Fuqarolar sogʻligʻini saqlash bu – iqtisodiy, ijtimoiy, xuquqiy, madaniy, ilmiy, sanitar-gigiyenik, epidemiyaga qarshi xarakterga ega boʻlgan va har bir fuqaroning jismoniy va ruhiy salomatligini mustahkamlashga qaratilgan chora…
Fuqarolar sogʻligʻini saqlash bu – iqtisodiy, ijtimoiy, xuquqiy, madaniy, ilmiy, sanitar-gigiyenik, epidemiyaga qarshi xarakterga ega boʻlgan va har bir fuqaroning jismoniy va ruhiy salomatligini mustahkamlashga qaratilgan chora tadbirlar jamlanmasidir. Bu oʻrinda alohida urgʻu jamoat salomatligiga berilib, yuqumli kasalliklarning oldini olish, epidemiyalar profilaktikasi aholini vaktsinatsiya va immunizatsiyalash yoʻli bilan amalga oshirilib kelingan.
Tibbiy yordam uchun aholi eng koʻp murojaat qiladigan yoʻnalish bu ambulator -poliklinika tizimi boʻlib, bugungi kunda eng katta muammolar ham ana shu tizimda kuzatilmoqda. Tibbiyot tizimi jamiyatda yuz berishi mumkin har qanday holatlarda ham yetarli darajada yordam tashkil eta olish quvvatiga ega boʻlishi zarur. Buning uchun butun tibbiy yordam tizimi, birinchi navbatda, uning birlamchi boʻgʻimini mustahkam, zarur zahiraga ega, zamon talablariga, dunyoda yuz berayotgan noxush holatlarga yetarli munosabat koʻrsata oladigan holga keltirish muhim. Bu degani favqulodda holatlarda ham, bugungidek global epidemiya holatlarida ham tibbiyot tizimi muvozanatdan chiqmagan holda sifatli, kafolatlangan tibbiy yordamni davom ettirishi kerak.
Bugungi tibbiyotimizning aholi talabiga javob bera olmasligi mening fikrimcha oʻn yillar oldin boshlangan ilmiy asoslantirilmagan, “islohot-islohot uchun” tamoyiliga asoslangan tibbiyot reformasi oqibatida yuzaga keldi.
Asosiy kuch va mablagʻlar katta ixtisoslashgan markazlar tashkil etish, katta shaxarlardagi katta shifoxonalarni modernizatsiya qilishga qaratildi. Toʻgʻri, “Salomatlik-1”, “Salomatlik-2” dasturlari orqali butun respublika boʻyicha QVPlar tashkil etilib, tibbiy jixozlar bilan taʼminlandi. (katta mablagʻlar evaziga olib kelingan tibbiy asboblar sifati alohida mavzu). Gʻoya juda yaxshi edi. Maqsad – malakali tibbiy xizmatni aholiga yaqinlashtirish boʻlib, FAPlar oʻrnida vrach bilan taʼminlangan QVP tashkil etilishi boʻlsada, amalda aholiga imkon darajasida yordam berib turgan barcha FAPlar tugatildi.
Oʻsha davrda terapevt, pediatr, akusher-ginekolog, xirurg, stomatolog kabi mutaxassislar faoliyat yuritgan qishloq vrachlik ambulatoriyalari umumiy amaliyot vrachi mavjud boʻlgan QVPlarga aylantirildi. Oliy toifali, bugungi kun taʼbiri boʻyicha tor mutaxassis terapevt, pediatr, ginekologlardan mablagʻ sarflab, UAShlar tarbiyaladik. Xalqimiz esa oradan shuncha vaqt oʻtsa ham bu tizimni qabul qila olmayapti.
Tibbiy amaliy markazlarni yaratish juda toʻgʻri va yaxshi gʻoya. Lekin u juda katta mablagʻ talab qiladi, holatni muvozanatga keltirish uchun asosiy eʼtiborni birlamchi tibbiy yordam tizimiga qaratish, profilaktika ishlari bilan jiddiy shugʻullanish zarur. Shundagina shifoxonalarga boʻlgan talab kamayadi. Tibbiyotga ajratilgan byudjet mablagʻlarining asosiy qismi shifoxonalarga taqsimlanib, barcha murojaatlarning 70 foizi toʻgʻri keladigan ambulator tizim bir necha yillardan beri moliyaviy yetishmovchilik holatida.
Bir holat hech esimdan chiqmaydi, oilaviy poliklinika xizmatini oʻrganish uchun moliya vazirligidan yoshgina mutaxassislar kelishdi. Barcha xonalar qatorida fizioterapiya xonasiga kirganda menga savol berishdi: Hamshira bemorga muolaja uchun tibbiy apparatni qoʻygach, oradagi 10-15 minut nima ish bilan shugʻullanadi, boshqa bir vazifani bajarib tursa boʻlmaydimi? Men javob berdim, birinchidan bemor bitta emas, bir vaqtda bir necha boʻladi, hamshiraning ishi muolaja olayotgan bemorni uzluksiz nazorat qilishdir, degan javobim ularni qoniqtirmadi. Shunda men, mayli sizning farzandingizni apparat oldiga qoʻyib hamshira chiqib boshqa ishni bajarib kelsa boʻladimi?, degan savolimga, tekshiruvchi faqat koʻzlarini katta ochish bilan javob berdi. Oxirda viloyatlardagi oilaviy poliklinika va QVPlardan fizioterapiya xizmati butunlay qisqartirildi. Bu esa fuqarolarning Konstitutsiyada belgilab qoʻyilgan huqularining cheklanishidir.
Ambulator tizimning eng katta muammosi moliya ham emas, balki kadrlar yetishmasligidadir. Uzoq kishloqlardagi QVP yoki poliklinika emas, Toshkent shaxri va poytaxt viloyatida ham poliklinikalarda vrachlar yetishmasligi odatiy hol boʻlib qoldi. Hozirda ushbu muassasalarda ishlayotgan vrachlarning asosiy qismi pensiya oldi yoki pensiya yoshidagi insonlardir. Yoshlar bu tizimda ishlashni xohlamasligi birinchi navbatda boshqa tarmoqlarga nisbatan ish haqining kamligi boʻlsa, yana bir sabab ishlash uchun zarur sharoitlar yaratilmaganidir.
Toshkent shahrida va boshqa katta shaharlarda poliklinikalar maxsus avtomobillar bilan taʼminlangan, qishloqlarda bu hali shirin orzu. Vrachlar yetishmasligi sababli bir necha vrachning vazifasini bajarayotgan mutaxassisga ragʻbatlantirish yetarli emas, yuritilishi lozim boʻlgan xujjatlarning koʻpligi, yosh mutaxassisni bu ishdan koʻnglini butunlay sovutmoqda.
Mening fikrimcha, oʻtkaziladigan har qanday islohat yakuniy natija yaxshilanishiga olib kelishi kerak, yaʼni tibbiyotda aholining salomatligi yaxshilanishiga sabab boʻlmogʻi lozim. Ambulator tizimda olib borilgan oʻzgarishlar na aholining manfaatini taʼminlaydi, na tibbiy xodimning ishini yengillashtiradi. Balki tekshiruvchi, nazoratchilarning ishlarini yengillashtiradi xolos.
Men hayotda optimistman, albatta bugungi qiyinchiliklar oʻtib ketadi, koronavirus ham chekinadi. Pandemiyadan biz qanday tajriba bilan chiqamiz ishimizda xalq roziligini olish uchun tibbiyot tizimida qanday oʻzgarishlarni amalga oshiramiz, ana shu muhum.
Maqsuda Vorisova,
Oliy Majlis Qonunchilik palatasidagi OʻzXDP fraktsiyasi aʼzosi.
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