The new system of remuneration of labor in budget health care: analysis of practice and problems of implementation

Abstract

In health care, as in other sectors of the public sector, introduced a new system of remuneration (NSOT). However, as the analysis of practice shows, the consequences of its implementation are ambiguous. Despite the growth of the average salary of all categories of medical personnel, its size does not correspond to the planned indicators in most regions of the Russian Federation. The presence in public health organizations of various organizational and legal forms has put institutions in unequal conditions of formation and distribution of funds of the wage Fund. As a result, medical personnel in one region receive different salaries for the same functions. These trends lead to the outflow of personnel from public health institutions in other industries and activities against the backdrop of increased intensification of labor of workers, an increase in the number of functions performed, a significant bureaucratization of their activities. Thus, one of the most important goals of the NSOT to attract and retain specialists in public health has not been achieved. There are serious shortcomings in the construction of basic salaries on the basis of professional qualification groups, due to which the size of the permanent part of the earnings of low-skilled workers in public health may be lower than the minimum wage in the region. One of the most important elements of the new wage system is an effective contract, the introduction of which has led to the fact that the share of variable wages in public health care is unreasonably overstated. It should be noted that in the medical institutions of the public sector there are often no indicators to assess the quality and results of work of employees and the organization as a whole, which leads to problems in determining the criteria for the effectiveness of personnel. Thus, in order to improve the new system of remuneration, it is necessary to eliminate these shortcomings, to develop methodological approaches to the formation of official salaries taking into account the requirements of labor legislation, all decisions in the field of remuneration should have a financial basis.