Doctors and nurses have taken to the streets across Russia to demand the payment of pandemic-related bonuses promised by Vladimir Putin in April but only partially paid out. According to the government, medical staff has no reason to protest, and some cities have tried to prevent the demonstrations quoting restrictive measures related to the pandemic. The protests may seem small, but they highlight a deeper problem with executive power in Russia.
The protests, with the slogan “Pay up for COVID” have taken place since late September in several towns and cities of ten regions, from Vladimir to Magnitogorsk, and more protests are planned in the coming days and weeks: on 11 October in Moscow and in several other regions later this month. In total, protests may take place in more than 30 cities and towns.
Medical staff are protesting because many of them still haven’t received bonuses promised, publicly, by Putin in April and some of them have since learned that even though they work with COVID-19 patients, they are not likely to receive any extra payments at all. Putin initially promised a bonus of 80 thousand rubles for doctors, 50 thousand for mid-level and 25 thousand for junior medical staff over three months, including for paramedics and drivers – a significant amount, given that doctors earned 79 thousand a month on average across the country last year (with wide regional variations).
But half a year later only a fraction of this money has been paid out – doctors’ salaries across the board grew by 10 percent in the first six months of the year, while nurses only saw an increase of 1 percent – even as the Ministry of Health insists that the payments are executed as planned. It is also not just now that medical staff started complaining about missing bonuses: many raised their voices already in May. Then they were told to file complaints electronically. Yet it seems that the problem remains unsolved.
Following Putin’s order in April, the government adopted two decrees – no. 415 and no. 484 – instructing regions to implement the payments. According to prime minister Mikhail Mishustin the government made available 27 billion rubles for the purpose, yet as of May only 4.5 billion was paid out. Then the government stopped reporting key figures about the payments. According to Andrey Konoval, head of the “Action” trade union, which spearheaded the protests, several hospitals interpreted the decrees in ways to limit the amount of money paid out to the staff. Some demoted junior staff, some calculated bonuses by the hour, some only paid people on their newly formed “covid teams”. Health care institutions are chronically underfunded and regions were themselves responsible for ensuring that there is enough PPE and ventilators in their hospitals, which in turn is difficult when they have no reliable data on which to base policies and budgetary transfers from the government are limited and uneven. In short, paying out bonuses for medical staff is not a priority.
The protests highlight a broader problem with multi-level governance in Russia. The system’s legitimacy relies broadly on two pillars. The first one is a vague sense of popular legitimacy, that is, the notion that even if elections are rigged, the result still broadly reflects the will of the people, or rather, the unwillingness of most of them to challenge the status quo. The second one is the belief that while the state is not omnipotent, it can get its way if it needs to. Above all, Putin has primed Russian voters to expect that when all other levels of government fail, he is able to resolve problems; in recent years, with cash-starved regional governments trusted to manage rather than govern their regions, the federal government becoming an administrator rather than an executive, and the State Duma turning into a place to resolve conflicts within the political elite, Putin indeed remained the only visible, tangible authority. This also meant that his trust rating became more sensitive to policy failures on all levels. If doctors do not get the bonuses that Putin promised – bonuses that they now even refer to as “Putin’s bonuses” – they might primarily get angry with hospital managers and regional governments, but what they will question is Putin’s ability to make good on his promises and to make lower-level officials carry out his orders.
This is not the first time that this problem has emerged, either. The execution of Putin’s “May Decrees” issued in 2012, which envisaged significantly higher salaries for state employees, to be paid out from regional budgets, also fell short of its stated goals, even as the government insisted that the targets had been reached. In 2019 Alexey Navalny tried to draw attention to this and tap into the disappointment by creating a labour union with the purpose of holding officials accountable for the decrees. The idea clearly worried the Kremlin, but the issue was superseded by last year’s regional elections, then Putin’s constitutional reform (and the social guarantees enshrined within) and most recently, the pandemic.
The protests of doctors and nurses threaten putting the issue back on the political agenda, only with a greater degree of urgency and visibility due to the ongoing pandemic. Some municipal and regional leaders have shown more sympathy to protesting doctors and nurses than others, but no one has come up with a solution to put the problem to rest. So far Putin has seemed more concerned about the negative impact of lockdowns on public mood – and there is data to back him up – but this is a temporary issue. He may find that some problems that arose in recent months are not going to go away when the virus is defeated.