The main mission of the social state
The social sphere is one of the most vital for the wellbeing of our citizens, and remains incredibly complex, governing our health, the education of our children, and the care and comfort of our elderly people
Ms. Kochanova, which key events do you wish to highlight from 2015?
It’s hard to say, as there were so many, and they are truly diverse. I’ll focus on the President’s signing of the Convention on Disabled People’s Rights, which approves the principles of state policy towards this category of citizens. Our task is to ensure equal opportunities: for disabled people to gain access to education, and employment, and for society to view them on an equal footing. Ratification of the Convention envisages a major package of measures for the long term, ensuring that disabled people can fully participate in society.
Additionally, thanks to recognition of the Belarusian health care sphere’s achievements by the international me-dical community, last October, Minsk hosted its first ministerial-level European conference: ‘Life-course Approach in the Context of Health 2020’. It was organised by the WHO, in cooperation with our Health Ministry.
A wide range of issues was discussed in Minsk and the best European experience shared, on preservation and promotion of health at all stages of life. As a result of the conference, the Minsk declaration was signed; it’s a strategic tool aiming at uniting all European countries’ efforts to improve health, from birth until death. It’s built upon three pillars: prompt action, quick treatment and joint action. It’s a patient-oriented approach focused on early prevention and interdepartmental interaction, aiming to increase life span and quality of life for our citizens.
The opening of a molecular and genetic laboratory of carcinogenesis and the Positron Emission Tomography Centre, at the Republican Scientific-Practical Centre for Oncology and Medical Radiology (named after N. Alexandrov), is a milestone too. Belarus is among the first states to have introduced individually tailored medicine.
There should be more of us
Last year saw an interesting trend of rising birth rates, and rising average life expectancy. What measures are influencing this?
You’re right. We’re registering positive dynamics in this respect, with the demographic scissors almost closed. We’ve been pursuing a particular policy, supported by the President and the Government. Undoubtedly, two main programmes of national demographic security are yielding fruit and we must continue promoting the trend. In 2015, the birth rate indicator stood at 12.5 permille (with mortality at 12.6 permille). If we continue, I hope we’ll achieve a natural increase in coming years.
As regards the level of access to reproductive health services, Belarus now rivals France, Finland and Luxembourg, and is listed among the top 50 for care during pregnancy and childbirth. It is ranked 26th for comfort during motherhood and 4th best for levels of infantile and maternal mortality. We never predicted such a growth in our birth rate. 2014 was a record year, with 114,000 children born, rising to 119,000 in 2015.
The positive increase in population is mostly down to immigration; however, we are close to ensuring the same figures even without migrants. Minsk is demonstrating good birth rates, giving a positive balance, and we hope that other regions will soon ‘catch up’ with the ca-pital. Naturally, we have to plan state financing to deal with this situation, such as by strengthening our material and technical base for healthcare and education. This year, 2016-2020 ‘The National Health and Demographic Security’ state programme was approved, extending processes to support continued demographic growth.
Has maternity capital been an incentive in this respect?
No doubt, this programme has made its contribution, as have others adopted at Presidential level (such as measures supporting families raising children). We have eleven types of such allowances, though I won’t list them all now. As regards maternity capital, 11,500 families have applied to receive it. We’re registering greater numbers of ‘large-size’ families: up from 77,000 to 80,000 at present.
Of course, we want families to raise children for their own pleasure, rather than for material benefit. The state has no wish to encourage the birth of ‘unwanted’ children. At present, 21,000 children are under state care, and most (80 percent) have living parents (deprived of their parental rights). Families need to be strong, with our younger generation given good examples to follow. The state has no desire to see more children taken into care.
Are the professions of teacher, doctor and social worker losing their prestige? Is this a real threat to the social sphere or only a temporary phenomenon?
I often remark that the professions of teacher, doctor do enjoy prestige. They’ve always been respected in society and I don’t believe that this will change. However, they may need to work to enhance their image and earn the respect due to them.
We know how challenging it is to gain a place at medical institutions and to graduate, so it would be bizarre for this to not entail prestige.
Opinions on teachers differ but I must note that, last year, there were six times more applicants to the Belarusian Maxim Tank University than in 2013. Meanwhile, these applicants had graduated from school with gold medals. Some specialties were oversubscribed by 100 percent in 2015, even for remote learning. All places at the ‘Russian Language and Literature’ of the Philology Department were taken by medal holders and contract specialists. Interestingly, there are fewer entrants as a whole. In addition, 103 profile classes focusing on pedagogics operate countrywide, training over 1,200 pupils. With this in mind, personnel-related issues in the field of education appear pretty much settled.
Many speak of teachers’ low salaries…
Each state funded establishment can apply for extra finances if they need to retain their staff (with money coming from bonuses or from non-budgetary funds). Experience and specialism count for a great deal. I often chat with teachers when I visit schools and their attitude towards salary does vary. One gymnasium teacher admitted that her wages are even higher, sometimes, than those paid to the director: she receives Br8-10mln a month, but never less than Br7mln. Others mention similar cases. Of course, to earn more, teachers need to perfect their knowledge and skills, and take on extra responsibilities, such as school clubs (or ask for overtime). They work hard but there are always opportunities to earn more.
About a thousand of babies came to life at the probationary ward of ‘Mother and Child’ RSPC
Doctors to be protected
The high level of our health care was recently praised at the WHO European Conference. However, people tend to mention a mismatch between the sphere of high technologies (such as transplantology, oncology, and traumatology orthopaedics) and out-patient services. They see lack of personnel, queues and lack of information.
You’re absolutely right. At a recent collegium of the Health Ministry, I put the question directly: although our doctors work hard, saving hundreds of thousands of lives, a single visit to a polyclinic can change a patient’s view of the system, if they experience poor communication with local health workers, or receive an incorrect diagnosis. Accordingly, we’ve been focusing on the work of polycli-nics, to make them more effective, with modern equipment and computarisation, overseen by the Health Ministry.
The WHO ministerial conference spent time discussing the need for early diagnosis, so that necessary treatment can be administered. It’s vital to access doctor consultation promptly, so we need to employ competent specialists at our primary out-patient clinics.
We have seventeen Republican centres, using the most advanced technologies and modern equipment; it’s important that our regions enjoy the same technologies as the capital. It’s often true that ‘gossip’ spreads when there are unfortunate cases, and the medical profession is no exception. If someone has a bad experience, they’ll spread rumours about a doctor not knowing their job.
We’ve long been transferring emphasis in our health system to primary care. However, the Health Ministry has been paying extra-special attention in recent years, having been granted increased funding (at least 40 percent of the total amount of health care financing). This is allowing us to develop the material and technical base of polyclinics and out-patient establishments, while introducing new technologies of diagnostics and treatment. Much is being done to improve them.
By Alexander Benko