МОРАТОРИЙ НА ОПТИМИЗАЦИЮ ЗДРАВООХРАНЕНИЯ

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В минувшее воскресенье в столичном Экспоцентре стартовал двухдневный форум по вопросам здравоохранения. «За качественную и доступную медицину» – именно так назывался съезд, в котором приняли участие более 600 человек: это врачи, ученые, фармпроизводители, эксперты, журналисты, активисты, руководители профильных министерств и ведомств. Обсуждение положения медицины в нашей стране началось со скандального выступления сопредседателя забайкальского штаба Общероссийского народного фронта Николая Говорина.

Почетный врач РФ выступил с докладом под названием «Народный взгляд на здравоохранение». Среди слушателей, кстати, была и глава профильного министерства  Вероника Скворцова. В своей речи Говорин остро раскритиковал Мин-
здрав за проводимую им оптимизацию. В частности авторы доклада считают, что зафиксированный в этом году рост смертности в нашей стране связан именно с проводимой ведомством реформой системы здравоохранения. Представитель ОНФ апеллировал статис-
тическими данными, выводами соцопросов граждан, постоянно цитировал слова президента Путина, который также раскритиковал новую реформу еще в мае. Так, например, в первом полугодии 2015 года умерло на 27 тысяч человек больше, чем за аналогичный период 2014 года.
«Наиболее острыми для населения стали вопросы организации работы первичного звена: наличие очереди и плохая организация приема пациентов», – сказал Говорин.
По его словам, «на фоне роста численности населения число посещений к врачам в 2014 году сократилось по сравнению с 2013 годом на 7,7 миллионов посещений». «Одновременно почти на 22 процента увеличилось число отказов в вызове скорой помощи», – подчеркнул врач.
По мнению ФОМ (Фонд Общественное Мнение) более 30 процентов россиян считают, что ситуация в сфере здравоохранения стала хуже, и всего лишь 11 процентов думают иначе. Исследовательские данные ВЦИОМ (Всероссийский центр изучения общественного мнения) показали: 50 процентов опрошенных утверждают, что укрупнение больниц и поликлиник ухудшило доступ к врачам.
Докладчик рассказал и о проблемах с лекарственным обеспечением: «Около 51 процента пациентов, опрошенных ОНФ в марте-апреле 2015 года, заявили о том, что льготные лекарства не всегда бывают в аптеках, их приходится ждать, заказывать или искать». По всему представители ОНФ считают, что граждане ощущают скорее дискомфорт от «оптимизации», чем наоборот. И выражается это в повышении цен на лекарства, острой нехватке врачей, невозможностью попасть на прием и т.д.
Исходя из данных соц-
опросов, в ОНФ делают вывод, что реформы «осуществлялись без предварительного анализа возможных последствий принятых решений».
На протяжении нескольких часов за главу министерства не заступился ни один из пришедших на форум. Да и сама Вероника Игоревна не спешила комментировать слова оппонентов. Министр выступила только в самом конце встречи. По ее мнению, здравоохранение, например, на селе улучшилось: там снизилась смертность. В целом смертность снижается во всех возрастных группах, а продолжительность жизни россиян «резко возросла».
Скворцова уточнила, что четкого плана «оптимизации» не существует. И в Минздраве речь шла о «необоснованной госпитализации», а не о сокращении количества коек.
В целом министр с выводами Говорина и его команды согласилась. «Отчасти она (критика в адрес здравоохранения) обоснована. Недостатки в системе сохраняются. Проблемы  министерство тоже видит, и очень хорошо, что мы будем вместе работать с Народным фронтом. Кое-что преувеличено или искажено, но это касается деталей и в целом на картину не влияет», – комментирует Скворцова.
7 сентября форум посетил и Владимир Путин. Его вниманию представили последние отечественные разработки: начиная от томографа, который в два раза дешевле импортных, и заканчивая инвалидным креслом повышенной проходимости. Именно цена и качество медицинских услуг стали основной темой обсуждения с президентом. Активисты ОНФ накануне форума объездили двадцать регионов страны и пришли к выводу, что далеко не везде реформа дает положительные результаты.
Говорин вкратце повторил президенту основные идеи и претензии к Мин-
здраву из своего доклада. В частности о том, что доступность услуг снизилась, лекарства подорожали, а врачей в больницах не хватает. Владимир Путин полностью согласился и с тем, что нельзя закрывать сразу все сельские больницы.
«Я слышу от граждан такие печальные шутки, что закрывают очередное учреждение на селе, а из лекарств у нас только чеснок. Как-то даже не знаешь, что и говорить. Поэтому внимание к сельской медицине мы, конечно, должны повысить», – сказал глава государства.
Также Владимир Владимирович успокоил собравшихся по поводу импортозамещения лекарственных препаратов и медтехники.
«Мы никогда не говорили, не говорим и не собираемся говорить, что мы будем запрещать какие-то импортные препараты либо импортную технику. Ни в коем случае»,  – прокомментировал он. Однако он повторил, что к 2018 году в России планируется производить до 90 процентов всех лекарственных препаратов.
Подводя итоги форума, Владимир Путин подчеркнул, что претензий к реформе здравоохранения действительно очень много, но и результаты есть. Активисты ОНФ согласились с президентом. Все выработанные инициативы и замечания пленарного заседания войдут в «банк предложений», который будет направлен для дальнейшей проработки и учета в Мин-
здрав.
Напоминаем, что данная реформа коснется в целом 952 медицинских организаций. Предполагается ликвидировать 41 организацию, остальные – реорганизовать. В результате к концу 2018 года число больниц сократится на 11,2 процента, поликлиник – на 7,2 процента.
Кроме того, до 2018 года регионы планируют сократить фельдшерские и фельдшерско-акушерские пункты (ФАПы), заместив их частично офисами врачей общей практики.
О первых итогах «оптимизации» говорили еще в середине апреля. Счетная палата тогда проверила доступность качественной медпомощи и образования. В ходе этой проверки были выявлены факты ограничения доступности медпомощи населению. Оказалось, что более 17 тысяч населенных пунктов вообще не имеют медицинской инфраструктуры, из них 11 тысяч расположены более чем в 20 километрах от ближайшей медорганизации, где есть врач. Причем 35 процентов населенных пунктов не охвачены общественным транспортом.
«879 малых населенных пунктов не прикреплены ни к одному ФАПу или офису врачей общей практики. Ряд регионов с низкой плотностью населения (Омская область, Камчатский, Приморский края) вообще не имеют мобильных медбригад», – говорил тогда аудитор.
В 2014 году произошло массовое сокращение мед-
работников. За год их стало на 90 тысяч человек меньше при сохранении высокого уровня совместительства – около 140 процентов. Сокращение проводилось без предварительного планирования и учета возможных последствий. 19 тысяч врачей клинической специальности были попросту уволены из больниц. При этом во многих учреждениях сохраняется высокая потребность во врачах и среднем медицинском персонале.
«Таким образом, реализуемые мероприятия по сокращению численности медицинских работников не соответствуют фактичес-
кой ситуации в регионах и сложившейся потребности. Требуется анализ проводимых кадровых мер, и по итогам возможна их корректировка», – сделал окончательный вывод аудитор.


Катерина АРТЕМЬЕВА.
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Backstage at the Rockettes' Radio City Christmas Spectacular Sagan Rose : "This is our reindeer costume, which is how we start the show. This is the only costume that we get in our dressing rooms upstairs. All of these bells are hand-applied — everything is so custom, they do an amazing job for us. The leggings have an ombré effect. It's the smallest details that make the biggest difference." Raley Zofko: "It goes all the way down into our custom-designed LaDuca reindeer boot to look like a hoof of the reindeer. But our favorite part of this costume is our antlers. And — surprise surprise, I'm giving away a little story — they light up at the end [of the number], and we control that. We have a button that we press on a specific count, to specific music, on a specific step." Rose, left, and Zofko. pre bonded hairRacked: How much works goes into fitting each costume to each girl? Sagan Rose: "We start rehearsals at the end of September, and we usually have our fittings a couple weeks before that. But the costume shop is working tirelessly all year. They're so good about it, even if it's the littlest thing — they want to make it so custom and nice for us, because we do spend so much time in them and have so many shows. They want to make sure that we're comfortable. I've been doing the show for eight years now, so they keep my costumes for me year after year. But, you know, things change, bodies change. And if I ever come back and need alterations, it's very easy." Raley Zofko: "And stuff happens throughout the season because we're moving. We're athletes in our costumes. If something unravels, they instantly fix it either during the show or after the show. Everybody is just so on it and professional, and it's what makes the show run smoother." Sagan Rose

: "This is my personal favorite. I just feel kinda sassy, like a cliché Rockette. I t's all about the legs — the numbers starts just from our feet to the top of our skirts showing. So that's the focus of this costume. This is pretty close to the original version when they started the 12 Days of Christmas number here, which I want to say was about 10 years ago. It's so pretty with the lights and the colors and everybody in line together. So they really haven't had to change much." Raley Zofko: "The mesh is different because everyone's skin tone is different, so the wardrobe and costume department custom-dye it. And then we have our head pieces that we have to pin on, and then we do a bunch of head turns to make sure that those are bobby-pinned...after our seven and a half-minute minute tap number, we do kicks, which is pretty exhausting. Our show shoes actually have this battery-packed mic that goes in between the heel." Sagan Rose: "So all the taps are live. We get notes that are like, 'Make sure the heel sound on count is clearer, or sharper, or faster, or together.'" Racked: You'll go out in costume a lot for charity and publicity. Where are some of the fun places you go? remy hair extensionsRaley Zofko: "I got to do the New York Presbyterian children's hospitals last year and it was so wonderful to talk to the children that just need some holiday cheer and love. We literally had a dance party with them, so we danced with all of the kids in our costumes and they were looking at us like, 'Oh my gosh!'" Sagan Rose: "I think it's always fun to do the Macy's Day Thanksgiving Parade. That's when I first saw the Rockettes. I'm from Kentucky, and my grandmother brought my family up to New York when I was little and I was like, 'I want to do that one day.' The parade is a fun place to be in costume because it's a tradition to have us there, and you feel like it's a really big honor." Raley Zofko: "I have friends and family that come up just for the parade. I'm from Alabama, and they fly all the way up to sit in the stands to cheer on the Rockettes." Raley Zofko : "'Soldiers' is my favorite number because it's been in the show since its inception. I feel like I am part of history when I put this costume on. W e have the jacket, we have the pants, and we have the two and a half foot-high soldier hat.

Sagan Rose: "Liza Minnelli's father [Vincent] designed this, and he choreographed the number. And we do the same choreography, wear the same costume. It's really cool because you can see that Raley and I are not the same height — she is closer to the center because she's a taller girl, and I am on the very very end of the line. And when we line up we all want to seem that we are the same height, so they custom-make these jackets and pants to your height. My jacket might be a little shorter than hers so that everything matches in line." Raley Zofko: "These pants are foam pants. Because back in the day, when I started the show, they starched-pressed the pants. They stood up on their own — those were very intense." Sagan Rose: "You walk a little straighter, a little stiffer, and it's easier to perform the 'Parade of the Wooden Soldier' routine with the costume like that. And then we have our tap shoes and these round little fabric cheeks that we put on. We go through about 30,000 of those in a Christmas season. Some girls tape them to their cheeks, but I do Vaseline, because my cheeks are sensitive to the tape." Raley Zofko : "We actually get notes if our solider hat isn't straight up and down. What we do is we put their head up against the wall, so that it lines up so and the back of the hat is straight. If someone's hat is too tilted or too back, it could throw off the line completely. We'll get hat notes, like, 'Raley, your hat was a centimeter back!'" Racked: When you're going from a costume like '12 Days of Christmas' that's all about the legs to being completely covered up as a wooden soldier, what does that change in the way that you're dancing or the way that you're presenting yourself? Sagan Rose: "The costume department and the designers take into consideration what movement we're doing in each number. So I don't feel hindered because the movement is fit for this costume, and the costume is fit for the movement. In rehearsals, we rehearse for a month and a half without costumes, and you get used to that. Then you put on the costumes, and it changes the way you dance." Raley Zofko: "Along with what Sagan is saying, I feel like they take into consideration the simplicity of 'Soldiers' or the extravagance of '12 Days.' In 'Soldiers,' it's just about the formations and the history of the number, so they don't need that much movement. And '12 Days' is very in-your-face, and the costume is accordingly descriptive in that fashion." Raley Zofko : "This is the 78-second change that we were talking about. We have our dress and the coats — right here we have green stripes but there's also red stripes as well. There are so many pieces to it, and we have to get out of all of ['Soldiers'] and get to this, and it's just organized chaos." Sagan Rose: "But it's so organized that it's not chaos! Depending on where you are in the line, there's red and green dresses. This jacket has really simple snaps that really get us in and out, because the change is so fast getting into it and it's choreographed getting these off [on stage]. It could be a little stressful if it wasn't so easy. It's kind of fun because, you know, we're human, and there are wardrobe malfunctions. So if someone's having trouble getting out of their coat, because we do get sweaty and things stick to you... Raley Zofko: "We stand next to each other in this number, too. Which is so funny because I'm so tall and you're so..." perruques cheveux naturelsSagan Rose: "Short. You can say it." Raley Zofko: "You're not as tall as I am. We've had the 'take the jacket off!' emergencies where you're praying the girl behind you can hear you and help you remove it." Racked: Is this where these little guys belong, fastened on the jacket? Sagan Rose: "These are the earrings, and they're there for the changes. We put them on the collar just to make it easy. You know where everything is — I know where to reach for my earrings even when I'm not looking. This is my last step of getting dressed." Racked: Is there ever any issue with the heavy makeup? Are you ever getting something on and you just take your face off on your dress? Sagan Rose: "It happens. We're sweating, we're working hard, and it gets hot underneath those lights. So occasionally, there's white fur near our face and we do get makeup on them, but wardrobe can handle something like that in a snap and by the next show it's clean." Sagan Rose : "So we go from glamorous, sparkly, sassy

Rockettes to this." Raley Zofko: "This is such a crowd pleaser, actually. This is one of my favorite numbers to perform, too. We get to go through the audience this year, which is so cool because we're dancing and stepping all jolly and you get to look at an audience member right in the face and say 'So be good, for goodness sake!' And some of them are freaked out, and some of them love it. This costume is awesome." Sagan Rose: "Everyone thinks that this is a real fat suit, like padded fat. But it's not — it's like a harnessed wire inner tube. We fit right in there and there's no padding down here. Everyone is really surprised that we're all jumping with that. It's nice that there is freedom in this, because we are doing such big movements. It's not necessarily pressed up against our bodies, so we can still move and jump around." Raley Zofko: "The thing that I want to point out here is the wig department — because we kind of get a little messy in our number, they curl our hair and fix this after every performance to make our Santa beards look real and authentic." Racked: Tell us about the space we're in right now — there are a lot of costumes in here. Raley Zofko: "This is the nap space, and lots of changes happen back here. The ensembles are back here, the Rockettes are back here — this is the largest space that we have to change." Sagan Rose: "There can be anywhere from ten to forty [costume] people back here." Raley Zofko: "We have about ten costume changes, and that's just as much choreographed backstage as it is on stage." Racked: Are you just throwing things off and leaving them in a pile for people to handle so you can get back out there? Sagan Rose: "We each have a spot that one or two girls will go to, and there's one dresser to about two girls. We have amazing, amazing dressers. As soon as we come off stage, we're running, and we know exactly where we're going, we know who to look for. It's even choreographed how, if we're changing together, I'll do my earrings first and my dress second and my shoes third, and she'll do her shoes first and her dress second and her earrings third." Raley Zofko: "It's as organized as a [quick] costume change can be." perruques cheveuxRaley Zofko: "This was a newly designed costume by Greg Barnes in 2014. There used to be a rag doll dress that was longer and less form-fitting, and this is cinched at the waist and shorter. And we have the cutest red-and-white striped tights. And underneath that, we have our custom-designed bloomers that I absolutely adore." Sagan Rose: "I wish I could purchase them at a store — they're that cute." Raley Zofko: "We have our glasses, and we have our wigs. This is a wire material that fits right on top of your head." Sagan Rose: "And they are actually pretty light on our heads. We keep the wig caps [from 'Dancing Santas'] on for that." Raley Zofko: "And then we have our Mary Jane tap shoes, which are also miked." Sagan Rose: "We charge the '12 Days of Christmas' tap shoes and these tap shoes after each show, just to make sure." Raley Zofko: "It's so much fun to be a rag doll and get to dance and make funny faces at your friend and look at the audience and blow them kisses." Sagan Rose: "A lot of us come up on the pit of the stage so we are literally this close to the audience, and there will be little kids in the front being like 'Oh my gosh!' They don't know what is happening, their minds are blown, so it's fun to play with them." Racked: You two are seasoned pros at eight and nine years. Has anyone in this cast been around for longer?

Raley Zofko: "There are girls that have been doing it for 16 years that are still in the line!" Racked: Do you have a memory of a favorite show that was a little bit out of the ordinary? Raley Zofko: "There's a gold cast and a blue cast, and I just transitioned from the gold cast." Sagan Rose: "The blue cast is all the morning shows. while the gold cast is all the evening shows." Raley Zofko: "But the gold cast hasn't been doing opening night — this year, when I transitioned to the blue cast, I got to do opening night. That was literally spectacular because there is just such an energy on opening night that I've never felt before. I don't really get nervous anymore. I've done it a lot, and the show is very similar in the ways it changes [from year to year]. I focus on the changes so that I know exactly what to not mess up on, or try to not mess up on. But I've never felt that much energy, love, and support. We had the other cast in the theater watching us, too." lace front wigsSagan Rose: "It was the best crowd I've had in eight years. I felt like a rock star." Racked: What has it been like to perform on this huge world stage, and how is it different to perform elsewhere? Sagan Rose: "Well, to me, I feel like Radio City is my second home. I feel so comfortable on stage and I feel like we all have a bond, especially during the holidays, because a lot of us are from different places and don't have families here. I just feel so at home and so at peace on this stage. [But] when we do travel and perform outside, it's always a nice, different energy that you get." Raley Zofko: "It might be a little bit nerve-wracking in a different way, but it's just as exciting. It's just different — you can't really compare Radio City to outside venues because there's that sense of comfortability on this stage." Sagan Rose: "This is one of my favorites to wear — like '12 Days of Christmas,' the legs are highlighted. With this design, they really wanted to emphasize that every snowflake, like every Rockette, is different, but we come together to make a beautiful snowstorm. So there are six designs of this costume in six colors. All of these straps [on the top] are the biggest change."

Raley Zofko: "On my purple costume, I don't have any of these straps in the front at all. And then we have multiple cuffs and ribbons with rhinestones, and everything is covered in Swarovski crystals. Like what Sagan said, every Rockette is different, and every costume is different, and that's what they try to do with this design. And I think it's so gorgeous. On stage, it's beautiful — with the choreography in the mix, we're beautiful snowflakes dancing in a snowstorm." Sagan Rose: "Linda Haberman was the choreographer for this, and she really emphasized that she really wanted to bring our individual personalities to the stage and celebrate that. Because when you think of the Rockettes you think of a big group of women, but we all are different and have different personalities and different ways that we dance. So it's a really nice number to perform." Raley Zofko: "And then on our LaDuca shoes, the color is painted to match our tights, and the heels have Swarovski crystals on them." Sagan Rose: "This heel is different than our other ones, because it's about a half inch higher to continue the line of the leg. It's a leggy costume." cosplay wigsRacked: What advice would you give to Rockette hopefuls? Sagan Rose: "Taking ballet is very important for dancers, because if you have that good technique background, it will show in anything you do." Raley Zofko: "Tap is very important, too. All versions and styles of dance are important for Rockettes because we are proficient in all of it. I would say take as many classes as often as you can and focus on your technique." Sagan Rose: "And any job, especially in the performing arts industry, is so specific in what they need. So one year, they might need a tall girl, or they'll need a shortish girl for my spot. I think it's perseverance — If you have a goal, don't ever take no for an answer." Raley Zofko: "I would finish that off with dream big, and don't ever lose sight of your dreams. I'm from a small town in the very tip of Alabama and there's not very much dance and entertainment and theater down there. So when I first started dancing, I didn't necessarily know what was out there. And it was just once upon a time — Sagan said she saw the Rockettes at the Macy's Thanksgiving Day Parade and so did I — and I thought, 'That is glamorous, that is beautiful. They are dancing, and I dance.' And it just became a tiny little dream that grew into a big dream, and now it's my life. It's just so unbelievable that it actually came true."