Instead of the foreword
Over the past two decades, healthcare in the Republic of Kazakhstan has undergone great changes. Only here, unfortunately, this process did not affect the system for obtaining quotas. Quotas are an opportunity to receive treatment at a high-class medical center at home or abroad.
The most amazing thing is that no quota allocation system today exists at all. This is indicated by officials from the Ministry of Health. The unified national healthcare system in this country is designed in such a way that quotas are virtually inaccessible for the population. Any resident of the country has the right to receive medical care in any institution of the country. Moreover, only his choice determines the place of treatment.
Let's try to figure it out
The patient chooses a hospital in which it is more convenient for him to undergo treatment. He receives a referral from a treating specialist and also submits an application. These two documents are entered into a common database. As soon as the turn approaches, the patient is invited to treatment.
According to statistics, most patients receive an invitation after 3 days, some (30%) have to wait ten days. The waiting time is gradually reduced, as any clinic is interested in treating as many patients as possible qualitatively. The more patients they cure, the more revenue hospitals receive.
But it’s not so simple. It would seem that there are no obstacles here. But local provincial and district medical commissions hinder the flow of applications. As small regional and city clinics improve their technical base, their capabilities increase, there is no need to refer patients to the capital. On the other hand, sometimes there are no more places left in district clinics. In such cases, patients are also referred to the center. Thus, in the capital's clinics you can be treated at your own choice and in the direction of the local medical commission.
What about quotas?
They are provided only in case of very complex and expensive procedures. For example, in vitro fertilization. One treatment session costs a million tenge. Of course, such money can pay units. About 6 hundred quotas for IVF are allocated per country per year.
Of course, a small part of those in need gets foreign treatment. Medical officials explain this not by the fact that the state allocates less money for quotas, but by the fact that today very many types of treatment are available in Kazakhstan itself. Liver, bone marrow and kidneys have already been successfully transplanted here, and not only that. The issue of donor organs is acute. Since religion does not encourage the use of the bodies of the dead or deceased for medical purposes.
Is this really so?
A clear and beautiful picture portrayed by employees of the Ministry of Health is destroyed by members of charitable and social organizations. It turns out that everything that was described in the article earlier is just a model, far from always applied in practice.
Indeed, everything was invented wonderful, but how is this done? Doctors often send sick children and their parents home, claiming that the disease is incurable. This occurs in most cases from a lack of competence. After all, medical science is constantly evolving. But if the doctor received his diploma twenty years ago and since then has not improved his qualifications at all, then he has hopelessly lagged behind modern realities.
A big problem in Kazakhstan with diagnostics. Sometimes doctors for some reason do not give direction to research in the capital or regional clinics. In some cases, they receive instructions from their bosses to treat patients on the spot. Referral of patients to the center can have sad consequences for small clinics - they are being cut back on financing, their rating is getting worse.
Sometimes the direction is not issued only because there are not enough funds for the diagnosis and treatment of the patient. But what does the local doctor care about money? His problem is to cure the patient. Unfortunately, in practice, everything is a little different.
Many doctors hesitate to refer patients for treatment according to quotas, so as not to be accused of squandering them. With such a vicious practice, only parents who seek and pierce walls with their heads can receive a quota for their child . But there are very few moms and dads who are quite knowledgeable about their rights. The vast majority believe in doctors, and their children are left without help. And to bring information to the public is not profitable for the medical staff themselves.
Health workers disagree
According to employees of the Ministry of Health, any patient ultimately chooses the place of treatment. The doctor’s business is only to determine the disease. But the whole process rests primarily on the ignorance of patients. There is practically no information about the possibility of treatment abroad. No instructions on the topic: "How to achieve a quota for treatment?" also does not exist. Of course, it is impossible to obtain this information at local medical institutions and even on Internet sites. No one is trying to convey to patients (many of whom are elderly and seriously ill people) information about the possibility of cure.
The problem is that the instructions for doctors, on the basis of which they refer patients to treatment, are not quite correctly composed. They mean a lot of tricks and opportunities to refuse a patient hospitalization.
Where does the money go?
Even the most debugged mechanism can fail. One such case will be described later.
A girl aged two and a half months suffered a cerebral hemorrhage. Doctors did not find any violations and sent the child for vaccination. 5 days after vaccination, the child's temperature jumped, the parents called the therapist to the house, which gave direction to the infectious diseases clinic. The girl was in a coma in the intensive care unit for a week. And only after 7 days in the hospital, parents were informed that the baby had hemorrhage. For a year, Kazakh doctors tried to cure the child.
The parents of the girl had no idea about the availability of quotas and the possibility of treatment abroad. Local doctors, on the other hand, set their parents to believe that the child was not a tenant. Someone from my friends advised me to try to treat my child in Urumqi. Parents drove the child there at their own expense.
Only after the journalists drew attention to the case, they called their parents from the medical department and informed that they were given a quota. Only now they didn’t specify - where to turn now, and what papers are needed for departure. The quota was on . During the preparation for the departure, it turned out that the doctors of the clinic where the girl was taken out did not have specialization in the treatment of brain atrophy. Parents contacted officials from the Ministry of Health, to which they received an answer: got a quota - go to therapy. There was no intelligible answer to the questions about how much money was allocated, which doctor will treat the child. Upon arrival for treatment in Israel, the child was kept in the hospital for 10 days and diagnosed. Its result was: the child does not have a convulsive syndrome and epileptic phenomena, therefore, he should be discharged and sent for rehabilitation treatment at the place of residence. And in this clinic in Israel, such treatment is not carried out. That's the result of the spent 50 thousand dollars. This is not a unique case - the Internet is full of similar stories of residents of Kazakhstan.
What to do?
Ministry of Health staff should think about how to convey information about quotas and treatment options to each patient. People should know that they can be treated not only in a rural hospital, but also in a metropolitan or regional one. It is very convenient to use the Internet for this purpose. One could develop a website that provides all the comprehensive information about treatment options.
However, the main work with patients should be carried out by local doctors. The contact between the patient and the doctor is very important, it is at the doctor’s appointment that the patient should receive the maximum information about where and how to be effectively treated in the country or abroad.