In this issue we will tell you what risks healthcare facilities face in practice after switching to an effective contract.

Goals and objectives of an effective contract

The Program for the gradual improvement of remuneration systems in state (municipal) institutions, which was approved by the Government of the Russian Federation on November 26, 2012, set clear goals:

• maintain human resources potential;
• increase the prestige of working in budgetary medical institutions;
• Bring the remuneration of medical workers in line with the level of quality of the work they perform.

To achieve these goals by 2018 in the healthcare sector, it is necessary to solve a number of tasks:

Disadvantages and advantages

While there is much to be gained from the idea of ​​an effective contract, the likelihood of risks must be taken into account when implementing one. Especially at the initial stage of work under the new remuneration system, when many questions arise regarding how much money and for what exactly health care facility employees will receive.

“It was supposed to organize the payroll system in such a way that both the complexity of the work and its quality were taken into account,” says Alina GALIULINA, project manager at SKB Kontur. “But this requires resolving the issue of the wage structure. So far, all proposed systems for assessing the work of doctors have a number of shortcomings. The original idea was to introduce performance criteria for each position, such as a point system. Each indicator for each specialty is assessed in points. Then the employee’s points are summed up, multiplied by a certain constant, and the resulting amount is paid to the person. Everything seems to be logical, but this option is bad because every month you have to calculate the points (and there can be several hundred workers in health care facilities), submit this data to economists, and they have to calculate the amount of bonuses in a short time. This is simply unrealistic; to calculate points, you need a department or at least one employee who will only do this.”

Therefore, many health care institutions, in order to avoid the huge amount of work with counting points, introduced a system of coefficients and were faced with a deficit in the wage fund. This happened partly because the payroll was not designed for 100% implementation of the plan by all employees, and partly due to the general underfunding of the healthcare sector.

According to the Accounts Chamber of the Russian Federation, the deficit of funds in the healthcare sector in 2014 amounted to 55.3 billion rubles due to compulsory medical insurance.

According to Irina TITOVA, head of the personnel department of the Krasnoufimskaya RB, there were many problems with payment in their medical institution. Despite the fact that, according to the roadmap, the basic and incentive parts of the payment should be 60 and 40%, respectively, in practice this is far from the case and the base part is much smaller. So it is not yet entirely clear how to achieve the level of wages provided for by the order approved by the President of the Russian Federation.

However, at the same time, Irina TITOVA notes the advantages of paying part of the salary in accordance with the labor assessment criteria: this stimulates workers to complete the assigned tasks one hundred percent.

“With the introduction of a new remuneration system, the efficiency of the staff has increased and their efficiency has increased,” says Elena SERMYAGINA, head of the personnel department of the Sverdlovsk Regional Clinical Hospital No. 1. — Of course, a large amount of work has been added for personnel officers and economists. And we need to continue to analyze the effectiveness of an effective contract, but so far we have not particularly noticed any disadvantages. And today a lot of systematic work is still expected, which justifies the essence of introducing effective contracts. Many more organizational measures need to be carried out, but in the end an effective contract will truly be effective in the full sense of the word. And then a person will know what and for what he works, the quality of his work and his attitude towards work will become better and better. I don’t see anything negative in introducing an effective contract. It’s just that people perceive everything new with caution, and there are always those who do not accept the new and like to live in the old way.”

In some health care facilities in the Sverdlovsk region, the transition to an effective contract occurred quite recently, but due to underfunding, it is unlikely that any positive changes can be expected.

“Yes, they renamed the employment contract, expanded it, and added responsibilities,” says the head of the human resources department of one of the regional hospitals. “But if there is no money, then this is just another government profanation.” Perhaps, with the introduction of an effective contract, the situation at some health facilities has improved due to the reduction of key positions, but not all. But new responsibilities fall on HR officers like a snowball; reporting has increased fourfold.”

Possible Solution

Regional departments do not give a clear answer on what to do if there are not enough funds to pay the incentive part of the salary. Therefore, personnel officers and economists from various medical institutions are trying to find a way out of this situation on their own.

The Karpinskaya Central City Hospital also faced a payroll deficit, and, as the head of the HR department Tatyana VASILISHINA says, she had to talk to employees, explain the situation, why the amounts received were less than expected, and also introduce new agreements to the payment agreement every month. All this, of course, adds paperwork to personnel officers.

In turn, in the Malyshevskaya GB GBUZ SO the introduction of a directly effective contract did not cause economic troubles, but the subsequent cut in hospital funding for 2015 also baffled hospital economists.

“As an option, you need to initially make a small coefficient for incentive payments in order to meet the planned payroll. But how can you predict in advance how much an employee will fulfill the plan? - says Alina GALIULINA. “That’s why now most health care facilities conclude effective contracts either with vague wording or without specifying indicators at all. But then any audit will reveal that there is no point in concluding an effective contract. The best way is to calculate the correct coefficient by analyzing work under an effective contract for six months. It takes a lot of effort and time.”

Read by F.N. Kadyrov (Deputy Director for Economic Affairs of the Federal State Budgetary Institution "Central Research Institute of Organization and Informatization of Health Care" of the Ministry of Health of the Russian Federation, Doctor of Economic Sciences, Professor, Honored Economist of the Russian Federation) sets out in an extremely clear and detailed manner the regulations and facts that are associated with the transition to an "effective contract" ", its true purpose, nuances for managers when formalizing this transition, forecasts for the period until 2018 regarding the implementation of Presidential Decree 597.
After listening to the lecture, I had a strong feeling that it was being read not for employees, but for managers, since all the stages of transferring subordinates to a new format of work, methods of “painless” transfer using skillful manipulation of employees and reticence, forms of notifications were listed and presented “on a silver platter.” and tactics of the HR department.
On the other hand, you need to know the enemy by sight. And there are a number of ways for the employee and the team to not prevent the transition - it will happen sooner or later, but to delay it, gain time, in response to new demands from the employer, extract new rights, write down the subtleties in the collective agreement, monitor the development additional agreements to employment contracts.
So, a report on the lecture (with the listener’s conclusions).

What is an “effective contract”?

The concept of “effective contract” (EC) implies:
- in the narrow sense - an employment contract.
- in a broad sense - a set of measures aimed at improving the quality and accessibility of medical care.

An effective contract is primarily aimed at SOLVING THE PERSONNEL ISSUE. The promised increase in wages is only a method of solving it.

At the same time, it was during this period (2013-14) that the trade union committee and workers have the opportunity to demand payments, since the situation in the legislative sphere at the level of institutions is quite blurred. In almost any situation where an employee is deprived of benefits, if an audit is initiated, the issue will be resolved in favor of the employee. In addition, the employer is required to meet the wage ratio indicator in his institution according to the “road map”.

* What to do if an employee is deprived of incentive payments?

Contact the trade union!

A representative of a trade union organization, both in the conditions of an “effective contract” and in conditions where the transition to it has not yet taken place, must take part in the work of the commission for calculating incentive payments - it exists in every institution.
It also includes: chief accountant, head of the economic department, chief of medicine. The commission's decision is made signed by the chief physician.
In the event that this commission decides for some reason to deprive an employee of an incentive payment, the consent of a representative of the trade union organization is asked.
In such a situation, he must express disagreement with depriving the employee of an incentive payment. And if he fails to convince the employer, then the mechanism is as follows:
The chairman of the trade union organization writes a complaint against the employer (chief physician) regarding the deprivation of benefits to the employee to the following authorities: the President of the Russian Federation, the plenipotentiary representative of the President of the Russian Federation in the region/city, the Ministry of Health of the Russian Federation, the Ministry of Labor, the State Labor Inspectorate, the prosecutor's office, the governor/mayor, the Health Committee, Terkom , Rayzdrav.
The complaint indicates to which authorities copies of the complaint were sent
The expected result is:
payment of funds in full, since the manager will be summoned to higher authorities (Gorzdrav, Raizdrav), and in order to prevent further proceedings from above, he will be ordered to resolve the issue in a manner favorable to the employee.

What criteria for assessing labor efficiency can be applied to employees?

The criteria, indicators and frequency of evaluating the performance of employees are established ONLY by the institution on the basis of methodological recommendations and orders. In other words, the employer can introduce any criteria for assessing labor efficiency for the employee - against the background of this, the responsibility of the trade union collective and employees who are not members of the trade union should increase. It must be emphasized - COLLECTIVE - since the chairman of a trade union organization is unlikely to cope with such a volume of work. Any employee, even those who are not members of a trade union, has the right to support and protection of their rights by a trade union organization.

Can an employee be fined under an effective contract?

According to the Labor Code, the use of disciplinary measures is strictly prohibited, except for the penalties provided for by the Code itself, federal laws, charters and discipline regulations. An employee cannot be forced to work seven days a week or be deprived of vacation. You cannot fine an employee.
When an employee commits a disciplinary offense, the employer (Article 192 of the Labor Code of the Russian Federation) has the right: to make an oral or written reprimand to the employee, to reprimand, to dismiss the employee. In addition, the procedure for applying disciplinary sanctions is clearly stated in Art. 193 Labor Code of the Russian Federation algorithm.
In the context of incentive payments, it may not be the imposition of a fine, but the non-awarding of a bonus, i.e. If employees fail to meet a number of criteria, the bonus will not be partially or fully calculated.
The additional agreement must clearly state all incentive payments due to the employee, the conditions for their non-accrual and the criteria by which they are accrued, as well as the amounts. The employer in the “amount” column may not give specific numbers or points and refer to the collective agreement and regulations on wages, regulations on the calculation of incentive payments.
If you have been charged a certain amount (say, 1000 rubles for non-compliance with the dress code), you have the right to go to court, where the employer will have to explain on what basis this particular amount was withdrawn. Therefore, if such subtleties are not spelled out in local regulations, the court will rule in your favor.

An effective contract as an employment contract.

The concept of an effective contract does not yet exist in the Labor Code; the concept of “employment contract” is used.
In order to improve the quality of medical care, and, accordingly, tighten the demand from medical workers, the government recommends CONCRETE the employment contract in the form of an effective contract.
That. An effective contract is an employment contract that specifies job responsibilities, terms of remuneration, performance assessment criteria for assigning incentive payments, as well as measures of social support for employees.
If previously it was enough for an employee to carry out his job duties without focusing on specific indicators, then when switching to EC, work will be characterized not only by the performance of the function, but also by a number of specific indicators.
As for existing employment contracts, your management does not have the right to terminate them and enter into new ones.
In addition, according to the correct algorithm for the transition to EC, the conclusion of additional agreements to employment contracts is one of the final stages.

IMPORTANT! Stages of transfer to an “effective contract” or what an ordinary employee and members of a trade union organization need to know.

1. We do not sign any contracts or additional agreements right away!
By law, you must be given written notice of a change in the terms of the employment contract determined by the parties (transfer to a new wage system and the need to conclude additional agreements to the EXISTING EMPLOYMENT CONTRACT) no later than 2 months before the transfer.
Amendments to the employment contract in this situation are carried out on the basis of Article 74 of the Labor Code of the Russian Federation (for reasons of organizational or technological changes in working conditions).
In no case is it permissible to re-sign an employment contract (terminate the existing one and conclude a new contract) - since this means dismissal with subsequent hiring. Perhaps this is a tactical move to eliminate an unwanted employee - you simply may not be hired again.
2. So, a general meeting has been held, at which you are informed about the need to switch to a new remuneration system - an effective contract with the need to conclude additional agreements.
3. Next, one by one, workers are called to the HR department, where they are verbally notified of the need to sign an additional agreement to the employment contract. Arguments for haste can be different - “it’s beneficial for you, everything is clearly spelled out there,” “otherwise you won’t receive bonuses,” “everyone will have to sign anyway,” etc.
Don’t worry - bonuses will be paid to you, because it is not profitable for the employer to reduce the average level of wages - his bonus also depends on this. And if they don’t risk not paying, read the paragraph * What to do if an employee is deprived of incentive payments?
And there is only one reason - managers are entitled to a bonus for early or timely transfers.
There are also those who will sign immediately. To the joy and relief of personnel officers and management.
4. Is the employee required to sign an additional agreement immediately?
No. Firstly, you must be given TWO MONTHS WRITTEN NOTICE about changes to the terms of the employment contract determined by the parties.
According to the article of the Labor Code of the Russian Federation, you have 2 months to think about it. If you do not express your disagreement in any way, after 2 months you will still be transferred to EC.
If you write “I do not agree” on the notice or in an application addressed to the employer, 2 months after signing the notice you must be provided with a vacant position that matches your qualifications or is less paid*
*it is important that working conditions should not worsen the employee’s position in comparison with the conditions prescribed in the collective agreement, and the vacancy should be provided in the same area, for example, an employee of a district hospital in a city should not move to a branch in a village, unless this is provided for by the collective agreement.
If there is none or if there is a refusal in accordance with Article 77, Part 1 of the Labor Code of the Russian Federation, you may be dismissed.

Why then wait 2 months?

In a situation where the employer first of all requires the employee to sign an additional agreement, without providing for changes in the collective agreement or the provision on incentive payments, we can talk about a violation of the transfer algorithm to EC.
The first stage of the transition is the development of a collective agreement with the trade union committee, regulations on incentives (since incentive payments will be specified in the additional agreement, most likely with reference to the collective agreement and internal regulations on incentives).
Only after this can changes be made to the employment contract with the employee.
Speaking of the collective agreement, its standard form is laid out in our documents, but in each institution the trade union committee can defend private details, since we are talking about an agreement, a contract - and this implies negotiations, concessions and agreements on BOTH PARTIES. The employer will not miss the opportunity to expand and deepen the range of your job responsibilities - so do not miss the opportunity to receive new rights and additional payments.
In addition, as long as you work under a valid employment contract and regulations on the accrual of incentives, bonuses should be paid to you on the same basis as other employees. In response to threats from the personnel officer (“since you have not signed the additional agreement, you are not entitled to a bonus”), immediately ask for a written justification for such a statement.

Are workers who do not provide medical services included in the list of workers covered by the Decree of the President of the Russian Federation? Should their salaries be increased?

According to regulatory documents, a statistician, an accountant, and a human resources officer at a healthcare facility are not included in the list of groups of workers whose wages should be increased, however, this is not prohibited - in the case when the categories of workers specified in the roadmap have achieved the target level. This issue is resolved by the employer.
The same applies to employees of children's institutions - increasing their salaries is the right of the institution.
It is also advisable to reflect these points in the collective agreement.

At what rate will wages increase?
According to the roadmap, the maximum increase in wages is planned for 2017.
However, until 2015, the pace will be low. First of all, this is due to the calculation of tariffs in accordance with Federal Law 354 of November 30, 2011 “On the amount and procedure for calculating the insurance premium tariff.”

Why hasn't my wages increased?

The employee talks like this:
- if, according to Presidential Decree No. 597 and the “road map”, a doctor’s salary in 2013 should be 129.7% of the regional average (for doctors in St. Petersburg the average salary should be about 47 thousand), then working at one and a half thousand two bets I will earn one and a half to two times more - 60-90 thousand.
However, this does not happen. Why?

The salary level is currently assessed per individual.

How is the average salary calculated?
Based on Rosstat Order No. 574 dated October 30, 2012, the average wages of employees are calculated by dividing the wage fund by the number of INDIVIDUALS for these categories of employees (for example, managers, doctors, nurses, and orderlies are considered separately). Thus, taking into account the high percentage of internal combinations in medical institutions, according to the monitoring carried out in accordance with Order 574, the average salary turns out to be higher than the average salary at the rate.
And, accordingly, basically, the target indicators are considered achieved - there is no need to pay employees extra! And the indicators are met, and the stakes are covered, and the chief physician receives incentive payments for achieving the set indicators. Only the employee is at a loss.
Not all employees will be able to receive the amounts indicated in the roadmap. Salary will depend on qualifications, quantitative and qualitative performance indicators. PART OF THE WORKERS WILL NOT RECEIVE SALARY IN THE AMOUNT SPECIFIED IN THE PRESIDENTIAL DECREE. Thus, STIMULATION is achieved.

What to do in such a situation?
It is clear that from 2013-2014, especially in connection with the transition to an effective contract, the employer’s incentive payments will depend on the achievement of the target average wages for the institution.
In such a situation, he will be forced to “tighten” the wages of his employees.
Now let's think about what is more profitable - to work like a normal person, at a rate, go home on time or for an external part-time job and receive a base salary of 17 thousand plus incentives up to 47 thousand, or work at two rates in one institution, earn a salary of 34 thousand and receive incentives in the amount of 13 thousand?
Therefore, many workers see a solution in “Italian strikes” - work strictly according to the labor code, with the fulfillment of job duties, hiring standards no more than at the rate, in compliance with the hiring regulations.

“METHODOLOGICAL MANUAL “Introduction of an “effective contract” in state (municipal) healthcare institutions” Approved by a resolution of the Presidium of the Central Committee of the Workers' Trade Union...”

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PROFESSIONAL UNION OF HEALTH WORKERS OF THE RUSSIAN FEDERATION

TOOLKIT

“Introduction of an “effective contract”

in state (municipal)

healthcare institutions"

Approved by a resolution of the Presidium of the Central Committee of the trade union

healthcare workers of the Russian Federation

The material was prepared by the legal department

and social protection of the apparatus of the Trade Union in Moscow Appendix No. 1 to the resolution of the Presidium of the Central Committee of the Trade Union of May 13, 2014 No. 18-12 Methodological manual “Introduction of an “effective contract”

in state (municipal) healthcare institutions"

Ideological justification for the introduction of an “effective contract”

Budget message of the President of the Russian Federation dated June 29, 2011 on budget policy in 2012 - 2014 Decree of the President of the Russian Federation dated May 7, 2012 No. 597 “On measures for the implementation of state social policy”

Budget message of the President of the Russian Federation dated June 28, 2012 on budget policy in 2013 - 2015;

List of instructions of the President of the Russian Federation dated July 27, 2012 following the meeting on the implementation of Presidential decrees in the field of social policy Order of the Government of the Russian Federation dated November 26, 2012 No. 2190-Program for the gradual improvement of the remuneration system in state (municipal) institutions for 2012 - 2018 Unified recommendations dated December 25, 2013 on the establishment at the federal, regional and local levels of remuneration systems for employees of state and municipal institutions for 2014. Order of the Government of the Russian Federation dated December 28, 2012 No. 2599-r “On approval of the action plan (“road map”) “Changes in sectors of the social sphere aimed at increasing the efficiency of healthcare" The term "effective contract" was first used in the election article by V.V. Putin in 2012 “Building justice, social policy for Russia.” Subsequently, in the Decree of the President of the Russian Federation dated May 7, 2012 No. 597 “On measures to implement state social policy” and in the Budget Message of the President of the Russian Federation dated June 28, 2012 “On budget policy in 2013-2015” for the purpose of preserving personnel potential, increasing the prestige and attractiveness of professions in the public sector of the economy. The Government of the Russian Federation was entrusted with developing a program for the gradual improvement of the system of remuneration for workers in the public sector of the economy, conditioning the increase in wages on the achievement of specific indicators of the quality and quantity of services provided.

Implementation of the priority national project “Health” (in terms of additional payments);

Implementation of Federal Law No. 83-FZ (expansion of the rights of institutions, new requirements for an employment contract with the head of a budgetary institution);

Implementation of regional modernization programs (in terms of introducing standards and additional remuneration for increasing the availability and quality of medical care).

According to the Order of the Government of the Russian Federation dated December 28, 2012.

No. 2599-r “On approval of the action plan (“road map”) “Changes in the sectors of the social sphere aimed at increasing the efficiency of healthcare” stipulates that the purpose of the “road map” in the sectors of the social sphere is to improve the quality of medical care based on increasing the efficiency of activities medical organizations and their employees, and it is designed to ensure the establishment of mechanisms for the dependence of the level of remuneration of workers on the quantity and quality of the provision of free medical services to the population.

The document notes that in order to establish effective mechanisms for the dependence of the level of remuneration of employees of medical organizations on the volume and quality of medical services provided (ensuring the provision of medical services), it is necessary to transfer medical workers to an effective contract.

The Budget Address of the President of the Russian Federation for 2013-2015 states that “...The use of an “effective contract” is also intended to increase the competitiveness of the state as an employer in regional labor markets and the comparability of labor costs in the state, municipal and private sectors of the economy.”

Thus, an effective contract is designed to ensure that the growth of workers’ wages corresponds to the increase in the quality of public services they provide (performance of work).

The conceptual basis of an effective contract is the activities of a medical organization in the form of a set of all processes that are subject to analysis and continuous improvement to ensure the quality of medical services. An effective contract will provide an opportunity to reward employees who achieve the best results.

What goals and objectives were set in the Program for the gradual improvement of remuneration systems in state (municipal) institutions, approved by the Order of the Government of the Russian Federation of November 26, 2012

No. 2190-“On approval of the Program for the gradual improvement of the wage system in state (municipal) institutions for 2012-2018”?

The main goals of the Program are:

maintaining human resources;

increasing the prestige and attractiveness of working in a medical organization;

ensuring compliance of workers' remuneration with the quality of their provision of state (municipal) services (performance of work).

What is needed to achieve these goals:

improve employee remuneration systems focused on achieving specific indicators of the quality and quantity of services provided;

create a transparent mechanism for remuneration of heads of medical organizations;

develop the personnel potential of employees;

create organizational and legal conditions for achieving target indicators for the level of average wages of certain categories of workers, determined by Decrees of the President of the Russian Federation dated May 7, 2012 No. 597 and June 1, 2012 No. 761.

An effectively working doctor can become a hostage to ineffective management!

Therefore, an effective contract can only be implemented in an “effectively managed institution.”

For effective management of an institution, a team must work - a group of people who perform a specific task and in which the result of the efforts of team members is manifested, which is always greater than the result of the work of an individual employee.

"Answers to questions from the Government of the Saratov Region on monitoring the implementation of Decrees of the President of the Russian Federation of May 7, 2012 N 597 "On measures for the implementation of state social policy", dated June 1, 2012 N 761 "On the National Strategy of Action in the Interests of Children for 2012 - 2017" and dated December 28, 2012 N 1688 "On some measures to implement state policy in the field of protection of orphans and children left without parental care", as well as the Program for the gradual improvement of the wage system in state (municipal) institutions for 2012 - 2018, approved by order of the Government of the Russian Federation dated November 26, 2012 N 2190r":

4. On the application of a sample form of an employment contract with employees.

When switching to an “effective contract”, in relation to each employee, his labor function, indicators and criteria for assessing performance must be clarified and specified, the amount of remuneration must be established, as well as the amount of incentives for achieving collective labor results.

The competence and leadership of the entire management team of the institution is decisive in the development of an effective contract, allowing, through its implementation, certain benefits to be achieved for all interested parties. Particular importance is given to the role and competence of the head of a medical organization.

A deep mistake is the opinion of managers that a team can be appointed and only monitor its actions.

The transfer of employees to an effective contract will require the management team to first think through structural changes in the divisions of medical organizations. For these purposes, it is necessary to bring the staffing table in accordance with the approved nomenclature of specialties.

Management must create a system of incentives for employees for active and effective participation in providing quality medical services to the population.

But even for the head of a state (budgetary, state-owned, autonomous) medical organization, there are incentive payments associated with achieving the values ​​of the indicators stipulated by the employment contract, one of which is ensuring the achievement of the annual values ​​​​of indicators established by the institution for the ratio of the average wage of certain categories of employees of the institution with the average wages in the relevant constituent entity of the Russian Federation, specified in the additional agreement, which is an integral part of the employment contract (Resolution of the Government of the Russian Federation of April 12, 2013 N 329).

From 01/01/2013, the maximum level of the ratio of the average salary of managers and employees of federal institutions must be established by the federal government body exercising the functions and powers of the founder of the relevant institutions, in a multiple of 1 to 8.

In this case, the specified maximum level can be increased by decision of the federal government body - the main manager of federal budget funds, which is in charge of the institution, in relation to the head of the institution included in the relevant List approved by the Government of the Russian Federation (Regulations on the establishment of remuneration systems for employees of federal budgetary and government institutions, approved by Decree of the Government of the Russian Federation of 08/05/2008 No. 583 with subsequent additions and amendments; in the constituent entities of the Russian Federation - clause 25 Unified recommendations of 12/25/2013 on the establishment of remuneration systems for state and municipal employees at the federal, regional and local levels institutions for 2014).

–  –  –

__________________________________________________________________________, (name of the institution in accordance with the charter) represented by ___________________________________________________________________, (position, full name) acting on the basis of ________________________________________________

(charter, power of attorney) ___________________________________________________, hereinafter referred to as the employer, on the one hand, and _________________________________________, (full name) hereinafter referred to as the employee, on the other hand (hereinafter referred to as the parties), have entered into this employment agreement on the following :

I. General provisions

1. Under this employment contract, the employer provides the employee with work on _______________________________________________________

(name of position, profession or ___________________________________________________________________, specialty indicating qualifications) and the employee undertakes to personally perform the following work in accordance with the terms of this employment contract:

___________________________________________________________________________

(indicate specific types of work that the employee must perform under the employment contract)

2. An employee is hired:

__________________________________________________________________________.

(full name of the branch, representative office, other separate structural unit of the employer, if the employee is hired by a specific branch, representative office or other separate structural unit of the employer, indicating its location)

3. The employee works in the structural unit of the employer _______________________________________________________________.

(name of a non-separate department, department, site, laboratory, workshop, etc.)

4. Working for an employer is for an employee: ______________________

(main, part-time)

5. This employment contract is concluded on: _________________________

__________________________________________________________________________.

(indefinite period, definite period (specify duration), for the duration of certain work, indicating the reason (grounds) for concluding a fixed-term employment contract in accordance with Article 59 of the Labor Code of the Russian Federation)

6. This employment contract comes into force on "__" __________ 20__.

7. Start date "__" ____________ 20__

8. The employee is given a probationary period of ________ months (weeks, days) in order to verify the employee’s suitability for the assigned work.

II. Rights and responsibilities of an employee

9. The employee has the right to:

a) providing him with work stipulated by this employment contract;

b) ensuring safety and working conditions that comply with state regulatory requirements for labor protection;

c) timely and full payment of wages, the amount and conditions for receipt of which are determined by this employment contract, taking into account the qualifications of the employee, the complexity of the work, the quantity and quality of the work performed;

d) other rights provided for by the labor legislation of the Russian Federation and this employment contract.

10. The employee is obliged:

a) conscientiously fulfill his labor duties assigned to him by paragraph 1 of this employment contract;

b) comply with the internal labor regulations in force at the employer, labor protection and occupational safety requirements;

c) observe labor discipline;

d) take care of the employer’s property, including the property of third parties located at the employer, if the employer is responsible for the safety of this property, and other employees;

e) immediately inform the employer or immediate supervisor about the occurrence of a situation that poses a threat to the life and health of people, the safety of the employer’s property, including the property of third parties owned by the employer, if the employer is responsible for the safety of this property, and the property of other employees.

III. Rights and obligations of the employer

11. The employer has the right:

a) demand from the employee the conscientious performance of duties under this employment contract;

b) adopt local regulations, including internal labor regulations, requirements for labor protection and occupational safety;

c) bring the employee to disciplinary and financial liability in the manner established by the Labor Code of the Russian Federation and other federal laws;

d) reward the employee for conscientious, effective work;

e) other rights provided for by the labor legislation of the Russian Federation and this employment contract.

12. The employer is obliged:

a) provide the employee with the work stipulated by this employment contract;

b) ensure the safety and working conditions of the employee that comply with state regulatory requirements for labor protection;

c) provide the employee with equipment, tools, technical documentation and other means necessary to perform his job duties;

d) pay the full amount of wages due to the employee on time;

e) process and ensure the protection of the employee’s personal data in accordance with the legislation of the Russian Federation;

f) familiarize the employee, against signature, with the adopted local regulations directly related to his work activity;

g) fulfill other duties provided for by labor legislation and other regulatory legal acts containing labor law standards, collective agreements, agreements, local regulations and this employment contract.

IV. Salary

13. For the performance of labor duties provided for by this employment contract, the employee is paid a salary in the amount of:

a) official salary, wage rate ___________ rubles per month;

b) the employee receives compensation payments:

–  –  –

c) the employee receives incentive payments:

Name Conditions Indicators Frequency Amount of payment payment receipt and payment criteria for assessing performance

14. Payment of wages to an employee is made within the time frame and in the manner established by the employment contract, collective agreement and internal labor regulations.

15. The employee is subject to benefits, guarantees and compensation established by the legislation of the Russian Federation, regulatory legal acts of the constituent entities of the Russian Federation, collective agreement and local regulations.

V. Working time and rest time

16. The following working hours are established for the employee (standard hours of teaching work per salary) _____________________

__________________________________________________________________________.

(normal, shortened, part-time)

17. Working hours (working days and weekends, start and end times of work) are determined by the internal labor regulations or this employment contract.

18. The following features of the work mode are established for the employee (specify) ________________________________________________________________.

19. The employee is granted annual basic paid leave of ____________ calendar days.

20. The employee is granted additional annual paid leave of ______________ in connection with __________________________

__________________________________________________________________________.

(indicate the basis for establishing additional leave)

21. Annual paid leave (main, additional) is provided in accordance with the vacation schedule.

VI. Social insurance and measures of social support for the employee provided for by law, industry agreement, collective agreement, this employment contract

22. The employee is subject to compulsory social insurance in accordance with the legislation of the Russian Federation.

23. The employee has the right to additional insurance under the conditions and in the manner established by _____________________________________________

__________________________________________________________________________.

(type of insurance, name of local regulation)

24. The employee is provided with the following social support measures provided for by the legislation of the Russian Federation, the legislation of the constituent entities of the Russian Federation, industry agreement, collective agreement, this employment contract (specify):

__________________________________________________________________________.

VII. Other terms of the employment contract

25. The employee undertakes not to disclose secrets protected by law (state, commercial, official and other secrets) that become known to the employee in connection with the performance of his job duties.

The employee must be familiarized with the list of information that constitutes a secret protected by law upon signature.

26. Other terms of the employment contract ___________________________________.

VIII. Responsibility of the parties to the employment contract

27. The employer and employee are responsible for failure to fulfill or improper fulfillment of their assumed duties and obligations established by the legislation of the Russian Federation, local regulations and this employment contract.

28. For committing a disciplinary offense, that is, failure or improper performance by an employee through his fault of the labor duties assigned to him, disciplinary sanctions may be applied to the employee as provided for by the Labor Code of the Russian Federation.

IX. Change and termination of an employment contract

29. Changes can be made to this employment contract: by agreement of the parties, when the legislation of the Russian Federation changes in the part affecting the rights, obligations and interests of the parties, on the initiative of the parties, as well as in other cases provided for by the Labor Code of the Russian Federation.

30. If the employer changes the terms of this employment contract (except for the labor function) for reasons related to changes in organizational or technological working conditions, the employer is obliged to notify the employee in writing no later than 2 months in advance (Article 74 of the Labor Code of the Russian Federation) .

The employer is obliged to notify the employee personally and against signature of the upcoming dismissal due to the liquidation of the institution, a reduction in the number or staff of the institution's employees, at least 2 months before the dismissal (Article 180 of the Labor Code of the Russian Federation).

31. This employment contract is terminated on the grounds established by the Labor Code of the Russian Federation and other federal laws.

Upon termination of an employment contract, the employee is provided with guarantees and compensation provided for by the Labor Code of the Russian Federation and other federal laws.

X. Final provisions

32. Labor disputes and disagreements between the parties regarding compliance with the terms of this employment contract are resolved by agreement of the parties, and in case of failure to reach an agreement, they are considered by the labor dispute commission and (or) the court in the manner established by the legislation of the Russian Federation.

33. To the extent not provided for by this employment contract, the parties are guided by the legislation of the Russian Federation.

34. This employment contract is concluded in 2 copies (unless otherwise provided by the legislation of the Russian Federation), having equal legal force.

One copy is kept by the employer, the second is given to the employee.

–  –  –

The employee received one copy of this employment contract __________________________________________

(date and signature of the employee) Commenting on the term “effective contract”, it is worth noting that in labor legislation there is no concept of an effective contract, and there is also no concept of “contract”. Consequently, all changes in relationships with employees occur within the framework of those provisions that are enshrined in the Labor Code of the Russian Federation, and exceptions are the provisions of the Labor Code of the Russian Federation, establishing new grounds for terminating an employment contract with the head of an institution and his deputies (clause 7.1 of part 1 of article 81 of the Labor Code Code of the Russian Federation).

Thus, we can conclude that an effective contract is the same employment contract, only containing specification of its individual norms.

Article 56 of the Labor Code of the Russian Federation establishes that an employment contract is an agreement between an employer and an employee, according to which the employer undertakes to provide the employee with work for a specified labor function, to provide working conditions provided for by labor legislation and other regulatory legal acts containing labor law norms, a collective agreement , agreements, local regulations and this agreement, pay the employee wages in a timely manner and in full, and the employee undertakes to personally perform the labor function defined by this agreement and comply with the internal labor regulations in force for this employer.

The current labor legislation in Article 57 of the Labor Code of the Russian Federation established the content and conditions of the employment contract, which must contain the following information (Part 1 of Article 57 of the Labor Code of the Russian Federation):

Last name, first name, patronymic of the employee;

Employer's name;

Information about the employee’s identity documents;

Taxpayer identification number;

Information about the employer’s representative who signed the employment contract and the basis on which he is vested with the appropriate powers;

Place and date of conclusion of the contract.

The conditions that are included in the employment contract are divided into mandatory and additional.

The following conditions are mandatory for inclusion in the contract (Part 2 of Article 57 of the Labor Code of the Russian Federation):

1) place of work (name of the organization), and if an employee is accepted into a branch, representative office or other separate structural unit of the organization located in another area - place of work indicating this unit and its location.

2) labor function (work according to the position in accordance with the staffing table, profession, specialty indicating qualifications;

specific type of assigned work).

In accordance with the order of the Ministry of Labor of Russia dated November 30, 2012 No. 565 in the field of healthcare, professional standards for medical workers must be developed and approved, the main elements of which must be included in the employment contract;

3) the start date of work, and when concluding a fixed-term employment contract, also its validity period and the circumstances (reasons) that served as the basis for concluding this contract. In this case, the period can be determined either by a specific date or by the occurrence of an event;

4) terms of remuneration (including the size of the tariff rate or salary (official salary) of the employee, additional payments, allowances and incentive payments);

5) working hours and rest hours (if for a given employee it differs from the general rules in force for the employer);

6) compensation for hard work and work with harmful and (or) dangerous working conditions, if the employee is hired for such work, indicating the characteristics of working conditions at the workplace;

7) conditions determining, if necessary, the nature of the work (mobile, traveling, on the road, other nature of work);

8) a condition on compulsory social insurance of the employee;

9) other conditions in cases provided for by labor legislation and other regulations containing labor law norms.

The drawing up and signing of an “effective contract” (additional agreement) must take place in accordance with the labor legislation of the Russian Federation.

From Order of the Government of the Russian Federation dated November 26, 2012 N 2190-r:

A change in the procedure for remuneration is a change in the conditions determined by the parties to the employment contract and is carried out in accordance with the legislation of the Russian Federation.

So, the algorithm for implementing an effective contract in relation to a specific medical organization is as follows.

1. Issuing an order from the head of the organization on the introduction of an effective contract in the organization.

Approaches to the selection of criteria for the incentive part of wages; the remuneration system for employees of institutions should ensure:

Differentiation of remuneration for workers performing work of varying complexity;

Establishing wages depending on the quality of government (municipal) services provided (work performed) and efficiency;

Activities of employees according to specified criteria and indicators.

The procedure for establishing certain types of incentive payments may be prescribed in the employment contract itself, and for other incentive payments, references to the relevant provisions on remuneration may be made in the employment contract.

From Article 135 of the Labor Code:

The terms of remuneration determined by the employment contract cannot be worsened in comparison with those established by labor legislation and other regulatory legal acts containing labor law norms, collective agreements, agreements, and local regulations.

Regulations on remuneration of healthcare institutions, as a rule, provide for the following incentive and compensation payments:

For intensity and high results of work:

bonus for labor intensity;

bonus for high performance results;

bonus for performing particularly important and responsible work;

For the quality of work performed:

bonus for having a qualification category;

award for exemplary performance of state (municipal) assignments;

While working:

long service bonus;

bonus for continuous work experience;

Bonuses based on work results for:

Workers engaged in heavy work, work with harmful and (or) dangerous and other special working conditions;

For work in areas with special climatic conditions:

regional coefficient;

coefficient for work in desert and waterless areas;

coefficient for work in high mountain regions;

bonus for work experience in the Far North and equivalent areas;

For work in conditions deviating from normal:

additional payment for combining professions (positions);

surcharge for expanding service areas;

additional payment for increasing the volume of work;

additional payment for performing the duties of a temporarily absent employee without release from work specified in the employment contract;

additional payment for performing work of various qualifications;

surcharge for night work.

Remuneration systems, employment contracts and additional agreements to employment contracts may provide for other compensation and incentive payments in accordance with labor legislation, other regulatory legal acts containing labor law norms, as well as collective agreements and agreements.

The amount of incentive payments should be established by a local act of the organization in agreement with the elected trade union body based on the representation of the heads of structural divisions.

From Order of the Ministry of Labor of Russia dated April 26, 2013 N 167n “On approval of recommendations for formalizing labor relations with an employee of a state (municipal) institution when introducing an effective contract”:

P.5. It is recommended to conclude an additional agreement to the employment contract as indicators and criteria for assessing the labor efficiency of the institution’s employees are developed to determine the size and conditions for the implementation of incentive payments.

Among the criteria for assessing the performance of structural units and employees, criteria for the incentive part of wages may be provided:

Compliance with production and load standards

Patient satisfaction with treatment results

No complaints

Absence of complaints during quality examination (internal and external)

Implementation of labor discipline

Completeness of performance of official duties

Others (here it is advisable to provide for additional payment at the expense of the employer to the non-exempt chairmen of the primary organizations of the Trade Union for their additional social workload).

How to make the transition to an effective contract?

Is it possible to terminate an employment contract with an employee and enter into a new one?

It is necessary to make changes to the current employment contract.

How? - Draw up an additional agreement to the current employment contract in two ways:

Amend the employment contract by agreement of the parties (Article 72 of the Labor Code) What are the grounds for amending the employment contract?

Article 72 of the Labor Code establishes: “A change in the terms of an employment contract determined by the parties, including transfer to another job, is permitted only by agreement of the parties to the employment contract, with the exception of cases provided for by the Labor Code.

An agreement to change the terms of an employment contract determined by the parties is concluded in writing.”

Make changes to the employment contract unilaterally at the initiative of the employer (Article 74 of the Labor Code of the Russian Federation) From the Order of the Ministry of Labor and Social Protection of the Russian Federation dated April 26, 2013 No. 167n “On approval of recommendations for formalizing labor relations with an employee of a state (municipal) institution at introduction of an effective contract":

“... In accordance with part two of Article 74 of the Labor Code of the Russian Federation, the employer is obliged to notify the employee in writing no later than two months in advance of the terms of the employment contract determined by the parties, as well as the reasons that necessitated such changes, unless otherwise provided for by the Labor Code of the Russian Federation.”

From Article 74 of the Labor Code “Changing the terms of an employment contract determined by the parties for reasons related to changes in organizational or technological working conditions”:

In the event that, for reasons related to changes in organizational or technological working conditions (changes in equipment and production technology, structural reorganization of production, other reasons), the terms of the employment contract determined by the parties cannot be preserved, they may be changed at the initiative of the employer, with the exception of changes in the employee’s labor function.

The employer is obliged to notify the employee in writing of the terms of the employment contract determined by the parties, as well as the reasons that necessitated such changes, in writing no later than two months, unless otherwise provided by this Code.

In the absence of the specified work or the employee refuses the proposed work, the employment contract is terminated in accordance with paragraph 7 of part one of Article 77 of the Labor Code of the Russian Federation

Changes to the terms of the employment contract determined by the parties, introduced in accordance with this article, should not worsen the position of the employee in comparison with the established collective agreement, agreements. Additional conditions may be included in the employment contract that do not worsen the position of the employee, for example, about a specific workplace, about probation, about payment of severance pay in an increased amount, non-disclosure of secrets protected by law, etc.

The absence of any of the mandatory conditions in the contract does not lead to its recognition as not concluded and is not a basis for its termination.

In this case, the employment contract must be supplemented. In this case, the missing information is entered directly into the text of both copies of the agreement and certified by the signatures of the parties and the seal of the employer.

The missing conditions are established by a separate agreement of the parties, which is concluded in writing and is an integral part of the employment contract. If the absence of mandatory conditions in the employment contract is discovered during the inspection, the official conducting the inspection will demand that the violations be eliminated. If this requirement is not met within the prescribed period, the organization may be brought to administrative liability (Article 19.5 of the Code of Administrative Offenses of the Russian Federation).

An employee’s refusal to continue working due to a change in the terms of the employment contract determined by the parties (part four of Article 74 of the Labor Code) may lead to termination of the employment contract.

Part 1 of Article 77 of the Labor Code “General grounds for termination of an employment contract”

7) the employee’s refusal to continue working due to a change in the terms of the employment contract determined by the parties (part four of Article 74 of the Labor Code).

Thus,

An employment contract will be concluded with the newly hired employee that meets the requirements of an effective contract,

Additional agreements to employment contracts must be concluded with other employees.

In practice you will need:

OR read previous versions of employment contracts, add phrases like:

“Item No....supplement with the phrase...”

OR use a phrase similar to the following:

“State the text of the employment contract with ... (full name of the employee) in the following wording: ...”

Appendix No. 2 to the Resolution of the Presidium of the Central Committee of the Trade Union dated May 13, 2014 No. 18-12

–  –  –

Concluding agreements with the heads of state (municipal) institutions Introducing changes to collective agreements Introducing changes to the regulations on wages Familiarizing employees with changes in the employment contract Concluding contracts/additional agreements to the employment contract with employees of state (municipal) institutions

Organizational prerequisites for the transition to an effective contract:

–  –  –

In the Order of the Government of the Russian Federation dated December 28, 2012 No. 2599-r “On approval of the action plan (“road map”) “Changes in sectors of the social sphere aimed at increasing the efficiency of healthcare”

it is stipulated that the goal of the “road map” in the social sphere is to improve the quality of medical care based on increasing the efficiency of the activities of medical organizations and their employees, and it is intended to ensure the establishment of mechanisms for the dependence of the level of remuneration of workers on the quantity and quality of the provision of free medical services to the population.

The social effectiveness of the implementation of the “road map” is the establishment of effective mechanisms for assessing the performance of medical workers and the compliance of the level of remuneration with the quality of work.

–  –  –

As a result, the goal of the “road map” is to attract qualified specialists to state and municipal medical organizations and eliminate the outflow of medical personnel to private medical organizations, creating conditions that allow medical workers of state and municipal medical organizations to receive a competitive salary level.

Thus, an effective contract is designed to ensure that the growth of workers’ wages corresponds to the increase in the quality of public services they provide (performance of work)

–  –  –

For effective management of an institution, a team must work - a group of people who perform a specific task and in which the result of the efforts of team members is manifested, which is always greater than the result of the work of an individual employee.

–  –  –

In this case, the specified maximum level can be increased by decision of the federal government body - the main manager of federal budget funds, which is in charge of the institution, in relation to the head of the institution included in the relevant List approved by the Government of the Russian Federation (Regulations on the establishment of remuneration systems for employees of federal budgetary and government institutions, approved by Decree of the Government of the Russian Federation of 08/05/2008 No. 583 with subsequent additions and amendments; in the constituent entities of the Russian Federation - clause 25 of the Unified Recommendations of 12/25/2013 on the establishment of remuneration systems for state and municipal employees at the federal, regional and local levels. institutions for 2014).

What is an “effective contract”?

–  –  –

a remuneration system that takes into account differences in the complexity of the work performed, as well as the quantity and quality of labor expended, approved by the employer in the prescribed manner

–  –  –

detailed specification, taking into account industry specifics in employment contracts, of the job responsibilities of employees, indicators and criteria for assessing labor, conditions of remuneration “Effective contract”

This is an employment contract with an employee, which specifies:

–  –  –

indicators and criteria for assessing the effectiveness of activities for assigning incentive payments depending on the results of work and the quality of provided state (municipal) services measures of social support Article 56 of the Labor Code of the Russian Federation establishes that an employment contract is an agreement between an employer and an employee, in accordance with which the employer undertakes to provide the employee to work for a specified labor function, to ensure working conditions provided for by labor legislation and other regulatory legal acts containing labor law norms, a collective agreement, agreements, local regulations and this agreement, to pay the employee wages in a timely manner and in full, and the employee undertakes personally perform the labor function defined by this agreement, comply with the internal labor regulations in force for this employer.

employer's name

–  –  –

Based on the definition given in Part 2 of Art. 57 of the Labor Code of the Russian Federation, the concept of “labor function” includes work in a position in accordance with the staffing table, profession, specialty indicating qualifications, as well as the specific type of work assigned to the employee. It follows that a labor function is a list of certain operations that an employee is obliged to perform on behalf of the employer. These operations are determined in accordance with the position of the employee for which he was hired.

The following conditions are required to be included in the contract (continued)

–  –  –

In accordance with the order of the Ministry of Labor of Russia dated November 30, 2012 No. 565 in the healthcare sector, professional standards for medical workers must be developed and approved, the main elements of which must be included in the employment contract. The algorithm for introducing an effective contract in relation to a specific medical organization is as follows

–  –  –

2. Creation of a commission or working group to organize work related to the introduction of an effective contract. The working group should include representatives of workers represented by the primary trade union organization.

3. Development, on the basis of performance indicators of state and municipal organizations approved by executive government bodies or local government bodies, of performance indicators for employees of this particular organization, taking into account its specifics.

4. Introducing changes and additions to the Regulations on the remuneration of employees of the organization in terms of clarifying the indicators and criteria for assessing the effectiveness of activities for the appointment of incentive payments depending on the results of work and the quality of government (municipal) services provided. At the same time, we recommend avoiding phrases like “reducing incentive payments” - instead of reducing payments, it is better to use the mechanism of proportional accrual of certain types of payments for each of the grounds.

When introducing a new remuneration procedure, it is necessary to focus not on “penalties”, but on incentive payments as labor motivation.

5. Preparation of additional agreements to employment contracts, amendments to employment contracts with employees of the organization.

6. Notifying employees in writing about changes in the employment contract.

7. Adjustment of job descriptions of employees in terms of new job functions, as well as bringing them to the attention of employees against receipt.

Approaches to the selection of criteria for the incentive part of wages - the remuneration system for employees of institutions should ensure:

–  –  –

the activities of employees according to specified criteria and indicators. The procedure for establishing certain types of incentive payments can be prescribed in the employment contract itself, and for other incentive payments, references can be made in the employment contract to the relevant provisions on remuneration.

The same may apply to social support measures.

–  –  –

Remuneration systems (including tariff remuneration systems) for employees of state and municipal institutions are established:

collective agreements, agreements, local regulations in accordance with laws and other regulatory legal acts of the Russian Federation.

Regulations on remuneration of healthcare institutions, as a rule, provide for the following incentive and compensation payments:

–  –  –

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The program for the gradual improvement of remuneration systems in state (municipal) institutions, which was approved by the Government of the Russian Federation on November 26, 2012, set clear goals:

• maintain human resources potential;
• increase the prestige of working in budgetary medical institutions;
• Bring the remuneration of medical workers in line with the level of quality of the work they perform.

One of the mechanisms for achieving these goals is the introduction of an effective contract, including in healthcare. The term itself is not fixed in labor legislation and implies an employment contract containing criteria for assessing labor efficiency, which are needed to determine the size and conditions for incentive payments. We give an example of an effective contract in healthcare for a nurse.

What to include in an effective healthcare contract

The parameters of the incentive part of wages in healthcare should ensure:

• differentiation of wages for those who perform work of varying complexity;
• remuneration scheme depending on performance;
• activities according to specified indicators.

In an effective healthcare contract, performance evaluation criteria might include:

• fulfillment of production and load standards;
• patient satisfaction with treatment results;
• no complaints;
• absence of complaints during the quality examination (internal and external);
• maintaining discipline;
• completeness of fulfillment of official duties, etc.

The provisions on payment for healthcare institutions, as a rule, also provide for other incentive and compensation payments:

• bonus for labor intensity;
• premium for high results;
• bonus for performing particularly important and responsible work;
• for quality;
• bonus for having a qualification category;
• long service bonus;
• bonus for continuous service;
• additional payment for performing work of various qualifications;
• surcharge for night work.

In addition to the agreement itself, which will be concluded with new employees, the budgetary institution must also develop an additional agreement to the employment contract, which will be concluded with existing employees upon transition to an effective contract.

Download a sample of an effective healthcare contract for a nurse

Download a sample additional agreement to a doctor’s employment contract

How to switch to an effective contract

The implementation algorithm in relation to a specific medical organization is as follows:

1. The head of the organization issues an order to implement an effective contract.
2. A commission or working group is created to carry out the work. The composition should include representatives of workers (represented by the primary trade union organization).
3. Indicators of the performance of the organization's employees are being developed on the basis of those approved by executive government bodies or local governments.
4. Standard employment contracts are being developed for newly hired employees.
5. Additional agreements are being developed to the employment contracts of those who are already working.
6. Employees are notified of changes to the employment contract in writing no later than two months in advance.
7. Changes are being made to the Regulations on Remuneration (and, if necessary, developed anew) on the appointment of incentive payments depending on the results of work and the quality of government (municipal) services provided. Employees become familiar with the changes by signing.
8. The job descriptions of employees are being adjusted as they relate to new job functions. Changed job descriptions are brought to the attention of employees against signature.

An employee may refuse to enter into an additional agreement to the employment contract. In this case, the employer is obliged to offer him in writing another job available in the organization, including a lower-paid one, which the employee can take (Part 3 of Article 74 of the Labor Code of the Russian Federation).

Most often, a budgetary institution completely switches to a new wage system, so it will not be possible to find a vacancy that does not fall under the new conditions. In this case, there is only one way out - to terminate the employment contract (clause 7, part 1, article 77 of the Labor Code of the Russian Federation).

Fixed wages, as a rule, do not encourage employees to perform their duties at a high level. And really, why work hard if you can meet the minimum requirements and get the same money?

Until 2012, employment contracts stipulated clearly established wages for a specific specialty, and this approach created negative trends in the labor market:

• outflow of young specialists and valuable personnel;
• low quality of medical care to the population (as a result of lack of motivation to perform their work at a high level);
• The main income of doctors is unofficial paid services, which means: patient dissatisfaction, insufficient budget filling and underfunding of the industry as a whole.

According to the Order of the Government of the Russian Federation dated November 26, 2012 No. 2190-, the Program for the gradual improvement of the wage system in state (municipal) institutions for 2012-2018 was approved. The key reform of the program is increasing the efficiency of the contractual form of interaction between employers and employees.

An effective contract is a special form of employment contract between an employer and an employee with prescribed job responsibilities for a specific employee (and not just a representative of a certain specialty) and criteria for assessing the effectiveness of the work done. These indicators are used to determine wages, which include incentive bonuses.

The Program Annex contains a sample of an effective contract in healthcare, the mandatory conclusion of which is planned to be introduced in all government agencies by 2018. Methodological recommendations for introducing an effective contract in healthcare have also been developed.

Will an effective contract be effective?

In the article “Effective Contract in Healthcare,” Doctor of Economics F.N. Kadyrov reports that the transition to an effective contract in municipal institutions will clearly determine the dependence of the salary of medical workers on the quantity and quality of work performed. Now, when concluding an employment contract, each employee will clearly understand the scope of his responsibilities and the potential amount of additional payments that he can receive by performing his work at a high level.

You can see an example of an effective contract in healthcare.

Based on the provisions on an effective contract in healthcare, we can draw conclusions about the following advantages of the innovation:

• Incentive for staff. Exceeded the planned amount of work and received a substantial bonus.
• Improving the quality of medical care. Employees interested in salary increases perform their duties more carefully. As a result, patients receive medical services of a higher level.
• Growth in average wages of healthcare workers.

In institutions that have switched to an effective contract, there is already a positive dynamics in the growth of doctors’ wages. Thus, the head of the personnel department of MBU Children's City Hospital No. 5 of Yekaterinburg, Sada Nazimovna Bagirova, confirms: “... in addition to guaranteed payment (salary, bonuses for position, length of service, category, harmfulness), doctors, depending on their specialization, when exceeding the plan, receive incentive payments from 20 to 28 thousand rubles.”

True, not everything is so smooth

Overall, the idea of ​​an effective contract has many positive aspects. However, in practice there are some problems associated with its implementation. The new wage conditions raise many questions among employees of public medical institutions about the amount of wages.

Current job evaluation systems have many significant shortcomings. Thus, the initial idea was to create performance criteria for each position (for example, a point system). Each specialist receives an assessment of the work done in points, which are summed up, multiplied by a constant, and the result obtained is paid to the employee. However, this method requires the creation of a new department in institutions that would deal exclusively with scoring, since in municipal clinics there can be several hundred employees, which significantly complicates and slows down the scoring process.

Another significant problem is insufficient funding for the healthcare sector. According to the Accounts Chamber of the Russian Federation, in 2014 the deficit amounted to 55.3 billion rubles. The wage fund is simply not designed for all employees to fulfill the plan 100%. Therefore, the management of medical institutions often faces a situation where the plan has been fulfilled, but there is no money to pay bonuses. So it is necessary to initially indicate in employment contracts a small coefficient for incentive payments.

What should you expect?

In accordance with Decree of the President of the Russian Federation of May 7, 2012 No. 597 “On measures for the implementation of state social policy,” by 2018 it is planned to increase the average salary of doctors to 200% of the average salary in a particular region. Therefore, we can only hope that healthcare financing will improve. In the meantime, all municipal medical institutions need to switch to an effective contract system.

The form of an effective contract in healthcare, as an improved type of employment contract, can change the current state of things for the better. Its implementation creates a significant incentive for healthcare workers. As for the shortcomings of this system, active work is currently underway to simplify and improve it. In the article “New effective approaches to remuneration of medical workers” (Borisova E.A., Savina N.V., Lutskan I.P., Timofeev L.F.), the authors propose to solve the problem of the complexity of regularly assessing the work of employees using computer programs.

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