Civic Chamber presents results of quality monitoring of medical and social assessment institutions
The results of a quality assessment of medical and social assessment institutions were presented at a round table as part of a study entitled ‘Problems faced by people with disabilities: priorities and substantive approaches’.
The study revealed that employees at such institutions are either unaware of changes to existing legislation which make it easier to examine and re-examine people with disabilities, or they are overcautious, stated the Vice-President of the Civic Chamber of Russia on social policy, industrial relations, trade union relations and the support of veterans, Ekaterina Kurbangaleeva.
In March 2018, a decision was taken by the Government of the Russian Federation to change the regulations on how people with disabilities were examined. Regarding children, a new list of specific diagnoses, used to diagnose disability during an initial examination when the child is aged 14 to 18, was introduced. Previously, children with disabilities had to prove their status once a year. The changes also affect the individual programme of rehabilitation and habilitation.
The quality assessment of the social and medical institutions showed that clinics were the main way that patients obtained information about examinations. According to Kurbangaleeva, clinics were the only sources of this information. She stressed the necessity of making medical and social assessment institutions more informative and the need to engage public organisations and civic chambers in information campaigns, given people had previously encountered a lack of information about examinations.
The analysis also revealed that one in three to four patients receives a referral for examination within just over a month, while many people wait two months for a referral. Kurbangaleeva notes that this is due to a lack of qualified staff.
The study showed that in some cities, it was not possible to make an appointment at the medical and social assessment institutions by telephone. Moscow was not immune to this problem: while telephone appointments could be made in the city, getting through to the right number was practically impossible. The majority of patients don’t consider the need to visit the institutions a serious problem because they think that attending in person can help rectify the errors in the documents they have supplied. In several cities, such as Stavropol and Saint Petersburg, the doctor in change of the case writes to the assessment institutions, and it would be good to widen this practice, says Kurbangaleeva. Moreover, the study showed that calling the institutions before an appointment didn’t mean that patients could avoid waiting in a real queue.
Experts recommend developing mechanisms to monitor compliance with the order issued by the Ministry for Labour and Social Protection in Russia on equipping the institutions with special information devices, as well as creating accessible environments and adequate conditions in the waiting areas. Civic Chamber experts consider that the institutions should provide quarterly statistics and reports detailing instances of staff refusing to grant disability status or missing the deadline for granting such status. Moreover, it is essential to strengthen the role played by community councils at the head office for medical and social assessment, solve the problems of parking next to the institutions, develop a unified standard for remote pre-appointments and start a dialogue on follow-up mechanisms for the implementation of individual rehabilitation programmes.
A road map to enhance the system of social and medical examinations was confirmed in 2017. Experts within the field believe that the adoption of classifications and criteria in the assessment institutions will allow them to be more objective about defining groups of disability. In July 2018, the Ministry for Health in Russia was called upon to base medical and social commissions in the places where people with disabilities were living, not where they were registered.
The Civic Chamber also intends to request data from the Ministry of Science and Higher Education on the number of students with disabilities accepted according to the national quota. This comes after changes to legislation were implemented, which changed the requirement so that students could only submit applications to one higher education establishment with a single specialism.
A member of the Civic Chamber Commission for social policy, labour relations, trade union relations and the support of veterans, Andrey Tsarev, stated that there was a need to dedicate attention to problems faced by people with intellectual disabilities. In his view, recent progress has been made in this sphere, but the level of efficiency required to solve the problems had not yet been achieved. If people with impaired physical functions primarily needed physical equipment to aid their rehabilitation, those with mentally impaired functions were in need of services that were currently inadequate, he stressed. As things currently stand, parents give their children up for care by the state because they can’t cope or don’t have access to the necessary resources. We need to group together services for every age and work to raise the quality of life for those who are already live in residential homes, says Tsarev.
The senior deputy chair of the Commission on Support of Family, Children, and Motherhood, Yulia Zimova, presented a project entitled ‘A map of opportunities for children with additional needs’, which intends to help parents raising children with disabilities. The interactive map allows parents to gather information about the institutions available for children with special needs. Zimova believes that institutions will continue to be added to the map. Once it has been completely filled up, the institutions that have been added will be reviewed in order to determine where high-quality services ought to be provided.
The suggestions of those who participated in the round table will be included in the draft tasks of the Civic Chamber for 2019. According to the chair of the Commission of the Civic Chamber for the development of the non-commercial sector and support of socially-oriented, not-for-profit organisations, it is essential to facilitate the effective interaction between key platforms which work to solve problems for people with disabilities, such as the Civic Chamber, the community council under the Ministry for Labour and the Council for care-givers in the social care sector.