Experts criticize TƏBİB

The activities of TƏBİB (Association for the Management of Medical Territorial Subdivisions of Azerbaijan) cause criticism not only in the society, but also among specialists. Psychiatrist Bakhtiyar Mursakulov writes in this regard on the social network:

- The epidemic is declining, but two Olympic centers are being converted into modular hospitals, additional medical workers are invited from other countries, new laboratories are being deployed. What for?

The operational headquarters, TƏBİB, has ceased to report data on persons who are on the so-called "outpatient observation". Recently there were almost 12 thousand of them. What is up with them? It is not reported how many patients with coronavirus are in hospitals. The headquarters, TƏBİB, provides data exclusively on persons whose "COVID test" (analysis) is positive. How many patients with severe pneumonia, patients whose computed tomography shows the symptom of "frosted glass", but the result of their "COVID test" is “negative.” Surely, all this is recorded and taken into account, but the data is not reported. They are all in "non-public" statistics.

There is a lot of confusion about deaths. TƏBİB daily reports deaths of persons who have a positive COVID test, but this does not mean that the persons die of COVID. At the same time, there are no reports of deaths from severe, clearly "COVID" pneumonia of persons, but with a negative COVID test. According to the Law of the Republic of Azerbaijan "On the protection of public health", all deaths in "COVID hospitals" are subject to postmortem autopsy. Nevertheless, it is not reported what percentage of the deaths in "COVID hospitals" underwent a postmortem autopsy and autopsy results. Posthumous laboratory research can give a positive result of the "COVID test".

Unofficial lists of doctors who have died from "COVID" are published in the Internet. However, not only doctors, but also other workers of medical institutions died from "COVID": middle and junior staff, technical workers. TƏBIB and the Ministry of Health are clearly evading the publication of an official list of medical workers who died from COVID and infected with COVID.

The Labor Code of the Azerbaijan Republic is grossly violated, but neither the Ministry of Labor nor the trade union interferes. According to the Labor Code of the Republic of Azerbaijan, the employee must be provided with a break for eating, a short rest. Without such a break, the full performance of the work is disrupted and a hazard to the health of the employee is created. We still have not regulated the time (duration) of continuous work in overalls - a protective suit. Prolonged stay in it does not contribute to the "health protection" of the protected medic. On many of these overalls, the time spent in is indicated: no more than 4 hours. In our country, in most cases, one overalls are issued per work shift. (Divers have developed standards. You can focus on them.)

There is a special question about payment for work in “COVID conditions”. On the Internet, many complain that payments are not made, business trips are not paid, etc. A group of medical scientists noted this issue as a separate item in their appeal to the Operations Headquarters.

The issue of "payment has become sharply aggravated" after the invitation of foreign specialists to the republic. Their work is the same as that of our specialists and is paid by our state. In principle, for the same work (in quality and quantity) there should be the same payment, regardless of who performed it: our specialist or a foreigner. Most likely, foreign specialists are paid more than our specialists are. Uzbekistan has officially announced that it will pay a doctor who works with "COVID infected” $ 1,500.

Let me touch on another aspect of "payment". This is the payment of sick-leave benefits. A paramedic contracted COVID in the workplace. For his work, he received a "5-fold" salary. Sick leave will not be paid to him at the rate of "5-fold" salary. If his work experience is short, then he will not even receive 100% of his salary. In the event of his death, the family will receive a “benefit” based on a “one-time” salary.

Doctor Bakhtiyar Mursakulov published on the network

Open appeal to President of Azerbaijan Ilham Aliyev

The appeal reads:

- In December 2018 was published the President’s Decree "On a number of measures to ensure the implementation of compulsory health insurance in the Republic of Azerbaijan" (hereinafter - Decree) No. 418 dated 20.12.2018.

The decree actually confirmed the refusal of the state from "complete free health care". Instead of "full free health care", the use of "compulsory health insurance" is provided.

According to the first paragraph of the Decree, the Agency must create a public legal entity "Association for the Management of Medical Territories" (hereinafter - TƏBIB) and be its founder. According to the second clause of the Decree, the Ministry of Health of the Republic of Azerbaijan (hereinafter - the MoH) must transfer to the subordination of TƏBIB, with some exceptions, treatment-and-prophylactic and research institutions. In simple terms, a structure similar to the “republican health department” was created under the authority of the Agency (under it). Moreover, this is an artificial division of public health care. The decree did not clearly define the goals, duties, powers and responsibilities of TƏBİB.

The agency hastily approved the TƏBIB Charter. However, it turned out to be so bad that the Agency has now posted the “2nd edition” of the Charter on its website. However, even in the "2nd edition" of the Charter there are strange provisions. For example, “3.1.3-1. in the sphere of compulsory health insurance relations, medical and prophylactic institutions that are subordinate are provided with medicines, bacteriological (?), viral (?) drugs and other medical products; (“3.1.3-1.

During the current year, the country's health care was to pass completely to the compulsory health insurance system. This process began in the northern regions of the country, and many problems immediately surfaced, as well as the lack of professionalism of TƏBIB. At the same time, the COVID disease pandemic began, and the transition to the compulsory health insurance system was stopped. Taking into account that since the beginning of this year, the bulk of the medical and preventive and research (?!) Institutions have been subordinated to TƏBİB, and the fight against the pandemic has practically been entrusted to TƏBİB. It was wrong: TƏBIB is not an anti-epidemic structure. After some time, the unprofessional activity of TƏBIB was clearly revealed. The biggest problem: the state health care system consists of two "autonomous" parts - the Ministry of Health (MoH) and TƏBIB. One is the Ministry of Health, “unarmed”, and the other is TƏBIB, an unformed “inexperienced” formation. There was no sense of unified leadership in the fight against the pandemic. When the situation worsened, some of the powers were returned to the Ministry of Health. However, the "dismemberment" remains.

TƏBIB's unprofessional activities have damaged the state budget. Currently, we have invited doctors from abroad to work in hospitals. The agency, which believed that many doctors in the country were unexpectedly faced with a "shortage of doctors." In my opinion (it is supported by many health care organizers) TƏBIB is "artificial" (unnecessary) formation for the healthcare. With the formation of TƏBIB, the process of studying in residency became very complicated. Responsibility for training in residency is not TƏBIB, but the MoH. However, the MoH has virtually no clinical bases left under its jurisdiction.

The doctor suggests:

1. Transfer TƏBİB to the subordination of the Ministry of Health of Azerbaijan (goal: unified leadership and management);

2. Expand the involvement of the sanitary and epidemiological service in the fight against the pandemic and strengthen the service;

3. Instruct to prepare a new payroll mechanism for health workers;

4. After the end of the pandemic, openly discuss, with the participation of health workers and stakeholders, the organization of the health system and, improve the health system.