of October 4, 2021 No. PP-5254
About measures for transformation of surgical service, improvement of quality and expansion of scale of surgeries in regions
For the purpose of creation of necessary conditions for improvement of quality of rendering to the population of the surgical help, widespread introduction of low-invasive and high-technology surgeries in regions, increases in potential of health workers in the direction of surgery, developments of science in the sphere:
1. Determine the main directions of transformation of surgical service:
ensuring interaction between the Republican specialized scientific and practical medical center of surgery of name of the academician V. Vakhidov (further - the Center of surgery) and medical institutions of areas, areas (cities);
widespread introduction of low-invasive and high-technology surgeries at the level of regions and areas (cities);
widespread introduction in the Center of surgery the practician of transplantation in cooperation with foreign specialists;
increase in potential of surgeons, anesthesiologists, resuscitators, nephrologists and other specialists, the organization of increase by them in qualification and passing of training in prestigious foreign medical institutions and the centers, establishing training of specialists in the modern simulyatsionny center;
development of research activities in the direction of surgery, increase in scientific potential of workers;
strengthening of material and technical resources of the Center of surgery, its branches, departments of surgery, anesthesiology resuscitation of district (city) medical associations for the purpose of rendering qualified medical services to the population.
2. Agree with the offers of the Ministry of Health and Ministry of Finance providing:
a) for the purpose of widespread introduction of endovascular treatment of congenital heart diseases at children, their complete improvement in short terms, removal from disability:
allocation to the Ministry of Health in 2021 10 billion sum on purchase of 500 units of medical products (okklyuder) intended for treatment of heart diseases within the funds allocated to the ministry for development programs;
prediscretion, since 2022 proceeding from the needs for parameters of the Government budget, necessary means for annual purchase on average 2500 okklyuder;
b) from the republican budget of the Republic of Uzbekistan, and also additional sources of the budget of the Republic of Karakalpakstan, local budgets of areas and the city of Tashkent in equal shares:
allocation of 42,5 of one billion sum for equipment by the modern equipment of branches of the Center of surgery in 2021 according to appendix No. 1;
the 71,4 direction of one billion sum for equipment by the modern equipment of departments of surgery, anesthesiology resuscitation of 26 district (city) medical associations which are not assigned to the interdistrict centers of the combined injuries and sharp vascular diseases in 2022-2023 according to appendix No. 2.
funds for these actions are allocated from the republican budget of the Republic of Uzbekistan, and also at the expense of the means saved as a result of implementation of low-invasive and high-technology surgeries on places, soft credits and grant means of the international financial institutions;
by reasonable calculations of Council of Ministers of the Republic of Karakalpakstan, khokimiyats of areas and the city of Tashkent from the republican budget of the Republic of Uzbekistan the budget advance is allocated to the corresponding local budgets for equipment with condition of return with the equipment of departments of surgery, anesthesiology resuscitation of district (city) medical associations.
3. To the Ministry of Health (A. Hadzhibayev):
together with the Chairman of the board of Ministers of the Republic of Karakalpakstan, hokimama of areas and the city of Tashkent to provide during 2022-2023 increase in scale of low-invasive and high-technology transactions, including increase in the transaction types which are carried out in areas (cities) from 60 to 79, in regions - from 130 to 168, and also implementation in the Center of surgery of performing transplantation of heart and lungs;
provide until the end of 2022 adjustment of surgery (S. Ismailov) by the Center, Republican scientific center of the emergency medical care (D. Tulyaganov) and the Republican specialized scientific and practical medical center of nephrology and transplantation of kidneys (B. Daminov) of practice of transplantation of kidney in all regions;
take measures for the direction in 2021-2022 of the employees of the Center of surgery and regional public medical institutions which are well knowing foreign languages in prestigious foreign medical institutions and the centers for advanced training and passing of training in the urgent directions of field of surgery, and also involvement of the leading foreign experts to activities of the Center of surgery by fund of support and attraction in medical institutions of gifted and qualified medical specialists of the Ministry of Health, the local budget.
The working group on support and attraction in medical institutions of gifted and qualified medical specialists (B. Musayev) provides transparent selection on competitive basis of the workers directed to advanced training and passing of training according to this Item;
the obligation of working off in the Center of surgery and regional public medical institutions is assigned to the workers directed to advanced training and passing of training in accordance with the terms of the agreement signed with the Center of surgery.
4. Establish procedure according to which in case of involvement of foreign specialists in the public medical institutions:
compensation of foreign specialists is made in accordance with the terms, stipulated in the agreement;
expenses on acquisition of air tickets for them there and back (no more than two times a year in case of long-term employment contracts) and expenses on accommodation in hotels of the republic are paid by the relevant public medical institution in national currency;
source of financing of expenses on their attraction and material security is fund of support and attraction in medical institutions of gifted and qualified medical specialists of the Ministry of Health, extrabudgetary funds of the relevant public medical institutions, grants of the international financial and other organizations, foreign government organizations, and also other sources which are not forbidden by acts of the legislation.
5. Determine additional tasks of the Center of surgery in the field of organ and tissue transplantation of the person:
implementation of basic and practical researches and development of innovative projects in the field of transplantology;
studying and implementation of methods of implementation of high-technology transactions on transplantation;
establishment of cooperation and the organization of joint surveys with the profile scientific organizations, the centers and experts of the foreign states;
rendering assistance in preparation of qualified scientific personnel in the direction of transplantology.
Create in the Center of surgery:
The scientific laboratory on organ and tissue transplantation of the person performing activities on the basis of system of basic financing;
since 2021/2022 academic years department of surgery and transplantology of the Tashkent medical academy.
Determine that the Center of surgery is the main clinical base for bachelors, clinical interns and masters studying at this department.
6. To the ministry of investments and foreign trade (Sh. Vafayev) together with the Ministry of Health in week time to take measures for attraction of financial resources of the international financial institutions and the foreign government financial organizations in the amount of 11 million US dollars for upgrade of the Center of surgery.
7. Approve the Program of measures for transformation of surgical service in 2021 - 2023 according to appendix No. 3.
Provide to the Ministry of Health timely and high-quality execution of the measures determined in the Program and also to quarterly enter information on the done work in the Cabinet of Ministers.
8. To the chairman of the board of Ministers of the Republic of Karakalpakstan and hokima of areas in week time according to requirements of this resolution to develop the Program of measures for development of the surgical help in the Republic of Karakalpakstan and areas in 2022-2023, to provide its consideration and approval in the Jokargi Kenes of the Republic of Karakalpakstan and Kengashakh of People's Deputies of areas, and also submission to Administration of the President of the Republic of Uzbekistan.
9. To the Ministry of Health (A. Hadzhibayev) together with the Ministry of Finance (T. Ishmetov) to make in the Cabinet of Ministers the offer on implementation of system of the differentiated compensation to health workers proceeding from the level of complexity of surgeries and performance indicators in a month.
10. To the Ministry of Health (A. Hadzhibayev) since November 1, 2021 taking into account the best foreign practices to adjust in the Center of development of professional qualification of health workers retraining and advanced training of heads of the republican specialized scientific and practical medical centers and other public medical institutions on short-term training courses on administration in health sector (Healthcare Administration) and to approve the schedule of their training at these rates.
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