Federal Law No. 265-FZ dated July 29, 2017. Age limit for chief physicians.
Heads of health care facilities who will not be affected by the age limit. Introduction of honorary positions for chief physicians.
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The State Duma adopted the bill on limiting the age of chief doctors in the third reading last summer, and in the fall of this year Federal Law No. 256-FZ of July 29, 2017 came into force, in connection with which Article 350 of the Labor Code of the Russian Federation was amended.
According to the adopted document, persons who have reached the age of 65 will no longer be able to manage medical organizations of the federal, regional or municipal level and their branches, as well as hold the position of deputy chief physician.
Age limit for chief physicians: explanations
The law on the age of chief physicians applies to both federal and regional health care facilities, as well as city-level institutions. It came into force this fall, but in the first three years of its validity some exceptions will be made for many “age” chief physicians.
The chief doctors of medical institutions and their deputies will be removed from their posts upon reaching 65 years of age, while the term of their employment contracts will not matter. They will be transferred to other positions that correspond to their level of qualifications.
The transfer procedure will be carried out with the written consent of the head physician and his deputies.
However, there is one caveat - the chief physicians can remain in office until the age of 70 by the decision of the general meeting of the collective. In turn, the deputy chief doctors can also remain in their places by the decision of the head.
Thus, the maximum age for the head physician will be 70 years. But you need to understand that his removal from a managerial position does not at all mean that he will be prohibited from doing it.
Former chief doctors will be able not only to receive patients, but also to take a direct part in operations. They will simply be relieved of administrative duties.
Which chief doctors will not be affected by the "age qualification"
A smooth transition to the rules specified in the Federal Law on the Age of Chief Physicians will take 3 years. At the same time, as already mentioned above, the founder will be able to leave the head of the healthcare facility, who has reached the age of 65, in his position for another 5 years, if such a desire is expressed by the collective at the general meeting.
Health workers ask which chief doctors will not be affected by age prices. Indeed, there are exceptions - these innovations will not affect feldsher-obstetric points, regional hospitals and branches.
While supporters of the adopted law argue that the dismissal of chief doctors based on age is a necessary measure, many experts oppose the adoption of these amendments, referring to the provisions of the Labor Code on the inadmissibility of discrimination against employees on the basis of age.
In their opinion, it is possible to talk about only when there are health problems that do not allow to fully fulfill their official duties.
Age restriction for chief physicians: MP's comment
Deputy of the State Duma, First Deputy Chairman of the State Duma Committee on Health Protection Fedot Semenovich Tumusov answered questions about the age of the chief doctors.
Why set an age limit for chief physicians
In science, this rule is already in effect, in the army, in education. There is only one area left - healthcare. This is the first reason for this legislative initiative.
The second is that the bill is aimed at updating. There is a change of generations of leaders. Those who are now 65 years old were brought up in Soviet times, they have a Soviet mentality. Of course, they have adapted to market realities, but a new generation is coming to replace them.
Is there a connection between the age of the head physician and the quality of management
Age affects energy, performance, but this is compensated by wisdom and experience.
Therefore, for example, I do not see a direct correlation between the age of a leader and the quality of management.
I think that no one has done any research either.
Moreover, any research is money. We still have to try to find a sponsor on this topic. The bill is aimed at updating. Going heads
The draft law does not say a word about the definition of criteria for "deterioration" of the business qualities of leading medical workers. Accordingly, this is a baseless, unsubstantiated initiative.
What percentage of senior physicians will be subject to the bill?
I have no such statistics. But recently there was a publication about the N.N. Blokhin. There, almost all deputies turned out to be 65 years old. There was a massive layoff.
Does the law contradict the Labor Code
There is an element of discrimination in the age limit for chief physicians: if you are old, you are not needed. But it is mitigated by such provisions as a transitional period - 3 years, the opportunity to take another position.
In any case, there is a task, as I have already said, - to update the leadership of medical organizations in connection with management. Therefore, I believe that there are elements of discrimination, but they are leveled by other provisions of the bill.
Honorary positions for chief physicians
According to the new law, the age limit for chief physicians will be 65 years. However, the Ministry of Health plans to introduce honorary positions for these leaders.
Chief physicians who have switched to them will be able to concentrate their efforts on medical, scientific or educational activities.
The program "Zemsky Doctor" is very much awaiting not only young specialists, but also older doctors. Natalya Sanina, the first deputy chairman of the State Duma Committee on Health, and the head of the Central Research Institute for Organization and Informatization of Healthcare of the Ministry of Health of Russia, and in the past, Minister of Health of the country, Vladimir Starodubov, speak of the need for a mentoring program in medicine. Young and not so much doctors need experienced assistants ... Otherwise, what's the point in discussing the availability of treatment?
A completely different trend has taken hold in the organization of medical care. The law, signed by Russian President Vladimir Putin on Sunday, July 30, sets an age limit of 65 years for the heads of medical organizations, as well as their deputies and those specialists who manage the branches of medical institutions. By decision of the staff of the hospital, medical center or polyclinic, the head physician can remain in office for another five years. For doctors who are already over 65 or 70 today, there is a three-year transition period.
Health improvement
The authors of the document were the head of the State Duma Committee on Health Protection Dmitry Morozov as well as deputies Andrey Isaev, Tatiana Saprykina, First Deputy Chairman of the State Duma Committee on Housing Policy Alexander Sidyakin and First Deputy Chairman of the State Duma Committee on Labor, Social Policy and Veterans Affairs Mikhail Tarasenko... The parliamentarians see the purpose of the new legal act as staff turnover and the improvement of the industry with its help.
What will follow the initiative, which should come into force on October 1? A rejuvenated workforce and more modern treatment, or headless healthcare facilities and a declining level of patient care?
The list of doctors who will lose their positions in the coming years is, of course, impressive. Alexander Rumyantsev, Head of the Dima Rogachev Federal Research Center for Pediatric Hematology, Oncology and Hematology, Ivan Dedov, Head of the Endocrinological Research Center, Zurab Kekelidze, Director of the V.I. Gennady Sukhikh. In the same list - the director of the Scientific Center for Cardiovascular Surgery named after A. N. Bakulev Leo Bokeria ...
From rector to director
However, let's digress from the list of outstanding doctors - often not only the heads of medical centers, but also the main specialists of the country in their field of medicine. The concept of an age limit is already in force in domestic legislation.
So, in accordance with Part 12 of Art. 332 of the Labor Code in state and municipal higher educational institutions, the positions of rector, vice-rector, heads of branches of institutes are replaced by persons under the age of 65, regardless of the time of conclusion of employment contracts, explains lawyer Tamerlan Barziev.
Article 25.1 of the Federal Law of 27.07.2004 No. 79-FZ "On the State Civil Service of the Russian Federation" also establishes the maximum age for staying in the civil service - 65 years. In the original version of the document, however, there were no such restrictions: the article was introduced at the end of 2010 by Federal Law No. 317-FZ.
An adviser or assistant may, in certain cases, continue his work until the term of his leader expires. But the head of the civil service can be extended to 70 years by the state body or the person who appointed him to the post, Barziev comments.
And finally, on July 30, 2017, the President of the Russian Federation signed the Federal Law "On Amendments to Article 350 of the Labor Code of the Russian Federation, according to which labor contracts concluded with the heads of medical organizations, deputy heads, as well as heads of branches of medical organizations, which have reached 1 October 2017 of the age of 65 or reach this age within three years after the specified date, remain valid until the expiration of the periods provided for by such employment contracts, but no more than three years from the date of entry into force of the Federal Law.
Is age an insufficient basis?
The legality of labor restrictions by age was studied by the Constitutional Court in 2006. In his ruling of July 11, 2006 No. 213-O, he decided:
“The age limit for filling the posts of heads of departments in state higher educational institutions ... cannot be considered as a special requirement due to the nature of this activity, the peculiarities of this type of work, and the fact of reaching the age limit cannot serve as a sufficient reason for dismissing the head chair or hinder participation in elections for this position.
... The proclamation of the independence of universities in the selection and placement of personnel and, at the same time, their responsibility for their activities before the individual, the state and society assumes that when deciding whether a person over sixty-five years old meets the necessary requirements for heads of departments, the opinion of the management of universities and their collegial bodies should be of decisive importance. "
However, “in general,” the position of the Constitutional Court was ambiguous ... And today all legislative norms on the age limit remain valid.
To make way for the young?
“Similar laws have been in force for a long time in relation to a number of employees of state budgetary institutions. The leadership rejuvenation process should be. In universities and research institutes, this did not cause rejection. After all, there is the position of the scientific director of a research institute, and the status of the president of the faculty, - comments Director of the National Research Institute of Public Health Ramil Khabriev... - The leader is bad who did not give his subordinates the opportunity to grow, did not prepare a replacement for himself ... To transfer knowledge is a natural human desire. And it is necessary that the head of a medical institution thinks about preparing a worthy replacement for himself. "
Supporters of the new amendment to the Labor Code hope that it will motivate the heads of hospitals and clinics to be more attentive to junior specialists. And this will help medicine to rise to a higher level.
However, as Leonid Roshal, “children's doctor of the world,” noted back in March: “At the age of 82, I decided to leave the post of director of the Research Institute of Emergency Pediatric Surgery and Traumatology. Found a worthy replacement. But he still needs my help. "
At the round table of the All-Russia People's Front "How to overcome the personnel problem in healthcare", the doctor supported the proposal of Natalya Sanina and Vladimir Starodubov about a special mentoring program.
Big ... fight?
“No matter how we relate to famous doctors, their charisma, authority and experience in decision-making are enormous. With their departure, the "big fight" of less charismatic and authoritative people will begin. Struggle, inertia, search for a way out, reaction of authorities at different levels, attempts to find a replacement, staff turnover due to unsuccessful decisions. Those who are directly affected by the law, their entourage - and new ones, along with those whom they will bring with them, ”warns President of the League of Patients' Defenders Alexander Saversky.
On social networks, a fierce debate unfolded around the new law. Some refer to the experience of European countries, for example Germany, where, upon reaching the age limit, not a single head of a health care institution can retain his post: the chief physician either retires or is engaged in teaching. Others are perplexed: the director can be appointed to the position of scientific supervisor - there he will be able to defend the interests of his medical center much more successfully.
Still others pay attention to personnel statistics: “In our country, district doctors are 76 years old, do you think they work why? Let's be honest. I don’t know the figures for Moscow, but in the periphery the staffing is not enough - 50 percent or more! In cities with a population of one million! " Still others, with bitter irony, propose to introduce age restrictions for State Duma deputies. And also in some industries and institutions.
"They were over 65, but they invested so much in us ..."
Fifths are indignant: "There is a feeling that this is a purposeful policy - to behead the country altogether, depriving it of valuable and thinking people!"
As noticed doctor Lyudmila Fokina:“Those who made such a decision have no idea how long it takes a doctor to gain experience and have time to pass it on to the younger generation! And since medicine is a living science, the laws in it change exponentially. And every medical professional is an expensive “product”. Practice and experience form high-class professionals! The older they are, the more they know, which means they can convey. I still remember Myasnikov, Vorobyov, Chazov, Struchkov, Petrovsky, Persianinov, they were well over 65, but they invested so much in us that this knowledge still “works”.
The problem is the organization!
“Only at this age all organizational abilities of a person are revealed. And any chief physician or director is, first of all, an organizer. When the law comes into force, the level of medical care will fall even lower, - warns Honored Scientist of the Russian Federation, Member of the Committee for Civil Initiatives, Professor Yuri Komarov... - It's not about clinical medicine. At the very least, it develops, new methods and technologies appear. The problem is precisely in the organization of medical care ”.
The age of chief physicians is a private problem. The root cause of all the difficulties with the training of personnel and the organization of primary health care is the lack of order in health care, explains Yuri Komarov. Movement without a rudder is still only at the level of "general and whole" ...
He shared his personal opinion and Deputy Chairman of the State Duma Health Protection Committee Sergey Furgal:“I think that the law is at least premature. And it will hurt very much. In addition to Moscow, there are other regions where there are 2-3 doctors in district, city, and rural hospitals. If they are fired due to their age, there will be no one to replace them. Anarchy will begin. Any piece of legislation must be enforceable - and must improve the situation. And here the result will be the opposite: both the quality of medical care and its availability will decline throughout the country. The age limit amendment is not needed at all - health care needs to solve other, systemic problems. And in my opinion, only knowledge and health can be a limitation in labor activity ”.
The circle is complete. Staff shortage, lack of conditions in which young doctors could live and work ... Having set an age limit for doctors, does the country run the risk of losing not only the luminaries of medicine, but medicine as such?
Last week, the State Duma Committee on Labor, Social Policy and Veterans Affairs unanimously approved a bill according to which the heads of state and municipal medical institutions and their deputies must be people not older than 65 years. At the same time, for the head, the term of office can be extended up to 70 years on the recommendation of the general meeting of employees of the organization. As for deputies who have reached the age of 65, it is proposed to conclude employment contracts with them for a period not exceeding the term of the expiration of the powers of their immediate superiors.
Unfortunately, some mass media have misinterpreted this document: allegedly, many prominent practicing doctors, who are also heads of medical institutions, will be fired. In fact, the bill is not about dismissing them from the profession, but only about exemption from administrative and economic work: signing payments, repairing roofs and replacing sewer pipes in hospitals, solving other domestic issues.
Today, more and more new information technologies are being actively mastered, and in these conditions it is advisable to ensure the inflow of younger personnel for organizational work, including in the health sector. And the current leaders, who have reached the age of 65, need to be given the opportunity to concentrate on their medical and scientific activities, on the preparation of students. They will be obligatorily offered other positions corresponding to their qualifications. The transfer to these positions will be carried out with their written consent.
Similar norms establishing the age limit exist for civil servants, for heads of scientific organizations and their deputies, for rectors and vice-rectors of higher educational institutions. Let me remind you that after the age limit for rectors was set, the post of president was introduced in many universities. Rectors began to elect younger researchers, the former leaders became presidents: they could focus not on the current administrative and economic work, but on the development of their scientific school, on teaching, and so on. I think that a similar system can be implemented in the healthcare sector. Thus, there will be a smooth rotation of personnel in medical institutions.
This is especially important today, when many young qualified and talented specialists go to private clinics, because they do not see the prospects for career growth in state and municipal organizations and, as a result, work only for a more materially secured part of the population. Our task is to make sure that they provide medical care to all citizens of Russia.
Among other things, the proposed bill establishes continuity in the health sector: new chief doctors of hospitals and clinics will begin their activities when their predecessors are still active and ready to help with advice. I also note that within three years from the date of entry into force of the law, labor contracts concluded with the heads of medical institutions and their deputies will remain in effect, even if these persons are over 65 years old. Three years, from our point of view, is a sufficient time to prepare yourself a worthy change.
This bill was supported by both trade unions and the government. We hope that the State Duma will adopt it in the first reading in June.
The State Duma may establish an age limit for chief doctors of hospitals. What do doctors themselves think about this, whose professional experience is important in their work?
The State Duma is considering a bill to limit the age of heads of medical organizations. The amendments may come into force as early as June 1. The Duma Committee on Federal Structure and Local Self-Government Issues recommended that they be adopted in the first reading. What do doctors themselves think about this?
The director of the Sklifosovsky Research Institute of Mogeli Khubutia, for example, is now 70 years old. Leonid Roshal, President of the Research Institute of Emergency Pediatric Surgery and Traumatology - 83. Leo Bokeria, Director of the Bakulev Center for Cardiovascular Surgery - 77 years old. If the law is passed, then the heads of state medical organizations who have turned 65 years old should be dismissed. The restriction is extended up to 70 years if the employees of the institution spoke up for it. Here is the reaction of Mikhail Davydov, director of the Blokhin Russian Cancer Research Center, who is now 69 years old.
Mikhail Davydov Director of the N.N.Blokhin Russian Cancer Research Center“We have a lot of examples when people over this age work brilliantly, lead and are the most experienced professionals. Although there is such a template all over the world, in fact, there is an age limit for executives, so it is quite debatable. I would still make a limit of 70 years for chief doctors. If he is an experienced leader, he is in great shape up to 70 years old, and, of course, he can be of great benefit. "
The deputies explain the idea by the need for staff rotation. Prior to this, the age limit had already been introduced for university rectors and heads of scientific organizations. By the way, there are no restrictions for the State Duma deputies themselves: Iosif Kobzon, for example, 79, Valentina Tereshkova - 80. There are also heads of state who are already over seventy. And there are examples in business: 86-year-old Bernie Ecclestone, who led the world's major auto races for 40 years. But when there is no border, it can also be bad, comments the former chief physician of the Moscow 62nd Hospital Anatoly Makhson.
Anatoly Makhson former chief physician of the Moscow 62nd Hospital“There are other examples: he is already under 80 years old, maybe he is no one as a leader, but he works, and when there is no border, maybe it’s not very good. On the other hand, when some kind of border is introduced, it no longer makes sense, because in our country many managers did what they did: suppose you know what it is, and so that you do not have strong competitors, you can say that you mow down competitors around you. This is also bad. If you know that you will leave at 70, say, or at 65, then you need to prepare a successor, as it was before. But that's my opinion. "
The bill specifies that after reaching 65 or 70 years of age, the head can be transferred to another position. An ingenious doctor is not always a good leader, and a brilliant surgeon can continue to perform operations, comments Pavel Trakhtman, head of the department at the Rogachev Center for Pediatric Hematology, Oncology and Immunology.
Pavel Trahtman Head of the Department at the Rogachev Center for Pediatric Hematology, Oncology and Immunology“A person, even being a great, great boss, cannot hold his position forever. He becomes blurry, he is no longer so eager to do something necessary and useful. Still, after reaching a certain age, not everyone, it is clear that this does not happen for everyone, but still, the ability to work and work capacity, and mental functions decrease. If a leader knows that upon reaching a certain legal age - in Europe it is 65 years, in Israel it is 65 years old, in the United States of America, in my opinion - generally 60 years old - he should leave the administrative post in government agency. Usually they all open their own private clinics and run them beautifully. "
Although now the chief doctors, or rather their spouses, no one bothers to do this. For example, in the summer of last year, Life.ru wrote that the highest personal income among the chief doctors in Moscow was found in the head of Dental Polyclinic No. 4, Manvel Aperian. His wife, according to Life.ru, owns 40% of the private clinic "Atri-Dent", and in 2015 the family earned 42 million rubles.
It will be possible to manage a state or municipal medical institution until the age of 65. A bill has been submitted to the State Duma establishing an age limit for chief doctors. Of course, the chief doctors will not be kicked out into the street, according to the document, they will be offered another position "suitable for qualifications".
The opinions of experts are divided: some believe that such an approach will give a "green light" in the growth of young personnel. Others insist on the need for unified rules and an individual approach.
They want to adopt the law promptly: from July 1, 2017. At the same time, the authors explain that, firstly, a certain transitional period is envisaged: senior managers will not be removed from office for the next three years. In addition, the founder of the medical organization will be able to extend the term of office of the head physician to 70 years, if requested by the general meeting of the team of the medical organization. But, in fact, it may not be extended.
Similar restrictions have been in effect for two years in the education and science system: the same 65 years for university rectors and directors of scientific institutes. By the way, legislators use the exact opposite approach for leading positions in the civil service. Since January 1 of this year, the opportunity has been introduced to extend the powers of federal leaders to 70 years, a draft law is on the way for regional officials as well.
“Today, innovative technologies are being actively introduced in medicine, new specialists are needed. I believe this will help to avoid situations where managers are sitting on the ground and not working effectively. "
There is an acute shortage of competent leaders in medicine
At the same time, Larisa Popovich, director of the Institute for Health Economics at the Higher School of Economics, recalls that according to the Labor Code, age discrimination is prohibited in our labor relations. She is also supported by the vice-rector of the Academy of Labor and Social Relations, Alexander Safonov. In his opinion, it is possible to talk about age restrictions only if the employee's health does not allow him to fulfill his job duties. "In all other cases, this is a restriction of rights," the expert is sure.
“I can guess what this initiative may be connected with - with the fact that a number of heads of medical institutions are trying to pass the leadership in them“ by inheritance, ”- believes Alexander Safonov. - But these sensational cases are isolated. So don't shoot from a cannon. Probably, the rotation of personnel is really needed. But to judge whether a person can lead or cannot, it is necessary not in terms of his age, but the efficiency of his organization. , then why break it? But for the founder to be able to assess the effectiveness of the organization, it is necessary to develop clear criteria for such an assessment. "
It is impossible to "cleanse" the medical staff so rudely, the head of the Department of Healthcare Management at the State University of Management, Professor, Honored Doctor of the Russian Federation, Viktor Cherepov, is convinced. “We have an extreme shortage of competent leaders in medical institutions. In the regions, they are generally worth their weight in gold. I am a doctor, who is 66 years old, and I am ready to work for another 20 years. a special, difficult profession, "Viktor Cherepov told RG.
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