  

For example, in Germany namely associations solve pharmacological-economic issues - their experts determine what sum of money must be spent for treatment of some or other diseases.

I would like to speak about the independent expertise in the healthcare system.  In 2009 we accredited almost all public health organizations. However our experts need to be taught how to work, they must realize that putting their signature under accreditation they share their responsibility with the organization.

We need a national registry of medical workers because we do not know the exact number of doctors working in state structures, private clinics, departments and hospitals. This list will allow the Ministry of Healthcare to have a real picture of the situation - the number of disabled doctors, unmarried mothers, how many of them have debts in banks and do not have enough money to hire nurses for their children. 

There also must be a national registry of medical facilities - then there will be a clear picture of what we have today in healthcare sphere.
 
Mrs. Aizhan Sadykova, you are a participant of the III Astana Economic Forum. What kind of proposals will you initiate there?

The forum will focus on implementation of the Business Road Map program, namely, state-private partnership in healthcare sphere. For instance, participation of the state in construction of private clinics, providing medical care in joint ventures, construction of industrial facilities for healthcare.

As for implementation of educational programs with attraction of experts from Russia and non-CIS countries, I can say that we should open the clinics which meet all European standards and which are provided with up-to-date equipment.

Noteworthy to say, that the strategic line of the program has already been defined and all of us have to perform huge work on its realization. I share the position of our Minister. He says, that the more we discuss the program the more remarks and recommendations are made and the more successful it will be. I would like to thank him for his openness and bravery. It is not easy to be a reformer, to be a leader.

I think that Kazakhstan healthcare system will be able to reach the level of other civilized countries, where the mechanism of attraction of public organizations to state programs' realization is functioning in reality.

Thank you for the interview!