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Home / policy / “Optimized” medicine. As Sergei Sobyanin has deprived Moscow of protection against coronavirus

“Optimized” medicine. As Sergei Sobyanin has deprived Moscow of protection against coronavirus

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

The city authorities to urgently build a new infectious diseases hospital in Moscow. And pereprofilirovanie existing health facilities under the treatment of a coronavirus. Because of this, some patients, such as cancer patients, just <ins>stopped </ins>to get treatment. And just a few years ago on the initiative of Sergei Sobyanin massively closed hospitals, including infectious diseases, part of the so-called optimization of health. “Base” is calculated how much the city lost then hospital beds and who in the end came out a winner.

Since the beginning of March on the orders of mayor Sergei Sobyanin between villages Golokhvastovo and Jane in New Moscow in the emergency mode, to build a new infectious diseases hospital 900 seats — especially for cases of coronavirus. - услуги фрилансеров от 500 руб.

Official data, how much it will cost, no. Officials build a hospital without the usual competitive procedures. But it is now clear — the account goes on tens of billions of rubles. At the site in shifts <ins>work</ins> 10 thousand builders. As <ins>told the media</ins> Vice-mayor Pyotr Biryukov, a new hospital is being built “almost in the open field”, which increases its cost because you need to build and network engineering.

Free recently, a tender MOESK to conduct electricity to the hospital network will cost 1.6 billion rubles. There are another two tenders of waterworks — system drainage (the total amount of 212 million rubles). Based on these costs, according to “Izvestia”, with reference to its sources <ins>reported</ins> that the price of construction of the center will amount to 40-50 billion rubles, seem closer to the truth than the figures announced by officials of the city hall (5-7 billion).

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


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But it’s not all costs. Sergei Sobyanin, April 8, was ordered to allocate capital to hospitals “to combat the spread of coronavirus infection” 5 billion rubles. The money will go to redesigning clinics, their preparation to receive the sick from the new virus.

A little bit about the logic of the mayor, or rather its absence. On <ins>words</ins> Sobyanin, a place for the construction of a new infectious case was deliberately chosen away from large residential complexes: “Sewer effluent will be displayed on Autonomous sewage treatment plants, are equipped with decontamination systems… the Next individual houses located 250 m from the future hospital, which is 2.5 times more than the required canzoni. And I guarantee that there is no danger for the local residents it will not submit”.

Why do we talk about infectious security housing outside the city cost about 50 billion roubles, unless at the same time you converted thousands of beds in the existing hospitals located within the city limits?

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


Today patients already taking coronavirus in Filatov, the Morozov hospital, the medikit in Kommunarka, infectious diseases hospitals No. 1 and 2, the hospital in Shabolovka, a children’s city clinical hospital named after Z. A. Vashlaevoj, and a dozen other hospitals. Coronavirus hospital, opened even in the hospital for veterans of wars № 3. They are all in the city that the mayor does not bother.

In the near future the number of Moscow hospitals receiving patients with coronavirus will increase. “We are starting this week to accept patients under the “crown”. One of the buildings was urgently released from the remaining patients”, — told the staff of the 1st City.

Moscow authorities themselves admit that the healthcare system of the capital were not ready for such a large-scale epidemic:

— The number of patients with pneumonia compared with last week rose more than doubled (from 2.6 thousand to 5.5 thousand). Along with the growth of critically ill patients has dramatically increased burden on municipal healthcare. Now our hospitals and ambulance service are at the limit, Deputy mayor Anastasia Rakova.

Rakova has promised that in the next two weeks, the city health system an additional $ 10 thousand beds for patients with coronavirus. That means about two dozen Metropolitan hospitals will be converted into the treatment of patients with coronavirus.

Inefficient infectionsi

The current actions of Metropolitan municipality for combating coronavirus resemble military actions: mobilize all forces to fight the epidemic, regardless of the cost and common sense. And more recently, the mayor believed that Moscow is the oversupply of hospitals. Optimization was explained like this: you need to close inefficient hospitals and transfer them load effective.

Among the officials cited arguments highlight two. First, it is the age of advanced medical technology, and earlier if the patient was lying on the bed almost a month, now just a few days. Second, Sobyanin said that the optimization is concern about doctors: “If we have not optimized the number of administrative staff, beds in Moscow, costs, unnecessary costs… Wages of Moscow doctors would be not 140 thousand, and 70 is two times less.”

Video: the social network

One of the first came under the knife, so much needed now the infectious diseases hospital. Interestingly, by the time they close the world has experienced a pandemic of “avian” and “swine” flu, which showed a high fatality rate and rapid spread across the world. It is unclear what the effectiveness of the municipality wanted from the hospitals, the profile of which is saving lives in emergency situations.

In 2014, shut down the infectious diseases hospital № 3 on the 1st Kur’yanovskaya street. There were 420 beds. That is about the same, how many will be built in New Moscow for tens of billions medical center. But it’s not just about the numbers: it was one of the largest infectious hospitals Moscow, intended for the treatment of patients with especially dangerous infections and HIV. In addition to the nine infectious units in the 3rd hospital intensive care unit. Plus 350 staff person whose primary specialization is Virology.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


Now, the hospital is closed Technopark “Messepark” (city-owned) that provides “the infrastructure companies in the field of biomedical technology, pharmaceuticals, IT and electronics”. The site indicated that the residents were 32 companies and two clinical research centre. On specific companies, sitting in an industrial Park is little known, a complete list of residents there. As follows from the data of Rosreestr, the company “Sert-clinics”, which is engaged in clinical research, rented one of the buildings of the Technopark. In General, according to <ins>the website</ins> “Monetary”, its main activity is the leasing of warehouse and industrial complexes.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

Photo: “Base”

Warehouses and offices is good, but now would hospital more useful. If not eliminated, it could be used for the treatment of coronavirus. Moreover, to update the clinic would be much cheaper than to build anew, especially in the open field.

— If optimized hospitals were “on the move”, that is now would work, they can tailor them to the coronavirus not so difficult, says the former head of the Institute of General plan of Moscow Sergey Tkachenko. — Reverse engineering system, to put some other equipment to replace… ventilation If the building is not brought to the state of emergency, all things are possible and not so expensive. You do not want to touch walls and ceiling. The level of complexity is how to overhaul and redevelopment. Nothing special about it.

Director of the Institute of health Economics HSE Larisa Popovich believes that closing medical facilities was needed: “They were not adapted to increased demands for comfort and modern technologies. Then there were some strategic objectives, which was to optimize the number of beds, and now others. Now the situation is urgent, extreme even. When the epidemic passes, all medical facilities that now are under a coronavirus, will return the reduced capacity of the period”.

In 2012 it was closed also two children’s infectious hospital № 8 in Luzhnetsky proezd № 12 on the 1st street Yamskogo polya. The building was old — built in 1938. But not only that officials have described the reason for the closure. Nikolai plavunov, who was then first Deputy head of the Department of health, spoke about their ineffectiveness. “The bed works 180 days a year, and the remaining six months idle” — <ins>said </ins>it. In total, the two hospitals were 300 beds.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


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No one took into account the opinions of the doctors who <ins>claimed</ins> that the result of the optimization will be liquidated one of the most stable and efficient operating centres for paediatric medicine. Do not pay attention to the fact that shortly before the elimination of the building of the 8th hospital was renovated. According to doctors and patients in the 12th hospital of infectious diseases, despite the old buildings, was a unique Allergy Department, unique in Moscow did not exist.

On <ins>opinion</ins> and doctors, and patients, the only reason the hospital closed, expensive land in the city centre, which housed the medical facilities.

The city finally allowed to demolish the hospital of the company “Medstroyinvest” the businessman from Kazakhstan Zhomart Kamenova, so she built a hotel there and a club house. As compensation, the company has built an infectious case for a children’s hospital named Speranskii 200 bed — that is one-third less than in carried infektsionke.

And in place of the demolished children’s infectious disease hospitals “Medstroyinvest” not built ANYTHING! In Luzhnetsky passage was supposed to be a hotel-apartment, but there is still a vacant lot. According to the Rosreestr, in March 2020, it was transferred to the Historical Museum in perpetuity. As <ins>reported</ins> RBC, there will be built a Museum dedicated to the history of the Russian Orthodox Church and the Novodevichy convent. History of the ROC is, of course, more important than the health of Muscovites.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

A wasteland in place of the 12-th hospital for infectious diseases. Photo: “Base”

On the site of hospital No. 12 is also a wasteland. In the statement of Federal registration service has no information about whose property and rent it right now. In 2015-2016, the Department of city property of Moscow pleaded with the Federal registration service, which refused to register the lease contract of the Department with the “Medstroyinvest” on this site. The Federal registration service stated that the area went to companies without bidding and it’s illegal.

According to Rosstat, the number of infectious beds in Moscow has decreased twice: if in 2011 there were 4823, in 2018 — a total of 2661.

Thanks to the Ayuntamiento, the city has lost hundreds of professional doctors, years and decades have dedicated themselves to combating the most dangerous infectious diseases.

“I wrote in 2014, Moscow mayor Sobyanin that the reforms Pechatnikov (Leonid Pechatnikov, a former Deputy mayor for social development. — Approx. “Base”), wrong, especially in terms of the tangent of infectious beds that you can not reduce infectious beds, as they always must be in reserve,” — says the doctor of medical Sciences, Professor Guzel Ulumbekova.

She is confident that the decision to streamline has led to what is now the town can not cope with the epidemic: “In Moscow was taken just the most despicable decisions that have moved the funding of infectious beds, infectious disease hospitals and emergency medical care in OMS. These types of aid can never be financed! What does it mean? It means patient — you Finance, not the patient, do not get. Accordingly, the institution is forced to shrink. It absolutely was impossible to do. In Soviet times we always had reserve beds, not only infectious. Always the ambulance service and infectious diseases service, regardless of whether there are patients or not, needs to be in standby mode. We can’t bind to the MLA, that’s why even today, we have a serious problem.”

Clinic for Chapter destava

A shortage of beds has, not only on patients with coronavirus in any case treat, put one in Kommunarka, who redeveloped offices in Metropolitan hospitals. But for the rest of the patients fell on hard times.

Patients in critical condition and in a state of moderate severity transferred to other hospitals, the rest simply cease to be treated. “All patients of the departments of urology and gynecology transferred to other corps. Doctors say that almost all transferred to work with coronavirus patients to deal with us there will be nobody”, — told the “Database” patient 1st City.

As reported by <ins>media</ins> the paramedics trying to get to the hospital even with fractures: elderly woman, who received multiple fractures of ribs, refused hospitalization. Only a week later, already in critical condition is admitted to the hospital, but it was too late — the woman died.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

Photo: social networks

“In one patient, thrombus, and she at the end of March were preparing for the operation. But she said that this whole situation surgery was canceled and when to hold unclear. Needless to say that the clot — the kind of thing that can lead to serious complications or even death. In General, almost all urgent patients were sent home. Take only an emergency and fractures,” says the doctor at one of the capital’s hospitals.

The fact that the situation in other city hospitals, confirms the story the other nurses of the hospital: “We have released approximately 500 beds for patients with coronavirus. What about those who lay here? Who could all go home. Only very heavy was transferred to other corps. Operations reduced to a minimum: patients with cancer and those that arrive by ambulance. Appendicitis or something similar. Others have been told to wait until the end of quarantine.”

And how many people who have no coronavirus, but which needed mechanical ventilation, had not received it? Almost all Metropolitan hospital sent their medical ventilators in Kommunarka or hospital, redeveloped for the reception of patients with coronavirus.

As <ins>told </ins>MK, a cancer patient at the rehabilitation centre interrupted the course of radiotherapy, which must not be interrupted, and do not redirect. And here again it is worth remembering the hospitals (already with very different profiles) that were closed as part of the optimization.

If you take the whole “hospital bed round the clock hospitals”, their number in 2011-2018 year decreased from 107 thousand to 78 thousand.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


The majority of the private health facilities are indicated in the special terms of optimization, which was developed by city hall in 2014. As <ins>reported </ins>RBC with reference to this document, it was scheduled to close 28 medical institutions including 15 hospitals.

“Base” ordered the building at the discharge on all these buildings and found that some of them were transferred to other health facilities (which the municipality considers to be more effective), and some hospitals really are gone. Now in their place, private clinics, College, mail…

For example, in the street Dostoevsky was a hospital No. 59. There were 541 beds in departments of internal medicine, cardiology, surgery, traumatology, Orthopaedics and otorhinolaryngology. Now the hospital is closed and all its premises are given to the Moscow Fund OMS — the very structure that dictates the rules of optimization. The hospital eliminated to put on this site officials. Apparently, they are more effective, according to Mr Sobyanin, the doctors.

Another example: hospital # 56 on Paveletskaya embankment. The total bed stock (together with the adjoining gynecological hospital No. 11) was 650 beds, and in the year there were treated 14 million patients. At the clinic he worked microsurgery Department, which was established to carry out highly specialized care to patients in need of reconstructive operations on vessels, nerves, tendons.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

The building of the 56th hospital. Photo: “Base”

In addition, a unique specialty and had the Department of purulent surgery — it helped the patients bites. In <ins>an interview</ins> in 2013, the head physician of the hospital Irena Pogonicheva told about the imminent completion of the overhaul, and shortly before the elimination of the hospital received 59 pieces of modern equipment for a total amount of 76 million rubles.

In spite of the demand, a unique specialization of a number of offices and expenses for repair and equipment, the hospital “optimized”. The building and land transferred to the Medical Control center of Affairs of the mayor and Moscow government, i.e. the school officials. And again about efficiency: for five years the medical center has received more than 1 billion loss.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

Source: “SPARK-Interfax”

On the waterfront was Shitova hospital No. 54. There were 230 patients in the departments of internal medicine, cardiology, neurology and surgery. Now there is the Moscow state law University named after O. E. Kutafin (MSLA). Eliminated in the medical unit No. 33 in the malachite the street was 460 beds in departments of internal medicine, cardiology, neurology, surgery and gynecology. Now the building belongs to the “Moscow post office”.

Here’s a very revealing story. At Orsha the street / street of Academician Pavlova was located maternity hospital № 72, Moscow center of uroandrology and reproductive gynecology. The hospital was designed for patient 301. The building and all the land conveyed “the Clinic Lyadov”.

Konstantin Lyadov — surgeon, nurse, honored doctor of Russia. He directs the Agency and is a minority shareholder of the company. A principal owner (90%) — “Medinvestproekt”. This firm belongs to the “Pharmstandard” billionaire Viktor Haritonin (85%), company “AI PI ti medicine” (13%) and George Golukhova (2%).

Golukhov in 2012-2014 was the head of the Department of health of Moscow — that is, he developed a plan for the closure of hospitals and the results of the “optimization” went into business and got a small bonus in the form of shares in a private clinic, where only one consultation can cost 12-18 thousand.

The buildings of the clinic are decorated with “Cultural and educational center Drummer” that belongs to “Metinvestu”. One building (with an area of 2.5 thousand square meters) “the Drummer” the city sold four more (a total area of 18.6 thousand square meters) leased. Now, the former hospital is in full swing construction of the medical center. According to the “Medinvestproekt” it <ins>prepare</ins> the patients with COVID-19. Not only as Moscow authorities reminded the owners that it would be nice to pay debts for received at the hospital. However, this is a small price to pay for a few buildings with a total area of 22 thousand square meters.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

Photo: “Base”

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Funny on the street were demolished psychiatric hospital № 7. Within and<ins>investcontract </ins>of the city with “Medstroyinvest” Zhomart Kamenova last planned to build a hotel there with a medical center. But, as in the case of children’s infektsionke, haven’t built anything. In the form of compensation (for permission for the construction of commercial real estate) the firm had to build housing for the children’s hospital No. 13 named after Filatov. This package on the website of the company at<ins>cauldron t</ins>just as designed. The firm had to take it back in 2008. In 2010, the city sued the “Medstroyinvest” about the lease of land for construction of hospitals — it has not begun.

Also under the contract “Medstroyinvest” was to build luxury housing on the street Krasin (the territory of the children’s hospital named after Filatov) and in a Large Baptist lane (the area of the Botkin hospital No. 3). But these sites he did not commit. Zhomart Kamenov for their failures really hurt for the mayor’s office and even filed a lawsuit against the city by 16.4 billion rubles. The meeting is postponed to June 2020 due to the coronavirus. Got it from Kamenev and physicians as <ins>reported</ins> in 2014, he was beaten emergency physicians in Gelendzhik, which didn’t give way it “rolls-Royce”. It seems that the mayor and his subordinates know how to choose effective partners.

Another beneficiary optimization billionaire Vladimir Yevtushenkov and its structure, received from the city several hospitals. In 2012 was made a major transaction: GUP “Medical center” (owned by municipality) and “meds” (beneficiary company Yevtushenkov) United. Then sue bought the additional share issue of the group’s 6 billion, but paid no money, and hospitals. As its share in equity of the group (of 25.02%) sue invested three adult clinics, one hospital and three hospital with inpatient facilities. According to experts, the transaction was not entirely fair: with this contribution, the municipality initially could claim a large share of the group. And four years later, AFK “System” (the company Yevtushenkov) bought a share of the city in 6.1 billion rubles.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса


One of the hospitals located on Pyatnitskoye highway in Krasnogorsky district of Moscow region. The city gave the building a total area of 71.3 thousand square meters, the company Now has, rebuilding the complex, call it their “flagship multidisciplinary hospital”. Another hospital — medical unit № 47 (hospital of Glavmosstroy) on Michurinsk the prospectus. After the transaction, the hospital a few years it was closed. In 2017, as reported by “Vedomosti”, the municipality approved the plan of the group development phases: it is planned multi-storey residential buildings on 132,000 sq m medical centre (total area — 28 sq. m).

Not far from the Nagatinskaya floodplain located hospital No. 53 — in the framework of the “optimization” transferred to hospital No. 13. As a result, 40 thousand square meters for several years are closed with a dozen of buildings (total area of 23 thousand square meters).

There were 380 beds in departments of internal medicine, cardiology, surgery, urology, gynecology. By the way, the 53rd hospital closed in 2015, and a year or two previously there had been renovated for 12 million rubles. “Three years ago, according to the staff of the hospital buildings was renovated and introduced a new, most modern equipment. Now the equipment is dismantled, and the buildings prepared for demolition,” <ins>wrote</ins> media. At the same time sounded the version that the place of the 53rd build an elite yacht club.

The yacht club, as there is no hospital, whose body could take hundreds of patients in the midst of the epidemic.

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

«Оптимизированная» медицина. Как Сергей Собянин лишил Москву защиты от коронавируса

Photo: “Base”

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Large-scale optimization of the number of doctors in Moscow has dropped from 90 to 73 thousand.

Doctors are now lacking as well as beds. And salaries of doctors, which was the argument of the officials for carrying out the optimization is not so great. In the recruiting portals the majority of jobs in urban hospitals — is salary from 70 to 125 thousand rubles.

— When the mayor is talking about salaries, it’s not that is the average temperature in the hospital and that calculation includes the salary of the chief physician and his deputies, — said the EMT Dmitry Belyakov. — A simple physicians are forced to take 1.5, if not more, the stakes then are more or less normal money.

Those who are currently working with a coronavirus, promise to pay, but not always. “We are now working at home, and in Kommunarka. Shared sessions: one worked at the local hospital, the second one there. Promised to pay, but it’s not exactly” — says one of the employees of a large Metropolitan hospital. “We are in an order also said will be part of the shift to work in Kommunarka. Say: and who does not agree, let him write the statement. While no charges not promised,” says the doctor in another clinic.

According to experts, the so-called reform in health care has not solved a problem of wages, no problem of quality medicine. “What happened in Russia in the result of optimization? We see that the flow of patients has increased by more than 10 million people is a lot. The total number of doctors has decreased over the past six years 46 per thousand, hospital beds decreased by 160 thousand. In Moscow, the reduction was even greater,” said Professor Guzel Ulumbekova.

All of today’s problems related to shortage of doctors, beds and hospitals, the Moscow authorities can, in her opinion, to blame only yourself, “Rakova said that doctors are overworked. A third of medical staff are completely dedicated to the fight against coronavirus. And where is your promised results of the optimization, when doctors had to become more efficient and get more?”

The press service of the city hall answered questions from the “Base”.

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