Some problems of introducing performance-based contracts of employment into health care service

In 2018, performance-based contracts of employment for all health workers have been introduced. At the same time, the problems of quality of medical care and payment for labour of health workers are not thoroughly resolved. The authors identify the following problems of introducing performance-based contracts of employment into health care service: 1. There is no basic payment for a health worker under a performance-based contract of employment, allowing him\her to work only in one place; 2. Performance-based contracts of employment for health workers do not specify criteria of patients recovery; 3. The real salary of medical workers is on average 2 times lower than it is reported by the Ministry of Health Care of the Russian Federation; 4. The transition to per capita principle of financing medical institutions has increased the workload of health workers and has not improved the quality of medical care. The authors propose: 1. The basic part of the salary in an performance-based contract of employment should be fixed in the amount of 70%; 2. The average hourly wage of health workers should be bound to the average hourly wage through a constituent entity of the Russian Federation in the light of May Decrees of the President of the Russian Federation; 3. The basic criterion of the incentive part of the performance-based contract of employment should be the recovery (health) of the patient; 4. Health workers should be prohibited to have a second job more than at the rate of 0.5; 5. Unified Federal performance-based contracts of employment for each type of medical institutions should be developed.