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Before the meeting, the President visited the Petrozavodsk State University IT park, where he was taken around a display area with projects that are being implemented with support from the Agency for Strategic Initiatives.

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Excerpts from the transcript of a meeting with representatives of socially oriented non-profit organisations, charity foundations, volunteer movements and social entrepreneurs

President of Russia Vladimir Putin: Colleagues, friends, good afternoon.

I have always liked meeting with people who spend years doing what you are doing, that is, helping people, in particular, people who need assistance more than others. I am referring to senior citizens, people with disabilities and children.

I will not give a long and boring speech. We can start our discussion right now. It will be a free and open discussion without any restraints. Let us proceed.

This meeting is being attended by my colleagues from the Government and the Executive Office, and the acting governor. We are at your service. Let us talk about matters of importance and concern to you, about what is being done and what else all of us can do to work even more efficiently in this area of vital importance for us and for all Russian citizens.

Who would like to start? Go ahead.

Yelena Topoleva-Soldunova: Mr President, colleagues,

My name is Yelena Topoleva-Soldunova and I represent non-commercial organisation Agency for Social Information and am a member of the Russian Federation's Civic Chamber. I want to outline a few issues of concern to many non-commercial organisations and volunteer associations. Our citizens have become more active of late and we see vivid examples of people taking part in the work of organisations, public groups and initiatives, working to develop the places where they live and taking part in all kinds of public activity to improve people’s quality of life.

Of course, there is an interesting new area too – non-commercial organisations’ involvement in providing social services. There is some good practice and interesting examples in this area. I recently attended the Community forum in the Ural district, in Tyumen, where people from Tyumen Region and Khanty-Mansi Autonomous Area spoke about their excellent experience and about how they get non-commercial organisations involved in social service provision.

But I think it would be very important to establish a competency centre that would collect best practice and spread it to other regions and other areas, because this is something we still have problems with at present. In other words, things are active and going well in some areas, but there are problems in other ones. If it would be possible to support this centre’s establishment, I think this would benefit everyone.

Vladimir Putin: I think we already have such competency centres in 18 regions, and of course, we will develop this network further. The aim is to make these centres hubs for information, and identification and exchange of best practice. They already operate in 18 regions and I think, incidentally, that this is one of Agency for Strategic Initiatives' projects too.

Are you involved in this project?

General Director of the Agency for Strategic Initiatives Svetlana Chupsheva: Of course, we have now carried out initial monitoring over the course of the year. Seventy regions are involved in this work. We can already see that this is a good initiative, but there are some difficulties and problems.

Vladimir Putin: Yes, but these centres in the 18 regions, I do not remember which ones exactly…

Yelena Topoleva-Soldunova: Social sector innovation centres, probably? This is what we are talking about.

Vladimir Putin: Yes, innovation centres. They are already up and working. We will develop this work further.

Yelena Topoleva-Soldunova: I think it would be great if they open in other regions as well.

I also wanted to note that we often need greater interaction with government authorities. Take, for example, the volunteer movement. More people want to come and work as volunteers at various institutions, such as hospitals and children's homes, to name a few. However, the rules of interaction with the authorities, that is, who to contact and where, are not always clear. This tends to turn away people who could otherwise be of help.

Vladimir Putin: I think we need to find, at the federal level, people directly responsible for this aspect of ​​work. However, equally important, and perhaps even more important, is the regional component, since a large number of competencies and responsibilities lie with the regional and municipal authorities. So, in each region, there must be a person responsible for such activities with these organisations.

We will certainly promote this work in our interaction with the governors. I am confident that we will make it happen. At the federal level, we have Deputy Prime Minister Olga Golodets, who is in charge of social issues, and if we take this to the level of deputy prime minister, she is a natural choice for this aspect of work. In fact, this is how things are. Her responsibilities in this regard should be simply specified. Let us do so.

Yelena Topoleva-Soldunova: I think it would be the right thing to do. There are many members of the Board of Trustees for the Social Sphere among our participants, and this board is led by Ms Golodets. By the way, it is an effective public body, which achieves a lot through joint efforts, so, probably, it would be logical to do so.

Vladimir Putin: Agreed. We will do so. We will keep tabs on it and see it to completion.

Yelena Topoleva-Soldunova: Thank you.

There is another issue, which I would also like to raise. Not so long ago, we have …

Vladimir Putin: Is it only you and I who will talk here today? (Laughter.) I do not mind, though.

Yelena Topoleva-Soldunova: As my colleagues will say. I will be very brief.

There is a new status for NGOs now – providers of socially useful services. By the way, on July 12, all authorised representatives were to report to you on how the acquisition of this status is proceeding. So far we have 15 such organisations in the country because there are serious difficulties regarding the status acquisition procedure, in particular the proof that the services provided meet the required quality standards. The Civic Chamber has developed recommendations about how all of this could be simplified, because at present the procedure is overly formalised. However, everybody seems to ignore our recommendations.

Vladimir Putin: The Russian Government has already drafted two bills. The first should define the concept of social entrepreneurship as such. After all, this concept has not yet been codified in law. This is the main problem.

The second bill addresses implementation mechanisms. When it comes into effect – and I hope that it will be finalised and adopted by the Federal Assembly, that is, the Duma and the Federation Council, during the autumn session – it will be easier. Why? Because then the regions will also have certain guidelines.

Yelena Topoleva-Soldunova: Yes, yes, with regard to the quality of services, authority should probably be transferred to the regional level.

Vladimir Putin: As a matter of fact, it is already at the regional level but they need well-defined guidelines, standards and so on. Then I hope the situation will improve. Why do I hope so? I believe this is how is should be, this is what the laws are for.

Yelena Topoleva-Soldunova: Thank you.

Artyom Metelev: Good afternoon, Mr President.

My name is Artyom Metelev and I represent the Association of Volunteer Centres and, just like Ms Topoleva-Soldunova, I am a member of the Civic Chamber. Our organisation was established in 2014 following your meeting with Olympic Games volunteers, when you endorsed the idea of preserving the legacy of the Sochi volunteer programme. Now we bring together 125 regional organisations. Darya Makovetskaya is from Karelia, and the Karelian Centre is a member of our association. We also engage in volunteer activity with children, the Russian Movement of School Students, also university students and senior citizens.

We have a dream: We would like to make the volunteer movement a part of every Russian’s life so that it is a natural norm and habit for a person to help and participate in developing the area where he or she lives. I would like to share with you our innovative project, which could help bring us closer to seeing our dream come true.

Vladimir Putin: Do you want to make every citizen a volunteer, regardless of age and health?

Artyom Metelev: Yes, so that every citizen has experience. We have examples.

Vladimir Putin: This is an ambitious goal but go ahead. I am sorry for interrupting you but let us look at your project.

Artyom Metelev: During the Russian Popular Front forum in April you supported the idea of ​​creating a single federal online resource for covering the activities of volunteers, and issued corresponding instructions. We feel responsible for this, because the Government suggested using our platform. I wanted to show you the Volunteers of Russia platform as such a resource. Its functions and main purpose are to consolidate the volunteer movement in our country. It connects organisations that need volunteers and people who want to help.

For example, if we look at volunteers in the Republic of Karelia, where we are now, we will see a variety of volunteers registered here. For example, this girl works at the centre for orphans. Accordingly, the system invites her to participate in the rehabilitation programme for teenagers. In other words, the system identifies her as someone who is interested in working with children and lives in the Republic of Karelia, the city of Petrozavodsk, and suggests activities that this particular person might be interested in.

Vladimir Putin: Where do you get the openings from?

Artyom Metelev: We suggest that various organisations, nonprofit organisations, including the funds present here, such as Starost v Radost, Lisa Alert, Soyedineniye, and many other registered organisations, currently 647 of them, form an application and start looking for nonprofit partners as volunteers. We also discussed with the Ministry of Healthcare, the Ministry of Labour and all relevant departments the issue of whether budget-funded institutions could do this as well.

This is an intelligent system, which makes it possible to watch and process large amounts of data, analyse them, and issue corresponding advice. For example, the average portrait of a volunteer is a 23-year-old girl interested in social volunteering. In fact, more girls than boys do the volunteer work in Russia. Perhaps, this is a good thing, because women tend to be more compassionate than men. That is, if we see that here in Karelia volunteers are interested in culture and tourism, this is a clear signal to cultural institutions and authorities to create proper conditions for people.

Vladimir Putin: Who created this programme?

Artyom Metelev: Our organisation, the Association of Volunteer Centres, together with the Russian Centre for Civil and Patriotic Education of Children and Youth (Rospatriottsentr). The Agency for Strategic Initiatives is its partner.

Vladimir Putin: Did the ASI provide the funding?

Artyom Metelev: You did, Mr President. (Laughter.) It was created with a presidential grant, which we obtained. Many thanks to you and all your colleagues who appreciated our work.

Vladimir Putin: Thank you for reminding me about this.

Artyom Metelev: We have forwarded our proposals with regards to this to the Government. We do understand that it was a start-up project, and it did succeed. As many as 150 people register on the website every day. Having a stable financial model is important. As I already mentioned, we have submitted our proposals to the Government, but have not been given the green light yet.

Vladimir Putin: What do you mean by a “stable financial model?”

Artyom Metelev: What I mean is that this project should get stable annual funding instead of grants. We are facing a very ambitious task consisting of promoting volunteering and making it easier for people to become volunteers.

According to the Public Opinion Foundation, every second Russian is ready to become a volunteer.

Vladimir Putin: Artyom, you are quite right. All I want to know is what goals these funds will help to achieve? What do you intend to invest in?

Artyom Metelev: The funds will primarily pay for the website’s staff, moderators, administrators, software developers as well as designers. We want to create an application for mobile devices too.

Vladimir Putin: What amount of financing are we talking about here?

Artyom Metelev: We submitted our proposal to the Education Ministry, which was tasked with financing the website and our organization, its operator. As far as I know, the total envelope is about 27 million rubles.

Vladimir Putin: Per year?

Artyom Metelev: Yes, the association that develops the infrastructure…

Vladimir Putin: The amount of spending fades in comparison with the results that were achieved. What I mean is that this is a socially significant project, while the funding it needs is, to be honest, very modest. So let us think how this should be done and do it. Is that agreed?

Remark: Does this mean that all regions will be able to use this platform?

Vladimir Putin: Of course.

Artyom Metelev: We discussed with Ms Chupsheva that each region would have its own section. You have instructed the Agency for Strategic Initiatives to compile a plan in cooperation with the Civic Chamber. The plan is ready. All the volunteers can see what the government is doing for the volunteer movement, what is happening in the country and how it changes their lives. They can also create their own sections on the website and upload the content.

Thank you very much for your support. If you allow me, on behalf of the entire volunteer community I would like to invite you to the annual National Volunteer Forum. Every year, this forum brings together thousands of people.

Vladimir Putin: It is true that I am also a volunteer. Therefore, I have every right to attend this forum.

Artyom Metelev: Thank you very much. This would be the best gift for National Volunteer Day that you have already established. This is the day the forum will be held. It would be a great honour and pleasure for us to have you at the forum.

Vladimir Putin: Thank you very much for the work you are doing and also for the results you are achieving, and for making good use of the grant that you were given. We will seek to continue supporting you in the future.

Thank you for the invitation. To be honest, I cannot say whether I will make it, but anyway I wish you every success with the event.

Artyom Metelev: Thank you very much.

Vladimir Putin: Go ahead, please.

Grigory Sergeyev: Good afternoon, Mr President.

My name is Grigory Sergeyev, I am a member of the Liza Alert search group. We search for missing people in the city and in the countryside.

We are working with the Agency for Strategic Initiatives to create a search centre that could consolidate the efforts of our group, the state and the public.

By law, a missing person is the responsibility of the Interior Ministry, which often does not have sufficient resources to solve each and every case. If a person is missing outside a populated area, it will take the efforts of the entire community to find that person. It may take government agencies, the Emergencies Ministry and any organisation that can help, as well as volunteers. In reality, volunteers have been calling all the shots for years. We know what to do and how to do it. And we see that there must be a nationwide response system that we are ready to offer and develop with the Agency for Strategic Initiatives. I think we have adequate support. If you give the official instructions, it would be great.

Two more short questions. When a child goes missing in the countryside, anywhere in Russia, we have the experts and the equipment to send there to make the search as efficient as possible. But Russia is huge and transport is necessary. So, for example, there are Emergencies Ministry Il-76 aircraft sitting in Zhukovsky, but we cannot use them. It would be good if you could help us with this. My understanding is that it is expensive to transfer people to remote areas. Say, somebody is missing in Irkutsk Region but the best search experts are in Moscow. Of course, professionals must be trained elsewhere in the country but this is a long process. (…)

Vladimir Putin: I have a big favour to ask. Can you write down all your suggestions?

Grigory Sergeyev: Of course.

Vladimir Putin: We will work on them by all means.

Grigory Sergeyev: Thank you very much.

Vladimir Putin: Regarding the Emergencies Ministry air fleet, are there any restrictions if the Emergencies Ministry is willing to take your experts, volunteers and public organisation members on board? Nobody forbids them to do this. I do not see any restrictions.

Grigory Sergeyev: As far as I know, they employ local forces to search for this child. It is our initiative to fly there.

Vladimir Putin: I see. It would be your transfer.

Grigory Sergeyev: Yes.

Vladimir Putin: I need to think about this. You see, there will be too many groups to transfer across this huge country. It is more reasonable to establish search groups locally.

In terms of permission, we will talk about this specifically and if there are any restrictions at all, they will be lifted. However, indeed, you are talking about using heavy equipment to move a small group over a huge distance. Nevertheless, a person’s life or health is more important than any financial costs and it must be done. We will discuss this issue with the Emergencies Ministry.

Grigory Sergeyev: Thank you.

Vladimir Putin: Go ahead, please.

Alyona Meshkova: My name is Alyona Meshkova. I am the director of the Konstantin Khabensky Charity Foundation. We help children with cancer and serious brain diseases.

After your Direct Line in April last year and the awareness-raising letter of the Healthcare Ministry, we have been witnessing substantial changes as regards access to resuscitation units. This is major progress for us as a non-profit. Thank you very much for this.

To promote the successful practices of ‘accessible’ resuscitation throughout the country, in cooperation with the Association of Children’s Anesthesiologists and Resuscitators we created certain standards, rules and methodological guidelines for both visitors and medical personnel. Successful practices are not limited to major federal medical centres. They are also used in regional outpatient clinics and regular municipal hospitals. They exist and are being developed gradually. That said, very often decisions are still made by a hospital administration.

Vladimir Putin: What decisions?

Alyona Meshkova: Decisions on access to a resuscitation unit. Therefore, we have to resolve these issues with the Ministry of Healthcare on a case-by-case basis. We are saying that we are ready to cooperate and change these obsolete long-standing stereotypes among the medical personnel.

Vladimir Putin: You see, Alyona, current law allows relatives, guardians or other legal representatives of patients to be present during treatment. Their presence is allowed for the duration of the entire treatment.

As for resuscitation, anesthesiology and other sensitive areas, there are indeed some restrictions. You know all this, but I will say it in any case. These restrictions are linked to issues that are determined by the care necessary for the patient. They are related to their rest, hygiene and the like. You spoke about stereotypes. Probably, no, definitely they exist and may be outdated. It is very hard to issue directives in this respect. This is a very sensitive issue that should be regulated primarily by the specialists themselves. We cannot ignore their opinion. By the way, under current regulations, a decision on access to a resuscitation unit is within the jurisdiction of a medical institution. We have discussed this with the Healthcare Minister, but we will move to where you think we should move, considering that the openness of medical institutions is also important just as a limit to the control over what happens in them.

We will work on this. You come up with your own proposals and your best practices, and we will carefully promote them. All right?

Alyona Meshkova: Thank you.

Vladimir Putin: Thank you!

Please.

Ivan Kolomoyets: Good afternoon, Mr President.

My name is Ivan Kolomoyets. I am co-founder and general director of the interactive educational platform Uchi.ru. Since 2011, we have been developing interactive courses based on the school curriculum. At present, we have over 250 employees, most of whom are graduates of leading higher education institutions, including the Moscow Physical Technical Institute, Moscow State University, the Higher School of Economics and the Russian Economic School.

We have already developed an interactive course in mathematics for grades one through four, which is used by over 1.5 million school students across the world. In Russia (this is 20 percent of school students), in regions such as Moscow, Tatarstan, Tambov Region and the Republic of Mordovia, every second school student studies mathematics with the help of our platform.

In addition, I would like to say that we have taken the first successful steps in exporting our technology. This summer, in conjunction with the education ministries of Brazil and South Africa, we launched pilot projects at local schools.

Vladimir Putin: How did you get to them?

Ivan Kolomoyets: You will not believe it – we simply flew, first, to South Africa and then, quite by chance, we managed to meet with your counterpart Jacob Zuma.

Vladimir Putin: How do you mean by chance? Was he just walking down the street?

Ivan Kolomoyets: Just about. We arrived and were told that a Direct Line table was available for $800. And we won a lottery to ask a question.

Vladimir Putin: Good going. Brilliant, guys. (Laughter.)

Ivan Kolomoyets: We said we were from Russia and were into mathematics, and Russian mathematics is a seal of quality all over the world. So they asked if we could help them. All of that was live on the air.

Vladimir Putin: I will definitely thank Jacob for promoting our mathematical school.

Ivan Kolomoyets: We would be very grateful.

Vladimir Putin: I regularly meet with him. Soon we will have the next BRICS summit in China, and I will do so without fail.

Ivan Kolomoyets: Thank you very much. I think he remembers.

Vladimir Putin: Thank you.

Ivan Kolomoyets: And then likewise we flew in to Sao Paulo, just wrote letters, met and showed the quality of our platform.

Vladimir Putin: Whom did you meet there?

Ivan Kolomoyets: We had a meeting in the state of Sao Paulo, the Sao Paulo Education Ministry. It is the largest state – 50 million [people]. We also met with the minister and deputy minister.

Vladimir Putin: I will also thank Mr Temer, the President of Brazil, if he attends the summit.

Ivan Kolomoyets: Good, thank you very much.

Apart from mathematics, our platform also introduces students to the ABCs of entrepreneurship in a game format. We hold online academic contests for school students in which they can acquire some basic entrepreneurial skills.

Vladimir Putin: In a game format?

Ivan Kolomoyets: Yes, that is right. For example, the following tasks: you need to set up an ice cream stand and decide where – in a Tyumen forest or on the embankment in Sochi. Or your grandmother knits socks, but she cannot make more than 10 pairs a week and you need to help with distribution. Or design a motor vehicle for Africa, selecting the right components. We use this as a basis for academic contests, which children, teachers and parents enjoy greatly. In our first contest, there were 100,000 participants.

Vladimir Putin: Grandmothers also like this.

Ivan Kolomoyets: They do.

In this context, I would like to know whether you support our initiative to introduce school students to the basics of entrepreneurship and whether you believe a more systematic approach towards entrepreneurship courses at school should be considered.

I would like to use this opportunity to ask your advice. What country do you think we should introduce our mathematics course to next? (Laughter.)

Vladimir Putin: It is best, of course, to introduce it as much as possible in Russia, of course.

Ivan Kolomoyets: This is our first priority, of course.

Vladimir Putin: Otherwise, tell us where you think it should be, and we will try to support and help promote your product, which is certainly extremely important.

Ivan Kolomoyets: Thank you very much.

Vladimir Putin: Regarding an entrepreneurship course at school, as you know, under our law, the school itself decides what its curriculum should be. However, this curriculum should consist of two parts: the first is mandatory and the second is optional. After all is said and done, in my opinion, an entrepreneurship course may be included in both the first and the second. It may also be introduced and used in an extracurricular segment. We need to think about it. The problem of curriculum overload is well known.

Ivan Kolomoyets: Yes, yes.

Vladimir Putin: Yes, this is obvious. However, of course, I believe this is a very interesting and useful thing. I will certainly talk to the Education Minister. We will try to provide guidance to the heads of regions. And I also wish you luck.

Ivan Kolomoyets: Thank you very much.

Vladimir Putin: Thank you very much. It was very interesting and unexpected.

By the way, do you know what I think? We will have a BRICS summit, and I will probably tell everyone about your work.

Ivan Kolomoyets: We would be very grateful.

Vladimir Putin: Really, I will tell everyone, citing your positive work experience in South Africa and Brazil.

Ivan Kolomoyets: Thank you very much.

Vladimir Putin: I think other countries might also take interest and then there is China and India.

Ivan Kolomoyets: If you helped us with China and India…

Vladimir Putin: There is quite a bit of scope there.

Ivan Kolomoyets: Indeed.

Vladimir Putin: Please.

Yelizaveta Oleskina: Mr President,

My name is Yelizaveta Oleskina. I am the Director of the Starost v Radost [Happiness in Old Age] foundation. We help senior citizens and people with disabilities. We have been active for 10 years in 20 regions.

My question is related to our most complicated issue that we encounter every day as elderly people and people with disabilities come to us for help, which they cannot get at all or to the extent they need from social services. Ten years ago, when we started, those were mainly Great Patriotic War veterans, but today these are simply elderly people, the post-war generation. Social institutions constantly come to us when they lack the resources to provide care. Families and relatives also seek our help.

So there is a whole range of issues. First of all, there is the lack of a modern concept of a long-term care system. What is this? It is the absence of uniform standards of care. A shortage of personnel. An interagency divide, when elderly people often simply fall through the cracks between the Labour Ministry and the Health Ministry, or a person with the same condition may end up at home without any assistance or in hospital or in a care home. A large number of people fall by the wayside because in our system, they need to apply for help but they cannot or do not know how to apply. And of course, there is the lack of real support for families that look after such people on their own.

We are doing all we can. We have an extensive volunteer network. Private corporations and state corporations, such as VEB, are also gradually joining the volunteer movement, but to help all those in need we believe the political will of the country’s leadership is required, which will help unite society behind taking care of the older generation.

My question is this: Can a separate programme be developed that would integrate at the federal level and would deal with all the issues related to long-term care, that would include elements of medical and social care around an elderly person who needs help, who needs care?

Vladimir Putin: We have adopted a Strategy.

Yelizaveta Oleskina: Yes, within the framework of the Strategy, of course.

Vladimir Putin: Yes, a Strategy until 2025. Under this Strategy, I believe last year the Government adopted an important plan until 2020, for the short term. The issues that you have just raised should of course be taken into account there.

Yelizaveta Oleskina: There is none of that in the plan.

Vladimir Putin: Right, we will revisit this and I will speak to the Government to make sure they take a closer look. At any rate, this is a very sensitive matter, I agree with you. And as we know, society’s attitude toward elderly people, toward its own citizens speaks to the maturity of this society. The older generation needs this, but the rising generation needs it just as much, so that children, teenagers see how elderly people are treated. This is an extremely important job. And of course we do not give it the attention it deserves. We will revisit this, of course, look at it again.

Would you like to add anything? Yes, please go ahead.

Anna Federmesser: Thank you very much.

First, if I may, I would like to thank you for bringing us all together. Even as we were sitting here before you came, we managed to resolve a lot of important issues very quickly. Perhaps, we should get together more often.

What Alyona Meshkova said about intensive care is, I understand, a complicated issue.

Excuse me, I did not introduce myself: Nyuta Federmesser, Vera Foundation for Hospices.

This is an issue our fund raised many times. The fact is that intensive care units provide care not only to people who will be discharged after making a full recovery. Unfortunately, there are people there who will not leave them alive. This is both the result of an underdeveloped long-term care system – many gravely ill people end up there, although this is no place for them – and an ill-formed palliative care system.

(Anna Federmesser went on to discuss in detail long-term care, palliative care, hospices, pain management, and suggested solutions to these issues, in particular, she proposed developing standards and protocols as part of the corresponding national project.)

Vladimir Putin: Again, we will look into it and get back to it.

Have your formalised your proposals?

Anna Federmesser: I am sorry. It is in the national project passport. I brought along a presentation, which we did for pain relief.

Vladimir Putin: Did you send it anywhere?

Anna Federmesser: We did, but I will be pleased to hand it over to you nonetheless.

Vladimir Putin: Give it to us. We will look at it and get back to it by all means either in the form of a separate national project, or as part of the decisions that have been adopted, but which you think are still inadequate for implementation. We will definitely take a look at it.

Anna Federmesser: Thank you.

Vladimir Putin: As for the funding, it still needs to be increased. Of course, this is not big money. We will look into it.

Anna Federmesser: I am glad to hear you say that. Yes, the funding must be increased.

Vladimir Putin: With regard to what Lisa was saying about senior citizens staying at senior care homes, as of early 2016, about 100 such homes were dilapidated or structurally unsafe. Over the past year, their number has decreased by one third. Plans are in place to release fairly large amounts of money, more than 40 billion rubles, to bring them up to code. So, the funds you are talking about are completely incomparable. Perhaps, it makes sense to redirect some of them and use them more effectively, including, for the upkeep of senior care homes.

However, there is a snag, because then we will need to considerably amend the regulatory framework. What is this about? There are many issues, but one of them is when a person stays at home, then, as a rule, it is about co-financing by the state and the family. So, if the state sharply increases its share of funding, the family should match the increase, but is often unable to do so. Therefore, there are many things to be revised. That is, it is not just about lack of incentive to do so, but it rather entails a string of issues bound one to another. However, I cannot disagree that this needs to be resolved.

Anna Federmesser: We could work on it as a team within the national project.

Vladimir Putin: We will see.

Go ahead please.

Yelizaveta Oleskina: I am sorry, I will give you a very brief answer. It is very important that funds will be allocated but the worst thing is if they are used simply to repair buildings. As a result, we see repaired premises where care is terrible and people are completely ignored. Why am I talking about the long-term care system? Because in this case, we will be able to gather all the elements of this system and even distribute these funds.

Vladimir Putin: Liza, I am also worried about this because the easiest thing to do is to spend money on major construction and repairs and nobody knows what norms are being used in the process and how efficient this work is. But in any event, these buildings must be put into normal shape.

Yelizaveta Oleskina: Yes, we saw regions that have built new homes for elderly people – I do not want to name them so as not to offend regions. These are very expensive, excellent buildings but for some reason a hundred mobile people who wanted to live at home were brought there. They were told that now they have an institution. It is very important to adopt a comprehensive approach to this issue. We should leave at home those who want to stay at home and provide them with a nurse for one or two hours. Those who want to receive help in a day centre should spend their time in institutions rather than homes for the elderly because relocating there is a psychological barrier that cannot be overcome. A system of care in such institutions should be directed toward the recovery of patients that can be discharged later on.

Vladimir Putin: This is a sensitive issue. Let us work together on it.

Yelizaveta Oleskina: The Labour Ministry and the Ministry of Healthcare agree.

Vladimir Putin: Well done then. You must have actively worked with them so now they agree with everything. Thank you, Liza.

Please go ahead.

Maria Ostrovskaya: My name is Maria Ostrovskaya, I represent the St Petersburg charitable organisation Perspektiva, which works with children with multiple severe disorders, both mental and physical, and with adults with severe psychophysical disabilities. Of course, we have been focusing on child and adult specialised care facilities for 21 years now.

Vladimir Putin: Psychoneurological?

Maria Ostrovskaya: Yes, these are psychoneurological care facilities and children’s homes for children with disabilities, which are part of the social sphere. We operate through a broad volunteer network and a network of specialists. Every day, about 40 of our employees come to work at the department, and an additional 20 volunteers come to one of the departments, such as a psychoneurological care facility. We have many such sites.

For 21 years now, we have been trying to supplement state aid with non-state aid, in order to ensure decent conditions at psychoneurological institutions. It has become quite clear now that we need to develop alternatives and technologies that replace such care facilities, because, no matter how much money you pour in, it will not improve the quality of people's lives, ensure their human dignity, or even ensure their basic rights.

With children's homes, we have already more or less resolved the issue, at least in the sense that since the education system is now allowing children with severe disabilities to go to schools, the waiting list ceased to exist.

Vladimir Putin: Why?

Maria Ostrovskaya: Because schools began to take children in. That is, before a mother would take the child to a boarding school at the age of seven, because she had to either go to work, or take the child to a boarding school; there is no such dilemma now, and people can leave their children at home.

There is no progress with psychoneurological care facilities whatsoever. They remain enormous institutions, where scandal follows scandal due to the fact that they have become more transparent, and volunteers now work there, and they blow the whistle on the things that happen there.

The Ministry of Labour took this issue very seriously. A working group on reforming care facilities has been created, which I am part of. But what are we discussing again? The regional authorities suggest building new smaller and better facilities, and so on. This is absolutely not an economically viable solution to this issue from our point of view.

Many former Soviet republics have opted for a completely different solution and banned large care facilities entirely. Instead, they create assisted living homes for seven to eight residents with serious disabilities.

There is no political will. You are definitely the most decisive person in our country. And we, of course, all hope something very decisive will be adopted.

We would like to ask you to issue a ban on new patients on the waiting list going to these old institutions. There must be an executive order of some sort binding the regional authorities to create alternative solutions, such as home-based support, or small groups of patients residing in urban flats. Many nonprofit organisations in our country have come up with such model projects, so they can be replicated.

Is it possible to close the doors of such facilities, Mr President? Please tell us what you think.

Vladimir Putin: First, I give you credit for what you are doing, Maria. You have a very difficult job. In general, almost everything that is being done by the people gathered around this table today is complicated, but your job is especially difficult.

Maria Ostrovskaya: Can we give you our annual report? Everything is in it. Perhaps you will find time, for instance, in the car?

Vladimir Putin: Yes, I will look at it by all means. The facilities you spoke about – and we have over 500 of them, about 520 – were established in Soviet times according to a specific standard. They were designed for a thousand people each – some for more or less, but for many people.

I agree that many things must be changed there. This is perfectly obvious. I appreciate your professional approach and the decisiveness you showed.

Naturally, I would like to look decisive right away and ban everything but this is a very sensitive issue that certainly requires the involvement of professionals. But I cannot help but agree that whenever there is a conflict of interests it is necessary to display this will – not so much political as professional. What does politics have to do with this?

You have prepared all of these proposals, haven’t you?

Maria Ostrovskaya: Yes, we have.

Vladimir Putin: Is it possible to study them?

Maria Ostrovskaya: Yes.

Vladimir Putin: Let us have them, as well.

Maria Ostrovskaya: How should this be done technically?

Vladimir Putin: Technically?

Get in touch with Andrei Belousov, he is my assistant. I will draft an instruction to our ministries and the Government as a whole based on your proposals. I will make sure they are studied thoroughly by all means. And then we will see what can be really done as soon as possible.

What am I concerned about? Say, we close the doors of these facilities, as you said. They will not admit new patients. But are the regions ready to use other ways of resolving these issues?

 Maria Ostrovskaya: They will not be ready until they face difficulties.

Vladimir Putin: Maria, you understand that in the 1990s this was called shock therapy. They used to say, we must get rid of all this. Others were indignant and predicted that this therapy would impoverish and destroy the nation and ruin the entire social sphere. The initiators of shock therapy said, that is okay, there is simply no other way. But such methods have dire consequences. We should try to avoid them.

Nonetheless, I fully agree with you that it would be wrong and impossible to leave this system as is and do nothing. We should work towards its transformation. N we should not only split them up, which, by the way, may make sense, but also change the entire system from within. I absolutely agree with you that conflicts of interests among those who head these facilities are unacceptable. This is certainly an internal issue. There are also other issues that require solution. Let us work together on them, all right?

I agree that this is a very sensitive issue and we must certainly work towards a solution.

<…>

Vladimir Putin: In conclusion, I would like to thank you all. You know, after such meetings you get additional energy and want to work harder, more efficiently. I would like to thank you for what you do in all the areas that you spoke about. They of course require a special temperament, a special attitude to life, and it would be impossible to do the work you are involved in without these valuable, very kind, proper guiding principles. You have all it takes. You have not only this, but the ability to work.

I would like to thank you and wish you success.

We will be in touch, and we will implement everything we agreed on today. Our conversation is being recorded, and we will make note of all of this. That will naturally require some time. We will need to examine all of this, all your proposals. So we will continue our joint work.

Thank you very much.