Экспертиза временной нетрудоспособности в СССР и постсоветской России: врачи на службе государства в управлении трудовыми ресурсами

Журнал исследований социальной политики. 2017. Т. 15. № 4. С. 531–546.

Krasheninnikova Y.

The paper deals with the Soviet model and modern organisation of temporary disability examinations, which is one of the most common types of expert assessment within public administration in Russia. A comparative historical approach is used. Three aspects of these examinations are in focus: ideology or the dominant understanding of its tasks and the ‘mission’; the characteristics of the organisation and regulation of procedures; the practices behind these examinations. The key question is whether this institution, which was established in Soviet times, has undergone modifications given the dramatic changes in the state’s attitude to work and employment since the fall of the USSR. A comparative analysis of the regulations of the USSR and the Russian Federation is provided, as well as an analysis of the content of Soviet and contemporary educational literature for physicians. To determine how sick leave provision was organised in practice in the Soviet era, the archival documents of All-Union Central Soviet of Trade Unions over the period 1930–1980 (transcripts of meetings, reports on results of inspections etc.) were examined. Evaluation of modern practices of the examination is based on thirty-one semi-structured interviews with physicians and the representatives of medical centres management and monitoring bodies. Rather than operating as a means of social protection of the citizens, it makes more sense to view the Soviet-era institution of temporary disability examinations as a tool aiming at the rational distribution of labour resources for optimal use in the national economy. Medical providers could not cope with this task of examination and regarded its procedures and rules formally. However, these procedures and rules have influenced and continue to influence the organisation of professional medical practice and therapeutic process, defining routine interactions between medical institutions and patients.

Keywords: государственное социальное страхование, temporary disability examinatio, Soviet healthcare, medical commission, medical-labour examination, public social insurance, sick leave, sickness certificate, экспертиза временной нетрудоспособности, советское здравоохранение, врачебная комиссия, врачебно-трудовая экспертиза, больничный лист