Another Fascinating Russian Government Meeting

Kursk Citizens Support, Kiev's Strike on Western Oil Assets, Russian Healthcare, and Much More.

Russian Parliamentary Building

On 18 February, Putin held a video conference with members of government that covered a wide range of topics, some related to the SMO and others related to Russian domestic affairs. Yes, as usual it’s a long report with several newsworthy segments. The main report is the results of medical examinations of children and adults in 2024, since enhancing the wellbeing of Russians is now the subject of another national project, the national project "Healthcare", which ended in 2024, and the new national project "Long and Active Life", which began on January 1. I rather doubt that any Western Neoliberal ruled nation has any similar concern for the wellbeing of its citizenry. And as you’ll see, the first issue to be discussed also deals with support for Russian citizens:

Vladimir Putin: Dear colleagues, good afternoon!

Our main issue today is the results of medical examinations for adults and children in 2024. Tatyana Golikova will tell us about the results of this work, how this process is going now, and what needs to be done in addition.

I would like to start with a rather acute topic. If you have noticed, I recently met with the Acting Governor of the Kursk Region, Alexander Yevseyevich Khinshtein. He reported on what was done to support people who found themselves in a difficult situation after Ukrainian military formations and mercenaries entered some areas of the Kursk region.

As the acting governor reported, all citizens who lost their property received the necessary cash payments and compensation. To date, 80 percent of families who lost their homes have received cash payments for the purchase and construction of new housing, and almost 10 thousand families have been allocated funds to rent housing.

Nevertheless, Alexander Yevseyevich, after meeting with people, raised the question of how to help people additionally, bearing in mind the difficult situation in which they found themselves. I have asked both the Acting Governor and the Government to prepare and submit relevant proposals.

Anton Germanovich, I know that the regional authorities worked with the Ministry of Finance. What's the deal?

Alexander Siluanov [Minister of Finance]: Thank you, Mr President.

First of all, I would like to briefly report that your assignment to provide support to residents of the border regions of the region is being implemented in full. Pensions, allowances, and social benefits are paid. Partial compensation of salaries is paid to employees of organizations that have suspended their activities. Housing certificates are provided, payments are made in the amount of 150 thousand to citizens for the loss of property. Everything that you have commissioned is unquestioningly provided with funding, and, most importantly, the money reaches people.

Now, the question raised by the Acting Governor of the Kursk Region during your meeting is about additional decisions to increase payments for loss of property. Having worked out this issue, it is proposed to establish an additional monthly payment of at least one minimum wage for residents of the border areas of the region. Today, this minimum amount is 22,440 rubles. According to the region, this payment will affect more than 112 thousand citizens. It is proposed to make this payment until the release of the territory of the Kursk region. The Government of the Russian Federation will find the necessary resources in the budget to send to the region.

Mr President, we have prepared such proposals. Please consider it.

Vladimir Putin: Is Alexander Yevseyevich in touch with us?

Alexander Khinshtein: Yes, Mr Putin.

Vladimir Putin: How much, 22,440 rubles do we have?

A. Siluanov: 22,440.

Vladimir Putin: Alexander Yevseyevich, how much is the average salary in the Kursk Region?

Alexander Khinshtein: Mr President, good evening!

The average salary in the Kursk region in December last year was 64 thousand. And it seems to me that the amount of 22 thousand does not reflect the real need of people.

Vladimir Putin: It's clear.

Anton Germanovich, let's do this. As you suggested, for the period until the territory of the Kursk region is completely liberated from Ukrainian formations, all people who have lost their property, residents of the region, will be paid an average of 65 thousand rubles per month. And I ask you to find such funds from the federal budget and ensure the necessary payments. Ok?

Alexander Siluanov: I see, Mr President.

Let me just ask you if I understand this correctly. The payment, you said, is 65 thousand rubles. Many people today receive wages (from the borderlands), who have actually lost their property, lost their places of residence, homes, and shelter, but have found a job, and some people receive pensions, benefits, and partial payments related to the suspension of organizations ' activities. Do I understand correctly that these 65 thousand rubles will take into account the payments that people already receive today? How should I interpret your assignment?

Vladimir Putin: No, no. We will not pay extra up to 65 thousand rubles if a person already receives something, earns it. To all, I want to emphasize, to all residents of the Kursk region who found themselves in this situation, this is more than 112 thousand people, right? Alexander Evseevich, 112, right?

Alexander Khinshtein: Mr President, this payment of 150,000 rubles is slowly increasing. When did I report to you…

Vladimir Putin: I ask, how many people?

A. Khinshtein: 112,620 people at the moment.

Vladimir Putin: Let's pay all 112,620 people a monthly payment of 65,000 rubles in addition to what they currently receive until the territory is completely liberated from these gangs. This will give an opportunity to those who are going to equip a new home, start some repairs, and purchase some additional property.

Yes, this measure, this decision is extraordinary. We've never done anything like this before, but people have never been in this situation before. I need some help.

I ask the Ministry of Finance to provide the necessary funding, Anton Germanovich.

Alexander Siluanov: Yes, it will be done.

Vladimir Putin: Agreed.

Let's move on to the next question.

The next issue we have is related to the energy supply of the Kaliningrad region. Alexander Valentinovich, please.

Alexander Novak: Thank you, Mr President.

Historically, since about the end of the 60s of the last century, the energy systems of Russia (including Kaliningrad), Belarus, Latvia, Lithuania and Estonia have worked in parallel, in synchronous mode, as a single energy network. In 2021, a corresponding agreement was signed between the countries, already a new agreement, and this created reliable redundancy, stable operation of the energy systems of the Baltic countries in the first place.

In June 2018, the leaders of these countries made a decision, an absolutely politicized decision, to withdraw from the BRELL energy ring and join the European energy system. During this time, a number of technical measures were carried out, and as a result, on February 8 of this year, Lithuania, Latvia and Estonia disconnected from parallel and synchronous operation with the Russian energy system. At the same time, such a pompous action was held in the Lithuanian capital with the participation of European Commission President Ursula von der Leyen and the heads of the Baltic countries.

Accordingly, what do we see today? As a result of this separation from the Russian grid, electricity prices on the Nord Pool wholesale market in the Baltic States have actually doubled compared to what they were before the separation. If earlier it was about 100 euros per megawatt, today the average price for the last 10 days is already 200 euros, and it reached 270 on some days.

That is, in fact, residents of these three countries – Lithuania, Latvia, and Estonia - began to pay twice as much as before as a result of separation from the Russian energy system. And we believe that this is not even the limit, because there is a limited capacity with the adjacent power systems of Sweden, Poland, Finland, that is, to where they are reconnected.

Moreover, it was reported just a few days ago that the largest Estonian pulp and paper mill stopped its work due to high prices after leaving synchronous operation. As for this decision of the Baltic countries, this is their business, their consumers pay for it.

As for the Russian energy system and the Kaliningrad Region, our main task is to ensure reliable energy supply. I can say that our consumers did not feel this separation of the Baltic countries. The power system operates normally, the population, industrial facilities, social services, housing and communal services are reliably provided with electricity supplies, and there are no price consequences.

All this was made possible thanks to your instructions given back in 2014, when during this period–-from 2014 to 2020--we built additional energy capacities in the Kaliningrad Region, four large power plants with a capacity of 900 megawatts, additional power transmission lines and substations. In fact, the reserve capacity of the Kaliningrad Region's power system was doubled. And this made it possible not only to provide reliable current energy supply to industrial and social facilities, as I have already said, but also to lay the groundwork for the development of the Kaliningrad Region in the future within the framework of socio-economic growth.

We can say with confidence that thanks to the measures taken in advance, all the necessary conditions have been created for reliable energy supply to consumers and ensuring energy security in the Kaliningrad Region, allowing us to work normally today and, as I have already said, have a reserve for the future. Thank you.

Vladimir Putin: Good. We need to carefully monitor what is happening there. I've just discussed this with Gazprom's management, and they have everything loaded up, and if necessary, they can supply the required amount of LNG. Everything is in working order, everything is working, everything is fine. But I ask you to keep an eye out, too. Thank you.

Alexander Valentinovich, please tell us a few words about what happened at the CPC facilities near Novorossiysk and what is the current state of the facilities there?

Alexander Novak: Mr President, yesterday, in a short period of time, seven drones attacked the Kropotkinskaya oil pumping station in the Krasnodar Territory. This is a station that provides oil pumping through the Caspian Pipeline by the Caspian Pipeline Consortium. This is a company founded by American, European, and Kazakh companies. Last year, 62.5 million tons were pumped through this pipeline, more than 65 percent of which is oil that belongs to American and European companies.

As a result of the attack, power equipment, a gas turbine unit, and a substation were damaged, and as a result of switching on the backup pumping scheme, bypassing the Kropotkinskaya oil pumping station, we see a decrease in pumping volumes by about 30-40 percent compared to the level that was before the drone attack. There is a lot of work to be done to restore this facility, since it also used energy equipment from Western countries. This is the Siemens company, a gas turbine unit. Now the final survey of this object is underway. But on the whole, Mr President, we understand that it will take quite a long period to restore this work, and the volume of oil pumping will be reduced.

According to experts, the attack by Ukrainian drones is, in fact, a so-called response to the discussions that took place at the Munich Conference, and most likely, this is a response to the United States of America from Ukraine regarding the negotiations that were planned.

Thank you.

Vladimir Putin: It's not a Russian organization, it's an international organization with the shareholders you just mentioned.

Alexander Novak: Yes, absolutely.

Vladimir Putin: As far as I understand, under the production sharing agreements, the oil actually belongs to these foreign shareholders, the oil that was pumped through this CPC pipeline.

Alexander Novak: Mr President, that's absolutely true. This is oil that is produced on the territory of Kazakhstan under a production sharing agreement between Kazakhstan and the members of this consortium. As I have already mentioned, these are mainly foreign shareholders, the American companies Chevron, ExxonMobil, as well as a number of European companies. This company is not under sanctions, and it pumped oil through the territory of Russia using the pipeline infrastructure passing through our territory to Novorossiysk. In fact, this attack was, indeed, in order to stop the pumping of oil, which belongs to foreign shareholders.

Vladimir Putin: I understand that representatives of these companies are involved in assessing the damage that was caused as a result of this attack, and assess the timing and possibilities of restoring the object, right?

Alexander Novak: Mr President, yes. An assessment is currently underway, and the Caspian Pipeline Consortium is doing just that. An assessment is underway, but this is at least a few months, according to the preliminary estimate that we received.

Vladimir Putin: Well, yes. But if they themselves are interested in restoring the operation of the facility, then let them, despite all the sanctions, organize the delivery of the necessary equipment. They make it for themselves.

I understand that you are probably in contact with your partners. If you need something from the Russian Government, please provide it.

Alexander Novak: Yes, there is, Mr Putin. Thank you.

Vladimir Putin: Thank you very much.

Vitaly Gennadievich, what is happening with tankers in the Black Sea?

Vladimir Savelyev: Thank you.

Dear Vladimir Vladimirovich, Dear colleagues!

The Government Commission continues to work on eliminating the consequences of the emergency caused by the tanker crash in the Kerch Strait. Together with members of the Government Commission, we twice went to the emergency site in the Krasnodar Territory and assessed the situation on the spot.

At the end of January, as you know, we completed pumping fuel oil from the aft part of the Volgoneft-239 tanker, pumping out more than 1,400 tons of fuel oil. We started dismantling the aft part on the spot: Today, 280 tons of steel structures have been cut and removed, which is about 40 percent of the total volume. The cut metal is taken out by machines to a metallurgical plant in the Krasnodar Territory for further remelting. The issue of dismantling the aft part of the Volgoneft-239 tanker is under constant control of the Minister of Transport Roman Vladimirovich Starovoit, and we plan to complete this work by March 31.

The Ministry of Transport is also preparing proposals by the end of February to prevent fuel oil spills from sunken tanker fragments: the bow of the Volgoneft-239 tanker, as well as the aft and bow parts of the Volgoneft-212 tanker.

To date, about 3,500 people are involved in the elimination of emergency consequences on land, of which about 600 people are volunteers, more than 500 pieces of equipment. Today there is a combined diving group at sea – 70 divers and 28 watercraft. Spot discharges of fuel oil to the shore are promptly removed.

In addition, the diving team reviews oil-containing waste in the coastal zone. More than 185 thousand tons of contaminated sand and soil were collected, of which about 53 thousand tons of soil were exported to specialized organizations. About 5 thousand tons of soil have already been disposed of.

Control over the work is carried out by the Minister of Natural Resources and Ecology Alexander Kozlov.

Together with Rospotrebnadzor, we monitor the quality of atmospheric air, water and soil. With Rosrybolovstvo we monitor the safety of fish. Rosprirodnadzor participates in inspections of the activities of specialized waste management organizations.

Under the leadership of the Minister of Science and Higher Education Valery Falkov, work has been organized to collect proposals on technologies and technical solutions for emergency response both now and in the future. A special interagency working group considered 223 such proposals. We reviewed 36 proposals that are ready for implementation as soon as possible, including 23 proposals for onshore operations implemented by the Ministry of Natural Resources and Regional authorities, and 13 proposals for offshore operations that are under the responsibility of the Ministry of Transport of Russia.

The most widely implemented technology now is polypropylene networks. On the beach territory of the city of Anapa and the Temryuksky district, to minimize beach pollution and sand removal, a protective shaft is equipped and covered with polypropylene nets, the approximate length is about 32 kilometers. We also selected about 50 promising proposals that require further development. The Ministry of Natural Resources, the Ministry of Transport and the Ministry of Emergency Situations provide testing of ready-made proposals at the emergency site.

At the same time, we are working to restore the coastal strip of the Black Sea coast areas affected by the oil spill. Rospotrebnadzor specialists will conduct a preliminary assessment of the compliance of beaches and recreation areas with sanitary requirements by March 1 this year.

At a meeting of the Government Commission last Friday, February 14, the administration of the Krasnodar Territory, the most affected region, was instructed to replace the contaminated sand on the beach. According to Rospotrebnadzor, this is the only way to bring the beaches to a standard state this season. In the Krasnodar Territory, regional authorities are now going to conduct an inspection of about 139 beaches. We will make a decision on the opening and format of the summer tourist season only after confirming that the beaches meet the requirements of Rospotrebnadzor.

Dear Vladimir Vladimirovich,

I will report separately on the progress of your previous instructions.

The Ministry of Transport, together with the relevant ministries and departments, has started revising the regulatory framework governing the transportation of oil and petroleum products by sea and river vessels, as well as their storage and transshipment.

In addition, the Ministry of Transport organized a state inspection of the tanker fleet and an inspection of shipping companies operating the tanker fleet by the classification societies (sea and river registers, Rostransnadzor) and related ministries. Based on the results of the audit, proposals will be prepared to strengthen control over the technical condition of such vessels and the implementation of such transportation.

The inspections will also affect the activities of organizations and legal provisions related to the prevention and elimination of pollution by oil and petroleum products from ships, including as a result of spills. We will be ready to report on the first results of the verification activities separately in May of this year.

Dear Vladimir Vladimirovich,

The Government Commission has organized systematic work. At weekly meetings on Fridays, the government commission issues specific instructions and monitors the implementation of previously adopted decisions. On-site work is coordinated on a daily basis by the operational headquarters under the leadership of the First Deputy Chairman of the Commission, Russian Emergencies Minister Alexander Kurenkov.

Thank you for your attention. The report is finished.

Vladimir Putin: Good. Thank you.

I ask you to do everything as quickly as possible, of course, efficiently, but as quickly as possible. Of course, we need to work on the recovery process, as we discussed earlier. Well, there will be all this lying around, waiting like a time bomb for holes to appear there. We need to think about how to raise all that is still at the bottom.

You also mentioned the work of Alexander Kozlov.

Alexander Alexandrovich, how are we doing overall in the framework of the federal project "Clean Country"? How many years has this program been implemented?

Alexey Kozlov: Hello, dear Vladimir Vladimirovich, Mikhail Vladimirovich, colleagues!

272 objects of accumulated environmental damage were eliminated thanks to the federal project "Clean Country". These are municipal unauthorized landfills, sludge collectors, tailings dumps, and oil lenses. That is, what was in plain sight and poisoned the lives of a total of almost 30 million people.

First, 87 dangerous objects were abandoned and were located near settlements where 7 million people live, which is 50 settlements.

For example, a fuel oil storage facility in the city of Zlatoust, Chelyabinsk region. The lake of petroleum products remained from the former machine-building plant and was located just 10 meters from a five-story residential building.

The largest landfill in the Sverdlovsk region, the Shirokorechenskiy landfill, which was considered the main landfill in Yekaterinburg, has accumulated more than 6 million cubic meters of household waste since 1960. 63 million cubic meters is the volume of municipal solid waste landfills in the Moscow region, 27 objects occupied an area of 450 hectares and poisoned the lives of 2.5 million residents of the region.

Landfills have been eliminated, and their negative impact has been reduced, as confirmed by the Rosprirodnadzor laboratory.

Secondly, 185 unauthorized landfills were eliminated. They were located in 143 cities with a total population of more than 20 million people. Cleaning turned out to be really large-scale, because in fact we eliminated landfills in every eighth city of the country. Geography—from Kaliningrad to Vladivostok and from Murmansk to Crimea.

The work was carried out in completely different natural and climatic conditions. For example, in Arkhangelsk, four landfills were located on islands, where machinery and equipment were delivered by water. Two landfills in the Central Ecological Zone, the Baikal Natural Territory, and seven landfills in resort areas were removed.: These are Crimea, Sevastopol, Pyatigorsk, Belokurikha and Zelenogorsk. The largest urban landfills in Vladikavkaz and Chelyabinsk were eliminated, each with an area exceeding 70 hectares, which is almost 100 football fields.

To date, there are six landfills left in operation, which were not completed last year. In two cases, in Bryansk and Arkhangelsk, there are objective reasons for the delay: flooding of the ground required project adjustments. New contracts have been signed. Now the readiness is about 50 percent, the work is promised to be completed before the beginning of summer.

In Kaluga, despite the high readiness of the facility, more than 90 percent, the project documentation is already being adjusted for the third time. Until the end of February, we are waiting for the completion of expert examinations and the delivery of the object by April.

The situation is more complicated in three other regions. In Vologda and Rostov Novocherkassk readiness is 70 percent, contracts are terminated, contractors are included in the register of unscrupulous. The regions will start working only in March-April of this year. In Mordovian Krasnoslobodsk, the liquidation will be completed only after additional engineering surveys. For all three landfills, the governors guaranteed to keep the situation under personal control. We work with the regions together, and we help them where necessary.

In parallel, starting from 2022, an inventory of accumulated damage objects is being conducted throughout the country. To do this, we needed to change the federal legislation and give Rospotrebnadzor and Rosprirodnadzor the authority to evaluate it. They now assess how each object affects people's health and nature.

To date, specialists of the departments have already conducted a survey of 1,200 objects: from landfills to abandoned industries. Now they are ranked in order of danger to nature and humans. Our colleagues will complete their project-by-site work by June.

Of course, these lists should become desktop documents for governors. Regional authorities are obliged to keep order in the territories entrusted to them.

For financing, you can use so-called colored environmental payments. They come to regional budgets from administrative fines and payments for negative impact, and they can be used to eliminate accumulated damage. Last year, we raised approximately 29 billion rubles.

Of course, we will help you at the largest and most dangerous sites based on the results of the selection process. Federal funding is included in the new national project "Ecological Well-being".

We are supported by the federal environmental operator, Rosatom State Corporation, in liquidating large and complex facilities. Colleagues work at such giants as the Krasny Bor industrial landfill in the Leningrad Region, the territory of Usoliekhimprom and the Baikal Pulp and Paper Mill in the Irkutsk region. We also attract colleagues in new territories where they are currently designing, and we plan to liquidate them later.

In addition, this year, on your instructions, Vladimir Vladimirovich, they will take up the development of the concept and elimination of accumulated damage on the territory of the former Yaroslavl diesel particulate plant, which is located near the Volga River.

Thanks for attention. The report is finished.

Vladimir Putin: Alexander Alexandrovich, when should these six regions, which are lagging behind, complete this work?

Alexander Kozlov: Mr President, Bryansk and Arkhangelsk will be open until June 1, Kaluga by April, Vologda and Novocherkassk (from the last call we held on Tuesday) – this is September, and Mordovia too. Vologda, Novocherkassk and Krasnoslobodsk are still lagging behind – three objects that need to be completed by September, and the rest will be completed by the summer.

Vladimir Putin: Please keep in touch with the regional authorities to continue this work. It is necessary to achieve the final result without fail. Then, when everything is complete, be sure to report back to me, okay?

A. Kozlov: Of course.

Vladimir Putin: Thank you very much.

Maksut Igorevich, about the delivery of periodicals.

Mikhail Shadaev: Good afternoon!

Dear Vladimir Vladimirovich, Dear colleagues!

Today, Russian Post delivers almost 7,000 periodicals by subscription. The number of publications that are delivered, if we take titles, has increased by 50 percent over the past 5 years. This is due to the fact that commercial subscription agencies have completely left the market, and now only Russian Post delivers newspapers and magazines by subscription. This is due to the overall unprofitability of this type of activity.

At the same time, Mr Putin, the total volume of print media delivered by subscription has decreased by 2 times in 5 years, if we count in copies. In 2019, we delivered almost 500 million newspapers and magazines by subscription, down to just 257 million last year. This is also due to the development of the Internet access infrastructure and the fact that high-speed Internet has come to rural areas.

The most popular federal subscription publications are Komsomolka, Argumenty I Fakty, Moskovsky Komsomolets, Rossiyskaya Gazeta, and in fifth place is the magazine Khozyaistvo for those who are engaged in gardening.

Leading subscription regions: Moscow is in the first place, Krasnodar Krai is in the second, and the Republics of Tatarstan and Bashkortostan share the third place.

A few words about the economy, because it is, frankly, very difficult. Tariffs for the delivery of periodical printed materials are not regulated, but since 2020, realizing the social significance of this information mechanism, they have grown slightly even below inflation. That is, in general, the tariffs remain very affordable, despite the fact that the cost of the publications themselves, Mr Putin, has increased by 1.5–2, and sometimes even 4 times over this period.

Additionally, Russian Post provides a 25 percent discount on delivery of so-called socially significant publications on your behalf. This applies to about every third edition, but if you count again in copies of delivered newspapers and magazines, then about 75 percent of newspapers and magazines are delivered with this discount – 25 percent.

At the same time, the basic tariff itself, even without a discount, is not economically justified, as indicated by the Federal Treasury following an audit of the Russian Post and gave an order to increase the tariff to economically justified.

You have given instructions, Mr Putin, to maintain a preferential tariff for socially important publications according to the list determined by the Ministry of Digital Resources, according to the criteria set by the Government.

We made changes in December last year to the Law "On Postal Communications". We did not have such powers, so now the Government has the authority to set criteria for classifying publications that are delivered at a discount, and the Ministry of Digital Development has the authority to approve the list of publications that will be delivered at a reduced rate. Accordingly, it is planned that in the second half of 2025 we will deliver publications at the new tariff.

We have certain disagreements here. "Russian Post" suggests raising the commercial tariff three times. We think that it is economically justified to raise the tariff for all non-socially significant users twice. This is precisely due to the fact that we have halved the volume of delivered copies, as I said, from 100 million to 250, and we cannot reduce the number of postmen, Mr Putin, because the postman does not care how many newspapers he has in his bag, he is obliged to deliver them within the standard time limit, respectively, at home, one newspaper, two. Therefore, this parameter is not compressible. Our effective mail carrier loading rate has just doubled in five years in terms of delivery. Therefore, it seems to us that the tariff can be raised twice.

We have provided funds in the federal budget for a preferential tariff, which will be at the level of the current preferential tariff plus inflation for federal publications, Mr Putin. At the same time, taking into account the limited capacity of the federal budget, we propose to subsidize the preferential delivery of regional and municipal publications at the expense of regional budgets. Moreover, as I have already said, subscription leaders are budget-supported regions. Well, it should be understood that the lion's share of regional municipal publications is directly produced with the support of regional budgets, this is usually a subsidized type of activity.

According to the law, we must approve the list by September 1. As I said, starting from the second half of the year, we propose to introduce a new subscription tariff policy for socially important publications.

Thank you.

Vladimir Putin: Yes, Maksut Igorevich, in general, the approach is clear and correct. But we are talking about socially significant publications. This suggests that socially significant publications are not of a pronounced regional nature but are socially significant for the whole country. Therefore, for regions with good budget security, this is understandable, but if it concerns regions with weak budget security, then, of course, it will eventually come down to the fact that they will either raise their tariffs to the skies, or the distribution of these socially significant publications will simply stop.

I ask you, together with your colleagues from the Government and the Ministry of Finance, to look once again from this point of view, to look at those regions that will simply not be able to do this without federal assistance and will not be able to convey these publications to the reader. Take a look, please.

Mikhail Shadaev: Yes, Mr President, we will do it.

Vladimir Putin: Thank you.

Before we move on to the main issue – the results of medical examinations for children and adults in 2024–-before giving the floor to Tatyana Golikova, I want to return to where we started–-with assistance to citizens who live in the Kursk region and need special support from the state. The acting governor determined that this is how much, Alexander Yevseyevich?

Alexander Khinshtein: Mr President, there are 112,620 people at the moment.

Vladimir Putin: Yes, 112,620 people. When we agreed that we will provide assistance to people in the amount of the average salary in the region, which is 65 thousand rubles, I mean all citizens of this category: these are pensioners, working people, non-working people, and children--each and every one of them gets 65 thousand rubles. Please proceed from this so that there is no misunderstanding. Thank you very much.

A word to Tatyana Golikova. I ask you to.

Tatyana Golikova [Deputy Chairman of the Government of the Russian Federation]: Dear Vladimir Vladimirovich, Dear colleagues, good afternoon!

Disease prevention is our priority. This is the basis of the national project "Healthcare", which was completed in 2024, and the new national project "Long and Active Life", which began on January 1.

The basis of prevention is medical examinations and preventive examinations as the main tools for early detection of diseases. Every year, the Government decides to improve the quality and accessibility of medical examinations within the framework of the program of state guarantees of free assistance to citizens of the Russian Federation.

What additional work has been done in previous years? The duty of the regions to ensure the passage of medical examinations or professional examinations in the shortest possible time, as well as in the evening hours and on Saturdays, plus remote recording is established. Also introduced is the obligation to publish on the websites of regions the list of medical organizations where you can pass a medical examination, the work schedules of such medical organizations.

For residents of remote regions of Russia, field work forms are organized. Also, every year, including 2025, we increase the payment rate for medical services provided for preventive examinations and medical examinations.

Control over the procedure for passing professional examinations and medical examinations, in accordance with the current legislation, is carried out by regions and territorial mandatory health insurance funds. However, despite the established obligations, not all regions and medical organizations fulfilled their obligations in 2024.

Last year, I sent relevant explanations to all the governors where we saw delays, asking them to take this work under their personal control. Our colleagues have worked on this topic, but, once again, not all regions have achieved the set indicators.

Now, as for the overall results of 2024. According to the regions, more than 82 million adults have passed medical examinations and professional examinations, of which 42.5 million are able-bodied people and 27 million are children. This is almost 75 percent of the population of the Russian Federation.

I would also like to emphasize that in the Donetsk and Luhansk People's Republics, Kherson and Zaporizhia regions, 2.5 million people underwent medical examinations and professional examinations – which is 1.6 times more than in 2023.

But not only the fact of medical examination and professional examination is important, the results of further patient management are important if any deviations are detected. I'll give you one example.

In 2024, more than 630 thousand people with cancer were identified, and, most importantly, 60 percent are in the early stages. This means that we were able to provide timely medical assistance. We also record such statistics of early detection during medical examinations and professional examinations for other diseases. It is important that the saved lives of our citizens are behind these figures.

I would also like to note that starting from 2024, the state guarantee program for the first time provided for the opportunity for working citizens to undergo a medical examination at the workplace. This work began to unfold in 2024. At the end of the year, almost a million people underwent medical examinations at the workplace.

And it is very important to note such a new direction, which we are actively developing and which was continued in the new national project "Long and active life"—this is industrial medicine, sometimes it is also called "shop medicine". And here I would like to note the leadership positions of the Federal Medical and Biological Agency, which, while supervising the relevant critical enterprises, actively develops relevant technologies, which it distributes not only to enterprises subordinate to the FMBA, but also to other enterprises, replicating the relevant best practices.

Another innovation that was made in 2024 and improved by us in 2025 is the medical examination of veterans participating in a special military operation on an extraordinary basis. We are building this work together with the State Fund "Defenders of the Fatherland". Last year, 33,000 people were treated for medical examinations of demobilized participants and veterans of the special military operation, 80 percent of them were taken for medical observation, 13.5 percent were sent for rehabilitation, and just over 1 percent of them received high-tech medical care.

This year, taking into account the experience of last year, the Government, within the framework of the program of state guarantees of free medical care for citizens for 2025, established a special procedure for conducting medical examinations for participants of a special military operation, including the procedure for bringing participants of a special military operation who live in remote settlements to a medical organization, and also the possibility to the participant of a special military operation, which, as we understand, is extremely important in the case of health restrictions.

We also provided for informing the social protection bodies of the population by medical organizations in case a medical worker identifies a need for social services for a participant in a special military operation.

Also, in accordance with your instructions, we organized a medical examination of participants and veterans of the Great Patriotic War in the year of the 80th anniversary of the Victory. But this does not mean that we will start it only this year. I would like to note that last year 147 thousand of our veterans and participants of the Great Patriotic War underwent such medical examinations.

Now a few words about children's professional examinations. In 2024, the coverage of medical examinations of children was more than 97 percent. Only among adolescents in 2024, diseases were detected in 200 thousand, 141 thousand adolescents were sent for treatment before the development of serious diseases. And of course, this allows us to prevent further development of the disease and provide timely assistance.

I would also like to note that since 2024, medical examinations of citizens aged 18-49 have been launched to assess their reproductive potential. I must say that over the past year, 7 million of our citizens have undergone such medical examinations and such an assessment of their reproductive potential, including 2.6 million men and 4.1 million women. And also some other categories of other ages.

More than 230 thousand diseases of the reproductive system affecting the ability to have children were identified. Appropriate treatment has been provided, including in vitro fertilization (IVF). 1,200 women who have received IVF have become pregnant, and we would like to wish them and their families a safe birth of the desired child.

Dear Vladimir Vladimirovich,

Special attention is paid to the topic of prevention, this is our agenda. But we also work with feedback, with citizens and note the following appeals of citizens on this topic, including to you on the "Direct Line". These are the duration of medical examinations, complaints about waiting lists in polyclinics, difficulties with making an appointment, and in some cases there are questions about the so-called postscripts.

What do we do and intend to do next in this regard? At the end of 2024, you, Vladimir Vladimirovich, signed amendments to the Federal Law "On compulsory health Insurance". Now insurance medical organizations are required to inform insured persons about the possibility of passing a medical examination or professional examination, to help the citizen in passing a medical examination, including making an appointment with a doctor.

In order to prevent attribution, in addition to the control measures carried out, citizens were provided with the opportunity to see through their personal account on the Unified Portal of Public Services when and at what time they were provided with appropriate medical care, and if this does not coincide with their data, then inform the relevant insurance medical organization or the territorial compulsory health insurance fund that received it.

Taking into account that currently 109 million personal accounts of our citizens are open on the Unified Portal of Public Services, we believe that citizens should use this opportunity more actively, and then we will be able to respond together in a timely manner to the shortcomings and problems that arise in this work.

We also plan to inform citizens about the results of medical examinations or professional examinations at the final stage through the same offices at the EPSU. Such suggestions are made. We believe that we will organize this work if during the medical examination or professional examination some serious diseases were not identified that require further in-depth examination or appropriate examinations by other narrow specialists.

Currently, the Ministry of Health and the Federal Compulsory Health Insurance Fund, together with the country's regions, are reviewing the relevant regional programs and territorial programs of state guarantees for their compliance with the innovations adopted by the Government of the Russian Federation from January 1, 2025. In this case, I appeal to the regions of the country to take all this into account in their ongoing work.

I would also like to draw your attention to another topic that we are working on and comments on which are also found as part of our feedback to citizens. We are talking about people with limited mobility, who often find it difficult to go to clinics and get to clinics. Therefore, we are now working together with our colleagues on the possibility of their hospitalization, short-term hospitalization in hospitals for two or three days, so that they can pass such a medical examination and, if necessary, receive inpatient care. Moreover, in some regions, inpatient beds are underutilized.

But it is also important to mention something else–-transport accessibility, because the availability of medical organizations does not always depend only on health care. It also depends on how to get to the medical organization, which means that you need public transport routes within the region with the appropriate schedule. This is also important for our citizens.

In conclusion, I would like to once again address the regions of the country. We are now at the beginning of the implementation of the national project "Long and active life", we will continue preventive examinations and medical examinations, we will involve health centers as much as possible in this work, restarting their work. We believe that the indicators for national goals on life expectancy and healthy life expectancy will be implemented if we work together.

Thanks for attention.

Vladimir Putin: Thank you very much. Very important work, I fully agree. It is only necessary that later, after identifying certain diseases, was the reaction. We have discussed this issue many times. As for oncology, you can see that the response is good, and the healthcare system is responding to it. Great. But we need to work to the maximum, of course, on other detected diseases as well.

I would like to listen to Stanislav S. Voskresensky, Governor of the Ivanovo region, who heads the State Council commission on "Long and active life".

Please, Stanislav Sergeevich.

Sergey Voskresensky: Dear Vladimir Vladimirovich, Dear participants of the meeting,

In the regions, we understand the importance of the normal organization of timely health checks of our citizens. I will focus on several best practices in the regions that increase the convenience for our citizens, as Tatyana Alekseevna mentioned. Then literally three sentences.

First. Indeed, the regions actively use the practice of conducting medical examinations on a specially designated day, either in the evening or on Saturday. Here, the Government has adopted instructions on this issue, and they just need to be implemented.

Further. Along with informing the insurance organizations in a number of regions, agreements have been concluded with major insurance companies to ensure that a person, if for some reason it did not work out or it is inconvenient to make an appointment through a polyclinic or call center, can make an appointment for a medical examination through an insurance company. For example, the largest company Sogaz has signed such agreements with 14 regions.

Further. About on-site medical examinations, this is especially relevant for remote localities, especially in Siberia and the Far East. So–called "Health Trains" are being formed, trains in the literal sense, trains of Russian Railways, trains in the figurative sense--trains of mobile complexes, this is actively used. By the way, we agreed at the State Council commission site that insurance companies will inform residents of such remote localities in advance about the approach of such trains moving by rail, and the possibility of conducting medical examinations.

In addition, a number of regions are actually using the capabilities of so-called shop medicine. What's the point? When therapeutic areas are opened directly at the enterprise, and medical examinations are also carried out there. This is done not only by the FMBA, but also by the Russian regions themselves.

A number of regions use various kinds of incentives to attract citizens for medical examinations. For example, there is such a practice when, for example, a certificate required for obtaining a driver's license is issued free of charge during a medical examination. Such practices also exist, and we believe that it is possible to replicate them.

Now, just three sentences, if you'll excuse me.

First. The portal "Gosuslugi", as already mentioned, would be convenient for people and useful so that you can go through the initial survey on this portal and get a medical checkup itinerary. By the way, such solutions are implemented on a number of regional portals, for example in Moscow and the Moscow region.

Second. The final stage of medical examination was discussed. If a doctor's examination is carried out, tests are collected, it takes some time to get the results of these tests, the final procedure could be done in the form of a telemedicine consultation, so that you do not have to go. Indeed, someone could have done this by notifying the State Services, but someone still needs to talk to a doctor. In order not to go, if it is particularly far, it would be possible to provide for such a possibility.

The third. Many large companies, especially in the energy sector, provide medical examinations for their employees through voluntary health insurance, but this is not visible in the state health system.

It turns out that a person de facto passed a medical examination, took care of his health, but the polyclinic runs after him, asks that he pass a second medical examination. It turns out that if it is successful, then the money is spent twice. The company has already provided medical examinations, and the state is spending them for the second time. Therefore, it would be right to establish an information exchange between the state healthcare system and large companies on the subject of those people who actually passed the medical examination. These are three sentences.

In general, we strongly ask you to step up the information campaign, which doctors ask to notify people in the whole country that medical examinations are convenient, necessary and useful. Thanks for attention.

Vladimir Putin: Good. Thank you very much, Stanislav Sergeevich.

I would ask Mikhail Kuznetsov to also say a few words on this topic, how it looks from the Popular Front, and then Tatyana Alekseevna to comment on what you think is important, what may already be being done, and how to respond to it.

Please, Mikhail Mikhailovich.

Mikhail Kuznetsov: Mr President, thank you very much.

Under the leadership of Leonid Mikhailovich Roshal, the People's Front collects feedback from citizens on the quality of medical care. During the preparation process, we analyzed 2 thousand requests to your "Direct Line" and conducted a survey on 26 thousand patients of state polyclinics.

Several issues that have been identified.

The first is the inability to pass a medical examination at least two days in advance. We understand that it is not always possible to do this in one day, because laboratories open in the morning, but at least in two days. Despite the fact that the Labor legislation provides for one paid day off for medical examination. According to our survey, 14.5 percent of citizens do not come for medical examinations, because it takes several days.

Let me give you one example from your "Direct Line". The woman writes: "A message comes to me that I should undergo a medical examination. I took a week off, went to see a therapist on November 6, passed tests on the 7th, got an ECG on the 11th, got a cardiogram on my hands, said there was no one to decipher it. To the gynecologist recorded on November 25, on ultrasound according to indications on December 16". That's the story. Of course, this is quite difficult, and it is clear that there are difficulties: there are difficulties with the shortage of doctors, with different buildings, but it is still important to improve the quality of this work.

We suggest considering the possibility of improving the convenience of passing medical examinations, including using Saturdays. Tatyana Alekseevna has already said that such a fundamental decision has been made. It is clear that this will be done only by appointment, but if, indeed, a sufficient number of people have signed up for Saturday afternoon, it may be possible to provide such an opportunity for people.

The second problem is complaints about the formal nature of medical examinations. It just so happens that these are the most numerous requests to your "Direct Line", there are about 700 requests, and while we were conducting a survey, another 1800 people complained to us. The vector of criticism is that people say that it is not possible to conduct an extended blood test, especially cancer markers. Tatyana Alekseevna said that a lot is revealed, but people talk about it. In some cases, it is impossible to carry out medical examinations, such as ECG and fluorography.

Currently, 13.6 percent of citizens do not pass medical examinations and routine examinations, as, in their opinion, they do not include the necessary research. In other words, we can work on the depth of medical examinations here, and this will also encourage some of our people to come and pass it. We propose to provide for the possibility of adjustment taking into account the characteristics of human health. Yes, often a person knows that he has diabetes, he says: "Can I do this and that as part of a medical examination?" But formally, something doesn't work.

The third problem is insufficient feedback from medical institutions and doctors on the results of medical examinations. Tatyana Alekseevna suggested an option on Public Services. Indeed, it is often necessary to go to the therapist in addition, so that you are told that you are healthy. It's a day off again, it's time to take time off from work again. There are a number of regions, like Moscow, that simply send this data to the medical office, if everything is fine with you – you went in, read it. If this is implemented in Public Services, it will be great, and it will remove some of the complaints that we hear from people.

The fourth problem is the lack of involvement of employers. In our country, 25 percent of citizens say that they do not get a day off from their employers, they are simply denied medical examinations. And 35 percent say they didn't even ask because they don't believe they'll get it. That is, about half of our citizens either take a vacation or agree on something else, but they do not receive this legal day off for medical examination. We suggest that we also think about incentive measures for employers, and probably also about the discipline of compliance with the Labor Code, because, in general, this is a very important common task. And here the doctors themselves, absolutely for sure, cannot bring people to the clinic, they can work with the quality of medical examinations.

And finally, the last, fifth problem, Tatyana Alekseevna also stopped there, is the postscript in the volume of medical examinations. Planned indicators that are communicated to healthcare institutions cannot be met by the efforts of the Ministry of Health alone. I won't mention the figures, because they are expert in nature and vary from region to region, but the fact that there is a problem is confirmed by everyone: the healthcare vertical, doctors, and patients. Not only do we push doctors to violate the law by overestimating the indicators, because they formally put a person who did not come, and funds are transferred from the compulsory health insurance, but we also really cause amazement among citizens who learn about the passage of an imaginary medical examination. Now you can order this service on Public Services, sorry for the tautology, and it will tell you what medical services you received.

I will allow myself to give another short example from your "Direct Line" that a woman writes to us. "The hospital itself makes an appointment, as if we are undergoing a medical examination, but we have not actually been to the clinic and do not know about it. In the State Services comes that we have an appointment with a doctor, make a cancellation for an appointment, they write it down retroactively. Many complain, and the WHO is still there." That is, we still have this problem.

We suggest setting realistic indicators for regions, removing post-entries, and taking into account the positive dynamics here. And also here is what Tatyana Alekseevna said, it is very important if you do not order this option in Public Services, but you will receive a message that you have passed a medical examination, and there will also be a check mark: "I didn't pass it." And then we will try to fight it digitally.

Mr Putin, we are ready to conduct a second survey in six months or several months, and if the situation does not change, then we can probably apply to the supervisory authorities. But not before, so that doctors do not suffer, they are definitely not to blame for the fact that they are brought to the indicators that they cannot fulfill. Thank you so much for your attention. I finished my report.

Vladimir Putin: Thank you.

Tatiana Alekseevna, please.

Tatyana Golikova: Thank you, Mr President.

Thank you, dear colleagues.

Once again, I would like to draw your attention to the implementation by the regions and all participants in this process of the changes in the Program of state guarantees of free medical care for citizens that we accept.

I mentioned in my speech that last year I had to send corresponding letters to the heads of regions in order for them to monitor the situation with the implementation of the measures taken at the Government level.

I don't want to name the regions, but unfortunately, in some regions this was not accepted. Only after my letter, the relevant work was carried out. In this case, I am talking about working in the evening and on weekends, on Saturdays, and about the availability of information that colleagues post on relevant information resources. We carry out this work and control.

In addition, I would like to emphasize once again what Stanislav Sergeyevich said about medical examinations and professional examinations at industrial enterprises. We have tried to bring the possibilities of passing medical examinations as close as possible to industrial enterprises and the possibility of placing appropriate offices at the industrial enterprises themselves with the appropriate payment.

As I have already said, we started to expand this work in 2024 and we hope that 2025 will make its most serious contribution to this direction from the point of view of the working-age population.

We support the topic that is related to the possibility of passing medical examinations in a mobile way. As you probably all know, dear colleagues, Mr Putin, your instructions were given regarding the possibility of organizing a corresponding train called Saint Panteleimon at Russian Railways, and our colleagues have done this work. Now we are completing a topic that is related to the mechanism of payment for medical care during such mobile medical examinations.

As for the transfer of data to state systems, if citizens are insured under voluntary health insurance, I would like to draw your attention to the following. We don't spend any extra money here. If there are such cases, please tell us about them. Why? Because citizens are insured, and we have data that a citizen is insured.

Accordingly, an insurance company will never pay for an additional medical examination if such a medical examination has already been paid for. And after the amendments to the legislation, which I mentioned in my speech, this will also be taken under special control.

Mikhail Mikhailovich gave examples of failure or desire, on the contrary, to pass separate examinations by individual citizens and their unwillingness to come to a medical examination, if such examinations are not provided.

I would like to draw your attention to the fact that we have our own standard for conducting preventive examinations and medical examinations, and in case of deviations or in case of any suspicions about the need for in-depth medical examinations, such referrals are issued by medical organizations. Here we give priority first of all, of course, to the doctor, because the doctor determines what additional examinations need to be performed.

As for not the first identified chronic diseases, for example, such as diabetes, it is surprising that such a topic was raised. We will deal with all these data, because patients suffering from diabetes are registered, since they are provided with both preferential drug provision and medical devices. Therefore, they are registered in all regions.

Indeed, there is a theme of separate days of referral to narrow specialists, when it is necessary. I believe that the opportunities that Public services provide us can be effectively used, and we will definitely work on this topic with our colleagues. The Ministry of Health is already working on this topic as part of our new project "Long and active Life", as we are implementing a project to create a digital platform in the healthcare sector on your behalf.

As for incentive measures for employers. I do not know, but I am cautious about this, Mr Putin, because we have provided the greatest possible opportunities for employers to organize this work on medical examinations and preventive examinations, including paying the appropriate tariff and so on. And in this sense, I would like to say that employers themselves should also be interested in ensuring that their employees are healthy, and then they will have fewer problems in terms of sick leave, first of all.

By postscript. And I have stopped, and Mikhail Mikhailovich said about it – - my colleagues and I will work on this topic together. As for specific cases, we are working on specific cases, including those that you received on the "Direct Line". Our colleagues transmit this information to us in stages, and we work on it individually. And here we are systematically united in terms of organizing accounting through the portal of Public services.

Thank you.

Vladimir Putin: Thank you very much.

We, colleagues, all understand that this work–-the work on medical examinations and the subsequent reaction to the results of this medical examination--is a very large-scale work. It is large, multi-faceted, and requires a lot of effort on the part of the federal authorities, regional authorities, and the business community. And, of course, there are some issues that we should pay special attention to. That is why I, Tatyana Alekseevna, would very much like you to look at what was said both by representatives of the regions, in this case by Voskresensky, and by Mikhail Mikhailovich. You just need to analyze whether something is actually working, and it is impossible or even impractical to correct it. You just need to consistently implement the measures that are already being implemented, but you need to pay attention to something. I have a request for you: Please estimate all this that we have discussed today and submit your vision to me in the near future. Ok? So that in the future we can be sure that this work is carried out at a qualitatively high level, because in general, the results are good and the return is good.

As for the duration and quality of life. Much also depends on how we set up this work to achieve these parameters, including in terms of life expectancy.

In conclusion, I would like to ask the Acting Governor of the Kursk Region, together with the Government, not only to inform the people of our decision and funds, respectively, and then report to me about it, but also to think that by the time the enemy is expelled from certain areas of the Kursk region, it will be necessary to prepare a program for the restoration of the affected areas.

It is necessary to provide support from the Government in the implementation of issues related to the complex for the restoration of social facilities, roads, and other infrastructure, including transport, industrial, and agricultural enterprises, to provide support to affected businesses, and so on.

This program, at least the main parameters of this program, should be prepared in the near future, so that we understand what we will have to do in certain areas after the necessary conditions are created from the point of view of ensuring security.

Thank you all very much. Good luck. [My Emphasis]

Yet again we are provided with more evidence that the Russian government has a much higher level of both concern and care for its citizens than most governments. The amount of environmental clean-up is astounding yet also tells us how badly polluted Russia was, which has contributed to the priority of medical provisions, not just facilities and research institutions but campaigns to motivate the public to complete a thorough medical examination. I must confess to still being confused about the Russian healthcare system, particularly its insurance aspects. Yet clearly Russia has some innovations like clinics at large industrial concerns and paid day off for medical appointments.

The utter idiocy of the Baltic states and celebration of that idiocy by the EU Dictatorship when they shut their connection to the Russian grid is simply amazing. That action has caused more than the pulp mill to shut down or greatly curtail operations because power costs doubled at minimum, and this is within a group of nations facing economic depression and demographic decay. The dementia that’s Russophobia within Europe was on full display over that last week, and for a rather large proportion ending the conflict in Ukraine won’t provide any sort of cure.

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