Disability — an acute problem that directly affects social and economic potential of any state. According to who, 15% of the world population have some form of disability, and most of these people live in countries with a relatively low income level[1]. That is, the share of developing countries account for 4/5 of all persons with disabilities in the world.
In 2006, Russia signed the UN Convention on the rights of persons with disabilities, and after six years ratified it, agreeing with the basic principles of policy in relation to this group of citizens, accepted in the international community (note that only 45 countries have laws relating to persons with disabilities).
A required component of this work is the accumulation of disability statistics, which our country engaged in Federal state statistics service, Pension Fund of Russia, the Ministry of labour, etc. the information they Provide is not always identical, since the techniques used vary, but the databases overlap. Nevertheless, it is obvious that the total number of disabled persons since the beginning of liberal reforms in Russia grew by an avalanche and this growth does not stop (Fig. 1). Given the unfavorable demographic situation in the country, the disability rate in the General population is increasing even faster.
Fig. 1. The total number of invalids in the Russian Federation, thousand people. [2]
If you look at the dynamics of the number of people for the first time recognized as disabled, it is noticeable a peak attributable to the year 2005, the infamous the Government carried out the Monetization of benefits when medication and Spa treatment was replaced by a cash payment. During which beneficiaries who need expensive medicines, left without them. The result is clearly visible on the chart (Fig. 2).
Fig. 2. The number of persons newly recognized as disabled (based on the data of Rosstat)
According to unofficial estimates of the actual number of disabled people in Russia exceeds the advertised service of state statistics, approximately two to three times[3]. Innovation will be the creation of a Federal registry of persons with disabilities[4], which will contain information about rated group, the degree of loss of health, social protection, etc. the Registry should become effective in January 2017, and its “curator” is appointed, the Pension Fund of Russia. The point is that the individual departments such as the Ministry of defence, Ministry of health, plus a regional base of beneficiaries with disabilities will be gathered into one.
The idea is good, but one of the key questions — can the officials to ensure the confidentiality of information about Russian citizens. The word “privacy” in our country much discredited and faith of our countrymen in the ability of the state to ensure the safety of your personal information small. People with disabilities — one of the most vulnerable categories in need of their own security, including of information.
In addition, when creating a single information system it is necessary to provide the fact that a significant portion of persons with disabilities is not physically able to use the “personal account” or simply do not have access to the Internet, and, consequently, the receipt of all necessary services and access to social programs should be possible without necessarily the immediate use of an electronic resource.
Officials are already warning that in the end create a single register the number of disabled people in Russia can vary greatly, because to date, existing databases often overlap and duplicate each other. Besides, the last time in the power environment has become fashionable to explain the increase in the number of disabled people, the mass character of unreasonable decisions on the granting of disability.
Apparently as a result, in 2016, has changed the procedure for establishing disability for adults and children. Idea of who is disabled and what are the evaluation criteria for this to apply were revised, the functions of experts experts perform medico-social examination (MSE), the Commission shall include only one physician specialty to which special requirements are not established. It is supposed that people with a medical education can be fully competent in all possible clinical entities.
Here’s how to characterize the current system, ITU head of the Interregional centre of independent medico-social examination d.med.N. Danilova S. G.: “the Level is really low. Professionals little: and the heads of the weak, sometimes embarrassed to listen to them — don’t know normative documents, poorly guided in the legislation, and experts in the regions do not have enough knowledge and competence for understanding and execution of orders of the Ministry of labor of the Russian Federation. It’s sad because the system is ITU — absolute monopoly. Its decisions cannot be challenged” [5].
Statistics of disability as a result of the introduction of new criteria, of course, will improve, will be saved considerable budgetary funds allocated previously to support the disabled, but social discontent will increase, because the already difficult economic and political situation of the least protected part of society may lose government benefits and subsidies.
The following changes in the assessment of health status and the manner of assigning disability have followed a flurry of complaints from disabled people who have lost this status in the current year. Changes naturally affected not only adult citizens, but also children. For them disability is the opportunity to be treated in specialized clinics, to medication, guide, to install the necessary timetable for the school to purchase special equipment. It is terrible and that parents, incredible efforts in bringing improved health of their children, the reform are denied recognition of their children with disabilities[6]. Consequently, deprived of the necessary for maintaining and consolidating the achievements of the state aid that threatens their children with new relapses.
The number of children with disabilities receiving social pensions in our country remains high. Moreover, the sharp escalation of the child’s disability occurred in the late twentieth century — if in 1990 in the Russian Federation in the bodies of social protection accounted for 155 thousand disabled children, then after only ten years, the indicator increased by 4.4 times, reaching values in 675 thousand (Fig. 3).
Fig. 3. The number of disabled children under 18 years receiving social pensions (based on the data of Rosstat)
On the dynamics of the child’s disability affect not only the purely medical factors, but, for example, military conflicts (according to the UN, each killed in the course of military actions of the child has three other people with disabilities), characteristics of the diet, the level of toxic addictions of the parents (in 60-80% of cases of disability in children due to perinatal pathology and is associated with parental deviance).
The greatest growth over the past eight years has received the following causes of disability: disease endocrine, nutritional and metabolic disorders, mental and behavioural disorders diseases of the nervous system and neoplasms. In the etiology of almost all these diseases an important role of psycho-emotional trauma and stress. In the post-Soviet period, primary child and adolescent morbidity increased by more than half (Fig. 4). Of course, not all diseases lead to disability, however, the General trend of deterioration of health of the Russian population, these data illustrate.
Fig. 4. The primary morbidity of children aged 0 to 14 years in recalculation on 100 thousand children (built according to Rosstat[7])
Disability in the country continues to grow, the health system and medical examination of social — reform, evaluation criteria of health status is to change. One thing is certain. The situation of persons with disabilities is one of the most accurate criteria of the degree of civilization of a state and the level of the moral state of society. At this stage of Russia’s development efforts bring virtually no positive results, and for each figure appearing or disappearing in statistical reports are the physical and psychological suffering of a particular person.
