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President of Russia Dmitry Medvedev: Mr Sobyanin, we have just had a look at the development of sports in Moscow. There are some good, solid projects involving a large number of children in sports and fitness, getting them to do something good for their health. But creating sports facilities is not enough to improve the nation’s health; we must also pay attention to healthcare. In this regard, the situation in Moscow is very uneven, with a lot of outstanding doctors working in the capital and a lot of excellent well-equipped health centres, but at the same time there are hospitals and outpatient clinics that are just alarmingly poor.

I would like you to brief me on the capital’s healthcare plans because Moscow’s facilities are not used only by the people who live here; patients come to Moscow from all around the country. We can move on to other issues later.

Mayor of Moscow Sergei Sobyanin: Mr President, indeed healthcare is one of the city’s key issues despite the fact that public healthcare has a great potential here, many clinics have top specialists and many healthcare centres have advanced equipment, but more than half of the clinics require major renovation work, refurbishment, modern equipment and so on and so forth. In fact, Moscow residents name healthcare as one of the city’s gravest problems. This applies to equipment, the quality of services provided and so on. Therefore, we understand it for ourselves that healthcare should be a priority for the Moscow City Government.

Jointly with the Healthcare Ministry and the Government of the Russian Federation we have drafted a two-year healthcare modernisation programme. The Healthcare Ministry undertook to allocate about 50 billion rubles, and the Moscow City Government will allocate approximately the same amount or even more. In total, the programme’s funding is 114 billion rubles for a period of two years.

What does it cover? It covers updating medical equipment in such a way that technology networks are created. That means that equipment will not be just dispersed among different facilities but will work as a part of a system, primarily covering problem areas. There are clinics where equipment is twenty to thirty years old and has become totally obsolete, both physically and technologically.

The second area involves the computerisation of healthcare, introducing electronic records and appointments, drug prescription, diagnostics, and so on. There is large enough set of issues.

And the third area is renovation, reconstruction and capital repair of the buildings that house our clinics and hospitals.

”It is imperative for Moscow to have cutting-edge healthcare both because of the opportunities here and because a huge number of people live in Moscow and use its clinics.“

Dmitry Medvedev: Yes, this area leaves much to be desired.

Sergei Sobyanin: This is a very comprehensive and rigorous programme, planned for two years. The problem is that many clinics have no design documents and there is no understanding of possible arrangements and installations in such clinics, because many of them are based in buildings that are registered as historical or architectural monuments. We must move those clinics and overhaul the monuments, which is a major challenge but we will deal with it.

26.5% of the total programme’s expenditure over the next two years will be allocated for the modernisation of children's healthcare. You have issued instruction regarding this and I believe it is very relevant for Moscow. The programme provides for the construction of perinatal centres, maternity hospitals and paediatric clinics. These facilities will be the first to be renovated, it will be our top priority.

We are fully aware that all these issues cannot be resolved in just two years, which is why we have already begun drafting a large five-year healthcare programme, which will stipulate not only the renovation and refurbishment of existing clinics, but also the construction of new clinics, with priority given to paediatric health centres.

Dmitry Medvedev: Of course, this is a long-term challenge but at the same time it is imperative for Moscow to have cutting-edge healthcare both because of the opportunities here and because a huge number of people live in Moscow and use its clinics. The subject should therefore be given a most close attention. You mentioned that many healthcare facilities in Moscow are located in buildings which are historical and cultural monuments. This will cause problems, of course.

In general, as I see it, Moscow has problems with pursuing a comprehensive urban development policy since it has been very patchy, for which, incidentally, Moscow authorities has repeatedly been criticised both by local residents and by history enthusiasts. I would like to see in the very near future some new approaches to urban development policy, because it has raised great concern and is causing a host of problems for the operation of various companies, hampered access to certain areas of Moscow, traffic jams and a variety of other hardships.

Sergei Sobyanin: This is a key question for the city’s development, for the way it will evolve: which areas will grow and what will they look like, how to prioritise housing, transport, retail, office and industrial construction. These are issues of vital importance.

The current urban development plan does not address all of these issues effectively. We believe that it is no longer possible to build anything in Moscow’s historical centre. In general, construction is too dense in the whole city but this is especially true of the historical centre. I believe the existing plans to build offices, shopping and leisure centres in the historical part of the city cause more problems than they solve. Therefore, when we analyse investment projects in Moscow, we try to reject those city centre projects that have not been launched yet or that do not have sufficient financing in place. We have rejected about twenty such projects. In addition, we have reduced the volume of retail and office space in the current investment contracts by 450,000 square metres. Of course, we discuss the situation with investors and try to reach agreement with them. If we don’t succeed, we go to court and resolve the matter in this way so that if anything is built in the centre of Moscow at all, it should be either housing or hotels, so that the transport situation in the city centre is not aggravated any further.

I think the historical centre is completely built up. We must gradually close it to construction projects, as it is done in all capitals around the world. Instead we should focus on improving what is already there, building local social facilities, sports grounds, modernising the city, and that's it. All other projects should be moved to the outskirts, where there is more than enough to do.

Mr President, in spite of such solutions, we have not reduced the amount of new social housing. This year we will build more than half a million square metres of social housing, and on the whole the volume of housing construction in the city will not be lower than last year and I think there may even be a 20 to 30 percent rise.

Dmitry Medvedev: This is certainly very important because despite its problems, Moscow is a growing city while some of its housing stock is becoming outdated. We must build new housing, and naturally, this housing should be built to higher standards. This should be reflected in the number of square metres per flat, and that applies both to social accommodation and to the housing sold on the open market.

But if we go back to the urban development policy, the situation in the centre and around Moscow, transport remains one of the most acute issues. We talked about this when you were appointed Mayor and during our subsequent meetings, and there is a clear need for a special programme. I realise this work is already underway. Could you report briefly on this issue because everybody wants to see a change as soon as possible. I've noticed some people even write: “So, we have a new mayor but the traffic jams are the same as ever.” Of course, nobody can solve a problem like this in a matter of months, but I would like to hear your report on what has been done during this time and what are the main current approaches.

Sergei Sobyanin: Mr President, in accordance with your instructions, we have held a meeting with the Transport Ministry and the Moscow Region. We have drafted the first ever comprehensive development programme for the Moscow transportation hub. 

Dmitry Medvedev: We have never had such a programme.

Sergei Sobyanin: It links the development of the Moscow Region, Moscow, the railways (Russian Railways Programme), the Transport Ministry programme for the construction of highways, including toll roads, the aviation hub, the metro, public transport and road construction. This programme was coordinated jointly by the Moscow Region, the Transport Ministry and us, and submitted to the Government. I hope it will be adopted soon. This will be a serious systemic framework for moving forward.

In addition, without waiting for the programme, we are implementing high priority measures related to the creation of intelligent transportation systems. We have started the tender already. The technical documentation and financing are in place. 

This year we will launch a large-scale project which has to do with the regulation of public transport, all transport in the city, traffic light control management and so on. Second, we will improve the metro system by updating trains, ventilation, ticket offices, security, reducing the turnaround time of rolling stock and all technology, which will make for a more reliable and smooth operation of the metro. As you know, we have appointed a new head there. So, the process has been quite dynamic there as well.

We also expect to greatly update the public bus fleet this year: we plan to purchase 2,000 low-floor modern buses for greater comfort, so that they can be used by the disabled and children. This is a modern form of transportation, which meets all standards.

”Such a joint transport development programme for Moscow and the Moscow Region, which have a combined population of 20 million people, should have been created ten years ago. I hope that now this tool will prove effective. So this is a crucial programme that can produce a tangible result.“

In addition, we have allocated substantial resources – administrative, organisational and financial – for the reconstruction of highways. This means organising localised works to build hard shoulders, parking lots and junctions, which can significantly increase the capacity of these highways. In parallel, we will build dedicated lanes for public transport, so that it can pass through our streets freely and on schedule. Public transport is a priority.

Just recently we started work on an important programme for commuter rail transportation jointly with the Russian Railways and the Moscow Region Government. I think there is a large untapped potential. Moscow has 200 kilometres of railways but they carry only 8% of passengers. I think that there is serious potential and we will work on developing it.

Dmitry Medvedev: Good. I am particularly pleased that you have started to work with the Moscow Region. Unfortunately, the poor relationship between the former leadership of Moscow and the Moscow Region affected the lives of great many people. Such a joint transport development programme for Moscow and the Moscow Region, which have a combined population of 20 million people, should have been created ten years ago. Unfortunately, nothing was done, which is unfortunate. I hope that now this tool will prove effective, because a large number of Muscovites live in the suburbs and in the Moscow Region. At the same time, a many people registered in the Moscow Region commute to Moscow. So this is a crucial programme that can produce a tangible result.

In fact, a whole range of decisions must be adopted, and we have already discussed them. This includes amendments to federal legislation, and work on the draft laws is currently underway. I hope that they will be adopted and help address the issues we have mentioned.

Sergei Sobyanin: This is an important draft law, without which there can be no regulation of public transport or taxis, and in general, it will be very difficult to address transport problems in large cities. This is a very important project, and we are working jointly with the Transport Ministry. I hope that it will be adopted in the second reading.

Dmitry Medvedev: Very well. Now, the last but no less important matter. Not long ago, I had discussions with you as well as the Governor of St Petersburg, several other governors, and the Prosecutor General about the gaming business and information regarding the enormous number of illegal gaming business locations. I gave instructions to the governors, to you, and to the Prosecutor General. What were you able to achieve?

Sergei Sobyanin: In recent months, gaming businesses, which were flagrantly run in the open, have been completely liquidated; they are now practically non-existent. Whenever new locations appear, we act swiftly. Overall, I think the situation is already satisfactory, in the sense that we do not have semi-legal gaming establishments working under various names. We confiscated tens of thousands of units of equipment that are now in warehouses, awaiting disposal.

Dmitry Medvedev: Yes, we need to dispose of them. If we bring them back, regardless of our goals, they will be back in use.

Sergei Sobyanin: Indeed. We have closed about 150 of such outlets. This work is ongoing, because we need to constantly apply pressure. As soon as we let go…

Dmitry Medvedev: Yes, people are writing about it on the Internet, updates on new locations.

Sergei Sobyanin: Exactly, we need to monitor it. As soon as something appears, we try to react immediately, together with the police, of course.

We have also proposed many legislative amendments in this area, in order to manage the problem even more strictly.

Dmitry Medvedev: That’s good. And in turn, I have made suggestions on amending legislation in order for our ‘talented’ gaming business dealers not to engage in mimicry – in other words, adapting their illegal businesses to the current situation and somehow making those businesses legal. It is imperative to monitor the legislation, update it in accordance with the realities of this business and punish those who are breaking the law. Please monitor it, because this is the topic that evokes a wide response, people react to it. I think you need to lay down the law.

Granted, I have to admit that many decisions concerning the gaming business have still not been fulfilled. I am referring to legal businesses. We need to create gaming zones, because this industry is lawful within the established boundaries. We just need to bring in investors and do things that are done throughout the world, instead of driving the situation underground.

Sergei Sobyanin: We have now created significant pressure on the illegal gaming industry. I think that this will objectively generate the potential for investing in legal businesses.

Dmitry Medvedev: I hope so. In any case, those who planned to limit themselves to modest investments need to understand that the government will not change its position and the legislation will remain as it is. We will prosecute and punish illegal businesses, whereas legal businesses in this area should be developed.

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