Under The Guise Of Public Good: Cleaning Up The Intercom Market And Stem The Loss Of Medical Staff

Belarus is proposing to tighten requirements for private healthcare workers and introduce licensing for intercom installation and maintenance services. The relevant amendments to existing legislation were discussed today at a meeting attended by Aliaksandr Lukashenka. Behind the guise of the public good, the agencies involved are pursuing their own corporate interests.

Not Enough

The Ministry of Health is proposing to increase from three to seven years the work experience at a state institution required to work at a private clinic.

Under the current law “On Licensing,” Article 207, “Pre-Licensing Requirements,” subparagraph 2.3 sets out the requirements for medical workers with whom an employment agreement or contract has been concluded. For workers with higher medical education, the current requirement is at least three years of experience “in a specialty corresponding to the services declared by the license applicant that constitute the licensed type of activity.”

But officials intend to make changes.

In the draft law “On Amendments to Laws on Licensing,” published on the National Legal Internet Portal, subparagraph 2.3 proposes to “replace the words ‘three years’ with the words ‘seven years, one of which immediately precedes the date of submission of the application for a license.’”

A Long Road To A Private Clinic

So, let us do the math. Medical universities in Belarus require five to six years of study, depending on the chosen specialty and form of education. Then there is an internship, which lasts one year for medical interns. Then there is mandatory service: five years for targeted-placement graduates and two years for graduates of state-funded programs. The period of mandatory service starts after completion of the internship. And then there is residency, for which the training period for most specialties in full-time study is two years.

With residency, that already adds up to around 10 years. It would seem that the coveted private practice is already within reach. But no. Ministry of Health officials want to postpone this opportunity for several more years. Mandatory service is no longer enough for them.

“Change The System”

The reason is clear: a shortage of personnel. This summer, the State Employment Service database listed more than 3,500 vacancies for doctors. The Minsk City Executive Committee’s Committee on Labor, Employment and Social Protection states that in January-August this year, medical workers — nurses, paramedics and specialist doctors — were among the most sought-after professionals.

This spring, Lukashenka called for not blaming the shortage of medical personnel and instead changing the system. And officials saluted.

The method of solving the problem is then perfectly clear. How should it be changed? Increase doctors’ and medical workers’ salaries — where would the money come from? The workload on specialists cannot be reduced either, given such a shortage of staff. And then there are the best professionals seeking to move to private medical centers, where incomes are higher and working conditions are somewhat different.

But a method was found nevertheless. A predictable one, because Belarusian healthcare officials know only one way to “change the system” — by putting up barriers, roadblocks and digging trenches with crocodiles — obstacles that those wishing to “desert” from the public sector into private practice will be able to overcome only with great effort. In other sectors, however, the bureaucratic approach is no better.

Health Minister Aliaksandr Khajayeu, of course, tried to present his ministry’s initiatives as concern for the public good. The idea, he said, is to “ensure an appropriate level of quality of medical care in all institutions, whether state-run or private.” Moreover, “there are certain forms of mentoring and assistance in the state system.” But we understand where this is really coming from.

For now, the proposals on new requirements for doctors at private medical centers have been sent back for revision. But something suggests that the Ministry of Health will push them through. It is, after all, in the “public interest.” And licensing everything and anything is the most convenient and, most importantly, effective way to compete with private businesses. And, crucially, it requires no expenditure.

In Response To “Numerous Complaints From Citizens”

And sometimes it can even generate revenue. So the Ministry of Health is far from alone in seeking to make money through licensing. The Interior Ministry is lobbying for licensing of intercom installation and maintenance services. According to Minister Ivan Kubrakou, if his ministry cannot find a licensed service provider, the Interior Ministry’s Security Department will take on this “burden” itself.

And here is a question with a twist — will it find one, or not? In my view, the answer is obvious. Why not take over the intercom market? On a national scale, it is quite a lucrative piece of business. And the 82 legal entities and 14 individual entrepreneurs engaged in intercom services in the country will be squeezed out by licensing in no time by Kubrakou’s ministry.

That is why the Interior Ministry is advocating for intercom systems to be defined as “an integral part of the concept of ‘technical security systems.’” And that is it — the rabbit is out of the hat.

There are other bonuses as well. Kubrakou said that “the Interior Ministry will begin developing a system whose functionality will enable emergency and law enforcement personnel to gain prompt access, <…> and unlock intercom system locks.” So, if it becomes necessary to search the homes of extremists, there will be no need to bother the neighbors — they can simply enter without knocking. Convenient.

And the “culprits” behind the licensing are Belarusians themselves, who, according to the minister, have “numerous complaints about the quality of the services provided, with complaints often being addressed not to employees of the commercial service companies, but to representatives of state municipal services.” One cannot argue with that — not everyone would dare to complain to the Interior Ministry.

Both of these stories are telling in showing how officials, under the guise of the public good, pursue their own corporate interests. And many more articles could be added to the licensing law. There are also plenty of agencies in the country with an interest in doing so. And the result is more barriers and roadblocks, allowing some to make extra money while others dam another stream of personnel leaving the public sector.

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The views and assessments expressed by the author may not coincide with those of the Reform.news editorial board.