ASTANA – The 100 concrete steps to implement the five reforms defined by President Nursultan Nazarbayev cover the issue of improving national health care. This was the subject of a recent conversation with Vice Minister of Health and Social Development Alexei Choi.
How is Kazakh medicine developing in practice?
The President instructed us that Kazakhstan should implement and master all the latest medical technologies, so Kazakhstan’s citizens can get high-quality medical care at home. Moreover, all these high technologies should be available to any citizen of our country.
In recent years, domestic healthcare has received major investments, both for the purchase of modern equipment and medicines, as well as for the education of doctors.
A lot of Kazakh physicians receive training in the best clinics in the world, and we are sending doctors abroad, not only from large medical centres, but also from the regions. In addition, the number of master classes, where foreign worldwide known experts come to us and provide training on-site for our doctors, has been increased. In addition, foreign doctors also perform complex operations in our own facilities.
Here a psychological factor is important: our doctors see that it is possible, that the latest technologies in medicine are practicable, and, secondly, that Kazakh specialists can then conduct master-classes for their colleagues from the regions.
Hospitals in Almaty are developing very dynamically. Now some municipal health care institutions are not worse than national ones, and some of them are better and with better equipment and personnel. It is encouraging that new hospitals and clinics are being built, not only provided with excellent equipment but also with a highly qualified staff.
It should be noted that the wages of doctors are increasing from year to year, and now are higher than in the general labour market. Therefore, for our young people choosing a profession, there is an incentive to go to study in a medical institute. Of course, the study takes up to seven years, but then there is a confidence that they will always find work, and that the salaries of a doctor will allow them to live with dignity.
And more importantly, and this is emphasised in the Plan of the Nation, the level of salaries of health care workers will depend on their contribution to the work, and, of course, the level of their professional skills. So it will be economically unprofitable to be a bad doctor.
Can we now say that our national health care is close to the international level?
Definitely. Now almost all of the technologies that exist in world medicine are used in Kazakhstan. Of course, there are problems and we do not hide it: our hospitals often do not keep up with innovations in terms of equipment; there are problems with the quality of care. But if, for example, organ transplants are considered to be the most complicated operations, they have been performed in Kazakhstan for a number of years. Liver transplant surgery, for example, was considered almost unattainable for our surgeons not long ago. Now such operations are performed, even at the regional level. Kidney transplants have become common practice; they are now provided in seven centres. Now, more and more foreigners come to us for treatment, and not only from the neighbour countries, but also abroad.
What is being done to reduce the gap between the major medical centres in Astana and Almaty cities and regional hospitals? Can people from the provinces access the same technologies as in the major cities?
In each regional centre or village it is not possible to build an ultra-modern hospital; moreover, this must not be done, we should look for other ways. For example, one of the 100 steps … includes priority funding for primary health care. Primary care would be central to disease prevention and their early treatment.
Now, an office of the World Health Organisation (WHO) is opened in Almaty. This is very important because there are a limited number of the regional offices of the WHO in the world and there is only one on primary health care, and it is located in Almaty. Many experts and specialists from Europe will hold conferences here, and training seminars, which will be an additional impetus for the improvement of our health care.
In addition, there is an order by the President for the construction of 350 family regional medical clinics, and the work programme “100 schools-100 hospitals.” We constantly visit different regions of Kazakhstan, including the remote places, and see how neat well-equipped, complete with a professional staff outpatient clinics are appearing in the villages.
As an example, I can cite the following fact: if the average salary plan for the village is $268–$322, a young doctor immediately gets about $967. Doctors in rural areas are very popular. … In rural areas, young doctors are immediately provided with accommodation, overhead, that is, many of life’s problems are solved.
As to whether the villagers can receive medical care of international level – of course, they can. Patients who need it are passed along a chain of rural hospitals through to major regional specialised medical centres in Almaty and Astana. A great helper in providing emergency medical care to people in remote villages becomes sanitary aviation, which is also well developing in our country.
In addition, physicians from Almaty, as well as from Astana, provide assistance to the regions, making visits during which they not only perform operations, but also train their colleagues.
What are Kazakhstan’s health care problems?
There is the process of population’s ageing, so we need to develop gerontology, the science of ageing and geriatrics … . In addition, it is planned to focus on childhood, because if children are healthy, we will have a healthy generation, a healthy gene fund for the nation, as is always mentioned by our President.
What is being done to improve the quality of health care?
As you known, in the near future it is planned to introduce health insurance, what is one of the targets of the 100 concrete steps, so I think it will change public health care a lot. The financial sustainability of health systems based on the principle of joint responsibility of the state, employers and individuals will be strengthened, and there will be additional opportunities to expand the scope of public health care, which is limited in our country.
As for the quality of medical services, we are working on it, perfecting the Service of Patients Support. If someone is not satisfied with the quality of service, if something is not done according to the standard, and so on, the patient can contact these centres by phone or e-mail with the claims. I assure you, every complaint will be considered very carefully.
In addition, at the level of health departments and healthcare quality control committees there are special blogs and hot lines. And I must say, people contact us very actively. If in some area the number of complaint becomes greater then appropriate, administrative solutions are taken to improve the situation.