Doctors. Unvalued labor?

Doctor's calling - to save lives. The most precious thing that a man has. Today, the Kyrgyz health system employs 13,000 doctors and 33,000 nurses. Over 2015 the medical institutions had lost more than a thousand doctors and 2,700 specialists with secondary medical education. The greatest outflow of specialists from the republic was observed in Issyk-Kul and Batken oblasts.

The main reason for the departure is salary. The State is still much to do, so it was decent, the President Almazbek Atambayev acknowledged. "The physician should receive deserved reward for his work," he stressed.

24.kg news agency asked the respondents how doctor's labor is estimated in the country today?

Aybar Sultangaziev, chairman of the Public Council of the Ministry of Health Care: 

- The whole country knows that the official salary of the doctor - crummy, which is equivalent to the cost of living - about 6,000 soms. Some earn a little more. This is the reason of secondary income and attitude of doctor to patient. If the doctor is not satisfied with life, how can he satisfy his patients? A decision is following. We openly say: let's recognize that we have a half-private medicine, let's legalize all flows, which now go into the pockets of doctors at risk and fear. Let the money of patients pass over the counter, and then we will make normal salary to physicians. One says about the development of public-private medicine. But it is represented somehow differently. This doesn't mean that the state medicine can be eliminated. Physicians should receive a decent wage. It is necessary to set the lower level - no less than $500.

- Do you think that the attitude to patients and quality of care will change then?

- Even in the last 3-4 years, when a trend towards a slight increase in salary has started, it is seen that doctors began to hold on their seats. In this regard, there are already some changes. If a person's stomach is full, he will work well. The second area on which to work, is equipping hospitals. We with our equipment soon will be not even in the XX century - but in the XIX.

Aisuluu O., frequent hospital patient:

- I believe that the remuneration of doctors is not only unworthy but degrading. That's why treatment in hospitals - real humiliation. Psychological. Medics forced to earn cynically, beg for money, sometimes blackmail. And the appetites of some increased in such volume that the amounts are assigned, regardless of the patient's possibility to pay. A doctor just such sum of money to purchase something. And the system is neglected in such an extent that even if by some miracle doctors' salaries will be raised, for example, up to 30,000 soms, those who got used to take money from the patient will continue to do this. Lust for money is ineradicable. I emphasize that it's not about all doctors.

Alena Ivanova, philologist:

- I believe that today the state is unable to pay doctors a decent salary. That is why many good specialists go into private medicine or even leave the country. And it's a shame. I think the problem can be solved by changing the approach to the system. It is high time to abandon the principle of free medical care. The market should define the cost of medical services. Yes, it will be expensive. But this is correct. The state shouldn't increase the salary of physicians, but to provide such benefits to vulnerable sectors so they could afford medical services.

Nargiza A., patient of hospital:

- We are talking about formal or informal rewards?

- Let's start with the official one.

- Of course, the salary of health workers, especially of the junior medical staff, is miserable. How one can live for 5-6,000 soms? And load on them is big. I am in the hospital and see how junior nurses wash the floors, walls several times a day, constantly busy with something. And as for informal reward, of course, doctors take money from patients. But they do a lot for patients. In general, one must constantly monitor his health, and then there will be no need to go to doctors often.

Marat Kaliev, chairman of the Mandatory Health Insurance Fund:

- I think that the salary of doctors is low. Unfortunately, there is no possibility to increase it. But it should be done. We are looking for opportunities to increase wages to people who have high loads without the expense of additional funds, but at the expense of internal resources, optimizing the system. In hospitals there is funding for the result. In 2016, we plan to implement this principle at the primary level, in the family medicine centers. However, the amount is small. But this is the first step. And the next - one needs to change the pay system in public health institutions. It shouldn't be tied to fixed gradation. Sometimes doctors have not very high load. When one physician can handle instead of two or three, there should be possibility to motivate him.

- What is the current average salary of doctors?

- According to the results of 2015, at the primary level a doctor received 12,000 soms, nurse - 9,600, nurse - 6.3 thousand. At the level of hospital doctors received a little over 13 thousand soms, junior nurse - little more than 10,000. It is not at stake, but the average salary actually received with all the allowances.

In many ways, the salary depends on the socio-economic development of the country. I think if we made a good step in the economic development, the payment of medical workers would grow simultaneously.

- In the meantime, patients carry their money to doctors...

- When we increase the formal part of the salary, we will be able to deal with informal components.

Dinara Alyaeva, head of "Pomogat legko" ("easy to help") public fund:

- The salary should be increased three times, no less. And first of all - to children's oncologists. They have the hardest job in the emotional, psychological level. Because 24 hours a day they are tied to children, who are dying. And to receive such miserable wages (from 3 to 10,000 soms) - just the humiliation of human dignity on the part of the state. In 2014, we helped the doctors, because the surgeon's salary was 3,000 soms, while the pediatrician's - 5,000. How can you live on that sum of money? It's enough for a week, if you have own apartment. And if rental? Higher education should ensure that young skilled professionals won't leave the country in search of work. If we continue squander brain-boxes, professional staff, soon there will be nobody to treat patients.

Talantbek Batyraliev, Minister of Health Care:

- If today doctor's salary is insufficient, this doesn't mean that the state or the government starves. Teachers, engineers and many other specialists complain about low salaries either. But considering the state of the budget, I think that the state fairly distributes the available funds among the industries. In percentage terms, the lion's share of payments goes to the social sphere. But compared with other countries, of course, this is not enough. Money will never be enough. Emphasize that insufficient wage doesn't give reason to reduce the quality of patient care. The most expensive reward should be the word "thank you" and the satisfaction of our patients that we, unfortunately, don't always provide.