The President inquired whether the list of services provided in Pridnestrovie under the auspices of the Ministry of Health is being updated. 365 new services have been introduced over the past five years in state institutions under the Ministry's jurisdiction, according to the Minister. These include examinations, diagnostics, procedures, surgical interventions, the maintenance and repair of removable appliances and structural components, medical assessments, the preparation of medicinal powders, ointments, and solutions, as well as the training of specialists in high-demand medical fields.
Mention was made among other things of lens replacement surgery, a procedure in high demand within both global and Pridnestrovian ophthalmology. In the first nine months of this year alone, 385 such operations have been performed. The number of interventions exceeded five hundred annually in the two preceding years. Kristina Albul highlighted the growing number of elderly patients and noted that the current goal is to maintain a high level of social activity and the ability to work while surgeries were previously performed mainly at advanced stages ("mature cataracts") to restore basic vision.
Another area addressed was joint replacement surgery (arthroplasty). Previously, hip and knee replacements were performed only abroad. Such operations have also been carried out in Pridnestrovie since December 2021. During this period, 746 patients were sent outside the republic for hip and knee replacements funded by the Pridnestrovian budget, while another 539 underwent surgery at the Republican Clinical Hospital. The need is substantial: 2836 people currently require joint replacement surgery. Some of these individuals need surgery on both the right and left joints. It is worth noting that the cost of the prosthetic implants is high, and far from everyone can afford a paid operation. Patients lose mobility and risk becoming disabled without surgery. Performing these operations at state expense amidst rising demand places a massive burden on the budget. The issue of major joint replacement surgery has taken on not only medical but also socio-economic significance consequently.
Another critical issue is staffing. Institutions under the jurisdiction of the Ministry of Health employ over 1500 physicians, nearly 3000 mid-level medical personnel, and 2000 junior medical staff. Vacancies do exist. Domestic basic training for medical specialists is of fundamental importance. The state covers year after year the tuition costs for a significant number of future medical professionals. However, there are instances where graduates whose education was state-funded fail to begin their duties at the republic's medical facilities to which they were assigned on time. Legal action is being taken against them; refusing employment entails an obligation to reimburse the state for the funds spent on their training. 19 individuals have voluntarily repaid a total of approximately 300000 rubles since 2023, while tuition costs totaling around 3.5 million rubles have been recovered from 292 graduates through court proceedings. Furthermore, reimbursement for state-funded training costs will also be required from former medical college students who did not complete their studies, funded by the republic's budget and were expelled before mastering the educational programs starting in 2025. There are cases where proceedings are terminated because the defendants ultimately take up employment at their assigned locations or within the medical units of other agencies, or continue their studies at the Medical Institute of the Pridnestrovian State University named after Shevchenko on a state-funded basis.
An interesting and significant point from the report is that the Pridnestrovian State College is designated as a higher professional education institution, starting in 2025. The college has entered into a cooperation agreement with the Russian Medical Academy. This arrangement offers Pridnestrovian specialists an additional opportunity to enhance their professional expertise. The higher professional education program has enabled, for instance, the delivery of advanced training courses on palliative care. Participants included 120 students and volunteers, as well as 46 instructors and nurses. Furthermore, a medical-social center for palliative care patients has been established at the college. Another new initiative involves training professional massage therapists from among the visually impaired – an important element in the social integration of citizens with disabilities. Work in this area is being carried out under a directive from the President.
The reorganization of the healthcare system during the reporting period received attention. 43 previously existing state institutions were consolidated into 27 organizations to optimize various processes, cut unjustified costs (including those associated with maintaining unused hospital beds), upgrade facilities and equipment, and improve the quality of medical care. The Minister considers this decision well-founded and notes that its effectiveness has already been proven. Positive outcomes include a noticeable increase in medical workers' wages. Data from the first half of 2026 show the average monthly salary for a hospital physician is 8099 rubles; 6016 rubles for a polyclinic physician; and for an emergency service physician, 10471 rubles. Corresponding figures for mid-level medical staff are 5634, 4740, and 7483 rubles, respectively; and 3836, 3992, and 4624 rubles for junior medical staff.
Regarding the sector's financing, the procurement of medical and pharmaceutical products and the supply of food to healthcare facilities cost the state 808.6 million rubles 2021-2026. Budget expenditures for treating citizens outside the republic during this period totaled 204 million rubles; care was provided to 4,730 patients, two-thirds of whom were referred to foreign medical institutions due to urgent medical needs. Half of the patients referred abroad by the Pridnestrovian Ministry of Health were suffering from acute coronary syndrome (ACS). Medical professionals maintain specific statistics and observations regarding ACS: there are 19–22% fewer cases in summer than in winter, and 25% fewer on weekends than on weekdays. Overall in-hospital mortality from acute coronary syndrome has recently dropped by 20%, thanks to the widespread adoption of endovascular interventions (such as PCI and stenting) and the timely transfer of patients to specialized vascular centers.
Special attention has been paid to rural healthcare facilities in recent years. Twelve outpatient clinics and four rural health posts have been renovated during several years, and six modular health posts have been constructed. A total of 250 million rubles has been allocated to medical facilities since 2021 regarding the healthcare sector's share of the Capital Investment Fund.