Head Physician 62 Oncology. Health system reform. Immunotherapy - a new method of cancer treatment

As a citizen of our state with you, I cannot help but worry inner life our beautiful country. My name is Dmitry, and I study in the capital medical university. My relatives, teachers and friends work in the healthcare sector and therefore I know the problem that I want to highlight from the inside.
Not so long ago, an order was issued by the Department of Health of the city of Moscow on the transfer of an autonomous institution (which was cancer hospital №62) to the budget. This deprives him of the right to independently purchase medicines. For the hospital it has great importance because they do chemotherapy and buy quite expensive drugs for patients with oncological diseases.

It is thanks to autonomy that the 62nd hospital has survived and continues to develop, providing cancer care citizens of the Russian Federation at the level of world standards.

With the transition to new status the right to purchase medicines is transferred centrally to the Department of Health. It is known from publicly available sources that when the 62nd hospital independently held tenders, the prices for the purchase of medicines were several times (up to 15 times!) Lower than when centralized tenders were held by the Moscow Health Department. For example, in 2016, the state purchased the drug Irinotecan at a price of 5,844 rubles per bottle, and the 62nd hospital purchased the same drug at a price of 1,213 rubles (almost five times cheaper) in the same year. The state purchased the drug Docetaxel at a price of 19,474 rubles per bottle, and the hospital at a price of 7,500 rubles (2.5 times cheaper). The state purchased oxaliplatin at a price of 5,839 to 13,580 rubles, while the hospital bought it for 859 rubles (6-15 times cheaper). It turns out that the state spends more money, but at the same time buys a smaller amount of medicine. Because of this, there was a shortage of medicines in hospitals, which became a deadly threat for patients with certain types of cancer.

Despite this, on November 8, 2016, at the request of the Vice Mayor of Moscow, L.M. Pechatnikov, "in order to improve medical care”, a decree of the Moscow government was issued on the transfer of GAUZ MGOB No. 62 to the status of a state budgetary healthcare institution. The resolution was carried out in violation of the law, since according to FZ-83 the work of the hospital is evaluated by the Supervisory Board based on the report of the chief physician, and if it turns out to be unsatisfactory, the board may decide to transfer the institution to the budget one. The Chairman of the Supervisory Board is A.I. hoarse. At the same time, the Supervisory Board never met in 2016.

Changing the status of an autonomous institution with effective management to the status of a budgetary institution in a crisis of limited health care funding will inevitably lead to a decrease in the ability to provide affordable, high-quality, modern medical care patients with oncological diseases, which will inevitably lead to an increase in the death rate of citizens of the Russian Federation.

The 62nd Cancer Hospital is one of the best in Russia in terms of its profile. In addition, it works unique composition specialists. Over the past year, the medical institution has provided assistance to almost 15 thousand patients.
15 thousand is the population of a small town, such as Ivangorod or, for example, the municipal Arkhangelsk region. it great amount lives saved, largely due to quality qualified assistance, affordable therapy and competent leadership Makhson Anatoly Nakhimovich, who was retroactively fired due to disagreements with the capital's Department of Health.

Institutions such as oncology hospitals should not be streamlined because there is constant struggle for Human Life. The outcome of such a struggle largely depends on the availability and quality of treatment, which in the current situation may be in jeopardy.

Therefore, I beg you to influence the current situation and return the status of an autonomous institution to the Moscow city oncological hospital No. 62.

Former chief physician"Moscow City Oncological Hospital No. 62" asked the FSB to check the Moscow Department of Health to establish an overstatement of purchase prices. This was reported on Tuesday, December 27 by the Vademecum portal.

On December 23, Anatoly Makhson, the former chief physician of the Moscow City Oncological Hospital (MGOB) No. 62, sent applications to the FSB and investigative committee with a request to check the purchases of the Moscow Health Department (DZM) and bring officials to criminal responsibility if violations are detected. Purchase prices for five cancer drugs and two pieces of medical equipment purchased by the department in 2016 were overpriced by 217.8 million rubles, the statement said.

For example, the hospital bought Novotax for 2,900 rubles per unit, and the Department of Health - for 25,400 rubles - a difference of almost nine times. Makhson asks to bring the perpetrators to justice.

Moscow Vice Mayor Leonid Pechatnikov, explaining how the 62nd clinic manages to save money, said that the hospital bought medicines with an expiring shelf life, which the city cannot afford - the official's speech was published by the Vademecum portal.

Business FM published an interview with Mahson, in which he pointed out the difference in the purchase price of appliances.

“In our hospital we have two devices in the same laboratory, absolutely identical, from the same company, bought with a gap of three months. One device costs 5 million rubles, the other - 13 million. The only difference is that for 5 million we bought it ourselves, and for 13 million we received it through a centralized purchase by the Health Department,” said Anatoly Makhson.

The conflict between the Moscow Department of Health and the head physician of the Moscow City Oncological Hospital No. 62 began in November.

Related materials

On November 8, the Moscow government ordered to change the status of the Moscow City Oncological Hospital No. 62 from autonomous to budget - "in order to improve medical care." On December 1, the relevant order No. 963 was signed at the Moscow Health Department. The Moscow authorities justified this decision by the need to “improve and optimize the activities” of the hospital, as well as “improve the quality of the services it provides.” At the same time, the Moscow authorities have repeatedly emphasized that the 62nd hospital is one of the most successful hospitals in the capital, but did not explain why such a hospital should be optimized.

Anatoly Makhson, chief physician of the Moscow City Oncological Hospital No. 62, opposed the transfer of the hospital from an autonomous status to a budget one. Anatoly Makhson told TASS that the decision of the capital's health department to transfer the institution from the status of an autonomous to the rank of a budget institution would greatly limit the ability to purchase cancer drugs at optimal prices, which would ultimately affect patients.

Moscow Cancer Hospital No. 62 is one of the best in the country. It has been operating as an oncology hospital since 1959. According to the chief physician Anatoly Makhson, in 2016 more than 20 thousand people became patients in the hospital, and doctors performed about 6.5 thousand operations. Mortality does not exceed 0.7 percent.

Oncologist and hematologist, member of the European medical center» Mikhail Laskov, in a conversation with the Meduza portal, noted that the main advantage of the 62nd is its personnel.

“There are some competent specialists in other institutions, but the 62nd has a fantastic team for Russia, highly qualified doctors who are always up to date latest news, latest developments. The hospital has always rationally distributed resources, for example, they didn’t buy anything insanely expensive, but it’s not clear what they need it for. But at the same time, we methodically assembled this complex puzzle: when all the individual services - diagnostics, chemotherapy, surgery and others - work very well and smoothly,” Laskov said.

Originally posted by rusanalit at "Optimize" (close) the 62nd oncology hospital

Original taken from stalic Q My daughter has been diagnosed with cancer

It's very hard for me to talk about it. First, because we have never experienced such severe and prolonged pain. Secondly, because I know that people on the Internet are much meaner and meaner than in real life. Surely there will be scum who will try to hurt us even more.
But I have someone to write this text for. Because so many - alas - have yet to face cancer. And I understand that now our experience, knowledge and some information can help these people.

EARRING

I had a friend, Sergei. I played in the ensemble in the 16th school, and he played in the 23rd.

Here he is in the middle.

And this is him in his student years. Red shoes are from that same rock and roll.

And then he moved to Kaliningrad. When I moved to Moscow, I came to visit me a couple of times during my holidays. I was happy.

Once I woke up at five in the morning, and his wife calls on Skype. Cries and says:
- Seryoga has lung cancer.
That's the same thing he complained about his heart, he thought that this heart hurts! And then there was, he called and said that his neck hurts and he was undergoing electrophoresis. It turned out - cancerous tumor grown.
I thought at first:
- Oh, cancer ... it's like that serious disease. Will he stay alive? We need to send them money for treatment and tell them not to return it.
And then I thought:
- Why is she calling me? Really, no one else? It turns out that I am the closest to them? Do they rely on me? Help? Take on this burden? Do I need it! But, stop, stop. Since the Lord sends, it means that for some reason it is necessary. Yes, on the other hand, if I don’t help him now, and if this happened to me, who will help me then?
Thoughts flashed through my head in an instant, and on Skype I said:
- Come to Moscow today! Let's get treated!

Oh, and I was arrogant then! I thought it was so easy to arrange a person from Kaliningrad for treatment in Moscow on December 25th.
First, Moscow is fenced off from the rest of Russia by an insurmountable palisade of bureaucratic regulations, pieces of paper and some kind of "pink coupons".
Secondly, on December 25, everyone who can make a decision is already resting.
To whom I just did not turn! To everyone, to all acquaintances, friends, friends of acquaintances. Several people helped me, especially dunduk_culinar - Marat Abdullaev. It was he who advised me to contact the 62nd city oncological hospital, which is located on Novorizhskoye Highway, a dozen and a half kilometers from the Moscow Ring Road. We got a "pink coupon" and drove off.
Council. Invite me:
- Who are you sick?
- I'm his friend. I am treating him.
- You see, his tumor is very large and is located in the upper part of the lung, one might say, near the shoulder. We need to do an operation - open chest cavity, get to the tumor, take a piece of this tumor for a biopsy. Only then will we know which chemotherapy drugs should be used to treat him. But all this - after the New Year.
- When?! Yes, in the three days that I have, he has weakened right before my eyes! He can no longer climb the stairs to the second floor, his voice has disappeared. After the New Year - is it after the "old" New Year? Yes, a few more days for hospitalization, tests, preparation for the operation ... It will just be time to drink three glasses and a glass of compote.
I continued:
- Listen, because I see that you are all competent, experienced people. You almost certainly know what type of cancer he has, right? Let's start chemotherapy today, if we hit, we will continue, and if not, then we will act according to the proposed scheme.
The doctors reluctantly agreed. They took Sergei to the emergency room, and only then did he understand everything:
- Do I have cancer? I will die?
- Seryoga, what are you doing! You - well, so, there is some kind of tumor, you need to be treated, because many pass.
In the ward, besides him, there was a priest. Seeing that Sergei did not really like the hospital atmosphere, the priest said:
- And you should be baptized with both hands at once, that you got here, in the 62nd! I haven't been anywhere! You have not seen other hospitals, but here - order.
In fact, the ward was located in an old building, but it was quite clean there, a good bed, and warm. But a hospital is a hospital, you know.

And so, a young, smart, cheerful and cynical doctor comes and brings Seryoga with jars on his chest. Tubes, catheters. Explains to me and Sergey's wife what and how. Like, in three days you will pull out the catheter, and that’s all.
- Wait, doctor! How about we take him? Where? Home?
- Yes! Let's celebrate the New Year!
Wow! With such and such banks and tubes - I thought they were only in intensive care. I ask carefully for the second time:
- What can he do?
- To him? Now everything is possible for him! You think about yourself, what is possible and what is not. And now he doesn't care!
- What, and drink? And barbecue?
Yes, whatever you want!

A couple of days later, for New Year's table, Sergey has already cheered up. He reached for a barbecue, asked for cognac. And then he suddenly cleared his throat and, pretending to check the microphone, spoke:
- Once! Once!!! One two Three! Voice! The voice has arrived!
Hooray! The chemotherapists hit the mark!
After the second course, he felt even better, and I told his wife to go home. What is here? We can handle it ourselves!
He endured the third course worse, from the fourth he was very ill - he felt sick, vomited, but he understood that he had to be patient.
Closer to summer, radiotherapy began. And so, we are walking through the park of the 62nd hospital for the next session, and Seryoga says:
- Look, Stalik! Summer!
I say:
- So what? June! Yes, of course it's summer!
- And I'm alive!
I turned away so he wouldn't see the tears in my eyes.

Seryoga returned to Kaliningrad, went to work. I went to a concert of my favorite rock band "Nazareth", gave me a CD autographed by Dan McCafferty and began to communicate with the priest from the church.
In the fall, he got worse again. I told his wife:
- Well, let there, in Kaliningrad, they will instill the same chemistry as in Moscow! What difference does it make where to drip?
I, a fool, could not even imagine that somewhere they would drip something different from what was in Moscow. They took it twice and he got worse.
- Let's then again to me, to Moscow!
By this time I was already familiar with the head physician of the hospital and knew how and where to get the same "pink coupon". (by the way, they have now been canceled, but this did not make it easier for non-residents)
Two cycles of chemotherapy in Moscow and suddenly Sergey comes to me and with some kind of evil fun of a doomed person says:
- BUT! All! I've been discharged! - And he slashed with his hand from top to bottom.
- What are you? How is it - written out? Did it get easier for you? Or will they do something else?
- Not! I was told that now I can go and be treated with folk methods.
Yes, how is it?! Let me call Anatoly Nakhimovich, the head physician.
- How it is? Why was he released?
- Stalik, we have done everything that is necessary. If we do something arbitrarily, and then he dies - and he will die for sure, this is already one hundred percent - then we will be to blame.
- So what? Nothing can be done?
- Well, there is one drug, dear, really. Tartseva. But it does not cure, but only prolongs.
I found such a drug for Sergey. Wrote in LiveJournal and someone gave us the rest after the deceased relatives, for free. Then he bought another pack with a good discount, because the expiration date was expiring in three months, but he would have had time to drink one pill a day. But he didn't.

KARINA

My daughter was doing well. She graduated from college and got married. The husband is a great guy, hardworking, calm, self-confident. A girl was born. They moved to Moscow, we helped to buy an apartment, a car. And then my brother-in-law lost his job.
He was so worried about this that he ended up in the hospital. I arranged for treatment, everything ended well. We return with him from the hospital, and at home we are in for a great joy. Daughter says she's pregnant! A few months later, an ultrasound shows that there is a boy. They jumped up to the ceiling for joy!
Two weeks later, the son-in-law calls:
- We'll come, we need to talk.
What happened? Working day, he already got a job. Why isn't he at work? Why did he have a dull, unaccustomed voice?
They come, the daughter is crying. What? Are they getting divorced? What misfortune? And she:
- Dad, mom, I have cancer! breast cancer.

Just the day before, we had a married couple visiting us, where the wife also suffered from cancer, but was cured. I saw with my own eyes what she had a good appetite, she was cheerful, they would have said to dance - she would have danced. I to them:
- Where were you treated? In Germany? Give contacts! And you can’t talk to the doctor, maybe he will advise colleagues not in Munich, but in Berlin, where my sister lives?
The next morning I received a chain of letters by e-mail. Then the Germans corresponded until midnight, describing the situation to each other and consulting. As a result, I had the contact of the best surgeon-oncologist.
But besides that, I called the 62nd hospital. Anatoly Nakhimovich said:
- Stalik, pull yourself together, come in the morning.

Meanwhile, the daughter said that she felt the tumor two months ago. Went to the clinic. She was told to go to a mammologist. But by that time the mammologist had already "optimized" and she waited for an appointment for more than a month.
After all, I asked while my son-in-law did not have a job:
- Need money? Do you have money? Take it if you need!
But they didn’t take it, they were shy, but my daughter didn’t have several thousand rubles to go to paid doctor. Okay, that was our mistake, of course. My children misunderstood the word "modesty" and used it in the wrong place. But think, how many women in Russia have nowhere to get this money from?! That is, many will not be able to get to the doctor on time, just like my daughter.
After all, the mammologist said:
- Immediately in oncology!
And the daughter did not want to scare us, she went somewhere herself, took tests, and came to us when it was already known for sure - cancer, third stage, metastases. Two months ago, the cancer was just beginning, it was then necessary to start treating it!
Thank you very much, optimizers, effective managers. I bow low at your feet. I pray to God that you never experience what I, father, experienced! And if something happens - you are celestials, you will be cured.

I'm also a guy not halam-balam. I had money - I saved up for an apartment for my son. I also borrowed from friends, they gave me everything from whom I asked. A classmate called
- Stalik, I have 12,000 dollars, come and take it!
- Lyuda, thank you, I have already collected enough money!
And half an hour later he calls again:
- Stalik, I still have a million rubles. Of these, I will need only half a million by the summer for my daughter's wedding, and you can return the rest when you have them.
- Thank you, Luda, if needed, I'll call, I'll come.
Not long before this, this Lyudmila's mother had died of cancer; she understood what we were facing. But we had no problems with money, and tens of millions of my fellow citizens have such problems. And you read further about how it is better not to get cancer if there is no money.

We arrived at the 62nd. The head physician summoned the head of the chemotherapy department, Daniil Lvovich Stroyakovsky. Karina was taken away somewhere, and they began to read the documents and look at the tests. I was told:
- Stalik, your daughter has a very severe form of cancer. The survival rate is as follows: for the first year 50%, for three years - 30%, for five years - 10%. Who lives longer than five years, we consider healthy.
And further:
- Get ready for the fact that you have already lost your daughter. Let's save the child.
Do you understand, can you imagine for a moment what I experienced that day?
But I wasn't about to give up. Karina was undergoing an emergency additional examination, and I was already preparing visas, tickets, my sister made an appointment with a doctor, my sons ran about registration - it was necessary to register Karina so that she could be treated in this particular hospital.
D.L. Stroyakovsky returned to the head physician's office with papers.
- Stalik, I looked. In the world, only 18 cases of such cancer during pregnancy have been studied. There is one way. Let's try. First 4 cycles of chemotherapy. Then C-section. After that, more chemistry, but here one medicine is needed, which is not yet available in Russia. It is very expensive - about 5,000 euros per ampoule. Every three weeks one ampoule during the year. Then the operation. Then radiotherapy.
- How to do chemotherapy during pregnancy?
- Starting from 4 months, the placenta does not miss chemotherapy, we will use special drugs, with caution.

Everything was spinning in my head, thoughts were confused.
- I'll still take her to Germany. I have money, I can't save on my daughter, I can't take risks.
- Stalik, in Germany you will fall into the hands of intermediaries, they will pull money from you. For what we did today, they will charge you 10-15 thousand euros, and then also treatment. It is enough to bring from there the medicine that we told you about.
- No, I'll go.
But the next day, I nevertheless took my daughter to the hospital and she received the first course of chemotherapy. A day later we were already in Berlin.

Thanks to my sister and contacts obtained through friends in Germany, we managed without intermediaries. The surgeon referred me to a fellow chemotherapist. A female professor, excellent English, friendly, self-confident. She looked at the documents and asked:
- You have all the tests, we trust our colleagues from the 62nd, we know them. What do you want from us?
- Please write a treatment plan.
And she began to write. Word for word everything that D. L. Stroyakovsky wrote.
Only about that expensive medicine didn't write. I asked why she did not want to use this medicine?
- But this is a very expensive medicine, we can try to do without it ...
- Listen, this money is being printed somewhere here in Germany, I will get it. But my wife will not give birth to my daughter again!
I asked how much it costs to be treated in Germany, how much an operation costs, how much radiotherapy costs. She convinced me that our surgeons, and especially in the 62nd, are no worse than in the Berlin Sherite Clinic. Yes, it is better to undergo radiotherapy in Germany, where the equipment is better, and therefore the doctors are more experienced - they simply have something to work on. And at the end she said:
- Well, if you have a desire to be treated, there is money, then all you have to do is pray to God and everything will be fine! Yes? Deal?
We were already leaving, and I remembered:
- Where is the money to pay?
- There's an ATM down there. If you wish, pay 500 euros there.
With the money saved, I took my daughter to Paris and Rome. We had time before the next course of chemotherapy, and judging by the words of the German doctor, her mood was very important. And I decided - let him see beautiful cities, let him calm down a little. By the way, the doctor in Germany was very happy when she heard that we had already begun treatment. Said:
- Well done! Correctly!

After the first course, the daughter felt that the tumor had decreased. Ultrasound confirmed her assumption. After the second and third sessions, the tumor remained within the same limits, did not grow, but did not decrease either. And after the fourth, the tumor began to grow again and we were told to urgently perform a caesarean section. The baby in the womb was 7.5 months old.

This is how we saw him for the first time.

This is how he became by the day he was supposed to be born. Here our grandson is exactly nine months old, counting from conception.
Many thanks to the doctors of the regional perinatal center for all their work, for the generosity of the soul, for the fact that they were leaving him, they were not afraid to take on a very difficult case.

Immediately after the birth of our grandson, we had another chemotherapy, using the same one - new and expensive drug Periette, which was to be brought from Germany.
My sister in Berlin has a good friend, a doctor, a native German who married a Serb and converted to Orthodoxy. She called all the pharmacies in Berlin and found one in which they agreed to sell us Perietta with a minimal markup. I flew to Berlin, bought five ampoules and remembered that the EU has a tax-free tax refund system. But the pharmacist hadn't even heard of the special checks that had to be issued. His sister explained to him, he went to look for information on the Internet, printed out the form, carefully filled it out and we went to the airport.
At the airport, the customs officer was surprised at the amount on the form and asked:
- What is it you have so expensive?
I showed the ampoules and explained why I needed them. Unexpectedly, the customs officer switched to Russian (apparently, he taught it at school):
- If you give these documents here, at the airport, at the next window, you will receive only 10-11% of the amount, the company will take the rest. This is a lot of money, you still need it. There is still time before your flight. Go back to the pharmacy, give these documents to the pharmacist and he should return you 19%.
You should have seen the pharmacist's face - everything that he thought about himself was written on it. "Why did I contact these Russians!"
But when everything was explained to him and after long consultations with the tax and customs office, he came out holding a wad of money in his hands and said:
- Ya, ya, everything is correct, I must return it to you, here is ain, zwei, dry ... and one euro cent!
As a result, the medicine cost us almost twice as much as we thought.

The medicine began to work miraculously. A week later, my daughter told me that she felt with her fingers and realized that the tumor had disintegrated into several grains. Three weeks later, when I drove her to the next procedure, she said that she stayed there. small swelling the size of a grain of rice. Ultrasound confirmed her assumption!
A few days later, D.L. Stroyakovsky called:
- Stalik, another woman has the same diagnosis as your daughter. But everything is very neglected in her, already the fourth stage and metastases are everywhere. Can you help her buy such medicine?
Yulia Belousova called me. I began to explain to her. And she says:
- Okay, I'll get a visa in two weeks, I'll fly ...
Out of indignation, I switched to "you":
- What are you? Do you understand what you're saying? What two weeks? Come to me, I will give you medicine, do it tomorrow! Then you fly and bring me!
We became friends, began to call each other often and flew to Berlin for medicine in turn. Good woman Julia, she has a great husband, Dmitry, they have two teenage children. It was very important for me that Yulia also stayed alive. And she will live as long as she will inject this Perietta. That's what doctors say, at least.
The family of Yulia and Dmitry was well-to-do, but their money began to melt rapidly. She called me, she cried:
- I so wanted to finish building this house, and now it has to be sold, in a crisis, for half the price.

And suddenly one day she says:
- Stalik, do you know what the Moscow region received a small amount of Perietta, the state bought?
And I went to the State Duma, to the Health Committee. He came and told me everything. I was listened to by the Chairman of the Committee, Deputy Kalashnikov S.V. and said:
- We will try to help you. Go to my assistant, write a statement, he will deal with your issue.
I went to an assistant and cheated. Let Sergey Vyacheslavovich Kalashnikov forgive me, but I entered the second name in the application - Yulia Belousova.
Two months later, the assistant reported the good news that a positive decision had been made to purchase medicine for my daughter and Yulia. But now, according to the Public Procurement Law, our lot is put up for auction and we have to wait for the allotted time.
Listen, please, carefully, read these lines. These are cancer drugs. Cancer can sometimes kill people in a matter of weeks. They burn like matches. But cancer drugs must be purchased under the Public Procurement Law. And wait for the right time. Not one day before!
Yulia and I still had money left, we could buy this medicine on our own. But people who can afford such purchases, well, if a few percent. And the rest?!

We waited! We were given three ampoules per hand. The remaining ampoules were promised to be given out later. But two months later we went to the pharmacy, but ... there were no medicines, they didn’t arrive. I flew back to Berlin. A month later it's gone again. And again. I no longer bothered the deputy, but called his assistant. He was outraged:
- How it is? Purchased for you for the entire course of treatment! I'll find out.
They gave out two ampoules. And again no. Again flew to Berlin, again called the State Duma. They gave out two more ampoules.
For the third time, a big scandal arose and the remaining ampoules were given out all at once.
Do you know how these medicines were given out? No passport, no signature. Dmitry came, "I am the husband of the sick Yulia Belousova" and they give him three ampoules worth 900,000 rubles. Understand who needs it and why cloudy water in this case?
Yes, exactly to those who sell these medicines on the Internet: http://aptekamos.ru/apteka/price.html?id=75337&r=1
These medicines should not be sold over the counter. Consider that each ampoule is played with someone. Do you understand? There are people who decide for themselves who should see the red sun, who should stroke the child's head, and who should not. And they redistribute the years and months of life of those who have no money in favor of those who have money.

FURTHER FATE of the 62nd Hospital

There are many cancer hospitals. There are those where doctors are a little less indifferent, there are those where they are a little less than completely indifferent. Many have resigned themselves to the fact that their patients do not receive medicines, are operated on antediluvian equipment, and do not have the opportunity to do CT scans.
The 62nd hospital is wonderful. In addition to Karina and Yulia, several of my friends have recovered in this hospital over the past time. My close friend, also a doctor from Fergana, took his son to Israel. I convinced him to come back and be treated here in the 62nd. My friend, a CMN himself, a resuscitator, was very worried at first. But when we came with him to the hospital and the surgeon showed on the computer a video recording of the operation, where scalpels come out of centimeter tubes, then "sewing machines", then tweezers, some kind of clamps - in general, it all looked like science fiction, like a movie from the future, only then my friend said:
- Yes, I never dreamed of seeing this! Their equipment is, of course, the strongest.
Here is what his son wrote to me, and I quote:

My history:
Petersburg, in private clinic, was diagnosed with a tumor of the stomach. They suggested expectant tactics - whether the tumor will progress. But my parents convinced me that I needed to go to Israel for high technologies (to be examined and operated on there, if necessary). I went. All the same examinations were duplicated there in the same form, only money was stolen many times more. They suggested surgery. While waiting for the results of their examination, he returned to the Russian Federation and was examined at the 62nd Moscow oncological hospital. The conclusion and actions of the Israelis were the same as in the 62nd - you need to operate. The operation was offered the same (laparoscopic removal of the tumor), but only in Israel they broke the amount of 22 thousand dollars for this, and even with the reservations that this is "not the final cost", that it may still increase depending on various circumstances(such as lengthening the duration of the operation, the need for "intraoperative" examinations, etc.) paid department The 62nd operation cost me 100 thousand rubles. Satisfied with the result. I liked the hospital: competent, friendly staff, modern equipment, cleanliness and comfort. Many thanks to the chief doctor of the hospital Makhson Anatoly Nakhimovich for organizing the work and thanks to the attending physicians Dr. Yury Yuryevich Kaner and Yury Dmitrievich.
I don't know Yury Dmitrievich's last name.

Those who returned to normal life patients, I personally know a few more people. Well, what can I say, look at my daughter, these are photos from my grandson's birthday:

This is her with her husband and our grandson.

This is with the head physician of the 62nd hospital Makhson A.N.

And this, next to my son-in-law and grandson, Daniil Lvovich Stroyakovsky.
We invited these people to our holiday because it is their holiday too. Because these people have become family to us. Because if it were not for their golden hands, I would not be so happy:

The other day my daughter called:
- Dad, do you know that the 62nd hospital is closed?!

I called the head physician. Not that they are closing - they are optimizing. Probably, about the same way as they "optimized" the mammologist, because of the absence of which we missed the very beginning of my daughter's illness, why I then had to do two operations, such complex chemotherapy, radiotherapy. Okay, thank God, everything ended well for us - there were medicines, there were knowledgeable doctors, was the equipment. And what will happen to those who fall ill after us?

I understand that there will be people who will say, "Since such treatment is not available to us, let no one have it." Remember - after these words, you stood on the same level with those optimizers who are killing our health care. Optimizers will have money for Israel-Germany-America, and if sanctions happen, they will "solve issues" for them, but you won't have a single chance at all, because once they close BEST hospital, or because the restless Makhson A.N. interferes with someone, whether because someone needed a luxurious land plot 14 km from Moscow, I don’t know, I can’t think of a single reason why at least someone could come up with the idea to close SUCH a hospital. Such hospitals should not be closed or optimized, but their experience should be disseminated. But the experience is that the chief physician should not give a quiet life to officials - knock out, demand, get. And next to such a head physician, golden heads will automatically appear, like the chemist Stroyakovsky, to whom there will be a queue in any country, wherever he works, like a surgeon Burlakov, like laboratory assistants - after all, laboratory 62 is one of the best in Europe. Imagine, there are only two laboratories in the whole of Europe, the rating of which is higher than that of the laboratory of the 62nd hospital. And this is what needs to be optimized, right? Kill, kill? Don't these people understand that destroying such a hospital is tantamount to building a gas chamber?! They don’t think that it’s okay - people, you think there, some little people - God sees everything ?! Are they not afraid of him? Or will they pay off with candles, with temples? Hey guys, officials, guardians of our budget!!! Why, after all - people, and every person is a TEMPLE! There is no need to build temples, your sins will not be forgiven there, it is better to help the children so that their mothers are alive. Yes, these children may not thank you, but you yourself will feel like honest people! Or do you not know what a thrill it is, the pleasure of being in harmony with your conscience is unknown to you?!

I would not share our personal history with the Internet, I would not show you our family photos.
But our story is no longer personal. Because now my daughter is healthy, but anyone can get sick, remember that. Now this is your story. Now something depends on you, dear readers.
Spread, ring all the bells! Social networks have become a significant force, let's use our strength to the fullest.
Dear journalists! If you need, we are ready to communicate, we are ready to tell you everything in more detail than what is described here. Dozens of other sick people who have recovered will tell you everything, and their relatives will tell you about the dead. Remember, both you and your relatives can end up both in this world and in the next, but, alas, the Lord God does not always decide this - sometimes officials. So help them make the right decision!

survive

Us for a long time the fact that we are an autonomous healthcare institution helped to survive. Like budget institutions, we belong to the government of Moscow. But unlike them, we had quite a lot of autonomy in economic activity. Those. we are given a government order that we cannot refuse, even if we do not have enough funds. But everything that we have earned ourselves, we can dispose of ourselves.

Problems arose due to a shortage of medicines that were purchased centrally with the help of the Department of Health (the number of unfulfilled prescriptions with a delay of up to 1.5 months exceeded three thousand in the polyclinic of MGOB No. 62 - ed.).

223 the federal law allows us to purchase medicines on a competitive basis. Of the 400 million rubles we earned, a quarter went to salaries, we spent the rest on the maintenance of the hospital. We had to buy chemotherapeutic drugs for 80 million rubles in order to treat patients under compulsory health insurance. I raised this issue many times, but the result was only trouble.

Price difference

When we bought drugs, it turned out that we buy them two-three-four times cheaper than they are purchased centrally. We had a non-resident patient who was undergoing surgery by OMS. And he wanted to undergo a cycle of chemotherapy, which is not carried out under compulsory medical insurance. But when he found out the cost, he suddenly refused and left. I was very surprised, because the hospital bought the medicine he needed at 7.5 thousand per bottle (that is, only 30 thousand). BUTwhen we started looking into it, it turned out thatat that time in the treatment room there was a medicine that we received centrally, the cost of which was 25 thousand per bottle (only 90 thousand). Those. what we buy ourselves cost the patient 30 thousand, and what is bought centrally, 90 thousand. That's why he refused.

Why such difference? Because we buy drugs ourselves, according to the 223rd law. Moreover, we purchase them on the same site, but at separate auctions.

But instead of putting things in order with purchases, it was decided to transfer the hospital to the budget. Now everything will be the same, everything will be “normal” and there will be no problems for people who are interested in this ...

"Service Improvement"

The transfer of an institution is a violation of the law and the charter. The autonomous institution is managed by supervisory board, which is formed by a third of the employees of the City Health Department, by a third - from social activists, by a third - from hospital employees not from the administration, plus one person - a representative of the Moscow Property Department.

It is the Supervisory Board that considers the plan of financial and economic activities of the institution, the results of its work, makes all decisions on transactions and, if necessary, changes the type of institution. Suppose, if we are inefficient as an autonomous institution, the supervisory board decides to return to the budget.

However, this year the Supervisory Board did not meet at all. The Moscow government itself decided to transfer 62 hospitals from an autonomous institution to a budget one with the wording "to improve medical care." At the same time, they did not hear any reports, did not discuss with anyone, there was no voting. I'm not talking about the fact that these are colossal costs: you need to change all forms, seals, etc.

Don't interfere

Per last years the efficiency of the hospital has increased by 2.5 times, and if we count day hospitals - by 3.5 times. We have the highest surgical activity in the city, and many operations in Moscow are performed only by us. Mortality at one time was 4.5%, now - 0.7%.

Our hospital is the only one that treats complex cases at the world level. When I became the chief physician, we didn't even have an ultrasound, there were only 2 X-ray machines. How we worked then, I can't imagine now, but we worked. Now we are equipped no worse than any European clinic: we have five computed tomographs, two magnetic resonance tomographs, etc. And all this was acquired not only through modernization - sponsors gave us equipment worth 10 million dollars. In addition, we have a unique laboratory that does contract research for oncology centers.

The problems started when we were transferred to CHI, because the CHI does not pay the real cost of treatment. But with our margin of safety, we lived for almost two years. If we were not disturbed, we would continue to live normally.

Now they ask me: “What does the hospital need?” I answer: “One thing is needed - do not interfere, follow the law. Centralized purchases are not allowed - give us the money and don’t interfere.” But this is unrealistic for officials ...

What will happen?

The people who work for us will not die, they will be snatched up with hands and feet. But where will the thousands of patients who have no money go? I have been working in a hospital for 42 years, as a head physician for 27 years. And I already wanted to leave this position, because it became impossible to work. For the first time we come to the conclusion that we have nothing to buy drugs. The only thing I asked was that a person from the hospital be put in my place, who would not ruin it, and that centralized purchases should be abandoned. But they didn’t hear me, on the contrary, they found a person from the outside who was completely unsuitable. Since I'm on sick leave right now, they can't terminate the contract. My contract ends on December 2, they, apparently, were just going to not renew it.

But they left me no choice. I'll leave anyway, but I'll try to save the hospital. I understand that people at the top don't care - they will find where to be treated. And what about ordinary Muscovites who are unable to pay, what will they do? Now we are supported by our patients - simple people whom we have treated. They call, write, offer help. We must try to do something, it’s impossible to destroy everything and say that everything is wonderful with us.

Recorded by Roman Kizyma

The other day, MedNovosti turned to the press service of the Moscow City Health Department for clarification and received the following answer: “There are no plans, let alone administrative documents, to close the Moscow City Oncological Hospital No. 62 in the Moscow City Health Department. On the contrary, the Department of Health plans to further strengthen and develop this clinic. Moscow City Oncology Hospital No. 62 is one of the leading clinics in the capital in terms of oncology. It is equipped with the most modern laboratory, x-ray, endoscopic, ultrasound, surgical equipment. The hospital has the only molecular biological laboratory in the city health care system, which allows to identify genetic disorders and prescribe modern targeted drugs to patients. Over the years, the hospital has traditionally developed organ-preserving surgery for tumors of the bones, lungs, breast, and kidneys.”

In the meantime, Muscovites, concerned about the fate of the hospital, are collecting signatures for a petition demanding “Ban the “optimization” of 62 oncology hospitals in Moscow.” The appeal has already been signed by more than 10 thousand people.

My purely personal view of the situation around the Moscow 62nd hospital
Recently, the "progressive community" has been actively discussing the situation with 62 cancer hospitals. Briefly, the essence is as follows: having received the status of "autonomous" a year ago, in November the hospital was again returned to the state budget institutions. (Let me remind you that in Moscow it was the only autonomous hospital). Her Chief Physician, who did not really agree with this, began to defend the former status, in particular, motivating this by the fact that he makes independent purchases of drugs at an order of magnitude cheaper than the Moscow Health Department does. A certain tension arose between the head physician and the DZ, as a result of which a new contract was not signed with him. Moreover, as far as I know, proposals were made, but no consensus was reached. Shortly thereafter, a movement began on social networks: "Let's save 62 hospital!" And finally, thunder struck: Dr. Makhson (former chief physician) turned to the FSB (KGB) with a statement about the need to check the activities of the Moscow DZ. For me personally, this was a signal to express my opinion about what was happening: I grew up and was brought up in an environment where such statements to the “authorities” AFTER FACTUM were called denunciations, which I actually wrote about recently on FB.

Meanwhile, the social media situation is heating up. A lot of articles, petitions ... a proud, honest and independent chief physician, is fighting a thoroughly rotten, corrupt DZ and stealing bureaucrats! "We will protect", "we will not allow", "how long?!"
I repeat after the hero of Bulgakov from the "White Guard":
"who are you going to protect, answer me?"
62 hospital? What exactly is wrong with her? One of the best cancer hospitals, continues to work and develop, no one is going to either close it, or reduce it, or fire doctors like a "witch hunt".

Is there a check from the side of the DZ? Well, did you seriously think that after such events there would be no verification?! My hospital just had 2 major checks for much lesser reasons!
And, then we defend its status as autonomous? Do you understand a lot of these statuses? (About the price difference in purchases a little later, first about the principles). The difference in status today is minimal. Today, both an autonomous hospital and one like mine, a budget one, buy medications INDEPENDENTLY, for the proceeds from compulsory medical insurance, without the participation of the DZ. Only we are guided by 44 Federal Laws (from my point of view, they are useless and do not protect against any corruption), and the autonomous hospital is 223 Federal Laws, initially more liberal, but in meaning not much different from the 44th. Today, thanks to the efforts of the Federal Antimonopoly Service in Moscow, all these hints at simplification of purchases have been brought to naught. Therefore, there are practically no advantages of autonomous status, but there are risks. Which? When there is a shortage of funds, an autonomous enterprise, taking a loan, answers with its fixed assets. And in a very costly oncology, today immersed in the compulsory medical insurance system with its meager rates, it is very difficult to even reach self-sufficiency. An illustration of this is the fact that this year Autonomous Hospital No. 62 received 200 million from the DZ "for equalizing salaries." (I saw this in the table at the weekly meetings of the chief physicians). Compare, a large oncological hospital did not have enough 200 million (and we are all equal now, we all receive money ONLY FOR WHAT WE EARN IN THE OMS SYSTEM), and my Budget Hospital for the same time -2016, not only did not take a penny from the DZ , but it also comes with a plus of 250 million. Despite the fact that our average salary is higher, it is generally the highest in Moscow. And if the 62nd hospital would not have received these 200 million? Therefore, the Budget is more reliable and calmer: there are fewer risks, and there is almost no difference today, as I tried to illustrate. I repeat, a budget hospital today purchases drugs on its own, without remote control, just like an autonomous hospital, with a slight legal difference in design.

So then the most important thing remains: to bring to clean water thieves-officials, swindlers, stir up "Ulyukaevshchina" and so on. The question is, why shout and write petitions? The authorities are informed, checks are underway, let's just wait for the result. Oh, well, let's not let it be hushed up. Okay, more about purchases. I will not talk now about drugs with a limited shelf life, although there were such drugs and no one denies this. The drugs were purchased by the DZ not at the expense of the hospital from compulsory medical insurance. These were purchases with BUDGET money for all oncology hospitals to help them with drug provision BEYOND what they buy themselves with MHI funds. “What’s the difference ?!”, you say, and you’ll be right - there is a difference for the hospital and its head doctor (they don’t take it away, but rather give it from above, but what and how is the tenth thing ...), but for all citizens, budget money - this is what they give to the State in the form of taxes. And they have the right to protest when they are stolen or spent irrationally.

Among more than 100 items of drugs purchased by the HC for Oncology hospitals, 5 items were indeed purchased much more expensive than the head physician of 62 hospitals managed to do. I emphasize - cheaper than in Russia as a whole, but much more expensive than theirs. I don't really understand why 62 could buy them so cheap? Let me explain: I am a drug manufacturer and I consider it possible to sell it at such a reasonable price. Found a buyer in the form of 62 hospitals. So they bought everything in the bud? If not, then why did not go to the auction DZ??!. I would go out, there are no restrictions, everyone is welcome! At these prices, I have no competitors and I would sell everything I wanted, guaranteed and without hassle! (By the way, I wrote earlier that if I were Makhson, I would immediately go to the DZ and say: look how cheap I can be, let's do it too). Something doesn’t add up in my head ...... I’m far from the “conspiracy theory” and assumptions about the start of someone’s war for the redistribution of the pharmaceutical market, but either the recent series about Sherlock took too much to heart, or something else, but "vague doubts torment me ..."

But what is, that is: out of the total billions of purchases of drugs, DZ spent 6 million on the purchase of drugs at a price more expensive than other, albeit individual buyers. And this is now sorted out by all kinds of checks from very competent authorities. And if so, remember the presumption of innocence. Stop calling people thieves! Wait a bit, maybe you will be ashamed!!! Prove it, then yes, it will not seem enough! But I am sure that there is no theft and does not smell. I personally know these people and believe them, no matter how ridiculous it may seem to you all! And then we are all on pathos, and someone seals up the car numbers with papers, someone walks "to the left", someone carries something from work .... I'm talking about who has the right to throw a stone first. Yes, the scale is not the same, but the principle is the same. Wait for the results, not long left, chill ....

The last thing remains: to protect Dr. Mahson personally. Get him back in charge! Many owe him personally and are ready to defend him to the end. I agree - a very competent and authoritative doctor, a professional. Does he want to go back to his job? After all? Appeals to the KGB, heating up a public scandal? I'm not sure. Personally, if I were the director of the DZ, after such a denunciation (excuse the term!) I would not have taken him back. But I am an overly emotional person, but not in power. I fully admit that those in power are more pragmatic and would compromise. But I don’t believe that the former chief physician needs this, I don’t understand at all what kind of game is going on here. I see something else: YOU ARE ALL INTENTIONALLY INVOLVED IN IT!

Remember Mowgli: in order to destroy the village, he, with the help of his wolf brothers, raised a herd of buffaloes and drove him forward, destroying everything! Stop rocking the boat. Our health care may not be able to withstand this this time! I will quote from the same episode of the "White Guard": "Moreover, you will pay for this farce own blood absolutely pointless - all of you. "You are not protecting the hospital and its head physician, you are destroying our health care that is just starting to raise its head with chaotic movements and" careless handling of fire "and it will be worse for absolutely everyone. Be patient, wait for the results of the investigation, it already going.