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Human rights activists are worried that because of the epidemic people stopped treatment

The human rights organization Zona Prava sent a letter to Prime Minister Mikhail Mishustin, chairman of the government’s coordinating council for combating the spread of coronavirus infection, with a proposal to introduce a unified temporary organization of work for medical institutions in the regions. Now, human rights activists remind, in accordance with the order of the Ministry of Health of March 19, regional epidemiologists were recommended to approve the temporary procedure for organizing the work of medical organizations providing medical care on an outpatient basis and in an inpatient setting. This led to the fact that in a number of regions patients’ access to qualified medical care was severely restricted: prohibitions on planned hospitalization were introduced, and outpatient clinical care was transferred to a remote mode.

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For example, in Tatarstan, medical organizations, regardless of the legal forms and forms of ownership, prohibit planned hospitalization of patients. An exception is made for patients with diseases that pose a danger to others (their list is approved by the government) or in which a delay in the provision of medical care may lead to a deterioration in their condition, a threat to life and health. What kind of diseases is not specified in the document. The Ministry of Health of the Republic promises that outpatient care for the population on medical grounds, including consultations of narrow specialized specialists, will be provided at home, as well as remotely.

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A similar situation, human rights activists say, has developed in St. Petersburg, the Novosibirsk and Rostov regions, and a number of other regions. But in the Samara region, pregnant women were allowed to visit medical institutions for procedures or tests. In the Tver region, the leadership of the regional Ministry of Health only appealed to local residents with a request to postpone visits to doctors for urgent consultations and contact medical institutions only in case of illness.

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The representative of the “Zone of Law” Bulat Mukhamedzhanov says that far from always the severity of measures taken by the regions directly correlates with the epidemiological situation: in Tatarstan, for example, there are dozens of people with coronavirus, and thousands risk losing medical care.

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The Russian Ministry of Health did not respond promptly to a request from Vedomosti about the possibility of such a document appearing.

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Judging by the appeals, the most questions arise for people with oncology – they had to undergo scheduled examinations, which are now canceled – and also for pregnant women who should visit a gynecologist, says a medical lawyer from Novosibirsk, Julia Kazantseva. Many women were observed in private clinics, which are now closed, but they are no longer registered at the place of residence. Local regulations provide for the provision of medical care only in case of a direct threat to life and health, notes Kazantseva. But this is a very vague definition, in fact, this issue is left to the discretion of local organizations. She recalls that under the Constitution everyone has an equal right to medical care and it cannot be limited depending on the region. “I think that lawyers and doctors should work together to develop a temporary procedure for the provision of medical care, which will define clearer guarantees in this area,” said Kazantseva.

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Pen & Paper partner Maria Nikolaeva does not exclude that in the near future some additional regulation will appear. Now everything is happening very quickly and the legal technique is suffering, the necessary adjustments are made literally on the run, she notes. For example, in St. Petersburg on March 23, by a decree of the chief medical officer, a ban was imposed on the planned hospitalization of patients and visits to clinics until April 30, and two days later the health committee specified that the ban applies to activities that can be delayed without worsening the condition of patients, recalls expert.

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Under the conditions of the beginning of the breakdown of the country’s legal space (including two simultaneously acting or temporarily not functioning Constitutions) decentralization is the price that the country’s management system, which is used to a much lower pace of life, has to pay in times of crisis, states political analyst Mikhail Vinogradov. But if decentralization acts as a way of removing responsibility in the political system, then it becomes quite logical in the field of healthcare: the level of epidemiological risks in the regions is not the same, the capacities of funds of healthcare organizations are different and against this background it would be strange to build a common algorithm for everyone – it could be far not the most effective, the expert warns.

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