One-time allowance for medical workers. On a one-time compensation payment to medical workers when moving to work in the countryside. Accounting for compensation payments when on duty at home

03.04.2020

Faculty Medical Law again returns to the discussion of the issue of guarantees and compensations provided by the state medical workers. As you know, medical workers when moving to countryside a lump sum payment is provided. Today we will talk about the procedure for providing this compensation as part of the changes for 2017.

About the one-time compensation payment

So, according to section 12.1. article 51 federal law dated November 29, 2010 No. 326-FZ “On compulsory medical insurance in Russian Federation"(hereinafter - Federal Law No. 326) a lump-sum compensation payment to medical workers is provided to medical workers who meet certain criteria, who arrived to work in a rural settlement, or a working settlement, or an urban shooting settlement, or who moved to work in a rural settlement, or a working settlement, or an urban-type settlement from another locality.

You should be aware that the amount of a one-time compensation payment to medical workers is 1,000,000 rubles.

Financing of one-time compensation payments to medical workers in 2017 is carried out at the expense of other interbudgetary transfers provided to the budget of the territorial CHI fund from the budget of the Federal CHI Fund in accordance with Federal Law No. and on planning period 2018 and 2019”, and the budget funds of the constituent entities of the Russian Federation in the ratio of 60 and 40 percent, respectively.

Note that in accordance with paragraph 37.2 of Article 217 tax code RF lump-sum compensation payment is not subject to taxation.

The purpose of this payment is to attract medical workers to rural settlements and compensate for the costs associated with moving and settling, as well as the inconvenience caused by less comfortable living conditions compared to other (non-rural) settlements.

At the same time, the legislator does not at all limit medical workers who come to work in a rural settlement in what the amount provided will be spent on.

The medical worker, in turn, upon receipt of a lump-sum compensation payment, must work for a certain period of time in medical organization rural settlement of that subject of the Russian Federation with which the specified agreement is concluded. Typically, this period is 5 years.

It should be noted that Federal Law No. 326 does not provide any explanation as to which locality can be considered rural.

A similar explanation is contained in the Letter of the FFOMS dated 05.02.2013 No. 801/21-i “On the implementation of lump-sum compensation payments in 2013” (hereinafter - the Letter of the FFOMS No. 801/21-i). On the issue of attributing settlements to rural settlements and workers' settlements, it is necessary to be guided by part 1.1 of article 10 of the Federal Law of October 6, 2003 No. 131-FZ "On general principles organizations local government in the Russian Federation" (hereinafter - Federal Law No. 131). Since the FFOMS Letter No. 801/21-i refers to the old version of the Federal Law No. 131, we will cite the current provision of the Federal Law No. 131 on this issue.

So, according to part 1.1 of article 10 of the Federal Law No. 131, vesting municipalities the status of an urban, rural settlement, municipal district, urban district, urban district with intra-urban division, intra-urban district, intra-urban territory of federal cities is carried out by the laws of the constituent entities of the Russian Federation.

It is worth noting that the criteria that apply to medical workers applying for a one-time compensation payment change from year to year.

So in 2017, the lump-sum compensation payment will be paid only to those medical workers who meet the following criteria in aggregate:

age - up to 50 years (by the way, in 2012-2014 the age limit was up to 35 years, in 2015 - 45 years);
availability of higher education;
arriving at work in a rural area in 2016 and 2017;
the existence of a concluded agreement with the authorized executive body of the constituent entity of the Russian Federation.

In practice, the authorities that are provided with such a package of documents also require a medical worker to have an employment contract between a medical worker and a state health care institution of a constituent entity of the Russian Federation or a municipal health care institution.

By the way, the FFOMS and the Ministry of Health of Russia speak about this condition in the Letter of the FFOMS dated July 8, 2013 No. 5124 / 80-1 / and “On judicial practice on consideration of disputes on the payment of lump-sum compensation to medical workers who moved to work in a rural locality "(FFOMS Letter No. 5124 / 80-1 / i) and the Letter of the Ministry of Health of Russia dated August 10, 2012 No. 11-11 / 3089 "On the implementation of lump-sum compensation payments to medical workers” (Letter of the Ministry of Health No. 11-11/3089).

However, it is worth remembering that the letters of the FFOMS, the Ministry of Health of Russia and other authorities do not have signs of normativity and can only be of an explanatory and recommendatory nature.

The publication of such explanatory letters by the relevant authorized bodies indicates that today there is no single procedure for providing a lump sum compensation payment.

In the absence legal regulation(of the procedure) for granting a lump-sum compensation payment, the FFOMS and the Ministry of Health of Russia provides authorized executive authorities of the constituent entities of the Russian Federation to resolve this issue independently, as indicated, for example, in letter FFOMS No. 801/21-i, according to which regulatory legal acts providing for measures of social support for medical workers, as well as the procedure for concluding an agreement between a medical worker and an authorized executive body.

Thus, the Procedure for concluding an agreement with a medical worker on the provision of a lump-sum compensation payment in 2017 in the Moscow Region was approved by Decree of the Government of the Moscow Region dated March 14, 2017 No. 145/8 (hereinafter referred to as the Procedure for the Moscow Region).

In accordance with this Procedure for the Ministry of Defense, the agreement on the provision of a lump-sum compensation payment must provide for:

the obligation of a medical worker to work for five years at the main place of work under the conditions of normal working hours established by labor law for this category of workers, in accordance with employment contract concluded by a medical worker with a public healthcare institution of the Moscow Region, located in a rural settlement or a working settlement in the Moscow Region, or an urban-type settlement in the Moscow Region (hereinafter referred to as a healthcare institution);
the procedure for providing a medical worker with a one-time compensation payment in the amount of one million rubles within thirty business days days from the date of conclusion of an agreement with the Ministry of Health of the Moscow Region (hereinafter referred to as the Ministry);
the obligation of a medical worker to return to the budget of the Moscow Region a part of a one-time compensation payment in the event of termination of an employment contract concluded by a medical worker with a healthcare institution, before the expiration of a five-year period calculated from the date of termination of the employment contract, in proportion to the period not worked out by the medical worker;
the responsibility of a medical worker for failure to fulfill the obligations stipulated by the contract, including the return of a one-time compensation payment;
provision on the consent of a medical worker to the processing of his personal data.

The procedure for the Ministry of Defense explains that the contract with a medical worker is concluded by the Ministry after the conclusion by the medical worker of an employment contract with a healthcare institution.

At the same time, a healthcare institution that has concluded an employment contract with a medical worker:

checks the availability and authenticity of the documents submitted by the medical worker;
submits to the Ministry an application from a medical worker for a one-time compensation payment (please note that there is no deadline for submitting such an application to the Ministry. Note that earlier the healthcare institution had to send an application to the Ministry within three working days from the date of conclusion of an employment contract with a medical worker).

Also, in the Procedure for the Ministry of Defense, it is noted that a one-time compensation payment is established and paid to medical workers only at their main place of work.

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In the commented Ruling of the Supreme Court of the Russian Federation No. 3-KG17-1 dated May 12, 2017, the arbitrators invalidated the decisions of the lower courts, which considered it justified to charge additional personal income tax in the amount of the compensation payment to middle-level workers received from the regional budget when moving to the countryside.

First, we recall that according to paragraph 1 of Art. 210 of the Tax Code of the Russian Federation, when determining the tax base, all income that he received both in cash and in kind or the right to dispose of which he has arisen, as well as income in the form of material established in accordance with Art. 212 of the Tax Code of the Russian Federation. At the same time, Art. 217 of the Tax Code of the Russian Federation provides for a list of income that is not subject to personal income tax. So, according to paragraph 1 of Art. 217 of the Tax Code of the Russian Federation, state benefits are not subject to taxation (exempted from taxation), with the exception of temporary disability benefits (including benefits for caring for a sick child), as well as other payments and compensations paid under current legislation. In particular, paragraph 37.2 of Art. 217 of the Tax Code of the Russian Federation that lump-sum compensation payments to medical workers made in the manner and on the conditions provided for in Art. 51 of Federal Law No. 326-FZ. This article (as amended in the period under review) determined lump-sum compensation payments to medical workers under the age of 35 who arrived in 2013-2014 after graduating from an educational institution of higher professional education to work in a rural settlement or a working settlement or moved to work to a rural settlement or a worker's settlement from another settlement and who has entered into an agreement with the body of a constituent entity of the Russian Federation. At the same time, the provision of lump-sum compensation payments to medical workers in 2013-2014 is carried out in equal shares at the expense of other interbudgetary transfers provided to the budget of the territorial fund from the budget of the FFOMS in accordance with the federal law on the budget of the FFOMS for the next financial year and planning period, and from the budgets of the subjects RF.

Regulations governing the provision of benefits

The regulation of incentive payments to health workers in 2020 is carried out on the basis of several regulations. The first of these is, namely article 129. It specifies the concept of wages and types of payments to employees of organizations.

Another regulatory legal act is Decree of the Government of the Russian Federation of August 5, 2008 N 583 (as amended on January 19, 2019) "On the introduction of new wage systems for employees of federal budgetary, autonomous and state institutions and federal government agencies, as well as civilian personnel military units, institutions and subdivisions of federal executive bodies, in which the law provides for military and equivalent service, the remuneration of which is carried out on the basis of the Unified tariff scale on remuneration of employees of federal state institutions" (together with the "Regulations on the establishment of remuneration systems for employees of federal budgetary, autonomous and state-owned institutions"), which establishes remuneration systems for people working in budgetary, autonomous and state-owned enterprises. There is also an Order of the Ministry of Health and social development RF dated December 29, 2007 N 818 "On approval of the List of types of incentive payments in federal budgetary, autonomous, state-owned institutions and clarifications on the procedure for establishing incentive payments in these institutions" (with amendments and additions), fixing the list of incentive incentives, factors , which determine the possibility of providing supplements to wages.

A list of performance indicators that are necessary to address the issue of stimulating workers is listed.

Local Incentive Payment Document

Each hospital should develop its own document that regulates employee benefits. It is called "Regulations on the payment of incentive bonuses to medical workers" and is considered an addition to the collective agreement, which is drawn up for one year.

This document must contain the following information:

source from which cash to pay incentives to health workers;
a list of employees eligible to apply for additional payments;
payment procedure;
the amount of the monthly surcharge;
a list of criteria that are used to check the quality of personnel work medical institution.

The sample Regulations on Incentive Payments for Medical Workers in each hospital are almost the same.

Who is eligible to apply for financial incentives?

In order to receive incentive payments to medical workers, a specialist must be certified in a specialty. The employee also needs to show Good work. After all, when deciding on incentives, the performance of each employee of a medical institution is taken into account.

The regional authorities themselves establish a list of positions that are entitled to receive cash benefits. The following healthcare workers do not qualify for the exemption:

administration of the institution. Managers can count on financial incentives, but only if they directly provide medical services;
health workers who take part in the Health program, namely, assist in the process of childbirth, care for babies, as well as other doctors working with them;
employees of medical institutions providing high-tech assistance.

Criteria by which the work of medical personnel is evaluated

Incentive payments to doctors are assigned after assessing the quality of their work. The following factors are taken into account during the audit:

The quality of the work performed per month.
The volume of provided honey. services.
Length of time in the institution.
Number of continuous seniority.
Skill level.
Collaboration work.
Individual increase factor.

In connection with the presence of these factors, it becomes clear that the implementation of material incentives for hospital workers depends entirely on how the work will be done. This is the optimal motivation for healthcare workers.

Accrual procedure

The procedure for calculating incentive payments to health workers is regulated local document, which sets out the rules for remuneration in the hospital. At the end of each month, the head prepares an order in accordance with which material incentives are paid to medical workers.

Also, management should create a list of employees at the end of the month indicating information about the work they have done. If the doctor failed to official duties, then the allowance may not be issued. The decision to award the award is made by a special commission, which includes:

Trade union chairman.
Head nurse.
Head of department.

Medical staff are informed about what grades they received for their work. The Commission evaluates the activity on a point system. Strong grounds are needed to deny the provision of presidential payments to medical workers in 2020. For example, the doctor did not fulfill his duties or grossly violated labor discipline.

If the employee was not given a bonus in the accounting department, then you need to demand the provision of an order on the basis of which the accountant acts. It must indicate the reasons for the negative decision. If the employee does not agree with the decision of the management, then he has the right to appeal it.

In addition to incentive payments, doctors and all other workers in the medical field are entitled to a number of other state preferences. These include:

years and others;
preferential consumer .

Approximate calculation of the amount of the allowance

The calculation of incentive payments to health workers is made depending on the work done. For example, the salary of a doctor is 20 thousand rubles. The multiplying coefficient after evaluating the work according to the established criteria is 0.2. As a result, the material incentive will be equal to 4 thousand rubles. This calculation example is approximate, it depends on many factors.

Do they receive payments for combination and replacement?

According to the Regulation on Incentive Payments to Medical Workers, people who replace other employees are also provided with additional monetary compensation. But at the same time, the documentary procedure for registering a part-time job must be observed.

That is, an employment contract is concluded with the employee on the combination of positions. If it is stipulated within the main labor agreement, then no allowances are made.

There are no changes regarding incentive payments to health workers in 2020 yet. This program is really good motivation for doctors. The state is trying to do everything to make the salary of medical personnel worthy of this profession.

In order to encourage medical workers in the Russian Federation, since 2014 there has been a program aimed at supporting citizens employed in this field. In particular, such support consists in receiving incentive payments, the assignment of which is carried out on the basis of criteria specified in the governing laws and regulations. In addition, incentive payments to healthcare workers in 2020, as before, are designed to attract more specialists to work in public institutions, since they are accrued exclusively in organizations of a non-profit type.

Legislative acts regulating the appointment of surcharges

On the basis of what can a medical employee qualify for payment for the intensity and high results of work? Amounts additional to the basic salary are accrued on the basis of the following legislative and regulatory acts.

Who is not eligible for incentive payments?

The provision on incentive payments in health care clearly limits the circle of workers who can claim to receive material supplements to their basic income as wages. An obligatory factor that makes it possible to accrue both permanent and lump-sum payments is that a medical worker has a certificate in the main specialty - this provision is spelled out in the RF PP No. 583, and other factors (merits in work, etc.) cannot be canceled can.

In addition, the appointment of payments is possible for certain categories of doctors and medical workers, subject to existing restrictions. So, such additional payments are not due to the following categories of employees employed in the healthcare sector.

Those persons who relate to the administration of medical institutions. In some cases, receiving an additional payment is allowed, but only on the condition that the employee, in addition to performing the main function, is also a practicing doctor.
Medical workers who provide assistance classified as high-tech according to the relevant classification.
Those employees who are members of the Health program operating in the Russian Federation. Participation in it provides for assistance in attending childbirth, caring for newborns, providing medical services as a pediatrician or family doctor, etc.

The principle of remuneration of medical workers

Speaking of incentive accruals, it is worth considering in more detail the types of remuneration that are related to employees employed in the medical field.

Based on the Labor Code of the Russian Federation, employees of medical institutions are entitled to the following types of charges.

Basic, or basic, which are calculated on the basis of the salary and the specifics of the type of activity.
Compensatory. Their accrual is regulated by norms that differ depending on the region in which the employee is working.
Social. They may be assigned depending on the health care worker's affiliation to any of the groups included in the list of recipients of social payments.
Stimulants- appointed as a result of the analysis of activities and the performance of direct duties by a doctor or other health worker.

It is worth noting that if all other accruals, except for incentives, are strictly controlled through federal or regional regulations, then incentives can be regulated directly by the management of a medical institution. To perform such an action, the administration of each individual institution is obliged to issue a document - a decree (created, of course, on the basis of the general law on payments and not contradicting its provisions). This document defines the nuances of assigning payments that can be applied directly to employees of this organization. Each of the employees belonging to the category of persons that may qualify for such payments has the right to familiarize themselves with this document.

What are incentive payments? These are monetary accruals assigned monthly on the basis of accepted criteria for evaluating the work of doctors and medical staff. In the event that a particular institution at the end of the calendar year has an unused part of the funds allocated exclusively for receiving incentive payments, it is allowed to receive lump-sum payments that will be assigned based on the results of the work for the current year.

The amount of incentive charges

It is worth noting that the amount of additional payments related to incentives is not constant - it is directly dependent on how much services related to the performance of direct duties were made by the medical officer.

Regarding the amount of accruals in the territory of the Russian Federation, the following rules apply.

The payment of a cash bonus of a stimulating nature is made on the basis of a separate order from the administration of the institution.
The order is issued every month.
The amount of payments is established by the administration of the medical institution, taking into account the permissible minimum and maximum values established by legislative acts.

Grounds for assigning an additional payment and evaluation principles

The following factors have a decisive influence on the amount of the accrued surcharge.

The time that a particular employee worked during the month for which the payment is accrued.
Fulfillment by the health worker of standards for the provision of first aid to the population.
Efficiency in the performance of work duties.
The duration of the employee's work experience and its continuity.

Without fail, the administration, when assigning payments, must be guided by the current this moment regulations on remuneration, as well as federal, regional acts and presidential decrees affecting the procedure for calculating and receiving such amounts.

The labor activity of medical personnel is specific - sometimes you have to work around the clock. However, not all health care workers work without hazardous conditions(when exposure to harmful and (or) dangerous production factors excluded or their impact levels do not exceed the established standards). Many physicians are affected by harmful and dangerous production factors. The Labor Code and other regulatory legal acts provide for a number of guarantees and benefits for employees working in such working conditions. You will learn about this by reading the article.

General rules

Every employee has the right to workplace corresponding to the state regulatory requirements protection, as well as complete reliable information about working conditions and labor protection requirements at the workplace.

Article 209 of the Labor Code of the Russian Federation defines working conditions as a combination of factors in the working environment and the labor process that affect the performance and health of an employee. A production factor is considered harmful, the impact of which on an employee can lead to his illness. And dangerous - the impact of which on the worker can lead to his injury. However, the conditions themselves do not become harmful or dangerous - to identify such factors, certification of workplaces is carried out according to working conditions.

Note. If, according to the results of certification or on the basis of the conclusion state expertise working conditions at the workplace are recognized as safe, then compensation (including annual additional paid leave) is not due to the employee (part 4 of article 219 of the Labor Code of the Russian Federation).

Article 219 of the Labor Code of the Russian Federation establishes that each employee, in addition to the basic rights established by Art. 21 of the Labor Code of the Russian Federation, is entitled to compensation established in accordance with the Labor Code of the Russian Federation, a collective agreement, an agreement, a local regulatory act, an employment contract, if he is employed hard work, work with harmful and (or) dangerous conditions. The amount of such compensations is established by Decree of the Government of the Russian Federation of November 20, 2008 N 870 "On the establishment of reduced working hours, annual additional paid leave, increased wages for workers engaged in heavy work, work with harmful and (or) dangerous and other special working conditions" (hereinafter - Resolution N 870).

Increased or additional compensation for hard work, work with harmful and (or) dangerous conditions may be established by a collective agreement, a local regulatory act, taking into account the financial and economic situation of the employer.

On February 13, 2013, Rostrud issued an explanation on the procedure for providing guarantees and compensations to persons employed in work with harmful and (or) dangerous conditions. In particular, this department, taking into account the Decision of the Armed Forces of the Russian Federation of January 14, 2013 N AKPI12-1570, recommended that employers use the List of industries, workshops, professions and positions with harmful working conditions, work in which gives the right to additional leave and a shorter working day to determine the amount of compensation (hereinafter - the List), and Instructions for its use. Therefore, in harmful and dangerous conditions, for example, work is performed:

- in infectious, fungal and tuberculosis (anti-tuberculosis) hospitals;

- in anti-leprosy institutions and departments, offices and points;

- in psychiatric (psycho-neurological), neurosurgical, drug treatment facilities, departments, wards and offices, as well as nursing homes (departments) for the mentally ill;

- in physiotherapy rooms (departments);

– in dental clinics, departments and offices;

— in pathological departments and laboratories;

- in specialized MTEC for tuberculosis and mentally ill patients;

- at the stations (departments) of emergency and emergency medical care and departments of mobile emergency and advisory medical care of regional, regional and republican hospitals;

- in sanitary facilities.

Compensation for harmful and dangerous working conditions

Decree N 870 provides that the following compensations are established for persons employed in heavy work, work with harmful and (or) dangerous and other special working conditions, based on the results of attestation of workplaces:

- reduced working hours - no more than 36 hours per week in accordance with Art. 92 of the Labor Code of the Russian Federation;

- annual additional paid leave - at least seven calendar days;

— salary increase — not less than 4% tariff rate(salary) established for various kinds work under normal working conditions.

Let's consider them in more detail.

Reduced hours of work

Working time is the time during which the employee, in accordance with the rules of internal work schedule and the terms of the employment contract must comply labor obligations. Normal working hours cannot exceed 40 hours per week (Article 91 of the Labor Code of the Russian Federation). However, Art. 350 of the Labor Code of the Russian Federation for medical workers, a reduced working time is set - 39 hours a week. If the health worker also works in harmful or dangerous conditions, the duration of his work should not exceed 36 hours per week by virtue of Art. 92 of the Labor Code of the Russian Federation.

Note that not only Labor Code regulates the reduced working hours of medical workers: the employer must also take into account some federal laws and decrees of the Government of the Russian Federation. Thus, medical and other workers involved in the diagnosis and treatment of HIV-infected people, as well as persons whose work is related to materials containing the human immunodeficiency virus, should be given reduced working hours on the basis of Art. 22 of the Federal Law of March 30, 1995 N 38-F3 "On the Prevention of the Spread in the Russian Federation of a Disease Caused by the Human Immunodeficiency Virus (HIV)". At the same time, the working time for them is determined in accordance with Appendix 1 to Resolution N 101 and is 36 hours a week.

Health workers who are directly involved in the provision of anti-tuberculosis care are also supposed to work less (Article 15 of the Federal Law of June 18, 2001 N 77-FZ "On Preventing the Spread of Tuberculosis in the Russian Federation"). The list of positions of medical, veterinary and other workers directly involved in the provision of such assistance was approved by Order of the Ministry of Health of the Russian Federation N 225 dated May 30, 2003, the Ministry of Defense of the Russian Federation N 194, the Ministry of Internal Affairs of the Russian Federation N 363, the Ministry of Justice of the Russian Federation N 126, the Ministry of Education N 2330, the Ministry of Agriculture of the Russian Federation N 777 , Federal Border Guard Service of the Russian Federation N 292. Note that in accordance with Appendix 3 to Decree N 101, health workers of tuberculosis healthcare organizations and their structural divisions should be reduced to 30 hours a week.

Medical staff performing work in psychiatric (psycho-neurological) healthcare facilities, institutions, departments, wards and offices, institutions social services population and their structural divisions designed to serve citizens suffering mental illness, on the basis of Art. 22 of the Law of the Russian Federation of 02.07.1992 N 3185-1 "On psychiatric care and guarantees of the rights of citizens in its provision" are also entitled to reduced working hours, which, by virtue of Appendix 1 to Resolution N 101, is 36 hours a week for them.

In addition, Decree N 101 establishes:

– 33-hour working week for medical workers of health facilities (polyclinics, outpatient clinics, dispensaries, medical centers, stations, departments, offices), physiotherapy facilities and offices, dental departments, offices and health facilities;

— 24-hour week for medical workers who directly carry out gamma therapy and experimental gamma irradiation with gamma preparations in radiomanipulation rooms and laboratories.

Please note that physicians employed in jobs with harmful or dangerous working conditions, where a reduced working time is established, the maximum allowable duration daily work(shift) cannot exceed:

- with a 36-hour work week - eight hours;

- with a 30-hour work week or less - six hours.

For some categories of health workers, the duration of daily work is specified within the List. For example, for doctors, middle and junior medical personnel, as well as a cleaner for industrial premises of pathoanatomical departments and laboratories, the working day (shift) cannot be more than five hours.

A collective agreement may provide for an increase in the duration of daily work (shift) subject to compliance with the maximum weekly working hours and hygienic standards of working conditions (Article 94 of the Labor Code of the Russian Federation).

Annual additional paid leave

Based on Art. 350 of the Labor Code of the Russian Federation, certain categories of medical workers may be granted additional annual paid leave. At the same time, the minimum duration of leave for work in harmful and dangerous working conditions is established by Decree N 870 and is seven calendar days.

Paragraph 2 of Decree N 870 determines that the minimum duration of additional annual paid leave, depending on the class of working conditions and the conditions for providing this compensation, should be established by the Ministry of Labor. However, to date, the relevant regulatory legal act has not been issued (which does not relieve employers from the obligation to provide additional annual paid leave). Prior to its adoption, the employer must provide leave of at least seven days. Of course, vacation can be more, but only if it is provided for by a collective agreement or local regulatory act.

If the profession or position of the employee who is entitled to compensation is included in the List and the duration of vacation indicated in it is greater than that provided for by Decree N 870, then when determining the amount of compensation, the List should be guided by (Decision of the Armed Forces of the Russian Federation dated 14.01. .

Note! By setting the duration of additional paid leave in the local normative act or a collective agreement, you need to focus on the List. For example, a medical statistician, paramedical employees of infectious and fungal health facilities, a cloakroom attendant employed in a dressing room for patients, are entitled to an additional vacation of 12 working days. The head doctor, his deputy doctor (with irregular working hours) of children's psychiatric hospitals have the right to 24 working days of rest. A psychiatrist, middle and junior medical staff involved in providing medical care to the mentally ill - for 30 working days, and doctors of anti-plague institutions - for 36 working days.

It should be noted that if, based on the results of certification of workplaces, the working conditions of a medical worker are found to be harmful or dangerous, the employer will have to provide additional paid leave, regardless of whether the name of the position occupied by the medical worker is included in the List or not (Determination of the Constitutional Court of the Russian Federation dated 07.02.2013 N 135-O).

Additional paid leave is also established by the Decree of the Ministry of Labor of the Russian Federation of 07/08/1993 N 133. In particular, an additional leave for work with harmful working conditions of 30 working days was established for psychologists and physiologists directly and full-time for those working with the mentally ill, for medical directors (with irregular working hours) of psychiatric (psychoneurological), neurosurgical, narcological treatment and prophylactic institutions, departments, wards and offices, nursing homes (departments) for the mentally ill and their deputies, as well as chief psychiatrists of health authorities directly involved in the provision of psychiatric care.

It may turn out that a health care worker is entitled to receive additional leave for work in harmful or dangerous conditions for several reasons. In this case, vacations are not summed up, but only one of them is provided - a longer one.

Labor legislation establishes that additional paid vacations are added to the annual basic paid vacation. But a question may arise here. As you can see, in general, additional leave should be provided in working days. But, according to Art. 120 of the Labor Code of the Russian Federation, the duration of annual basic and additional paid holidays is calculated in calendar days. How to convert working days of vacation into calendar days?

Rostrud explained in Letter N 625-BB dated 01.02.2002: from the start date of the vacation is counted a certain amount of days of the main vacation in calendar days, and then - a certain number of days of additional vacation in working days per six-day working week and the date of the last day of vacation is found out. After that, the total vacation period is converted into calendar days. The resulting number of calendar days will be the total duration of the annual paid leave.

For example, on March 13, 2013, an employee goes on annual paid leave of 28 calendar days. For harmful working conditions, he is entitled to additional paid leave of 12 working days. In this case, the last day of vacation will be 04/23/2013. Now we translate the total vacation period from 03/13/2013 to 04/23/2013 into calendar days, we get a vacation lasting 42 calendar days.

Increased pay

In accordance with Art. 147 of the Labor Code of the Russian Federation, remuneration for labor of persons employed in heavy work, work with harmful and (or) dangerous conditions, is established at an increased rate compared to tariff rates, salaries (official salaries) established for various types of work with normal working conditions, but not below the sizes established by the labor legislation - 4% of the tariff rate (salary).

As with additional leave, specific minimum dimensions such increases depending on the class of working conditions should be established by the Ministry of Labor, but so far this has not been done. Until the adoption of the relevant regulatory legal act the legislation of the former USSR that regulates these issues continues to operate - the Decree of the Central Committee of the CPSU, the Council of Ministers of the USSR and the All-Union Central Council of Trade Unions of September 17, 1986 N 1115 and the Decree of the State Committee for Labor of the USSR and the Secretariat of the All-Union Central Council of Trade Unions of October 3, 1986 N 387 / 22-78 adopted in accordance with it. According to the said resolutions, surcharges are provided in the following amounts:

- at work with difficult and harmful working conditions - 4, 8, 12%;

- in jobs with especially difficult and especially harmful working conditions - 16, 20, 24%.

The specific amount of the increase in wages for work in harmful and dangerous conditions for medical employees is established by the employer, taking into account the opinion of the representative body of employees.

Guarantees for work in harmful and dangerous working conditions

In addition to the compensations established by Decree N 870, medical workers for work in harmful and dangerous conditions are entitled to other compensations and guarantees. Let's consider them.

Medical examinations

Medical employees engaged in heavy work and work with harmful and (or) dangerous working conditions (including underground), as well as in work related to traffic, undergo mandatory preliminary (upon employment) and periodic (for persons under the age of 21 - annual) medical examinations (examinations) to determine suitability for the performance of the assigned work and the prevention of occupational diseases (Article 213 of the Labor Code of the Russian Federation).

Harmful and (or) hazardous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the procedure for their conduct are determined by Order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2011 N 302n.

Note that for some categories of medical workers, it is mandatory to undergo a psychiatric examination. Thus, Decree of the Government of the Russian Federation of April 28, 1993 N 377 established a list of medical psychiatric contraindications for the implementation of certain types of professional activity and activities associated with a source of increased danger. This list includes the following dangerous and harmful substances:

— antibiotics (production and use in medical practice);

- infected material and material infected with helminths (work in contact with infectious and helminth-infected material, with infectious patients);

– laser radiation (all types of work with lasers, work with ultrasonic medical equipment).

In addition, for medical workers of surgical hospitals, maternity hospitals (departments), children's hospitals (departments), departments of pathology of newborns, premature babies, psychiatric contraindications for work are also established, therefore, these workers are required to undergo a psychiatric examination.

Rules for passing a mandatory psychiatric examination by employees performing certain types activities, including those associated with sources of increased danger (with the influence harmful substances and unfavorable production factors), as well as performing their duties in conditions of increased danger, are approved by Decree of the Government of the Russian Federation of September 23, 2002 N 695. In accordance with these rules, the examination of a medical worker is carried out by a medical commission created by the health management body at least once every five years.

Remedies

Based on Art. 212 of the Labor Code of the Russian Federation, the employer is obliged to issue special clothes, special footwear and other personal protective equipment, washing and neutralizing agents that have passed mandatory certification or declaration of conformity, to medical employees employed in work with harmful and (or) dangerous conditions. Moreover, the employer must ensure the acquisition and issuance in accordance with standard norms. For example, standard industry norms for the issuance of personal protective equipment to employees of healthcare organizations and social protection population, medical research organizations and educational institutions, production of bacterial and biological preparations, materials, educational visual aids, for the procurement, cultivation and processing of medical leeches are approved by the Decree of the Ministry of Labor of the Russian Federation of December 29, 1997 N 68. In accordance with these standards, doctors and paramedical personnel of operating rooms, dressing and plaster rooms, generic and postpartum wards of healthcare facilities and institutions of forensic medical examination, a waterproof apron, rubber gloves, and when working in operating rooms with power tools, additionally dielectric galoshes are required.

Intersectoral rules for providing workers with special clothing, special footwear and other personal protective equipment were approved by Order of the Ministry of Health and Social Development of the Russian Federation dated 01.06.2009 N 290n. But the standard norms for providing employees of the disaster medicine service with special clothing and footwear were approved by Order of the Ministry of Health and Social Development of the Russian Federation dated November 18, 2004 N 201: medical workers of field hospitals, mobile medical teams, medical teams of healthcare institutions and formations of the disaster medicine service can count on them. In accordance with the rules approved by the same order, the issuance of special clothing and footwear is made to employees of the disaster medicine service, officials and professional duties which are related to ensuring the constant readiness of the forces and means of the disaster medicine service and which are involved in the performance of work in emergency zones.

Note. It is not allowed to replace milk with sour cream, butter, as well as the issuance of milk or other equivalent food products for one or several shifts in advance, as well as for past shifts.

Therapeutic nutrition and milk

At jobs with harmful working conditions, milk or other equivalent products are issued free of charge. food products(Article 222 of the Labor Code of the Russian Federation). The norms and conditions for the free distribution of milk are approved by the Order of the Ministry of Health and Social Development of the Russian Federation dated February 16, 2009 N 45n. Thus, medical workers working in hazardous conditions are entitled to 0.5 liters of milk per shift, regardless of its duration. If the time of work in hazardous working conditions is less than the established duration of the work shift, milk is issued when work is performed under the specified conditions for at least half of the work shift. Instead of milk, a health worker may be given equivalent food products, the list and norms for issuing which are given in Table 1 of the Norms and conditions for the free distribution of milk. The issuance of other products is not provided for by the legislation of the Russian Federation.

Instead of fresh milk, workers involved in the production or processing of antibiotics are given fermented milk products enriched with probiotics (bifidobacteria, lactic acid bacteria), or colibacterin prepared from whole milk.

Let us pay attention to the fact that the issuance of milk or other equivalent products to health workers according to the established norms, upon a written application of the employee, can be replaced by a compensation payment in an amount equivalent to the cost of milk and other equivalent products, if this is provided for by a collective or labor agreement (clause 10 of the Rules and Conditions free delivery of milk, part 1 of article 222 of the Labor Code of the Russian Federation).

At work with especially harmful working conditions, therapeutic and preventive nutrition is provided free of charge. The list of industries, professions and positions, work in which gives the right to receive free medical and preventive nutrition in connection with especially harmful working conditions, the norms and rules for issuing nutrition are approved by Order of the Ministry of Health and Social Development of the Russian Federation of February 16, 2009 N 46n. In accordance with this order, therapeutic and preventive nutrition is due to doctors, nurses, managers and specialists directly working in medical pressure chambers, as well as doctors of all categories and specialties performing medical and sanitary support for work related to the destruction of chemical weapons.

Pension provision

By general rule Men who have reached the age of 60 and women who have reached the age of 55 are entitled to an old-age labor pension. However, medical workers who work in harmful or dangerous conditions may be granted early retirement.

In particular, an old-age labor pension is assigned earlier than the specified age (for men at 50 years old, for women at 45), if they have worked, respectively, for at least 10 years and 7 years 6 months in jobs with harmful working conditions and have insurance experience, respectively, of at least 20 and 15 years. Such a right, for example, can be exercised by doctors, paramedical and junior medical personnel, barmaids and other workers engaged in sanitary and domestic maintenance of the underground parts of the organization.

In addition, the following are eligible for early retirement:

— middle medical personnel of X-ray departments (offices), as well as those employed in X-ray angiographic rooms;

- medical workers directly serving patients in tuberculosis and infectious diseases institutions;

- middle and junior medical personnel in leper colonies, psychiatric hospitals, boarding schools for mentally retarded children, underground hospitals (in spent salt mines);

— doctors, middle and junior medical personnel of burn and purulent departments, departments and chemotherapy rooms of oncological institutions;

- junior nurses (nurses) of pathoanatomical departments, prosector morgues;

- junior nurses for patient care, employed in x-ray departments;

— medical and pharmaceutical workers who became infected while on duty official duties human immunodeficiency virus.

Note. Direct patient care is work performed in conditions of contact between a medical worker and a patient: massage, injections, procedures, manipulations, food distribution and feeding of patients, their carrying, sanitization, washing, etc.