Age limit for chief physicians. Age limit for the position of "chief physician"

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 should be people no older than 65 years. At the same time, for the head, the term of office can be extended up to 70 years on the proposal of the general meeting of employees of the organization. With regard to 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 expiration of the powers of their immediate superiors.

Unfortunately, a misinterpretation of this document appeared in some media: allegedly, many outstanding medical practitioners 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 exempting them from administrative work: signing payments, repairing roofs and replacing sewer pipes in hospitals, and solving other household issues.

Today, more and more new information technologies are being actively mastered, and in these conditions it is advisable to ensure the influx of younger personnel for organizational work, including in the healthcare sector. And the current leaders, who have reached the age of 65, must be given the opportunity to concentrate on their medical and scientific activities, on the training of students. They will necessarily be offered other positions corresponding to their qualifications. 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, many universities introduced the position of president. Younger researchers began to be elected rectors, former leaders became presidents: they could focus not on 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 introduced 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 career prospects in state and municipal organizations and, as a result, work only for the more financially secure part of the population. Our task is to ensure that they provide medical assistance to all citizens of Russia.

Among other things, the proposed bill establishes continuity in the healthcare sector: the new chief doctors of hospitals and polyclinics 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 the law comes into force, employment contracts concluded with the heads of medical institutions and their deputies will remain valid, even if these persons are over 65 years old. Three years, from our point of view, is a sufficient period to prepare a worthy replacement for yourself.

This bill was supported by both trade unions and the government. We hope that the State Duma will adopt it in the first reading as early as June.

Federal Law No. 265-FZ dated July 29, 2017. Age limit for chief physicians.

Heads of healthcare facilities who will not be affected by the age limit. Introduction of honorary positions for chief physicians.

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From the article you will learn

The State Duma adopted the draft law on limiting the age of chief physicians in the third reading last summer, and in the autumn 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 at the federal, regional or municipal level and their branches, as well as hold the positions of deputy chief physician.

Age limit for chief physicians: clarification

The law on the age of chief physicians applies to both federal and regional healthcare facilities, as well as to city-level institutions. It entered into force this fall, but in the first three years of its operation, some exceptions will be made for many "age" chief physicians.

The chief physicians of medical institutions and their deputies will be removed from their positions upon reaching the age of 65, while the term of their employment contracts will not matter. They will be transferred to other positions, which correspond to the level of their 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 doctors can remain in their positions until the age of 70 by decision of the general meeting of the team. In turn, deputy chief doctors can also remain in their places at the decision of the head.

Thus, the maximum age of the chief physician will be 70 years. But you need to understand that removing him from a leadership position does not mean at all that he will be forbidden to practice.

Former chief physicians will be able not only to receive patients, but also to be directly involved in operations. They will simply be relieved of administrative duties.

Which chief doctors will not be affected by the "age limit"

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 mentioned above, the founder will be able to leave the head of the health facility, who has reached the age of 65, in his position for another 5 years, if such a desire is expressed by the staff at the general meeting.

Health workers are asking which chief doctors will not be affected by age-related prices. Indeed, there are exceptions - these innovations will not affect feldsher-obstetric stations, district hospitals and branches.

While supporters of the adopted law argue that the dismissal of chief physicians by 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 workers on the basis of age.

In their opinion, it is possible to talk about only when there are health problems that do not allow them to fully perform their duties.

Age limit for chief physicians: comment of a deputy

State Duma Deputy, 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 they are being replaced by a new generation.

Is there a relationship between the age of the chief physician and the quality of management

Age affects energy, performance, but this is offset by wisdom and experience.

Therefore, I, for example, do not see a direct correlation between the age of a leader and the quality of management.

I don't think anyone has done any research.

Moreover, any research is money. We still need to try to find a sponsor for this topic. The bill is in the process of being updated. Goes heads

The draft law does not say a word about the definition of criteria for the "deterioration" of the business qualities of leading medical workers. Accordingly, this is a baseless, unsubstantiated initiative.

What percentage of age-old chief physicians will fall under the bill

I don't have such statistics. But recently there was a publication about the N.N. Blokhin. Almost all deputies there turned out to be 65-year-olds. There was a mass layoff.

Is the law contrary to the Labor Code?

There is an element of discrimination in the age limit for chief doctors: if you are old, you are not needed. But it is mitigated by such provisions as a transitional period of 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 offset 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.

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 the age limit for chief physicians. Of course, they won't kick the chief doctors out into the street, according to the document, they will be offered another "qualified" position.

The opinions of experts are divided: some believe that such an approach will give a "green light" to the growth of young personnel. Others insist on the need to unify the rules and 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: age leaders will not be removed from office for the next three years. In addition, the founder of a medical organization will be able to extend the term of office of the head physician up to 70 years, if requested by the general meeting of the staff of the medical organization. But, in fact, it may not last.

Similar restrictions have been in place for two years in the system of education and science: 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 possibility has been introduced to extend the powers of up to 70 years for federal leaders, a bill is on the way for regional officials.

“Today, innovative technologies are being actively introduced in medicine, new specialists are needed. Of course, the issue should still be discussed, but I support the direction itself,” Raziyet Natkho, expert of the working group of the ONF “Social Justice”, told RG. “If this is transferred to the chief doctors, I think this will help to avoid situations where managers stay in their places and do not work effectively."

Competent leaders in medicine are sorely lacking

At the same time, Larisa Popovich, Director of the HSE Institute of Health 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 health of the employee does not allow him to perform 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 transfer leadership in them“ by inheritance, ”says Alexander Safonov. - But these sensational cases are isolated. So there is no need to shoot from a cannon "Probably, the rotation of personnel is really needed. But to judge whether a person can lead or not, it is necessary not in terms of his age, but the efficiency of his organization. If the medical institution works fine, if there are no complaints from the public, consumers of services , then why break it? But in order for the founder to be able to evaluate the effectiveness of the organization, it is necessary to develop clear criteria for such an assessment. "

It is impossible to "purge" medical personnel so rudely, the head of the department of health 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 managers in medical institutions. In the regions, they are generally worth their weight in gold. I am a doctor who is 66 years old and is ready to work for another 20 years. a special, difficult profession," Viktor Cherepov told RG.

The Zemsky Doctor program is looking forward not only to young specialists, but also to older doctors. The need for a mentoring program in medicine is also mentioned by the First Deputy Chairman of the State Duma Committee on Health Protection Natalya Sanina, and the head of the Central Research Institute for the Organization and Informatization of Health of the Russian Ministry of Health, and in the past the Minister of Health of the country Vladimir Starodubov. Young and not even very experienced doctors need experienced assistants... Otherwise, what's the point in discussing the availability of treatment?

A completely different trend has taken root in the organization of medical care. The law, signed by Russian President Vladimir Putin on Sunday, July 30, sets the age limit at 65 for heads of medical organizations, as well as their deputies and those specialists who manage branches of medical institutions. By decision of the staff of the hospital, medical center or clinic, the head physician may 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 and deputies Andrey Isaev, Tatyana 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 purpose of the new legal act, parliamentarians see the turnover of personnel and the improvement of the industry with its help.

What will follow the initiative, which should come into force on the first of October? Rejuvenated workforce and more modern treatments, or decapitated medical facilities and declining levels of patient care?

The list of doctors who will lose their posts 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 Endocrinology Research Center, Zurab Kekelidze, Director of the V.P. 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 country's main specialists in their field of medicine. The concept of the 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-rectors, heads of branches of institutions 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 July 27, 2004 No. 79-FZ “On the State Civil Service of the Russian Federation” also establishes the age limit for 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 powers of his leader expire. But for the head himself, the term of civil service can be extended to 70 years by the state body or person who appointed him to the position, 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 heads of medical organizations, deputy heads, as well as heads of branches of medical organizations, which reached 1 October 2017 of the age of 65 years or will reach this age within three years after the specified date, remain valid until the expiration of the terms provided for by such employment contracts, but not more than three years from the date of entry into force of the Federal Law.

Age is not enough reason?

The legitimacy of labor restrictions by age was studied by the Constitutional Court back in 2006. In his ruling dated July 11, 2006 No. 213-O, he decided:

“The age limit when filling the positions of heads of departments in state higher educational institutions ... cannot be considered as a special requirement due to the nature of this activity, the characteristics of this type of work, and the fact of reaching the age limit in itself cannot serve as a sufficient basis for dismissal of the head department or prevent 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 to the individual, the state and society suggests that when deciding whether a person whose age exceeds sixty-five years meets the necessary requirements for heads of departments, the opinion of the leadership of universities and their collegiate 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 in force.

To give way to the young?

“Similar laws have been in force for a long time in relation to a number of employees of state budgetary institutions. The process of rejuvenation of the leadership should be. In universities and research institutes, this did not cause rejection. After all, there is both the position of the scientific director of the research institute, and the status of the president of the faculty,” comments Director of the National Research Institute of Public Health Ramil Khabriev. - That leader is bad, who did not give his subordinates the opportunity to grow, did not prepare a shift for himself ... Transferring knowledge is a natural human desire. And it is necessary that the head of a medical institution think 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 polyclinics to be more attentive to junior specialists. And this will help medicine to rise to a higher level.

However, as the “children's doctor of the world” Leonid Roshal noted back in March: “At the age of 82, I decided to leave the position of director of the Research Institute of Emergency Pediatric Surgery and Traumatology. Found a decent replacement. But he still needs my help."

At the ONF round table "How to overcome the personnel problem in healthcare", the doctor supported the proposal of Natalia Sanina and Vladimir Starodubov on a special mentoring program.

Big...fight?

“No matter how we treat famous doctors, they have enormous charisma, authority and decision-making experience. With their departure, a “big fight” of less charismatic and authoritative people will begin. Struggle, inertia, the search for a way out, the reaction of authorities at various levels, attempts to find a replacement, staff turnover due to unsuccessful decisions. Those whom the law will directly affect, their environment - and new ones, along with those whom they will bring with them, ”warns President of the League of Patient Defenders Alexander Saversky.

A fierce discussion has unfolded around the new law on social networks. Some refer to the experience of European countries, such as Germany, where, upon reaching the age limit, not a single head of a healthcare institution can retain his post: the head physician either retires or is engaged in teaching. Others are perplexed: the director can be appointed to the position of 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, why do you think they work? Let's be honest. I don't know the figures for Moscow, but on the periphery the understaffing is 50 percent or more! In cities with a population of one million! The fourth, with bitter irony, proposes to introduce age restrictions for deputies of the State Duma. And also in some industries and institutions.

“They were over 65, but they invested so much in us ...”

Fifths are indignant: "One gets the feeling that this is a deliberate policy - to decapitate the country altogether, depriving it of valuable and thinking people!"

As noted 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 professional in medicine is an expensive "product". Practice and experience form high-class professionals! The older they are, the more they know, and therefore 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 the 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 Worker of Science of the Russian Federation, Member of the Committee for Civic Initiatives, Professor Yuri Komarov. “It's not about clinical medicine. At the very least, it is developing, new methods and technologies are emerging. The problem is in the organization of medical care.”

The age of chief doctors 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 healthcare, Yuri Komarov explains. Movement without a rudder is still only at the level of “general and whole” ...

Share your personal opinion and Deputy Chairman of the State Duma Committee on Health Sergei Furgal:“I think that the law is at least premature. And hurt a lot. In addition to Moscow, there are other regions where there are 2-3 doctors in district, city, and rural hospitals. If they are fired because of 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 fall throughout the country. An amendment on the age limit is not needed at all - healthcare needs to solve other, systemic problems. And in my opinion, only knowledge and health can be a limitation in labor activity.”

The circle is closed. Staff shortage, lack of conditions in which young doctors could live and work... By setting an age limit for doctors, does the country run the risk of losing not only the luminaries of medicine, but also medicine as such?

The State Duma may establish an age limit for chief physicians 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 the Federal Structure and Issues of Local Self-Government recommended that they be adopted in the first reading. What do doctors themselves think about it?

Director of the Sklifosovsky Research Institute Mogeli Khubutia, for example, is now 70 years old. Leonid Roshal, President of the Research Institute of Emergency Children's Surgery and Traumatology, is 83. Leo Bokeria, Director of the Bakulev Center for Cardiovascular Surgery, is 77 years old. If the law is passed, then the heads of state medical organizations who are 65 years old should be fired. The restriction is extended up to 70 years if the employees of the institution advocated for it. Here is the reaction of the director of the N. N. Blokhin Russian Cancer Research Center, Mikhail Davydov, 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 older than this age work brilliantly, lead and are the most experienced professionals. Although such a pattern exists all over the world, in fact, it is an age limit for senior employees, so it is quite discussed. I would still make a limit of up to 70 years for chief physicians. If an experienced leader, he is in excellent shape until the age of 70, and, of course, he can be of great benefit.”

The deputies explain the idea by the need to rotate personnel. Prior to this, the age limit has already been introduced for rectors of universities and heads of scientific organizations. By the way, there are no restrictions for the State Duma deputies themselves: Iosif Kobzon, for example, is 79, Valentina Tereshkova is 80. There are also heads of state who are already over seventy. And there are examples in business: 86-year-old Bernie Ecclestone, who for 40 years led the world's main auto racing. But when there is no border, this can also be bad, comments Anatoly Makhson, the former chief physician of the Moscow 62nd Hospital.

Anatoly Makhson former chief physician of the Moscow 62nd hospital“There are other examples: he is already under 80 years old, he, perhaps, as a leader is already a nobody, but he works, and when there is no border, maybe this is not very good. On the other hand, when some kind of border is introduced, it no longer makes sense, because many of our leaders 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 anyway, let's say, or at 65, then you need to prepare a successor, as it used to be. But that's my opinion."

The bill clarifies that after reaching the age of 65 or 70, the head can be transferred to another position. A brilliant 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 Trakhtman Head of Department at the Rogachev Center for Pediatric Hematology, Oncology and Immunology“A person, even being a big, big boss, cannot hold his position forever. He becomes blurred, he is no longer so eager to do something necessary and useful. Still, upon reaching a certain age, not everyone, it is clear that this does not happen to everyone, but still, working capacity and working capacity, and mental functions are reduced. If the leader knows that upon reaching a certain legal age - in Europe - it is 65 years old, in Israel - it is 65 years old, in the United States of America, in my opinion - in general - 60 years old - he must leave an administrative post in public institution. Usually they all open their own private clinics and run them perfectly.”

Although even now the chief physicians, or rather their spouses, no one bothers to do this. For example, last summer Life.ru wrote that the head of Dental Polyclinic No. 4, Manvel Aperyan, had the highest personal income among the chief doctors of Moscow. His wife, according to Life.ru, owns 40% in the private clinic Atri-Dent, and in 2015 the family earned 42 million rubles.