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Установленные постановлением Правительства РФ от 9 октября 2019 г. № 1304 принципы базируются на основных принципах охраны здоровья, установленных ст. 4 Федерального закона от 21 ноября 2011 г. № 323-ФЗ «Об основах охраны здоровья граждан в Российской Федерации».
Так, выделено1 четыре группы принципов модернизации первичного звена здравоохранения в России:
обеспечение доступности и качества первичной медико-санитарной помощи и медицинской помощи, оказываемой в сельской местности, поселках городского типа и малых городах с численностью населения до 50 тыс. человек;приоритет интересов пациента при оказании данной медицинской помощи и соблюдение прав граждан при оказании первичной медико-санитарной помощи и обеспечение связанных с этими правами госгарантий;приоритет профилактики при оказании первичной медико-санитарной помощи;ответственность органов государственной власти и органов местного самоуправления, должностных лиц организаций за обеспечение прав граждан при организации первичной медико-санитарной помощи.
При этом перечислены конкретные мероприятия в рамках реализации каждого принципа с указанием их ожидаемого результата, сроков исполнения и ответственных исполнителей. Так, например, в рамках первого принципа предусматривается организация оказания медицинской помощи с приближением к месту жительства, месту обучения или работы исходя из потребностей всех групп населения с учетом трехуровневой системы оказания медицинской помощи, обеспечение транспортной доступности медорганизаций для всех групп населения, включая инвалидов и других групп населения с ограниченными возможностями здоровья, оснащение медорганизаций, на базе которых оказывается первичная медико-санитарная помощь, а также центральных районных и районных больниц оборудованием для оказания медпомощи с учетом особых потребностей инвалидов и других групп населения с ограниченными возможностями здоровья. Также намечено устранение дефицита кадров в первичном звене здравоохранения и повышение уровня их квалификации, в т. ч. в целях обеспечения возможности выбора медицинской организации и врача.
В числе мероприятий, направленных на реализацию принципов модернизации первичного звена здравоохранения, указаны, в частности:
проведение субъектами РФ инвентаризации объектов здравоохранения, на базе которых оказывается первичная медико-санитарная помощь населению, а также центральных районных и районных больниц и их кадрового обеспечения;разработка регионами оптимальных схем размещения объектов первичного звена здравоохранения, центральных районных и районных больниц, обеспечивающих их доступность, а также их паспортов с привязкой к кадровой укомплектованности медицинских организаций;с учетом схем размещения и паспортов медицинских организаций осуществление строительства, замены (в случае высокой степени износа, наличия избыточных площадей), капитального ремонта медицинских организаций и их отдельно стоящих подразделений, а также их оснащение необходимым оборудованием и транспортными средствами;изменение системы оплаты труда медицинских работников, в т. ч. оказывающих первичную медико-санитарную и скорую медицинскую помощь населению, медицинских работников центральных районных и районных больниц;реализация региональных мер социальной поддержки и стимулирования медработников;совершенствование системы оплаты первичной медико-санитарной помощи и т. д.
Кроме того, документом утверждены правила проведения экспертизы проектов региональных программ модернизации первичного звена здравоохранения, мониторинга и контроля за их реализацией.
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1 С текстом постановления Правительства РФ от 9 октября 2019 г. № 1304 «Об утверждении принципов модернизации первичного звена здравоохранения Российской Федерации и Правил проведения экспертизы проектов региональных программ модернизации первичного звена здравоохранения, осуществления мониторинга и контроля за реализацией региональных программ модернизации первичного звена здравоохранения» можно ознакомиться на официальном сайте Правительства РФ.
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