Will there be a salary increase for doctors from October? Latest current news about medical salaries

The salary of doctors is one of the hot topics discussed in society today, because, despite the importance and demand of this profession, the salaries of health workers remain quite low, and even the government’s promise to raise the salary of doctors from January 1, 2019, as evidenced by the latest news, cannot stop the outflow of personnel.

Should we expect the situation to improve, and what will doctors’ salaries be next year? We offer you to understand the problems of financing and the features of calculating the salary plans of a health worker.

Relevance of the problem

Of course, the problem of low wages is relevant for many areas dependent on government funding. But the salaries of doctors require special attention from the leadership of the Russian Federation in 2019, because the path from a medical university applicant to a highly qualified specialist in the field of medicine is very long and today there is an acute shortage of personnel in public medical institutions in the country. Experienced doctors are looking for more lucrative jobs in private clinics and abroad, while young people are in no hurry to apply to medical universities, clearly understanding that after difficult and lengthy training they will be faced with responsible and difficult work with low pay.

There is a way out, and it lies in reform, part of which is a new decent salary for doctors, designed to bring a tangible improvement in the well-being of doctors already in 2019, as well as other measures aimed at increasing the prestige of the profession.

Doctor's payroll

The salary of a health worker, as in many other areas, consists of the following components:

salary;
additional payment for labor intensity;
allowances for length of service and category;
regional allowances and compensatory surcharges, calculated taking into account correction factors adopted for a number of regions of the Russian Federation;
bonuses, night shifts, overtime, etc.

In this case, only the first parameter is subject to indexation – the rate (basic salary), while the size of the variable component of a doctor’s real income in many government institutions drops sharply, as noted by the doctors themselves.

Of course, if we take the statistics of large medical centers in Moscow, St. Petersburg and other Russian megacities, the percentage of personnel outflow will not be large, but nationwide, over the last 5 years, more than 90,000 specialists have left medicine, which confirms that the problem exists and requires an immediate solution.

Previous attempts at reform

This is not the first time that talk about increasing the income of health workers has come up. According to the “May decrees” signed by the president 5 years ago, by 2017 doctors’ incomes should have reached a record 180% of the average income in the region, and by 2018 – all 200%. And, although most doctors did not feel a real increase in income, beautiful figures appeared in the industry’s reporting documents confirming the implementation of the reform.

In real life, doctors were faced with the so-called “optimization”, in which the following occurred:

job cuts;
unification of sections and entire departments;
increasing overtime hours and the number of night shifts.

Thus, the workload on the doctor has significantly increased, which naturally does not contribute to improving the quality of the specialist’s work, and income, at best, has increased slightly or remained at the same level. At the same time, for doctors who remained working as before, their income remained approximately within the following range:

27,000 – 35,000 rubles for doctors;
about 20,000 rubles for junior and mid-level medical staff.

Of course, there are also regions in which the salaries of doctors can truly be called decent. These include Moscow, St. Petersburg, Sakhalin and Khanty-Mansiysk Okrug. The highest incomes, reaching 117,000 rubles per month, were recorded in Chukotka.

What to expect in 2019?

Talk that the salaries of doctors should increase significantly in 2019 in accordance with the same “May decrees” gives hope, but the latest news in the economic sphere suggests that the chosen path will not be simple and easy. Negative events such as a drop in oil prices and the imposition of economic sanctions undermine the country’s economy, but the financing of the medical sector is fully borne by the budget. It must be remembered that the planned increase in payments to employees of state medical institutions will require an additional 95.5 billion rubles from the budget by 2019, and another 170 billion by 2020.

Naturally, no one canceled indexation and from January 1, 2019, doctors’ salaries will be increased by 5.5%, which will not even cover the projected increase in prices for various groups of goods.

It is difficult to say whether the promise of a significant salary increase will be realized. Most likely, this law will add to the list of projects that are destined to remain only on paper, and by the beginning of the new calendar year there will be a list of amendments that will push back the fulfillment of the promise to more distant dates. And how I would like this assumption to be wrong...

The requirements of the May decrees that the salary of doctors in 2018 should be no less than twice as high as the average regional salary remained on paper due to the objective reasons of the unexpected crisis.

As they say in professional slang, the bottom line from the salaries of doctors, which Rosstat shows at the federal and regional levels, remains:

According to the results of the first half of this year, the average salaries of doctors are 52.9 thousand rubles. Which is almost 4 thousand more than last year;
the income of mid-level medical specialists is 29.4 thousand, and junior – 19.4 thousand rubles. And at the end of last year, their salaries were at the level of 28.0 thousand and 17.5 thousand rubles, respectively;
Moreover, the highest salary of 66.4 thousand rubles now goes to doctors practicing in the Northwestern Federal District. Here the leadership belongs to the Nenets Autonomous Okrug - 130.1 thousand rubles. In second place is the Far Eastern Federal District, although Chukotka is the leader in terms of income, where Aesculapians receive 144.1 thousand rubles;
As for the lowest salaries, North Ossetia-Alania distinguished itself with salaries of 28.4 thousand rubles. And also Kalmykia - 29.9 thousand rubles;
for comparison, doctors in Moscow have earnings of 90.1 thousand rubles.

Doctor's salary in 2018

Apparently, one should not hope that the salaries of doctors in 2018, the latest news, by the way, confirms these fears, will not increase significantly, as prescribed in the May decrees. Although, according to the head of the Ministry of Health M. Skvortsova, the government intends to fulfill the promise made to doctors and in October of this year, doctors’ salaries should be at the level of 180 percent of the national average, and by the end of the year in physical terms could reach 66 thousand rubles.

The expert community, however, as always in such cases, is divided into almost equal parts. When some analysts claim that the accumulated reserve funds of the government will in the near future make it possible to fulfill the requirements of presidential decrees, and the salary of a doctor in 2018 should be twice the national average, especially on the eve of the elections, this is quite appropriate. While others, on the contrary, say that the accumulation of funds is not so large as to implement the decrees.

But some and others agree on such a scenario for resolving the problem that the increase in doctors’ salaries in 2018 will be implemented in the form of indexation of their salaries according to the damage caused to doctors’ incomes from inflation.

Nurses' salaries in 2018

Previously, the review indicated that by October of this year - early 2018, doctors will receive within 180 percent of the average federal income, while the salary of a nurse in 2018 will barely reach 80 percent. Although, according to the requirements of the decrees, it must be equal to 100 percent, that is, it must be the same as the average salary in the country. If doctors' incomes lag behind the salary increase schedule by only one-tenth, then for average medical staff this lag is equal to one-fifth of their income, which is clearly unfair to the latter.

If you do even a cursory analysis of Rosstat on the income of nurses by region, the differentiation of their salaries is more striking than that of doctors. Which is also an element of unequal treatment of the work of doctors due to the different levels of their income depending on a particular region, with the same professional responsibilities.

Salary of nurses in 2018

The salaries of medical workers in 2018, both from a moral and ethical point of view, should be increased, at least for junior staff - orderlies and nurses of medical institutions, who have the lowest income. And here regional support is not enough, if only for the reason that not all regions have the financial resources to increase salaries for junior-level medical staff, even those working in rural areas where their incomes are minimal.

One can only envy, for example, German nurses, where they pay 800 rubles per hour in ruble terms to care for a sick or infirm person.

Increase in salaries for doctors in 2018

As a result of the review of the likelihood of an increase in salaries for doctors in 2018, it should be said that most likely it will not be so much an increase, but an indexation of income due to damage associated with inflation. As for the amount of indexation itself, it will be within 4 percent of the salary.

How are doctors' salaries determined?

The total amount paid to doctors is summed up from the following components:

direct salary amount;
additional payments taking into account the complexity of work and intensity of workload;
additional payment taking into account length of service and assigned category;
compensatory surcharges and adjustment factors that are adopted in each individual region.

When revising wages for certain categories of employees, only their first component – salary – increases. It is he who is subject to mandatory indexing. However, doctors' base salaries are typically low, and much of their monthly funding comes from bonuses, part-time jobs, and overtime. This is becoming a serious problem, because the indexation of salaries in 2019 will affect their size very little, and the calculation of additional payments today is completely entrusted not to the state, but to the management of medical institutions.

Analysis of the current situation

They promised to raise the salaries of doctors to 200% of the regional average!

Let us recall that five years ago the President of the Russian Federation issued the so-called May decrees. According to the orders set out in this document, already in 2018, the level of remuneration for doctors should increase to 200% in comparison with the average regional salary payments.

Regional authorities claim that this order is already being implemented - back in 2017, in most territorial subjects of the Russian Federation, doctors’ wages became equal to 180% of the regional average salary. Olga Golodets, who holds the post of head of the social sphere of the Russian Federation, assured Russians that the country’s budget has allocated funding to further increase the salaries of health workers, and October 2017 has already been marked by a salary indexation of 5.5%.

However, the increase in wages recorded by statistical agencies is explained by the so-called “optimization”. Many medical institutions today are simply laying off staff, which is causing the consolidation and consolidation of entire departments. According to some reports, in the last five years alone, about 90,000 people who previously worked in public medical institutions have been fired or transferred to other jobs. Those who still hold on to their jobs are forced to work under conditions of ever-increasing workload - working at one and a half times the rate and regularly taking night shifts.

Let's say even more - despite such labor feats, doctors complain about a drop in real income levels. This is because the total amounts are formed by adding the variable and salary parts. Many heads of medical institutions carried out the May decree very simply - they raised salaries and reduced additional payments. Now in most territorial subjects of the Russian Federation, doctors receive about 30 thousand rubles, and junior and mid-level medical staff - about 20 thousand rubles.

So far, as salaries increase, doctors’ real incomes only fall

Health workers representing the Jewish Autonomy, the Nenets District, Ingushetia and the Arkhangelsk Region say that they are receiving less than before the “increase” in salaries. Doctors from 25 regions reported that about a thousand rubles were added to their salaries, and Voronezh and Altai doctors amazed the public by declaring that their increase amounted to 32-53 rubles! If you look at the situation from a regional perspective, you can come to the following conclusions:

The minimum average salary received by doctors in Kalmykia is 27.3 thousand monthly. Ulyanovsk medical workers receive an average of 30 thousand rubles, Samara – 35 thousand rubles, Penza – 33.4 thousand, Ossetian – 28 thousand;
The situation is slightly better for those who work in Sakhalin and Chukotka, in Moscow, St. Petersburg and the Khanty-Mansiysk Okrug - regional authorities increased the salaries of local doctors by about 6 thousand rubles, and now the average doctor’s income is 117 thousand monthly;
If we take individual categories of health workers (for example, analyze payments to general practitioners), then significant regional disproportions are visible to the naked eye. In the capital, such a doctor receives about 60 thousand rubles, but as soon as he starts working in the region, his salary immediately drops to 45 thousand.

Alas, these statistical calculations do not quite realistically reflect the current financial situation in Russia. Since 2017, employees of this department have jointly calculated the average salary of doctors who work in clinics of all forms of ownership. At the same time, salaries in a city hospital are significantly lower than in private medical institutions. Well, if we compare with payments accrued to foreign doctors, the situation looks completely deplorable - for example, American therapists earn on average 416 thousand rubles, French ones - 200 thousand, and German ones - 225 thousand rubles.

The government comments on the situation with regional imbalances, explaining it by high premiums in the northern regions. Well, the rest of the doctors need to deal with local authorities, since the federal budget is formed every year taking into account the increase in salaries. The maximum that can be done is to split the increase into two parts: first, salaries will be increased at the federal level, and then at the regional level, taking into account local coefficients.

We also note that the head of the Ministry of Labor, Maxim Topilin, assured the public: in 2018, the federal budget will allocate 80 billion rubles to finance the salaries of health workers. He mentioned the “capita standard” (the amount allocated per year for each person assigned to a medical institution under a health insurance policy), which is planned to increase by 21.7%. As a result, this will cost the treasury about 333.2 billion in national currency.

Given the problems with financing the Mandatory Medical Insurance Fund, it is possible that the government will refuse to implement the May decrees

In the last speech of Anton Siluanov, who heads the Ministry of Finance, it was said that on average the salaries of public sector employees will increase by 23%, and the planned growth by industry will reach 4.1%, that is, salaries will be adjusted to take into account inflation. Thus, by the beginning of 2019, all financial obligations set out in the May presidential decrees will be fully fulfilled. As a result, average medical staff are guaranteed payments identical to the national average, and highly qualified public sector employees (doctors) receive salaries twice as high as the average.

Let us remind you that the salaries of employees financed from the Russian budget will be increased in two stages - the first (by 4.1%) will take place in October 2018, and the second (by another 4%) in October 2019. The minister said that as a result, state employees will receive an increase that will be significantly higher than inflationary manifestations.

The capital's mayor reported that in 2017-2018, salaries of health workers increased by 40%. Already in 2018, the average salary will be 140 thousand rubles, which is 2 times higher than the average monthly Moscow salary! However, the health workers themselves deny such information - they say that the average salary for their work in the capital is 64.73 thousand rubles. However, the government has allocated 500 billion rubles for a three-year wage indexation, of which:

196.6 billion – in 2018;
219.5 billion – in 2019.

At the same time, it is necessary to note the rather alarming news that appeared in the media not so long ago. We are talking about problems with financing the Compulsory Health Insurance Fund, which is replenished from contributions from wages of employees. According to plans, the Fund should be replenished by 1.89 trillion rubles in 2018, by 1.93 trillion in 2019 and by 2.1 trillion in 2020.

However, now the government believes that this is not enough. Already at the beginning of 2019, the Fund will reach a state of deficit. To cover it, it will be necessary to allocate 95.5 billion rubles from the budget in national currency, and in another year - to finance 170.4 billion rubles. Auditors of the Accounts Chamber came to the conclusion that already in 2018 the Fund will not have enough money to pay salaries to health workers, and the amount of the shortfall will be 43.1 billion rubles.

Previously, doctors were informed that it was the Fund’s reserves that would ensure an increase in their salaries. Now there is not enough money for the May decrees, since this Fund must finance, first of all, the purchase of equipment to provide high-tech medical care. As a result, the former head of the Ministry of Finance, Alexei Kudrin, proposed suspending the implementation of the May decrees so that the increase in salaries would not lead to a decrease in expenses for the purchase of medicines, ordering the latest equipment and repair work.

Some government members have proposed increasing insurance premiums charged to the wealthiest Russians. It is quite possible that this will help resolve the issue of increasing salaries for doctors. Statistical departments, having combined the salaries of public and “private” doctors when calculating the salaries, will ultimately receive an average figure for the Federation in the amount of 47-50 thousand rubles per month.

However, in reality, this can be achieved in a simpler way - through massive layoffs and an increase in the number of rates per health worker. Naturally, a doctor who works two hours will receive twice as much. Another question is how will this increased intensity of work ultimately affect patients and the quality of their treatment, or the health of the doctor himself?..

Reading time ≈ 5 minutes

We all know how important and responsible the work of health workers who have chosen such a difficult professional path is. It’s a shame, but today we can safely say that the work of medical staff in public medical institutions of the Russian Federation is valued an order of magnitude lower than that of doctors collaborating with private medical structures or foreign clinics. The government promised that this issue would be resolved this year, and the medical industry would once again become one of the most prestigious areas of professional activity.

It’s worth finding out if there is any new news on this matter, and what kind of salary doctors should expect under the current conditions.

Formation of salaries for health workers

Today, a health worker's salary includes:

the salary itself;
additional charges for loads, complexity and intensity;
bonus payments based on length of service and category;
compensation with regional coefficients.

Basically, medical staff can only count on an increase in their salary, because this component is often subject to indexation with increases. It can be noted that the gross part of the income of health workers is bonuses, compensation and additional payments. Namely, it is very easy to remain without them, because the calculation of these components of wages depends directly on management.

The requirements of the May decrees state that in 2018 there should be twice as many doctors as the average regional salary, but this remained only on paper due to unexpected crisis conditions.

Doctors' salaries are expected to double

The bottom line on the issue of wages for health workers, provided at the federal and regional levels by Rosstat:

The first half of this year showed that the average salary of medical staff is 52,900 rubles. This is almost 4 thousand higher than last year;
The income of mid-level specialists is 29.4 thousand, junior – 19.4 thousand rubles. Last year their salaries were 28.0 thousand and 17.5 thousand rubles;
the highest salary is a salary of 66.4 thousand for doctors who practice in the Northwestern Federal District.

The Nenets Autonomous Okrug is in the leading position - 130.1 thousand. The second place was assigned to the Far Eastern Federal District, here the championship in terms of income belongs to Chukotka, where doctors are paid 144.1 thousand rubles. As for the lowest salaries, a salary of 28.4 thousand rubles is received in North Ossetia-Alania. In Kalmykia – 29.9 thousand rubles. To compare, in the capital doctors earn 90.1 thousand rubles.

Salary increase

About new salary calculations for doctors in 2018

Recent news dashes hopes for a significant salary increase in 2018, despite what was promised by the May decrees. And although statements made by the head of the Ministry of Health M. Skvortsova indicate the government’s intentions to fulfill the promise made to medical workers, an increase in wages to the level of one hundred and eighty percent of the average salary in Russia should not be expected in the near future.

Let us recall that according to the May decrees, it was expected that salaries for doctors would increase in 2018 to 66 thousand rubles.

Experts' opinions regarding the growth of wages for medical workers are divided. One half of the experts is inclined to believe that salary calculations in a new way are possible, since the size of the government’s accumulated reserve funds is sufficient to implement the presidential decree on increasing doctors’ salaries in 2018.

In addition, the implementation of the plan will be appropriate before the presidential elections. The other half of experts argue that the funds needed to make this promise a reality are not enough.

Both agree on one thing: in 2018 we should expect salaries for medical workers. Their salaries will increase to compensate for the damage caused by inflation.

According to the May decrees, the salaries of doctors will be increased to 66 thousand rubles

About salary calculations for nurses in 2018

If we talk about the new salary calculations for nurses this year, then they should be 80% of the average salary in the country. And this despite the fact that, according to presidential decrees, nurses’ salaries must correspond to the average salary in Russia.

There is a disappointing picture of the lag behind the salary increase schedule not only for doctors, but also for nursing staff.

According to Rosstat, today there is a significant differentiation in the income of nurses by region. This figure is higher than that of doctors. This indicates an unequal attitude towards the work of medical workers, as can be seen from the different levels of payments by region for the same professional responsibilities.

The promised increase for nurses will not yet come

About salary calculations for nurses in 2018

Speaking about the growth of salaries for medical workers, we should once again emphasize the need to increase payments to junior staff (orderlies) who have the lowest salaries. Unfortunately, it is not possible to resolve this issue at the regional level due to the limited financial capabilities of most of them.

The profession of a medical worker is one of the most responsible, therefore it is precisely such workers who should receive an adequate income for their work. If a doctor is forced to constantly take extra hours, look for part-time work, or work part-time in a private clinic, then he is unable to provide high-quality medical care for a long time. The doctor simply gets tired of the overwhelming amount of work, which is why doctors need to be paid a decent salary. So what will the salary of doctors be in 2019, will it really be increased or will we have to be content with indexation this time.

Games with salary part and working hours

Some medical workers are joking about the salary cut after the latest increase. According to documents, wages have increased, but in reality they have remained the same at best. This effect was achieved due to a simultaneous increase in salary while reducing the variable part of the salary, as well as the redistribution of bonuses and incentives. As a result, salaries actually became higher, but in fact some of the medical workers ended up losing.

We should not forget that the reported increase in doctors’ salaries was partly due to an increase in workload. As the number of working hours and night/weekend/holiday shifts increased, wages also increased. At the same time, there was a slight reduction in staff to ensure there was enough work for everyone. Within one institution, the number of employees who left is small, but throughout the country, about 90 thousand employees of government medical organizations moved to commercial clinics or other work.

Declared 180% and actual salaries

The idea was correct; it was assumed that by 2017, doctors’ salaries would reach 180% of the regional average. By 2018, the figure was supposed to reach 200%, while for middle and junior medical personnel the salary is planned to be 100 percent relative to the regional average.

The same 180-200% may actually be real numbers in all reports and statistics. Just don’t forget that in fact, a salary that is 2 times the average for your region of residence in rubles can be quite modest. In addition, the crisis situation in the country has affected the incomes of workers in all areas, which in some cases has led to a drop in their salaries. As a result, the average salary also fell, so most of the 180% figure appeared without a real increase in the income of doctors. That is, their payments were not increased as much as the regional averages dropped. At the same time, we should not forget about manipulations with the increase in salary without an actual increase in wages.

The salaries themselves are not at all as high as many people think. Official statistics are far from being as accurate, especially in terms of reflecting the income of citizens. In fact, most medical workers receive a salary of about 20-35 thousand rubles. Moreover, the smaller figure is the income of junior and mid-level personnel, and the doctors themselves receive a little more. This does not mean that almost all doctors have a salary of 35,000 rubles; they still need to “work up” to such payments. However, there are those who receive more than 50 thousand rubles.

According to statistics for 2017, quite low salaries for doctors with all sorts of additional payments were recorded in a number of regions. For example, we can consider 5 regions and republics in order of increasing income:

Kalmykia - 27.3 thousand rubles.

North Ossetia - 28 thousand rubles.

Ulyanovskaya - 30 t.r.

Penza - 33.4 thousand rubles.

Samara - 35 t.r.

At the same time, in the capital, a simple therapist can easily earn over 60 thousand, and if we take the average income of doctors in some regions, including the Moscow region, the amounts are quite large. As an example, we can consider the average salary of doctors in both capitals, Chukotka and Khanty-Mansi Autonomous Okrug - the amount is about 117 thousand rubles. At the same time, many will immediately say that such amounts are indecently large, while other doctors are paid 30 thousand rubles. The unevenness of salaries is actually present, but still does not reach such values - the size of average incomes is influenced by the accruals of chief doctors, neurosurgeons and other highly paid specialists.

Planned salary increases and real budget possibilities

Several years ago, the so-called “May Decrees” appeared. In accordance with these orders, the salaries of medical workers should increase over a long period of time by an indecently large amount of interest. Initially, it was planned to systematically increase the income of doctors to a respectable amount, so convincing that doctors would not have to take on many part-time jobs while maintaining a high standard of living.

It is clear even to people far from the economic sphere that money for the salaries of health workers in government institutions comes from the budget. After an endless stream of crisis events and such a rapid drop in the price of oil, significantly less money began to flow into the budget. If the situation had been short-lived, the problems could have been avoided, but the price of oil remained low for too long, so many forecasts were not destined to come true.

In order to implement the planned increase in doctors’ salaries in 2019, it is necessary to find “free” 95.5 billion rubles in the budget. A similar measure in 2020 will require another 170 billion rubles. There is a law, but there is no money to implement it, and for quite objective reasons. The issue of increasing doctors' salaries is stuck; the law stipulates an increase, but there is a high probability that additional regulations will appear that will postpone the implementation of the plan to a later date. At the same time, no one forbids hoping that the situation will urgently improve, large revenues will begin to flow into the budget, and wages will increase in the previously promised periods.