The salary of doctors is one of the hot topics discussed in society today, because, despite the importance and demand of this profession, the salaries of health workers remain quite low, and even the government’s promise to raise the salary of doctors from January 1, 2019, as evidenced by the latest news, cannot stop the outflow of personnel.
Should we expect the situation to improve, and what will doctors’ salaries be next year? We offer you to understand the problems of financing and the features of calculating the salary plans of a health worker.
Relevance of the problem
Of course, the problem of low wages is relevant for many areas dependent on government funding. But the salaries of doctors require special attention from the leadership of the Russian Federation in 2019, because the path from a medical university applicant to a highly qualified specialist in the field of medicine is very long and today there is an acute shortage of personnel in public medical institutions in the country. Experienced doctors are looking for more lucrative jobs in private clinics and abroad, while young people are in no hurry to apply to medical universities, clearly understanding that after difficult and lengthy training they will be faced with responsible and difficult work with low pay.
There is a way out, and it lies in reform, part of which is a new decent salary for doctors, designed to bring a tangible improvement in the well-being of doctors already in 2019, as well as other measures aimed at increasing the prestige of the profession.
Doctor's payroll
The salary of a health worker, as in many other areas, consists of the following components:
- salary;
- additional payment for labor intensity;
- allowances for length of service and category;
- regional allowances and compensatory surcharges, calculated taking into account correction factors adopted for a number of regions of the Russian Federation;
- bonuses, night shifts, overtime, etc.
In this case, only the first parameter is subject to indexation – the rate (basic salary), while the size of the variable component of a doctor’s real income in many government institutions drops sharply, as noted by the doctors themselves.
Of course, if we take the statistics of large medical centers in Moscow, St. Petersburg and other Russian megacities, the percentage of personnel outflow will not be large, but nationwide, over the last 5 years, more than 90,000 specialists have left medicine, which confirms that the problem exists and requires an immediate solution.
Previous attempts at reform
This is not the first time that talk about increasing the income of health workers has come up. According to the “May decrees” signed by the president 5 years ago, by 2017 doctors’ incomes should have reached a record 180% of the average income in the region, and by 2018 – all 200%. And, although most doctors did not feel a real increase in income, beautiful figures appeared in the industry’s reporting documents confirming the implementation of the reform.
In real life, doctors were faced with the so-called “optimization”, in which the following occurred:
- job cuts;
- unification of sections and entire departments;
- increasing overtime hours and the number of night shifts.
Thus, the workload on the doctor has significantly increased, which naturally does not contribute to improving the quality of the specialist’s work, and income, at best, has increased slightly or remained at the same level. At the same time, for doctors who remained working as before, their income remained approximately within the following range:
- 27,000 – 35,000 rubles for doctors;
- about 20,000 rubles for junior and mid-level medical staff.
Of course, there are also regions in which the salaries of doctors can truly be called decent. These include Moscow, St. Petersburg, Sakhalin and Khanty-Mansiysk Okrug. The highest incomes, reaching 117,000 rubles per month, were recorded in Chukotka.
What to expect in 2019?
Talk that the salaries of doctors should increase significantly in 2019 in accordance with the same “May decrees” gives hope, but the latest news in the economic sphere suggests that the chosen path will not be simple and easy. Negative events such as a drop in oil prices and the imposition of economic sanctions undermine the country’s economy, but the financing of the medical sector is fully borne by the budget. It must be remembered that the planned increase in payments to employees of state medical institutions will require an additional 95.5 billion rubles from the budget by 2019, and another 170 billion by 2020.
Naturally, no one canceled indexation and from January 1, 2019, doctors’ salaries will be increased by 5.5%, which will not even cover the projected increase in prices for various groups of goods.
It is difficult to say whether the promise of a significant salary increase will be realized. Most likely, this law will add to the list of projects that are destined to remain only on paper, and by the beginning of the new calendar year there will be a list of amendments that will push back the fulfillment of the promise to more distant dates. And how I would like this assumption to be wrong...
It is important that depending on the region, the level of remuneration may vary significantly. Both capitals have the ability to maintain the level of income of doctors and other workers in the field at a decent level, but in other regions of the country things are not always as good. If the country's leadership sets the task of leveling these levels, then the capital authorities are trying to preserve the privileges of Moscow doctors. Recently, Moscow Mayor Sergei Sobyanin announced that in 2017-2018, salaries of employees of Moscow medical institutions will be raised by 40% compared to 2016. In absolute figures, it will be 120 thousand rubles per month in 2018, the mayor promised. The mayor also called on health officials to monitor the workload of doctors. What do we have in reality today? Everything is clear with Muscovites.
Increasing salaries for doctors in 2018: plans and realities
How to live? Dmitry Nikolaenko →Sat, 01/20/2018 — 22:54 #7 Having received my first salary as a resuscitation doctor in 1994, everything became clear to me, with my prospects and the prospects of my family, but since it was a pity to leave the profession, and I love my work, I had to master a parallel non-medical business and create my own office, while also remaining on the stand in a state-owned enterprise! An income of about 500 rubles a month seems to me to be quite commonplace, go for it colleagues and don’t expect handouts!) E-lena→ Wed, 01/24/2018 — 16:15 #8 Salaries are not being increased! The rate remains minimal! But there is a system of additional payments... and they throw you a bone before the elections so that you can take it away at any time. Everything is at the discretion of local authorities. And they believe that people should be treated by hungry doctors and nurses.
This is how it is in Rostov. It's a shame.
Increase in salaries for doctors in 2018
Cool, isn't it?? Alina7777777777…→Sat, 01/13/2018 — 22:03 #3 and at my work, a doctor received 12 thousand and a nurse received 18,600. Olga →Fri, 03/09/2018 — 00:31 #4 Envy is a great force! Let’s arrange for the nurses the Inquisition.
Elena_ 2018→Tue, 16/01/2018 — 18:35 #5 As always, lies!! I also received 20 thousand for December at 1.5 rates. Since 1990 I have been working in my specialty, the highest category.
Mira→Fri, 01/19/2018 — 17:17 #6 Today is 01/19/2018. They force me to write an application for transfer from nurses to cleaners.
All benefits, harmfulness and 14 days leave are removed. And the salary does not need to be increased, as the government promised! It’s a deception! We graduated as nurses six months ago. Now with the same amount of work for a lower salary.
The unpleasant truth about increasing doctors' salaries in 2018
It was previously noted that the base salary for doctors increased by 3 thousand rubles, while junior medical staff's salaries were increased by 2 thousand rubles, and for average medical staff - by 600 rubles. People, however, are indignant that in practice the increase that occurred was stolen by constantly growing inflation, when prices for basic goods and services in our country are growing very quickly.
Attention
The assurances of the federal authorities about priority tasks in terms of fulfilling previously assumed obligations are also striking. In this context, doctors are not left out of the list. They are promised a constant improvement in living conditions through higher wages.
But as soon as it comes to concretely increasing the material support of doctors, difficulties arise. People on the ground often do not get what they are promised.
Average salary in the hospital: doctors and nurses will divide the money of nurses
As a result, the authorities plan to achieve the following ratio:
- Doctors' salaries should be twice the regional average.
- The remuneration of junior and mid-level medical staff should correspond to the average salary in the region.
The budget for next year provides for MHIF revenues at the level of 1.89 trillion rubles. At the same time, the fund’s expenses will exceed 1.99 trillion. In such conditions, the targeted increase in medical salaries in 2018 is under threat, the Accounts Chamber warns.
In addition to the planned deficit, the fund's real expenses will be higher by 43.1 billion rubles, which will call into question the future indexation of income.
Salary of doctors 2018, increase for medical doctors, workers
This year, the government implemented two stages of indexation of doctors’ salaries:
- by 7.5% at the beginning of the year;
- up to 180% of the regional average from October 1 (for middle and junior medical staff this figure should be 90% and 80%, respectively).
Previously, representatives of the Ministry of Health noted structural problems of the current insurance system, which could interfere with the targeted increase in the salaries of doctors from January 1, 2018. In search of the necessary resources The government planned to attract resources for the planned increase in wages for health workers from three sources:
- MHIF funds (including support from the federal budget).
- Regional finance.
- Internal optimization (staff reduction, sale of property, etc.).
The revenue portion of the Compulsory Medical Insurance Fund is generated from insurance premiums, the Ministry of Health emphasizes.
When will salaries and wages for doctors be increased in 2017 and by how much?
Important
Internal optimization did not bring the expected savings in financial resources (officials planned to finance up to 30% of future salary increases from this source). The number of personnel has decreased by only 5-7%, and the plan for the sale of property is systematically not being implemented.
As a result, 70% of the upcoming increase will be financed by the Compulsory Medical Insurance Fund (including taking into account transfers from the federal budget). Given the lack of fund resources, future salary increases will be provided from the state treasury.
Analysts believe that the planned increase in salaries of public sector employees (including doctors) in 2018 will lead to a significant increase in the budget deficit. As a result, much will depend on the dynamics of the oil market, which forms the lion's share of state treasury revenues. Oil factor Increase in oil prices to 60-65 dollars per barrel.
Salaries for doctors in 2018
The medical profession cannot be compared with others, given the important role that doctors play in the life of a modern person. It would seem that representatives of this profession should be as well off as possible.
But in reality the picture looks much less optimistic. Doctors are constantly trying to figure out when and by how much their salaries will be increased. Based on the latest news, we can state that in the foreseeable future, namely in 2018, doctors should not count on any major changes in terms of real wage growth. The corresponding disappointing conclusions can be drawn by analyzing the draft budget of the Federal Compulsory Medical Insurance Fund for the next year. The Ministry of Health did not hide the fact that there is simply no money to increase doctors’ salaries.
In 2018, there will be another increase in the salaries of doctors, which will ensure the implementation of the May presidential decrees. Officials note that next year’s budget provides resources for indexing the salaries of medical staff.
However, experts believe that imbalances in the current compulsory insurance system may jeopardize the implementation of the authorities’ ambitious plans. Content
- 1 Increase for health workers
- 2 Finding the necessary resources
- 3 Oil factor
Increase for health workers In 2018, the goals set out in the May decrees will be achieved. In particular, the salary of medical staff will reach the target level, representatives of the Compulsory Medical Insurance Fund emphasize.
Let's imagine what these sources might be:
- Direct funds from the Compulsory Health Insurance Fund. Most likely, it will be he who will take the main cut, since he serves as the main target medical fund.
- Additional subsidies from the federal budget.
Increasing salaries for doctors is a very public image measure for the country's leadership before the elections, so infusions of assistance from other budget sources are guaranteed.
- Funds of the subjects of the federation. In the context of sanctions and crisis, there has been a steady tendency to delegate part of the costs from the federal to the regional level.
It is unlikely that the share of wage financing will bypass the budgets of the constituent entities.
- Optimization.
Is it true that salaries for health workers will be increased from July 1
The MHIF was able to form a reserve of financial resources, which will be used for future increases. However, in the future, the authorities will have to choose one of the alternatives:
- adjust contributions to the Compulsory Medical Insurance Fund, which will provide the fund with the necessary resources;
- increase transfers from the state treasury.
Some regions cannot cope with the planned rate of salary increases, which forces local authorities to turn to the federal center for help.
Experts from the Health Foundation also emphasize that in many regions of the federation the target indicators for 2016-2017 have not been achieved, which casts doubt on future salary increases. Local budgets should provide 30% of future increases in wages for medical personnel, experts say.
And on average across the country, if the task set by President Putin is completed, by the end of 2018 doctors should have a salary of 90 thousand rubles. But there is one big trick: Starting from 2017, the income of not only state healthcare institutions, but also private sector owners is added to the common “piggy bank”.
Add to this regional “scissors” - and the picture becomes even more confusing. Now officially the average salary for doctors is 47 thousand rubles.
In private clinics today, the “average” cosmetologist or other specialist has 90 thousand. A municipal therapist in Ingushetia can count on only 23 thousand per month, but in the Yamalo-Nenets and Chukotka Autonomous Okrug it reaches 110 thousand (including northern allowances).
Nurses are content with a salary of 20 thousand, and also on average.
Despite the fact that the medical industry in Russia is declared a strategic priority for the focus of internal reforms, the state of material support for both the medical institutions themselves and medical workers leaves much to be desired. The government says that this “period of turbulence” is short-lived. Starting from 2018, the activities of a doctor, nurse and paramedic will be able to return to the ranks of the most prestigious Russian professions. Are there economic prerequisites for the implementation of the stated plans? What salary can Russian doctors expect in 2018?
How much do doctors earn in the Russian Federation?
In order to have an idea of how a medical worker’s remuneration is formed, let’s look at the main components of his salary. What does the monthly income of a doctor, nurse, paramedic consist of?
first of all, this is the official salary;
secondly, this is an additional payment for intensity, increased loads, and, in general, the specifics of the work;
thirdly, these are bonuses for qualifications and length of service;
The regional coefficient and other payments are also included in the salary.
Despite such segmentation, it is precisely bonuses and allowances that make up the majority of the salary, while if the salary subject to indexation is set centrally by industry officials, then the amount of additional payments for intensity and other bonuses are determined in the medical institution itself, and can be accrued as , and were cancelled.
This arrangement caused a slight decline in the income of doctors in 2015-2016 - the salary increase simultaneously suspended the ability to pay a number of other bonuses, which caused obvious discontent among workers. Such a drop in the income of doctors was recorded in the Arkhangelsk region, Dagestan, Ingushetia, the Jewish Autonomy and other regions.
What salary do doctors and nurses receive, according to statistics? 30 thousand rubles and 20 thousand rubles, respectively, are the monthly income of doctors in most Russian regions.
The salary of Kalmyk doctors is minimal - their monthly salary is only 27,300 rubles per month. Doctors in North Ossetia do not receive much more - 28 thousand rubles per month. The situation is similar in Ulyanovsk - doctors with higher education have an income of 30 thousand rubles.
The highest salaries among Russian doctors are received by doctors in Moscow, St. Petersburg, Khanty-Mansiysk Okrug, Chukotka and Sakhalin. Their bonuses allow them to receive a salary, in some cases, exceeding 100-115 thousand rubles.
Such income inequality in the context of a regional link is widespread and affects all categories of doctors. So, for example, Moscow therapists receive more than 60 thousand rubles a month, and their colleagues in the region receive 15 thousand less. General practitioners in Kamchatka can expect a salary of no more than 40 thousand rubles.
On top of that, we note that the real salary figures for public sector doctors may be much lower - in its information, Rosstat takes into account the salary figures for doctors, both public and private medical institutions, where the income of doctors and nurses is traditionally higher.
Will the salaries of Ministry of Health employees be increased in 2018: latest news
Already in October 2017, doctors’ salaries will be indexed by 5.5%, in line with the inflation rate. As for 2018, expert opinions are divided: some believe that increasing the minimum medical salary to 50 thousand rubles in the country is quite realistic, given that elections are coming next year. Other financial analysts agree that a partial increase in salaries will be realized through cuts in the industry - there is simply no money in the state budget to increase the salaries of the existing number of doctors in Russia. It is predicted that doctors will “pay for” their increased incomes since the beginning of 2018 by increasing their workload – up to 1.5 times the rate.
However, both sides present their forecasts with the utmost caution.
Government plans to increase salaries of Russian doctors
But Russian government officials are more bold in their assessment of the prospects for increasing salaries for medical industry workers. Deputy Prime Minister of the Russian Federation Olga Golodets said that the increase in medical salaries to 200% announced earlier by President Putin in 2018 is quite realistic, and money has already been provided for these needs in the state budget. And, in general, the salary levels of doctors will be equalized in all regions of the Russian Federation.
Analysts have already managed to find a “loophole” in this statement: it is possible that a 200% increase in income will be made relative to salaries at the 2012 level - we recall that it was then, according to the “May decrees” of the President of the Russian Federation, that a program was launched to increase the salaries of public sector workers, and the end date of the program should be 2018.
Any action in our life has a relationship with another, and the second with the third, and so on. An example is the following: a low salary cannot serve as an incentive to work with high dedication.
And therefore, the question: whether there will be an increase in salaries for doctors in 2018 worries not only the doctors themselves, but also ordinary citizens. After all, the latter want to receive not just medical services, but also that they be of high quality. And the high level of wages for workers in medical institutions is a kind of incentive for them to provide them.
Against this background, Golodets’ statement that we should expect a 200 percent increase in salaries in the healthcare system in 2018 in the Russian Federation was a balm for the souls of doctors. True, this was said with a caveat, which most did not notice - the increase will be relative to the 2012 level. If you believe the words of the government representative, there are funds in the budget for these increases, the government voted “For”. So no one is going to cancel the presidential decree.
Medical workers are obliged to receive a decent salary, otherwise they are unlikely to be able to perform their duties at a high-quality level, since they will be thinking about something completely different. And everyone who comes to them for medical help may suffer from this, the Deputy Prime Minister ended her statement with these words.
The territorial location of medical institutions has a significant impact on the wages of people working in them. As you know, doctors working in both capitals of the country receive the highest salaries. But, according to Golodets, this difference will be somewhat leveled after the increase. After all, the increase in salaries for doctors in 2018 in Russia will be uneven. As a result, the salaries of health workers throughout the country should be straightened. That is, a doctor in Moscow and somewhere in Altai will receive approximately the same amount for his activities.
What at the moment?
Today, the wages of employees of medical institutions consist of the following components - salary, allowances and additional payments in the form of compensation.In accordance with the presidential decree, doctors' salaries will be increased. It seems to be happy and live for your pleasure.
It is very good that doctors’ salaries will be indexed next year. After all, the current salary calculation system does not meet with understanding from the majority of health workers. And the reason for this negativity is precisely the method of calculating compensation payments. It, as mentioned above, depends on the desire of the management, moreover, the payment is made based on the assessment of the workplace itself. But the position held by the employee does not affect the additional payment in any way. But previously it was she who had the greatest influence on additional payments and, accordingly, they were much larger. And there was an incentive to make a career, and therefore to work better.
What will happen?
If you believe official financial experts, now the average salary for doctors is approximately 35 thousand rubles, and after the increase it will be about 50 thousand, which is good news. But recently a small survey was conducted, in which about 5 thousand people from medical institutions from all over the country took part. So, most of them indicated that their monthly earnings do not exceed 20 thousand and they have not heard or seen about 35 thousand.Independent financial experts express great doubt that the plans of the country's leadership are feasible.
Moreover, against the backdrop of a general crisis, it is unlikely that the necessary amounts will be found in the country’s budget. In addition, such a rapid increase in salaries, especially since the government provides this not only for doctors, can have negative consequences for the country as a whole.
The recent healthcare reform has forced almost 9 thousand people to leave their jobs as medical workers and, according to experts, the upcoming increase may also cause a reduction in medical workers in 2018 in Russia, so that management can find funds to increase the salaries of the remaining workers.
This means there will be a shortage of workers in many positions. Which in turn will lead to combining positions. What will again affect the quality of the services provided - we again return to where we started - increasing wages so that the quality of the services provided improves.
The recent cuts are already having a negative impact on the healthcare system - every month each doctor began to spend 12 hours more on work. And this is only official; in reality, this figure may be higher. As a result, health workers simply do not have time to fully rest between shifts, and therefore, to provide quality medical care to those in need.
On the other hand, according to experts from the same group of independents, the likelihood that there will be an increase in the salaries of doctors in Russia in 2018, and the latest news does not lie, is high. There are the following reasons for this:
- Healthcare has not received normal funding for a long time. This has led to the fact that the salaries of medical staff really need to be revised and subsequently increased;
- Moreover, presidential elections are planned for 2018, which means that in the run-up to them, the current president is unlikely to renege on his words. Otherwise, faith in him and in presidential power in general will plummet. This could lead to people voting for the wrong person.
But again, the independents draw their own conclusion that there will at least be an increase. But it will not be at the level planned, but significantly less. After all, there are not many sources of budget financing and even in aggregate they will not be able to provide the necessary money supply. So what will happen to doctors’ salaries in the election year is not yet clear.
Against this backdrop of ongoing disputes, information about raising the VAT by 4 percent (from 18 to 22) with a simultaneous reduction in insurance contributions to the budget from 30% to the same 22 was heard almost unnoticed. This innovation was proposed by the Ministry of Finance. Such a mutual increase/decrease in rates should compensate for all losses for businessmen.
Experts expressed the opinion that this could provoke an increase in inflation, but the head of the Ministry of Finance, Siluanov, assured that this indicator would be controlled by the state and it would not allow it to rise by more than 2 percent. In addition, this move, at this level of inflation, will give the budget almost a trillion rubles of income. And raising the salaries of doctors will not be an unbearable burden for the state. The main thing is that this proposal from the Ministry of Finance is accepted by the government.
News feeds are full of headlines about increases in wages for doctors in the near future, and doctors’ salaries in 2018 should increase by 200%. This topic was raised back in 2012, when Vladimir Putin, who holds the post of Prime Minister, presented a strategy to increase the salaries of healthcare workers. The end point of the transformation is January 1, 2018.
It’s time to figure out what the amount in monetary terms will be on lucky January 1, which made such an increase possible, and whether there are any pitfalls in this process.
Salary increase program
The wage increase program is designed for a five-year period. It was published on May 7, 2012, and since then, according to statistics, the average salary of health workers has been growing steadily. Increases in percentage:
- The average salary increased by 24% in 2013;
- another 13% in 2014;
- an increase of 17% in 2015;
- as of October 1, 2017, payments should increase by 180% of the starting average salary in 2012;
- January 1, 2018 – the coveted 200% for doctors and 100% for medical staff.
According to the forecasts of Deputy Prime Minister of the Russian Federation Olga Golodets, the plan is being implemented, and the money for its implementation has already been allocated to the state budget. The upcoming elections in the Russian Federation can also become a guarantor of such an increase.
Real numbers and average salary calculation
According to government reports and forecasts, the implementation of the plan is in full swing, so in 2018, doctors should receive approximately 90 thousand rubles, but there is one caveat - this is the average salary.
Since 2017, when calculating the average salary, the salaries of not only government institutions, but also private clinics are taken into account. In addition, data from all regions of the country are taken into account. So it turns out that with an average amount of 45 thousand rubles, the average gynecologist and cosmetologist in private clinics already receive their 90 thousand, but a full-time municipal therapist receives no more than 40,000.
There is a huge difference in the amounts by region, for example, according to the Russian statistical office, doctors in Ingushetia receive 23 thousand, in the capital - 81,000, and doctors of the Yamalo-Nenets and Chukotka Autonomous Okrug live the most comfortably on just 110 thousand rubles. Please note that the latter regions are unlikely to be affected by the long-awaited increase in medical salaries in 2018; a 3% decrease in growth dynamics is already observed.
Pitfalls of health care reforms
To increase the salaries of public sector employees, a lot of money is needed, and it needs to be taken from somewhere. There has been no obvious economic leap in recent years, but there has been a wave of layoffs. During the implementation of the “May plan”, 90 thousand health workers were fired. The remaining doctors often took one and a half times the rate, thus independently increasing their income. Not everything is transparent with the salaries of those who continue to fulfill the Hippocratic oath. There are increases, but at the same time there is also an increase in the level of inflation, and over these five years prices in stores have been rising like mushrooms after rain. So 5 - 7% salary growth allows specialists to simply stay afloat.
What to expect for doctors in 2018
According to the latest news, the promised 200% increase is postponed to an unspecified date, but the government promises that the year will not change. Increases are planned, but throughout 2018, but what officials guarantee is maintaining the achieved level throughout 2019.
