Nelly Zinovieva, the former head of the “Regional Pharmacy Warehouse” (GKUZ “Procurement Center”) addressed a public letter to the parents of children with disabilities who receive discount drugs in the Vladimir region, and also announced an appeal to the General Prosecutor’s Office in connection with the situation in the Regional Health Department.
We remind that on May 6, the regional prosecutor’s office approved the indictment against the ex-director of the pharmacy warehouse. The woman is accused of failing to take measures for timely conclusion of state contracts for the supply of medicines, which, according to the investigation, affected 35 children with disabilities. Earlier, Elena Utemova, the ex-head of the Regional Health Department, put the blame for the drug collapse on the “Regional Pharmacy Warehouse”.
In March 2021, Nelly Zinovieva left the post of the head of this organization. The dismissal of the head was not followed by a prompt solution to the problem of preferential drug provision in the region. Back in the autumn of 2021, the regional healthcare department acknowledged the existence of delayed prescriptions. At the end of March 2022, the regional healthcare department said that in “recent months” the number of overdue prescriptions had been reduced 12-fold.
In a public appeal, Nelli Zinovieva writes that complaints about the issuance of discounted medications in the Vladimir region will continue until the region’s Unified Health Information Loop works:
“It would be easy if officials would comply with the prescribed provisions in the Orders of the Ministry of Health. For example, according to this legal algorithm: a primary outpatient doctor examines a child, makes a diagnosis, writes a prescription (preferably electronic), enters it into a common unified database, where the provision is tracked in the unified information loop of participants in the benefits of drug provision, which includes medical organizations in the region, the health care management body, pharmacy organizations, pharmacy network.
Well, if health officials do not comply with these regulations, trying to shift responsibility to the shooter, then they receive hundreds of complaints from parents of children with disabilities and respond with formal replies,” the letter says.
Nelly Zinovieva reminded about managerial decisions of the Regional Health Department that preceded the drug crisis. In autumn 2020, the Regional Pharmacy Warehouse was reorganized into the Procurement Center. If before that the hospitals and polyclinics themselves were in charge of drug procurement, after that this authority was raised to the level of the new “Procurement Center”. Nelly Zinovieva specifies that as a result of the reorganization she automatically became the head of the “Center”.
“What could I have done then in two incomplete months for disabled children, without full funding, without proper staff, including for procurement, without accounting, and most importantly without documents that would indicate requests, quantities, personalized information, both on medicines and children with disabilities?”
The defendant added that all documents about the reorganization, as well as the handling of complaints from parents of underage patients, are available for review by the affected party. The author of the letter urged parents to exercise this right and look into what had happened on their own. In particular, Nelly Zinovieva specified that at the beginning of 2021 the necessary drugs were available at the Regional Public Health Inspectorate, but there was a problem with their issuance:
“Roszdravnadzor also found that at the beginning of 2021 the pharmacy network had the necessary drugs for tens of millions of rubles, but for some reason they were not issued to disabled children and were not redistributed. Nevertheless, I (N.E. Zinovieva) am accused of this, which makes it unclear who was in charge of the region’s health care and who had the authority…?”.
The former head said that at the beginning of 2021 the employees of “Procurement Center” were working twelve hours a day, at the same time solving problems with the purchase of drugs for the treatment of coronavirus in the conditions of the pandemic. In order to be successful, the “Procurement Center” had to get the information they needed about what drugs to buy and how much to buy, as well as the funding.
“All this had to be determined initially by employees of the Department of Health, including the Department of Drug Provision, where the information from medical organizations of the Vladimir region “flowed down”, especially in relation to federal beneficiaries, which were children with disabilities.The Department of Public Health of the Vladimir Region was also responsible for control of drug stocks in pharmacies of the authorized pharmaceutical organization, according to the job description, which did not take any measures for redistribution of drug products between pharmacies”.
At the end of the letter Nelly Zinovieva once again expresses the opinion that the Regional Health Department should create a unified information system to solve the problem of drug supply:
“Without going away from human responsibility, I think, based on the current regulations, to restore the rights of children with disabilities to timely reimbursement of essential and not only medicines, we need to create a unified information system for all participants of the drug benefit provision, to make a transparent system of electronic prescriptions, so that every parent can see the movement of necessary drugs before his child and receive it, to fill up registers of children with disabilities, which provision can be financed by the state subsidies.
The accused ex-head of “Procurement Center” said that she had already applied to the supervisory authorities, setting forth arguments about what exactly in the health care system was a brake on the timely issuance of subsidized drugs:
A month ago I filed an appeal in the interests of children with disabilities to the General Prosecutor of the Russian Federation, the local prosecutor to compel the Department of Health of the Vladimir region to fulfill its responsibilities in terms of preferential provision of children with disabilities, with a list of all necessary.
Dear parents, I ask you to join my demands and to induce the Department of Health to execute the duties, and I hope the court will understand who is guilty.
Let us remind you that in the Vladimir region, the Department of Health structure “Medical Information and Analytical Center” continues to implement the digital health circuit under a contract with “Rostelcom” for 176 million rubles. The information support of the preferential drug provision is a part of the circuit. In September 2021, Sergei Biryukov, a member of the regional parliament, said that the “drug” segment was being prepared for launch in October 2021:
“We have high expectations with the launch of the unified digital circuit in healthcare. The unified information system will provide many opportunities, including convenient remote doctor’s appointments and more. But most importantly – we are counting on it – it will make it possible to provide people with the necessary (in some cases vital) medicines promptly and in full.
“We have high expectations with the launch of the single digital circuit in healthcare. The unified information system will provide many opportunities, including convenient remote doctor’s appointments and more. But most importantly – we are counting on it – it will make it possible to provide people with necessary (in some cases vital) medicines promptly and in full.
The original as well as the adjusted deadline for the contract has already been missed, but it appears to be ongoing. In early May 2022, the MIAC issued an announcement that it was facing “unconstructive criticism” from medical organizations, acknowledging some of the difficulties encountered in implementing the system. In spring, digitalization of healthcare was the topic of meetings with the acting governor Alexander Avdeev, then the MIAC staff visited Kaluga Oblast to share their experience.
According to the press service of the White House, the Acting Governor instructed to transfer all state medical organizations to a single digital platform (IGISZ) by June 2022, allowing to track the receipt of subsidized drugs for everyone in need.