The Role of Other Ministries and Public Enterprises as Providers of Health Care; as in
many former socialist economies Ministries often run their own parallel health services. The
Ministries of Defence, the Interior and of Transport all have polyclinic and hospital networks.
In total over 20 Ministries provide health care directly although as structures change
periodically it is difficult to give exact figures. In addition, large public enterprises continue to
house health care providers and to subsidize their activities. Again it is difficult to estimate
exact levels as industry is in a state of flux and firms under pressure to make profits are likely
to divest themselves of health care provision. The level of funding provided through these
routes is also unclear since data is not collected centrally.
Statutory Bodies; The Oblast, Autonomous or Krai Health Departments; govern regional
health care. Although they no longer handle all health sector funds they are expected to finance
up to 60% of costs and so retain a significant role. They report to the Russian Ministry of
Health on narrow medical issues and ensure compliance with federal programmes, in particular
those focused on the control of conditions and infectious diseases defined as of high social
priority. Otherwise they enjoy considerable autonomy within their administrative units. Some
Health Departments are clearly heavily involved in setting reform agendas, monitoring quality
etc. while others have abrogated many of their responsibilities to TMHIFs and serve only as
final arbiters in local disputes.