Ambulance staff in Abinsk (Krasnodar region) making payments for the work in the context of the epidemic. The hospital insists that the additional funds rely only infectious special teams. Doctors say that to go on potentially dangerous calls have all, without exception.
Trying to achieve a “Putin” allowances, nine health workers one of the ambulances of the Abinsk district of 18 may recorded a video message and posted it to the network.
“The management of GP CRB is trying to convince us that we no payments are provided for,” claimed the emergency workers.
According to paramedics, the crews of the Novel and Sergey (names changed at the request of the heroes), they were encouraged by the example of colleagues from Armavir who after recording the video message made decisions on payment of Federal benefits. In Armavir, as reported by the Union of medical workers “Action”, the money needs to all employees of an emergency regardless if they have been contacted by patients who had confirmed coronavirus infection.
“Reach out to any who can’t. Before that, we had a meeting with the leadership [GP] CRH, the management tried to explain the decision [of the government on the payment of allowances]. From their words, we are not supposed to, because that money is only infectious to the team and only those who had contact with patients in whom the diagnosis was confirmed Covid-19. Although we also went on calls where there were suspicions on the coronavirus that causes SARS, pneumonia,” – says Roman.
“At that time we knew nothing and believed that the leadership is hiding information from us, so we decided to video”, – says Sergey.
According to the paramedic, in April, none of the management of the hospital explained to them how to earn incentive payments, which said Vladimir Putin.
Who is at risk?
The salary of a Roman and his colleagues from the er – 22 thousand rubles, the drivers – 18 thousand. Per shift (day) paramedics depart on average from 17 to 19 calls. With the promised Vladimir Putin overhead, paramedics could “cavigny” April to plus 40% (8 thousand) to the salary – about 30 thousand rubles.
However, a few days after the publication of the video message to the card one of the assistants of the brigade fell to 760 rubles, another paramedic 3700, and the driver 300 rubles. In the accounting Department of the hospital the exact answer to the question, for what they have listed these amounts, according to the Novel, could not be obtained.
Why the emergency workers received not the promise: President money?
Promised Vladimir Putin payments legally issued two government regulations – 484 and 415.
The first refers to incentive payments to employees “davidnyc” hospitals and specialized “covenin” the ambulance. Thus, Novel and Sergei this ruling does not apply the General to the brigade, which has not been defined to work with “comicname” patients.
In decision 415 talking about “the implementation of incentive payments for special working conditions and the additional burden to medical professionals providing medical assistance to citizens who are diagnosed with novel coronavirus infection, and persons at risk of infection new coronavirus infection.”
“Actually, if you read the ruling, you can understand that the title and first paragraphs of the resolution 415 so formulated that it is impossible to decide which concept is agreed that the phrase “and persons at-risk, co – Chairman of the trade Union of medical workers “Action” Andrey Konoval. – Whether talking about patients at risk, whether on health workers at risk”.
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“But it is logical to assume that we are talking about patients from the risk group – as it is in this sense this concept is used in the 10th paragraph of the same decree and other documents of the Ministry of health. For example, in the order of the Ministry of health of the Russian Federation 198н on March 19, 2020 (the work of the medical organizations in the spread of infection Covid-19). It is found in the recommendations of the CPS. In these documents there is a speech about people older than 60-65 years, patients with chronic diseases, pregnant women,” – says Andrey Konoval.
As the co-chair of the trade Union “Action”, any emergency, a district clinic is faced with people at risk of infection with people aged over 65 years and patients with chronic diseases. “That is the decree 415, in theory, should extend to all health care workers,” he concludes.
Roman and Sergei, like many of their colleagues, felt that the definition of “risk group” refers to physicians who work in the spread of coronavirus infection.
As did the deputies and public men who came on may 17 at a meeting of physicians with the management of GP CRB.
But, as explained at the meeting with the medical staff, the chief economist of the hospital, Irina ilina, the risk groups are medical staff members who “work with biological material,” and they rely payments.
“Why us before it is said? Why not say in April? Why now…” asked one of the doctors.
“Regulation is new for us. We similarly asked questions in the [regional] Ministry, the Ministry, in turn, to the government of the Russian Federation”, – said Isaeva.
On 21 may, the MoH issued a clarification to the resolution 415, which implies that compensation can only count medical staff working with biological material.
According to the Farrier, therefore, is the substitution of the concept of “risk groups” and no reasoned narrowing of the range of health workers who can expect to be compensated for his work in the spread Covid-19.
From the new clarifications of the Ministry of health also follows that the General staff ambulance crews can’t count on the presidential pay, if they have not had to deal with patients with laboratory-confirmed coronavirus.
Paramedics Roman and Sergey work in General the team at the substation in the village of Chelm. Their team leaves for the challenges in other settlements, including remote, located at a distance of 40-50 km from the substation. It is the only ambulance to Chelm and the neighboring settlements.
With the beginning of the epidemic for patients with suspected coronavirus infection were identified, one ambulance crew, the rest had to work with patients where there is suspected Covid-19, told the Russian service Bi-bi-si the head of the Union Abinsky hospital of Larissa Kovalenko.
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“Each shift is allocated a team to work with patients with coronavirus infection,” confirmed the chief physician of TSRB Abinsk.
According to the authors of the video message, this division of teams in other infectious and doesn’t always work.
“We had two cases with suspected kovid. In the first case, the Manager reported that the patient complains of malaise, sore throat, and that she had come from Moscow. According to the anamnesis, people who came from other regions, especially from Moscow, it is assumed probably infected. Sent in my team, we went and we looked. The symptoms were the common cold, tests have no no. And its further fate is not known to me”, – says Sergey.
The colleague of the Novel says that potentially “covenin” can be even a challenge that doesn’t seem suspicious ambulance dispatchers.
“A second case – asked the Manager whether there was contact [with potentially sick] the patient. Like, no, said. But when we arrived, it turned out that it came from Moscow a son, two weeks lived, had left, and she had a fever for the third day held”, – says Sergey.
“According to the instructions for suspected coronavirus infection we had to call the infectious diseases team. We learned about the situation and reported to our management the senior paramedic then we were told to wear protective gear and carry the patient to the hospital. We had not yet the costumes were surgical gowns, gloves, beanies, ordinary medical mask. We got them back to the patient and began to prepare for transport, was taken to a hospital in Krymsk, specialized for patients Covid-19”, – says Roman.
According to Andrei Konoval, a division of ambulances on “govenye” and “noncommunicable” is beautiful, but an abstract plan, which in Russia is doomed to failure, especially in the context of the pandemic. He claims that even before the start of the pandemic ambulance crews across the country were in a state of acute shortage of staff.
According to the Union representative of the teams in the country and a half to two times less than recommended in Federal regulations. And besides, according to him, the General of the brigade often does not come with a second paramedic, and specialized transferred to status be General so as not to contain three paramedics. The farrier said that even with such a understaffed employees work at the rate of 1.5-2.
“If you send only specialized one just won’t come. Since the end of March in the regions where the coronavirus has gone in breadth, is the number of calls to SARS and pneumonia that have 99% of the teams to do specialized and in full to provide personal protective equipment. At the same time, it is necessary to provide other challenges. And in rural areas – there is a whole area of one or two teams, long distances, bad roads. That is a situation that is very hard division – an unrealistic plan,” emphasizes co-chair of the trade Union “Action”.
The head physician TSRB of the Abinsk on the question of the Russian service Bi-bi-si on the effectiveness of division teams on communicable and non-communicable said: “This is done in order to protect our paramedics. We have sick employees during this entire period no. So we’re doing the right thing?”
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Employees of the Kholm district hospital tell you how at the end of April an elderly man was allegedly waiting for the arrival of infectious brigade for about four hours at the same time, in order to pass the time while waiting, strolled in the hospital, out on the street.
“If he really was cowed, imagine how many people in the hospital during this time he was able to infect? We could do to get to a hospital in Krymsk”, – says Roman.
If the team of Roman then instructed to take the patient to the hospital, the staff of the brigade would have received the allowance only if confirmation of the diagnosis Covid-19 of the patient.
“The concept of “identified coronavirus infection” already suggests the possibility of different interpretations. At the moment, the authorities adopted an understanding that is laboratory-confirmed kovid. Moreover, antibody test, which is now done, is not considered a confirmation of the disease Covid-19″, – says Andrey Konoval.
At the beginning of April at the Congress “Man and medicine”, the chief freelance pulmonologist of Ministry of health Sergey Avdeev said that the sensitivity of the method of polymerase chain reaction (which is recommended by who for testing Covid-19) is about 70-80%.
At the end of April the mayor of Moscow Sergei Sobyanin is in the air “Russia 24” also said that up to 50% of critically ill by the coronavirus in the capital received two negative samples.
“Many patients these tests are not conducted at all. For a variety of reasons. Health care system are not yet able to provide universal testing of patients with signs of coronavirus. In this case we do know that approximately 40% of people with Covid-19 the disease is asymptomatic,” says butcher.
Immediately after physicians published in social networks a video message, they began to call in law enforcement.
“Asked who organized, which brought together. Said that such things cannot be removed,” – says Roman. In the end the police he was given a warning about the inadmissibility of extremist activity “during assemblies, rallies, demonstrations, marches and picketing” (a copy of the document is at the disposal of Bi-bi-si).
“You, as the organizer, are responsible for compliance with the legislation of the Russian Federation requirements concerning the order of holding mass actions and the prevention of extremist activity and its timely restraint”, – the document says.
Mass action, under the assumption of the paramedic, the police found the recording of the video message.
Publicly to this point decided to play only one team that works on substation in the village of Chelm. Other non-communicable brigade Abinskiy CRB, first going to support their colleagues, but then changed his mind and did not Express dissatisfaction.
Now, according to the authors of the video, they are being pressured – they are required to write a statement that claims against the hospital management on payments they have.
Almost simultaneously with the video team of Sergey and the novel of the same clip published ambulance staff Krasnoarmeyskaya CRH. They, too, were inspired by the example of colleagues from Armavir. Among the participants of the video message – ambulance staff being kept in quarantine after contact with a sick person Covid-19, and in the hospital with a confirmed Covid-19.
After that, video message of paramedic ambulance in Krasnoarmeysk questioned in the TFR, the investigator drew up a report on seizure of her phone.
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