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Minister of Healthcare Mikhail Murashko delivered a report on the main topic, namely, expanding healthcare infrastructure and primary care modernisation programmes.

Several current issues were reviewed at the beginning of the meeting.

The meeting was attended by Chief of Staff of the Presidential Executive Office Anton Vaino, First Deputy Prime Minister Denis Manturov, deputy prime ministers Tatyana Golikova, Alexander Novak, Dmitry Patrushev, Vitaly Savelyev, Marat Khusnullin, and Dmitry Chernyshenko, Deputy Prime Minister and Presidential Plenipotentiary Envoy to the Far Eastern Federal District Yury Trutnev, Deputy Chief of Staff of the Presidential Executive Office Maxim Oreshkin, and Minister of Finance Anton Siluanov. Other officials invited to the meeting included Presidential Aide Alexei Dyumin, Minister of Labour and Social Protection Anton Kotyakov, Minister of Healthcare Mikhail Murashko, Minister of Transport Roman Starovoit, Minister of Construction and Housing and Utilities Irek Faizullin, Minister of Science and Higher Education Valery Falkov, and Head of the Federal Taxation Service Daniil Yegorov.

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President of Russia Vladimir Putin: Good afternoon, colleagues.

Mr Murashko will discuss primary care modernisation programmes and infrastructure expansion in this sphere.

However, let us begin with a critical issue of getting ready for the winter.

Mr Fayzullin, how far have you got?

(Irek Fayzullin reported that, with due account of the outdoor temperatures, heating systems have been turned on in 1,686 municipal districts in 72 regions. In view of the accidents that occurred during last year’s heating period, accident response plans have been drawn up by the Ministry of Energy, the Emergencies Ministry and Rostekhnadzor agency, and emergency drills have been scheduled in each region.

Overall, 6.896 million blocks of flats, or 98.9 percent of housing are ready for winter, as well as 98 percent of public facilities and amenities, and 98.9 percent of utility infrastructure. A total of 160,000 kilometres of heating networks have been made ready. Sufficient fuel reserves have been stockpiled, and government support has been provided to the regions where necessary.

According to minister, the government continues working on the comprehensive integration of the newly reunited regions into the country’s economy. They are being included in all countrywide projects, including programmes to modernise utility infrastructure and create a comfortable urban environment, the integrated development of territories programme, and the Housing federal project.

Preparations for the winter are also underway in the Donetsk and Lugansk people’s republics, the Zaporozhye and Kherson regions, with assistance coming from Russian regions that committed to support certain communities there. The DPR has 97 percent of its systems prepared for the winter, the LPR, 98 percent, the Zaporozhye Region 95 percent, and the Kherson Region, 89 percent.

The minister also reported that preparations for winter in the Belgorod, Kursk and Bryansk regions are kept under special review as per the presidential instruction.)

Vladimir Putin: Good. Thank you very much.

The country is vigorously preparing for the winter. I hope that everything will be accomplished. Indeed, it is a major effort on a national scale.

And how did our summer tourist season end?

Mr Chernyshenko.

Deputy Prime Minister Dmitry Chernyshenko: Mr President,

I would like to point out growing interest in traveling around the country. We expect the number of tourist trips to exceed 90 million this year.

The most popular destinations are the Krasnodar Territory, which added 15 percent, and Moscow with 8 percent. Each of these regions was visited by over 3 million tourists. The tourist flow to St Petersburg soared 20 percent compared to last year and almost reached 2.5 million guests. Crimea, despite the temporary restrictions, saw an almost 6 percent growth, receiving 1 million tourists.

The geography of trips is also expanding. Our people are exploring new directions. For example, the tourist flow to Tyva has increased by 78 percent, to the Ryazan Region by 46 percent, and to Yakutia by 40 percent. However, I would like to note that some regions like the Chechen Republic and Daghestan have maintained high tourist flow growth for two years: Chechnya has increased it by 66 and Daghestan by 46 percent. We should definitely give due credit to the regional authorities for promoting tourism opportunities of their territories and arranging safe and affordable holidays. Russians really appreciate this.

We understand that the window of opportunity, let’s say, to develop domestic tourism, under restricted competition with foreign resorts, is limited, and we continue to create tourism infrastructure and ratchet up this pace. Today, there are already 24,000 hotels in Russia with over 910,000 rooms of various types. Since the beginning of the year, 4,500 rooms have been commissioned with state support measures for our national project alone.

Mr President, at your instruction, the Five Seas and Lake Baikal has become a federal project within the new national project, Tourism and Hospitality. The supporting infrastructure is being currently designed. In addition to the national project funds, the regions will provide budget loans, as you instructed.

As per your instruction, we also have to prioritise federal funds for the construction of new roads and airports in favour of this project. I would like to ask you to schedule a separate meeting on this at the beginning of next year if possible, which I propose to hold at one of the construction sites of the Five Seas and Lake Baikal project.

Vladimir Putin: Ok.

Dmitry Chernyshenko: This is essential, because, as per your instruction, it will provide 10 million Russians with exactly all-season seaside resorts where they will be able to go on holiday every year.

(Mr Chernyshenko further spoke about the expanding preferential lending programme and construction of glamping sites and modular hotels. According to him, businesses have come to believe in tourism, and investments in tourism amounted to over 377 billion rubles over the first half of this year alone. The Deputy Prime Minister also reported on the growing popularity of automobile tourism: the main increase in tourist flow was due to people travelling by car. At the President’s instructions, 58 auto tourist routes have been created throughout the country, of which 30 are priority directions around the M-4 Don, M-8 Kholmogory, M-12 Vostok, and M-11 Neva motorways. Work is underway to ensure that these routes have accessible communications, well-equipped motorway service areas, and road furniture.)

I would like to note that Russia is open to the international guests, and this summer season we welcomed 50 percent more foreign tourists than last year. In July and August alone, about one million foreign tourists visited Russia, and by the end of the year this number is expected to be nearly 5 million.

In addition to Moscow and St Petersburg, the Primorye, Krasnodar, and Stavropol territories, Karelia and Tatarstan, as well as the Novosibirsk, Irkutsk, and Sverdlovsk regions have shown strong growth in the number of foreign tourists.

Following your instruction, in 2023 the Foreign Ministry resumed the issuance of electronic visas, which was beneficial for the inbound tourist flow. Over the summer, one in five foreign tourists – over 300,000 guests – entered Russia using electronic visas. Most visitors came from China, Saudi Arabia, Turkiye, India, and Iran, as well as Kuwait, Bahrain, and Oman. Additionally, half a million tourists from China and Iran visited our country as part of group visa-free exchanges.

We are working hard to promote our tourism products internationally, making tourist aware of it and encouraging them to come to our country. This year, we launched the Discover Russia programme. We are promoting Russia as a tourist destination in China, India, and the Gulf countries. Next year, we plan to establish our presence in Southeast Asia.

Currently, we are connected by direct regular flights with 36 countries, and this year we launched 20 additional routes with these countries. In this regard, I would like to commend the coordinated efforts of the Ministry of Transport, the Federal Air Transport Agency, the Foreign Ministry, and the Ministry of Economic Development.

During our earlier meetings with you, we reported about safety issues, and now professional tour guides ensure tourist safety on challenging trails. Starting in July, certification for these guides has been conducted by the sports federations of mountaineering, sports tourism, and underwater sports. Currently, there are 5,000 certified guides, and everyone must notify the Emergencies Ministry before hitting the trail. Over the summer, according to the Emergencies Ministry, 20,500 such tourist groups were registered, with over 250,000 tourists, including 100,000 children. Certified tour guides enter information about all hikes into the Ministry of Economic Development’s electronic registry.

Mr Putin, according to VTsIOM polls, 45 percent of our citizens reported improvements in summer vacation amenities, which is 9 percent higher than last year. I understand there is still room for improvement.

We are now focused on the winter resort season and winter vacations. On October 18, the Ministry of Economic Development will hold a meeting with regional and federal authorities to make sure that winter vacations are comfortable, safe, and enjoyable. We will keep you informed about the results.

That concludes my report. Thank you.

Vladimir Putin: Thank you very much.

The flow is indeed growing. Mr Chernyshenko has just said that the transport system is also coping with the increasing number of tourists.

Mr Starovoit, how do you assess the operation of transport?

(Minister of Transport Roman Starovoit reported that over three summer months Russian airlines carried in total about 35 million passengers, which is 4.3 percent more than last year. Passenger traffic in April-September exceeded 63.2 million people. According to forecasts based on the results of the summer navigation from April to October, Russian airlines will carry 72.6 million passengers with a 5.4-percent increase.

From May 1 to September 30, 11.6 million passengers were transported by rail to Black Sea coast resorts. Transportation to Crimea in the summer season totalled 20.2 million passengers, an 8.2 percent increase. In the summer of 2024, 688,400 children were transported, which is 1.3 percent more compared to the same period last year.

In the first half of the year 2024, passenger traffic on all types of inland waterway routes increased by almost 10 percent and amounted to 2.47 million passengers. Most popular voyages in the European part are from Moscow to St Petersburg, to Solovetsky Islands and cities on the Volga.

Almost 1,800,000 cars and busses travelled across the Crimean Bridge in both directions from May 1 to October 1. It is 23 percent more than in the same period of 2023.

The core regions of tourist attraction are linked by 3,500 inter-regional bus lines – almost two times more than last year. Traffic safety along the basic tourist routes is maintained, among other ways, thanks to the road workers through proper current repairs and upkeep of motor roads.

The minister reminded that next Sunday, October 20, Russian road workers will mark their professional holiday. Currently, over 10,000 organisations employing 750,000 personnel are engaged in this sector. In the first nine months of this year, almost 3,000 kilometres of federal highways were commissioned after construction, reconstruction and repair. This is one thousand more than during the same time last year.

The minister spoke about the opening of new sections of motorways and bypasses of populated areas, as well as the repair of socially important roads in the Donetsk People's Republic and the Lugansk People's Republic.)

Vladimir Putin: I congratulate all road workers in advance – it will be on October 20, on Sunday – on their professional holiday.

Mr Falkov, what can you tell us about the national admissions campaign and its results?

Minister of Science and Higher Education Valery Falkov: Mr President, colleagues,

Russian universities have mostly completed the admissions campaign. What has the campaign revealed? Demand for higher education remains high, with over one million people submitting their applications.

As per your instruction, we have continued to increase the number of budget subsidised vacancies over the past few years. This year, their number reached an all-time high of 592,017, with regional universities accounting for 73 percent of this total.

This year, the biggest number of applications were for engineering, teaching and medical departments.

As of today, 903,806 people have enrolled at Russian universities. Average Unified State Exam scores have increased, constituting a positive trend this year. Subjects related to physics and linguistics are posting the highest average Unified State Exam scores.

(The minister also elaborated on the results of the targeted admission campaign, where applicants can view all offers from employers, regardless of their home region, and can apply to any university and employer of their choice. In this process, they know in advance their future place of work, official duties and even wages. Employers can submit targeted admission proposals online from any part of the country, thus encouraging interregional mobility. Valery Falkov provided the following example: students arriving from various regions have enrolled at Far Eastern Federal University in accordance with targeted admission quotas, in the interests of companies and organisations of the Far Eastern Federal District, including the Zvezda Shipbuilding Complex, Transneft – Far East, the Healthcare Ministry of the Primorye Territory and others. In total, universities in the Far Eastern Federal District have accepted 2,834 people in line with targeted admission quotas. Their number has reached 51,500 nationwide.)

Mr President, we will upgrade the targeted admission and training system, and are already planning some changes.

First, we propose expanding the range of employers who are eligible to sign targeted training contracts with applicants. This list will include all main employer enterprises that are part of the relevant list of Ministry of Industry and Trade, as well as enterprises in the agrarian sector. Key sectors will thereby receive additional opportunities for expanding their human resources and creating attractive working conditions for future employees, enabling them to accomplish economic and social objectives.

Second, starting from the next year, we will increase admissions under the targeted training quota, which will help enterprises meet their demand for human resources more effectively.

Third, while applying the targeted admission schemes in the interests of a client, we will take into account the results of prospective students’ participation in the client’s vocational guidance events.

And fourth, we have proposed augmenting the Personnel national project with measures to develop career centres at all universities, which will, in particular, monitor compliance with targeted admission agreements, help deal with arising problems and ensure that these graduates honour their obligations.

This completes my report. Thank you.

Vladimir Putin: Thank you.

Will schoolchildren, prospective students and parents have enough time to absorb these innovations?

Valery Falkov: Yes, Mr President, thank you for mentioning this. Changes in the admission rules are always a delicate matter. That is why we held an expanded meeting of the ministry’s Public Council on October 2, to which we invited all the interested parties. We have decided against making cardinal changes in 2025 and proposed several changes for 2026.

In particular, those who plan to enrol at subject teaching departments will have to sit for a mandatory unified state exam in the given subject. Today, such graduates use the results of the social studies exam, but starting in 2026, would-be chemistry teachers will have to sit for a chemistry exam, would-be physics teachers for a physics exam, and so on. The two-year time lag will allow prospective students to adjust to the new scheme, prepare for exams and realise their plans.

Vladimir Putin: All right.

(Minister of Labour and Social Protection Anton Kotyakov commented on the targeted admission scheme at the President’s request. He said the unemployment rate was at a historical low in Russia, and that creating a personnel reserve for enterprises was becoming a development priority for them. This year, 24,000 enterprises submitted requests for 171,000 targeted admission places at universities and about 115,000 at vocational colleges. The minister added that the targeted admission system should be improved. In particular, the number of places assigned to specific enterprises and the range of employers that can use the targeted admission scheme should be increased, and the drafting of a five-year personnel requirement forecast should be synchronised with the allocation of targeted admission quotas to take market requirements into account as much as possible.

The President noted that the minister’s proposals were based on labour market requirements and instructed him to set them on paper and forward them to the Government. He pointed out that these proposals would most likely be supported but he was always ready to help if and when necessary.)

Vladimir Putin: We have been discussing opportunities for attracting the workforce to the economy, but we also have a few fiscal issues.

Mr Yegorov, we announced a tax amnesty in July. How is it progressing?

Head of the Federal Taxation Service Daniil Yegorov: Good afternoon, Mr President.

I would like to first report on our preparatory work for all the changes to the Tax Code adopted as part of the initiative to build a fair taxation system. Before these novelties are enacted in 2025, we have 32 regulatory acts to adopt. This work is progressing normally; all the acts will certainly be adopted. Plans are in place to reconfigure information systems and actualise our services for taxpayers. These plans are being implemented.

We are collaborating with the developers of accounting systems to make certain changes to the taxation environment to enable taxpayers, primarily small businesses, to align their information systems with our new system. It goes without saying that we are also active in raising taxpayer awareness of the changes through all available channels.

(Daniil Yegorov further elaborated on the changes in the Tax Code for small businesses and the implementation of the President’s instruction on tax amnesty for small businesses that resorted to business fragmentation to avoid shifting to the general taxation bracket. The amnesty rules were developed jointly with the Government, with the participation of the State Duma, the Federation Council and business associations. The Head of the Federal Taxation Service also answered the President’s clarifying questions).

Vladimir Putin: I hope that this initiative will lead to good, positive results, will improve and revitalise the economy and create favourable conditions for business development.

Thank you very much.

Go ahead please, Mr Murashko.

Health Minister Mikhail Murashko: Mr President, colleagues,

Over the past five years, medical infrastructure and technology have developed at an unprecedented pace in the contemporary history of Russia. Of course, this happened thanks to your instructions and your personal attention to the system. Resources were used to create advanced high-tech centres that we open regularly, but also for thousands of facilities in primary healthcare, which are most widely used. Of course, special attention was directed towards rural areas.

I would like to note that infrastructural plans have been updated: we saved a bit, and the number of measures implemented has increased. As a result, we have created more than 6,000 new healthcare facilities over the past five years, and another 600 facilities will be commissioned by the end of this year.

Major repairs and renovations of existing facilities are also important, and 5,300 of them have been renovated. More than 236,000 units of medical equipment have been delivered, 60 percent of which was Russian-made. Almost 17,000 domestic cars have been purchased, along with nearly 1,800 mobile medical complexes, all of which are also Russian-made. A total of 720 billion rubles were allocated from the federal budget for these initiatives.

Regarding further development plans, 174 billion rubles are earmarked for 59 major facilities as part of the five-year planning of capital investments within the federal project for the development of healthcare infrastructure. An agreement has been reached with the Ministry of Finance to clarify these parameters during annual planning.

(The Minister further spoke about 650 billion rubles to be allocated up to 2030 for infrastructure development, including the ongoing modernisation of primary care, as part of the new Long and Active Life national project. It is planned to create more than 3,800 facilities worth 290 billion rubles, carry out major repairs in over 7,000 medical organisations, as well as supply nearly 16,000 units of equipment.

Mr Murashko also described the development of emergency care, cancer care, endocrinology centres, and the protection of motherhood and childhood as an absolute national priority. The Minister noted that the network of perinatal centres created in the country has demonstrated outstanding performance. As part of the Family national project, it is planned to equip and upgrade 120 perinatal centres, as well as re-equip children’s hospitals, especially with an emphasis on emergency car.)

Experts estimate that around 70 percent of the population assesses government’s performance based on the state of healthcare. Following your instructions, Mr President, we are closely monitoring public feedback on the development and quality of medical care. Over the past two years of extensive reforms, we have observed a 50 percent increase in positive evaluations. However, a comprehensive approach remains essential, including actively supporting medical personnel in adapting to new work models.

All these new facilities, equipment, and transport represent more than just infrastructure development; they embody new technologies that, thanks to the government’s focus, are becoming accessible to millions of our citizens. Thus, prioritising the needs of the population, our citizens, is of utmost importance.

In conclusion, today’s meeting commenced with discussions about winter preparations, and I would like to emphasise that the healthcare system is also gearing up. We are entering the epidemic season, which typically sees increased illness rates. We have procured 71 million doses of the flu vaccine, all of which have been delivered to the regions on schedule since July, and vaccination efforts are currently underway.

I would like to point out that as of today, 39 million people have been vaccinated, representing 45 percent of those subject to vaccination. I want to specifically address the citizens of our country: getting a flu shot, especially for the elderly and those with chronic conditions, is not merely a recommendation but a necessity as it is crucial for protecting your health and ensuring your well-being during the winter season.

Thank you very much. That concludes my report.

Vladimir Putin: Do you have an adequate supply of vaccines?

Mikhail Murashko: Yes, all deliveries were made on schedule.

We are actively engaging employers in this effort. I believe it is economically beneficial for employers to purchase additional vaccines for their employees, as it reduces the number of sick leaves and ensures that the production process remains uninterrupted.

Vladimir Putin: Are the recommended vaccines for this year different from last year’s?

Mikhail Murashko: Of course. The antigenic composition is updated every epidemic season according to forecasts from special expert groups. Every season, we plan vaccines with a new antigenic composition.

Vladimir Putin: Do we have enough domestic medicines, or do we purchase them?

Mikhail Murashko: No. Our need for domestic influenza vaccines and medicines is fully covered. I would like to emphasise that domestic production is of high quality, and the number of manufacturers is sufficient to meet both domestic and export needs.

Vladimir Putin: Doctors at the Central Clinical Hospital, where I undergo regular check-ups, recommend vaccination with a domestic vaccine.

Mikhail Murashko: Correct. I would like to note that this year special vaccines with maximum protection against the flu virus have been prepared for older people. Thus, we can avoid serious complications. Thank you very much for drawing attention to this.

Vladimir Putin: We must thank the manufacturer. I hope this is the case.

I have a question: when will the list of measures to develop the healthcare infrastructure be completed?

Mikhail Murashko: Today, all measures are being reviewed by every Russian region. We have a special database where all healthcare facilities are fully inventoried. We are almost at the finish line, so everything will be done as scheduled. We listen to each region, and this is discussed with the people living there. I think there are just two or three weeks left until this is finalised.

Vladimir Putin: When you said “as scheduled,” I instantly had a question: what is the schedule? What deadlines have you set? Will this take two or three weeks more?

Mikhail Murashko: Yes. We listen to each region and work on each one. We have been doing this since July. This is meticulous and highly precise work.

Vladimir Putin: All right.

You have mentioned the regions. When will the drafting of regional healthcare development programmes with federal financing be completed?

Mikhail Murashko: All federal projects are clearly aligned with the regional development programmes and the regional budgets. That is why I said that we have been working since July: because we have been verifying what should be done facility by facility, taking into account the needs of each region. When we met with you, the Ivanovo Region governor asked to consider them individually, and that is exactly how we are proceeding.

Vladimir Putin: Ok.

Mr Siluanov, what is the status of the federal funding component?

Finance Minister Anton Siluanov: Mr President, we have addressed all instructions issued in the Address concerning healthcare. In your Address, you stipulated that an additional trillion rubles should be allocated to healthcare over a six-year period. We have accounted for this amount.

We have now prepared the budget for the first three years. As Mr Murashko mentioned, in the coming years, we will also seek additional funding sources, such as increased tax revenues from alcoholic drinks and sugar-containing beverages. Therefore, we have the resources.

You rightly inquired: when will the regions receive information on the scope of measures being executed as part of the national project? By the second reading. We are currently compiling proposals for amendments from our ministries and agencies. These will be ready next week, and the allocations among the constituent entities of the Russian Federation will be submitted to the State Duma for the second reading. The first reading is scheduled for October 24. Following that, the Government will draft proposals regarding the regional component. We will review these with deputies and senators at a trilateral commission, and all allocations will be prepared for the second reading.

Vladimir Putin: All right.

Our preliminary plans stand at approximately 900 billion rubles, and we agreed to allocate an additional trillion from the extra revenues, correct?

Anton Siluanov: We have earmarked 938 billion rubles for the Long and Active Life national project and an additional 147 billion rubles for the Family national project.

Vladimir Putin: I see. Thank you.

Ms Golikova, do you have anything further to add?

Deputy Prime Minister Tatyana Golikova: No, Mr President, everything has been covered.

I would just like to remind you that 2025 will be the final year for implementing the first stage of the primary care modernisation programme.

The programmes have been developed until 2025. What Mr Murashko just mentioned involves cooperation with the regions, factoring in the experience they have gained and the objective that by 2030, using those additional financial resources, we aim to nearly complete primary care modernisation. This is our focus. We are also concentrating on the fact that from 2021 to 2025, we had leading regions that have managed to implement the primary care modernisation programme at a faster pace, considering their budgetary resources, while others, due to financial constraints, have not been able to do so.

For this subsequent period, we will prioritise both the regions and the facilities to meet the population's needs. Naturally, we are focusing, as Mr Murashko has already indicated, on the new regions, as they are now fully integrated into all our areas within the new national projects.

Vladimir Putin: All right. Thank you very much.

I trust that the matters we have just discussed, particularly the coordination between the social bloc and the Ministry of Education, will be agreed upon.

Regarding healthcare, indeed, significant progress has been achieved. I would like to extend my gratitude for that and expect that the programmes we have just discussed will be fine-tuned in the next two or three weeks. In any case, everything should be completed around the beginning of November.

Thank you very much. All the best!