Entrepreneurs have made their proposals to the draft of the health state program "Densaulyk" for the years 2016-2019

Discussion of the program was held at the site of the National Chamber of Entrepreneurs of Kazakhstan "Atameken" with the participation of Vice-Minister of Health Elzhan Birtanov.

The meeting in the format of a videoconference, allowed regional entrepreneurs to participate actively in the discussion of the draft program of the Ministry of Health.

"The text of the program is good, comprehensive, but it is presented in a chaotic manner. In this regard, we would like to offer a clear action plan, without which the program can’t be adopted, because without a plan it will be impossible to assess its performance in the future. It is necessary to pay attention to the financial component of the program. As we know, health care costs from 2010 to 2014 increased from 568 billion tenge to 879 billion tenge, but the draft program indicates  129 billion tenge for 2016 ", - said Yuliya Yakupbaeva, Deputy Chairman of NCE RK "Atameken".

Agreeing with the opinion of the business community that "the more we talk, the more clear becomes the document", Vice-Minister of Health Elzhan Birtanov presented at the meeting, the draft of the state program "Densaulyk" for 2016-2019.

According to him, for the implementation of the program will be used the state budget funds and money from the fund of compulsory social health insurance and other means not prohibited by legislation of the Republic of Kazakhstan. The total cost of the state budget for implementation of the program will amount to 2,837,761 805.0 thousand tenge. 129 billion tenge means not all of the health care system, but only for the implementation of the program of activities for 2016.

"Implementation of this program is designed for 2016-2019 years, and stipulates establishment of the service of public health care, priority development of primary health care, development of integration of all levels of health care, development of effectiveness of management in health care, introduction of elements of corporate governance. The program also involves the further development of the private sector and competition in health care, asset management and privatization of health care facilities, development of a private family practice, strategic management of human resources, modernization of medical education, integration of medical science, education and practice, further development of the school of medicine in the health system. It is also planned to improve drug provision based on international standards, to introduce mandatory social health insurance, development of the quality management system of medical services through a partnership of the  Government, professional associations and patients, to  improve efficiency and to optimize the health care infrastructure and the further development of information technology in health care", - informed the E. Birtanov.

Then Vice Minister answered the questions of entrepreneurs. So, business is primarily interested in whether the public-private partnership will be implemented, whether there has been foreseen presence of any long-term state order within the PPP, why the draft program does not provide for measures to promote gerontological assistance for improving dental care.

"The draft of the state program "Densaulyk" indicates that the share of private service providers SGBP has increased from 12% in 2010 to 27.4% in 2014. As noted under the 2-step "Priority development of primary health care" and introduction of CSMI the participation of private sector will increase, but, unfortunately, an increase of 5% is a small indicator and you must put real numbers. In this connection, please review the figures",  - shared his opinion Arnur Isabaev, chairman of the pharmaceutical and medical industry and medical services of NCE RK.

Entrepreneurs raised questions about creation of dental offices at schools. According to the deputy chairman  of  NCE Yuliya Yakupbaeva, the document does not reflect the development of health care system in regions and it is unclear how the medicine will be available in villages.

Mazhilis deputy Nadezhda Petukhova has prepared more than 10 question to the high-ranking government official of the Ministry of Health. And, of course, she is quite aware of the problems of domestic medicine. First of all, the Mazhilis deputy noted that so far the country has not been established a system of training general practitioners. Nadezhda Petukhova also noted that there were complaints about the lack of funding for guaranteed free medical care, as well as about the access to medical services.

Mazhilis deputy touched another pressing question. "Penalties for exceeding the volume of medical services, to be met by medical institutions, does not stimulate them, but on the contrary, leads to a kind of depravity," - said Petukhova.

Mazhilis deputy also considers it necessary to raise the issue of wage increase. "Without high salary, doctors won’t work properly!" – he said.

Nadezhda Petukhova also raised the issues of corporate governance in medicine, especially in districts, provision of gerontological care, development of paedodontics, medical care at schools, increase of drug prices.

According to Vice-Minister of Health, literally next week will be presented the draft Roadmap of PPP in medicine. "There will be compiled a list of facilities. We plan to introduce a new system of PPP related to the equipment of medical institutions ", - said Yerzhan Birtanov. According to him, within the framework of the PPP it is planned to expand the participation of private health care organizations in providing full range of services included in the PHC and CSHI, provision of some types of medical and non-medical services (laboratory, radiology services, cleaning, catering, procurement of tangible and intangible assets, maintenance of medical equipment and so forth.) will be passed on long-term outsourcing. Also, national and local health care organizations will be transferred to the trust management to private companies, including foreign ones, privatization of public health organizations is expected soon. There will updated the list of organizations whose services will be transferred to the competitive environment to attract private investment for the construction of health care facilities by different models of the concession. "This will create equal economic conditions for both public and private service providers", - said Deputy Minister.

Chairman of the Association of the pharmaceutical industry Serik Sultanov, raised the issue of increasing prices for medicines. He said that "today all domestic enterprises engaged in the health sector work at a loss in order to avoid job cuts". In his opinion, it is necessary to carry out indexation of prices for medicines for procurement under the SGBP for 15-20%. Also, he said, it is necessary to reduce the payment period for products delivered by LLP "SK-Pharmacy" up to 30 days, instead of 90 as stated today.

Serik Sultanov touched another, equally pressing question - exclusion of a number of drugs from the list of medicines purchased under the SGBP.

"In times of crisis we are guided by the British Pharmacopoeia, we remove drugs, without offering anything in return! Today, emergency medical service come without drugs, then why do we need them! "- said the head of the pharmacists.

The participants of the meeting agreed that NCE will present all proposals in the consolidated form to the Ministry of  Health Care. And to discuss the draft of the Action Plan, the Roadmap of PPP in medicine, corporate governance, etc. NCE RK will be used as a platform, and the Ministry of Health will actively cooperate in it.