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C.      BbIBO,l'.(L1 H PEKOMElI)l,Al.(HH ,lJ.JUIBbffiOPA BAPHAHTOB ....................................................70 

VI.   KAlJECTBO YCJlyr IIEPBK'lHOro 3BEHA 3)l.PABOOXPAHEHIDI C n03HU.HH 

nOTPEIiHTEJlEH H nOCTABllI.HKOB YCJIYr ...................................................................................75 

A.       MHEHHE nOTPEGHTEJlE'A 0 KAlJECTBE IIMcn .................................................................75 

        J(ocmyn K nepeU'lHOU MeiJuKG-caHumapHou nOMOUJU............................. ................................................. 75 

        Bbl60p YIlpe;)ICiJeHuu nepeU'lHOZO 3eeHa 30paeooxpaHeHUR. nOCell.4ae.MblX 'IJIeHaMU OOMOX03R'IJcme ...... 77 

        On.nama 3a YCi1YZU nep6U'IHOZO 3eeHG 3iJpa6ooxpaHeHUR ........................................................................ 79 

        rrOHRmue Ka'leCmeG .................................................................................................................................82 

        B030eilcmeue pecpopM .............................................................................................................................85 

B.       ll0311IUU1 nOCTABlUliKOB no KAlJECTBY YCJIYr JI..IU·.JI...... Jl.JI.....................................................,ou                                                                                                                                                                         

        BuiJeHue nOCma8UIUKaMU e03iJeucmeUR peqJOpM .................................................................................... 86 

        Cnpoc Ha ycllYZU nepeu'IHoii MeiJuKo-caHumapHou nOJUOl:qu.
        j(oxoo no£:maf8UIUK()6
        OmHoweHue K 'laCmHblM nO(:m'l8UIUKaM.
        ChieHKa 1(.O"leCm6a pa60mbl nocma8UIUK08 CBn.... ................................................................................. 94 

C. 	 B3AHMO,lJ.E'ACTBIiE MEiK,11.Y nOCTABlUHKAMH YCJlYT H MEcmblMH 

  YlJPEJK,In:HIDlMIi BYJlYlJmEHHII KAlJECTBA YCJIYr 3;::tPABOOXPAHEHHR............................. 96 

     Cnoco6bl nooa'lu ;)ICQJ106.........................................................................................................................96 

D.    BbIBO)J,b1 II PEKOMElI)l,Al.(H1i no nOBblmEHIDO KAlJECTBA YCJIYr .... ~ ............................ 99 

llEPBlI'IHoR ME~Ko-CAHHTAPHOH nOMOI.ltH ............................................................................99                                                                                                                                                                                       

VII.        OIiOlilll.EHHE BbIBO.llOB H PEKOMEH,llAUHH .................................................................102 

A. 	     KAqECTBO CHCTEMLI YI'IPABJlEHIDI •......•.•••.•.•••.••••••••...•..••••.•.•••.••••••••••.....•••••••..••..••••••••. 102 

         IlJIAHbIHA
OPHJlOJICEHHE ! ........................................................................................................................................109 

1.MEXAHII3MhllltllHAHCHPOBAHIDI ME,LUU.UmCKIiX YlJPEJlC,lJ.EHH'A ......................................... . 

2.0GS3AHHOCTII H OTBETCTBEHHOCTb IItHHAHCOBOro MEHE,lJ;)ICEPA CBll......................... 113 

HHIltOPMAIUUI 0 1It0H,llE P A3BHTIUI (llOCTAHOBJIEHHE KM N!414) .......................................114 

   3.PoJIH KJllOlJEBblX ArEHTCTB HA KOHCOJlH.lJ.HPOBAHHOM l(EHTPAJlbHOM YPOBHE B 

  CIICTEME 3AKynOK CEKTOPA 3)J.PABOOXPAHEHIDI ................................................................ 115 

DPHJlO~EHHE                 2............."'................   S . . . . . . . . . . . . . . . . . . . . . . . . . III1QIIIIII • • • • , • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •   118 



                                                                                                                    VB 

          l.CHCTEMA 3APAliOTHOH I1JIA TLI B CEKTOPE 3WABOOXPAHEHIDI: HEKOTOPbTE
   TEXHH"'IECKHE ,l{ETAJiH ..•••••••••..••••••••.,............................................................................................ 118 

2.PAIiOlfASi HAf1>Y3KA H TPY)l,OBOH CTAiIC ................................................................................. 120 

nPHJlOJKEHHE 3........................................................................................................................................ 122 

    1.,ll.OMOX03S1HCTBA, OIiPAD-'AIOD-'HECSl3A YCJIyrAMH nMcn H OCHOBHbTE llPlflIHHLI
   OIiPAlQEHHJllA nOMoUlblO ..........................                                                             122 

                                                                       II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



2. ~CTOTA nOCED-'EHIDI yqPEiIC,l{EHHH llMCn....................................................................... l25 

3.MHEHHE nOTPEIiHTEJIEH 0 CHCTEME nEPBlflIHoH ME)l,HKO-CAHHTAPHOH nOMOD-'H .... 128 

DPHJlOJKEHHE 4........................................................................................................................................129 

1.0IiCJIE)l,OBAHHE KAqECTBA nPE)l,OCTABJIEHIDI YCJIIT - METO)l,OJlorIDI ......................... 129 

2.PECnOH)l,EHTLI yrJlYIiJIEHHbIX HHTEPBblO C nOCTABD-'HKAMH ME)l,HIlHHCKHX YCJIyr 131 

3. YlfACTHHKH OIiCYiK)l,EHHH B cz,OKYC-f1>ynnAX .................................................................... 132 

4. YrJlYIiJlEHHbIE HHTEPBblO C nOCTABD-'HKA MH YCJlyr ....................................................... 133 

5.0npocbl nOCTABIl{HKOB ME)l,HIlHHCKHX YCJlyr ................................................................. 134 

6.HHcz,OPMAIlHSI 0 PECnOH)l,EHTAX OIiCJlE.lI:OBAHHSI )l,OMOX01RHCTB ................................. 138 

7.4»OPMHPOBAHHE BbffiOPKH )l,JIR OIiCJIE)l,OBAHHSI.lI:OMOX03J1HCTB .................................... 140 

8.4»OPMHPOBAHHE BbffiOPKH H XAPAKTEPHCTHKH PECnOH)l,EHTOB onpOCA HA BbIXO)l,E.142 

JlHTEPATYPA ............................................................................................................................................. 145 





                                                                            viii
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nepexO,1l0M OT CHCTeMbl 3aTPaTHoro Ha CHCTeMY no.uyweBoro cpHHaHcHpoBaHIDI.                                                                3TH       Mepbl
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nOMep:>KHBaIOIUHX               H     KOHipOJIHPYJOIllHX              ynpaBJIeHHe             'IeJIOBe'leCKHMH          H     cpHHaHcoBblMH
pecypcaMH B CBn, He cnoc06CTBYeT 60JIhWeH OTBeTCTBeHHOCTH no pe3ynbTaTaM                                                           ""r\nTl..l

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MexaHH3MOB KOH1ponSi H HaJl:30pa. B                                                      eCTh CBHJl:eTenbCTBa Toro, 'ITO U~f'''f\"g
CHCTeMa»,        KOTOpM              npe,IJ.WeCTBOBaJIa            peCPOPMaM           npoeKTa         «3,IJ.0pOBbe          1»,        Me]ll1eHHO
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                                       B03MO)KHOCTH                               P3CXO,IJ.OB    61O)J.:>KeTa      H    <l>OH,IJ.a      p83BHTIDI
 IO,LIlPbIIBaJKJT cpHHaHCOBYJO nO,IJ.OT'I:eTHOCTb CBn H nOJIHKJIHHHK. B                                    HaCTOHmee                       <l>OH,/J.bI
p83BHTIDI He nO]ll1e:>KaT TaKOMY )Ke npe,IJ.BapHTeJIbHOMY KOHipOJIIO, KOTOPhlH npHMeHHeTCH no
OTHoweHHIO K 06bI"IHOMY 61OJJ.:>KeTY. PyKOBO)J.HTeJUIM yqpe~eHHH He 1pe6yeTCH 0,IJ.06peHHe
3anpOCOB Ha paCXO,IJ.bl OT paHOHHblX cpHHaHCOBhlX OT,lJ.eJIOB, XOTSI OHH H ,lJ.OJI:>KHbI npe,IJ.CTaBJUITb
nO,IJ.p06HbIH    KB8PTaJIbHbIH              OT'I:eT              HCnOJIb30BaHHH          Cpe,IJ.CTB    CPOH,lJ.3    p83BHTHSI.            CJIa6bIH
KOHipOJIb      C03,IJ.aeT       B03MO)KHOCTH            ]ll1S1    HeueJIeBOrO         HCnOJIb30B3HIDI                                         Toro,
orp3HH"1eHHblH nOTeHUUaJI pecny6JIHKH B npoBe,IJ.eHHH cOBpeMeHHoro BHY1pCHHero H BHeWHero
aY,IJ.HTa              H 3aKYHO'lHbIX onepllI.tH.H oCJIa6mleT nO,IJ.OT'I:eTHOCTb 61O)J.:>KeTHbIX opraHH33UUH




                                                                      XIV
B HCnOIlb30BaHHH                                          Cpe.D.CTB, TeM CaMbIM, nOBblWrui 06mHH tP~HapHblH PHCK
B ynpaBIIeHHH Cpe.D.CTBaMH CeKTOpa 3.D.paBOOxpaHeHIDI.

20.        B     OTHOWeHHH                ynpaBIIeHHJI        Ka,D,POBbIMH      pecypcaMH              H   3apa60THOH               nnaToH,
                       Y.D.eJIJleT 60Ilbwoe BHHMaHHe noompeHHIO 3tPtPeKTHBHOH pa60Tbi H nOBblweHHIO
ypOBH.II 3apa60THOH nn8Tbl pa6OTHHKoB 3.D.paBOOXpaHeHH.II.                                B       TO            KaK HMeeTCJI
nOJIo:lKHTeIlbHblX .D.OCTIDKeHHH, Koropble HeIlb3.11 He OTMeTHTb, Bce eme cymeCTByJOT BIDKHble
BonpoCbI, ~6yJOmHe peWeHH.II.                                               PYKOBO.D.HTeIleH CHCTeMbI 3.D.P8BOOXpaHeHH.II
H      nOCT8BmHKOB ycnyr 3.D.P8Booxp8HeHH.II                      3a    nOKa3aTeIlH 3.D.OPOBb.ll           HaCeIleHH.II        OT.IIrOmeHa
                       C8MOCTO.llTeIlbHOCThIO B BblUOJIHeHH.II KJIlOqeBbiX ynp8BIIeHqeCKHX tPYHKUHH.
HeCMOTP.II       Ha    TO,        'ITO     Ha,D,   CHCTeMOH      ynp8BI1eHH.II                         .D.OMHHHPYeT           ueHTpaJJbHO
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:iKeCTKa, OHa Bce :iKe HMeeT p.ll.D. nOIlO:iKHTeIlbHbIX                                           nO.D.OT'I.JeTHOCTh nOCTaBmHKOB
ycnyr roCY.D.aPCTBY, OpHeHTHpOBaHHOCTb Ha pe3YIlbTaT, oueHKa K8qeCTB8 p860TbI H oroop
nepCOHaJJa H8 KOHKypCHOH OCHOBe. O.D.H8KO OCHOBHble Ka,D,pOBbIe                                              8 HMeHHO, CB060.D.8 B
Onpe.D.eIleHHH KOIlHqeCTBa H THn8                                       He06xo,D,HMoro,                     HaHJJY'lWHM 06pa30M
COOTBeTCTBOBaTb           MeCTHblM            nOTpe6HOCTBM,        no     60IlbweH      qacm           HaxO,D,BTCB       3a    npe.D.eIlaMH
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peryIlHPYeTCB ueHTpaJJH30B8HHO YTBep:>K,D,eHHblMH rOCY.D.apCTBeHHbIMH HOpM8THBaMH. KpOMe
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2] .       AHaJJorWIHo, HecMoTpJl Ha HOBbie nOIlHOMOqH.II no                                                             C06CTBeHHblMH
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CeTKe, KOTOprui .D.onOmUleTC.!I Pa3I1HQHblMH Ha,D,68BKaMH H .D.Onn8TaMH, perymtpyeMblMH CIIO:iKHOH
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IIeT    (TPY.D.OBOH                      6I1aro.D.8p.ll                3apa60T0K      Me.D.HuHHCKOro                                 MO:iKeT
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OCHOBSHHoro Ha Pa3JIHqHbIX KpHTepH.IIX KSqeCTB8 pa6OTbl, 6blIl0 BOCnpHH.IITO C 60IlbWOH
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           C03.D.8eT   ,D,II.II    Me,D,HUHHCKHX           pa60THHKOB       B03MO:iKHOCTh                            HeQ>opMaJJbHble
nnSTe:iKeH 38 CBOH YCJJYTH H nperurrCTByeT .D.aJJbHeHweMY yIIyqweHHIO KaQeCTB8 Me.D.HUHHcKOro
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YJ(OBIleTBOpeHHOCTH                B       CHCTeMe         3.D.paBOOXpSHeHHJI       He      npaKTHKYlQTcjI;               nOTPe6HTeIlH
npe.D.nOQHTaIOT peW8n. CBOH np06I1eMbI HeOQ>HUHaJJbHO B YCTHOH Q>opMe,· He                                                                K
.D.OKYMeHT8M B nHCbMeHHOM B}I,D,e.                         nOCIIe.D.HHe .D.Ba rO.D.a oqem. MaJJoe qHCIIO nOTPe6HTeJIeH



                                                                   xv
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CBOH    MaxaJIJIHHCKHe          KOMHTeThI.        Onpoc      ,lJ,OMOX03RHCTB        H    06c)')I()J.eHIDi    B
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Me)KJJ.y nOCTHBmHKaMH YC.nyr H nOTPe6HTeJIRMH.


3rprpeKmU6Hocmb          6   crpepe ynpa6JleHlIR pecypCaMU

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                 H                          3<p<peKTHBHOCTH.             B,IJ,06aBOK K CTPoroMY             KOH'TpOJIlO            KIDK)J.OH
nO,lJ,CTaTbH 61O,lJ,)li:eTa, cymeCTByJOmM npaKTHKa e)KeMeCRqHoro HOpMHpOBaHHoro Bbl,lJ,eJIeHHlI
,lJ,eHe)KHhIX cpe,lJ,CTB Be,lJ,eT K 38,1J,ep*KaM BblnJIaThI Cpe,lJ,CTB nepCOHaJIy                                H nOCTBBmHKaM.
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Cpe,lJ,CTBa no KOTOPhlM HMelOTCR B HaJlH'IHH, HO He 1"pc6ywTCJI B ,lJ,aHHOe BpeMJI, 'ITO KaK
ynoMHHaJlOCb Bblwe, yseJIHliHBaeT 06myw CTOHMooTh BC,IJ,eHIDi ,lJ,eJI.

24.       npe,lJ,BapHTeJIbHbIH KOIiTpOJIb, KOTOpblH OCymecTBJIJlIOT MeCTHblC <pHHaHcoBble oprsHhl
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pecypcSMH.                      CTPOrHH                       npOTHBOpC'IHT                                                   rH6KOCTH,
KOTOPbIH npe.zmOJIaraeTCJI B nO,lJ,yweBOM <pHHaHCHpOBaHHH CBn H nOJIHKJIHHHK.                                                     J(sHHhIe
:meMeHThI KOH'TpOJIR <p8KTH'IeCKH MeWaIOT Me,lJ,HIJ.HHCKHM Y'lpe)Ii:)J.CHIDiM HCn0J1h30B8Tb CBOH
                                                                                                    2
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Cpe,lJ,CTB, )J.JIR   TOro     "IT06hl   npHcnoo06HTbCa              K    H3MeIDilOmHMca          06croaTeJIbCTBaM.                 J(aHHM
,)KCCTKooTh THK*C        Be,lJ,eT K TOMY,            "ITO   nOCTBBmHKH nO,lJ,HHMalOT QeHbI                  )J.JIa    KOMnCHcaQHH
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CTOPOHbI Ka3Hal:JeHCTBa, COKpamM, TaKHM 06pa30M,                                              Me,lJ,HQUHCKHX Y'lpe)Ii:)J.eHHH B
paCnOpjJ)li:eHHH ,lJ,aHHblMH Cpe,lJ,CTBaMH )J.JIR nOKpblTIDi onepaQHOHHbIX H TeXHHl:JecKUX paCXO,lJ,OB,
"ITO HBJIMOCb OCHOBonOJIaralOmHM npHHQHnOM, CTORll\MM 3a BHe,lJ,peHHeM Cl>OH)J.OB

26.       B    QeJIOM,       nocneJJ.yK>1.I1Hif      KOH'I"pOJIb,       BKJIlO'IM   BHYTPCHHHH         H        BHeWHHH                 ay,lJ,HT,
HanpaBJIeH Ha TO, "IT06bI BblHCKHBaTh H HaKa3blBaTh 3a                                               HOpM. Ha        "''''''1'<''''''


2 nOCTpo'llThlD 61O)l)keT He .!laeT HH410PM8U1iH 06 3<P41eKTHBHOCTH H npOH3BO.!lHTeJI.bHOCTH npOrpaMM.                                      B
HeM HrHOP"PYlQTClI .!lOJIrOcpO'lH.ble CTp8TerH'leCKHe «eJIH B nOJI.b3Y Kp8TKOCPOt IHOro p8cnpe.!leJIeHHll
peCYPCOB. RCJIH Y.!leIDIeTClI 60JI.bwoe BHHMaHHe .!lellTeJIbHOCTH H P8CXO.!laM 3a npOWJIble nepHO)l.bl, TO
rmaHHpOBaHHeM npeHooperalOT. Kor.!la ooo6oe BHHMaHHe, B nO.!lP06HoCTlIX, Y.!leJIHeTCSI MOIUHOCTRM Ii
pecYPClIM, pe3ym,raTOM CTaHOBHTCli '1pe3MCPHO lKecTKHii npCJlOSPHTeJJbHhlii KOHTPOJIb BCCX nOJlPOfiHOCTCR.                       11,
HaKOHeu, npH nOCTpO'lHOM COCT8BJlCHHH filO.IDKeTS HCnOJlHCHHIO 61O.IDKeTS He XBa:raeT HanpaBJleHHOCTH HS
3$.pCIITHBHOCTh JlellTeJlbHOCTH.


                                                               XVI
.neHb B Y36eKHCTaHe OTCyrcTBYeT Q>YHKUHJI BH)'TpeHHerO ay.nHTa. KOlrrpOJlbHO-peBH3HOHHOe
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pa3BHTHeM nOTeHUHaJla no BH)'TpeHHeMY ay.nwry, KOTOPbIH, npH Ha.nnelKaIIleM npHMeHeHHH,
nOMOlKeT npeBpaTHTh KOHrpOJlb B MexaHH3M nOBhlweHHB                                                3Q>Q>eKTHBHOCTH HCnOJlb30BaHHB
pecypcOB.

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OTCYTCTBHeM TO""lHOrO onpe).leJleHHJI pOJleH H 06B3aHHocTeH KJlJO""IeBhlX BOBJle""leHHhlX CTOpOH.
TaK     KaK     Ha       rOCY).lapcTBeHHhle              3aKynKH         npHXo.nHTCB              3Ha""lHTeJlhHafI       ""IaCTh        paCXO).lOB
3.npaBOOXpaHeHHJI            (40%    OT 06IIlHX pacxO).lOB Ha 3).lpaBOOXpaHeHtUI                                            npaBHTeJJhcTBa
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rocy.napCTBO MOlKeT C3KOHOMHTb ).l0                        20-25%            Cpe).lCTB ""Iepe3 npOBe).lemfe rocY).lapcTBeHHblX
3aKynoK Ha KOHKYPCHOH OCHose.

28.       cDyHKUHOHaJlbHOCTb                    pbIHKa    3aKynoK             OCJla6J1BeTCB           OTcYTCTsHeM         ).l06pocOSeCTHOH
                      '!.ITO     Be).leT K 3aBblWeHHJO ueH Ha JleKapCTBa H 060pY).lOSaHHe.                                 TOJlhKO        30%   (s
Cpe).lHeM)     peQ>0pMHposaHHhIx                   H    3%     He       peQ>opMHpoBaHHhiX                  CBll       HCnOJlh3YJOT         MeTO.n
KOHKYPCHhlX           ToprOB         ).lJ1$I     3aKynKH       npenapaTOS                 H     Me.nHUHHCKHX           npHHa.nnelKHOCTeH.
KOHKYPeHUHJI           c.neplKHBaeTCB             OTCYTCTBHeM           nOJlHOueHHOH              H      ""IeTKOH    HopMaTHBHOH            6a3bl,
BLIweynoMBHYThIMH Henp03pa""lHLIMH npoueCCaMH, MHoroypOBHeBbIM KOHTPOJlHpOSaHHeM ueH,
Ka""leCTSa H CepTHQ>HKaUHH                                 KpOMe Toro, ""IaCThIe C.1l}"I.IaH npOCpO""lKH l1J1aTelKeH H
TPy.nHOCTH         ).lJ1J1       HMnoprepOB/noCTaSIIlHKOB                     B      npHo6pereHHH               HHOCTPaHHOH              BaJllOThl
    pO'rHI~O)leficTBY:1OT KOHKYPeHUHH, TaKlKe KaK H BblCOKafI CTOHMOCTb TeH).lepHbIX ).lOKYMeHTOB,
3a""lacTYJO COCTaBJIJlJOIIlafl .nO             600 .nOJ1J1apOB CillA.                HaKOHeu, KOHq,JlHKT HHTepeCOB B 3aKynKax
CBHtlereJlhCTBYeT 06 OTCYTCTBHH paBHblX YCJlOBHH ).lJ1J1 KOHKYPeHUHH.

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pe3YJlbTaTOB B rex cq,epax, f).le npaBHTeJlbCTBO H                                                         HaJla.nHnH tlHaJlor H rOTOBbl
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                                                                   xviii
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         JIeT B He'ITO, 'ITO             OCHOBblBaereH Ha HaBbIKaX, cnOcOOHOCT.lIX H Ka'l.feCTBe pa60Tb1.


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         e./lHHHuy' TOBapa B proYJIbTaTe e./lHHOBpeMeHHoH omOBOH 38KYflKH.




                                                              XIX
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                                               xx
                                                           I.   BBEJlEHHE



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Y1l3BHMbiM .llJIlI l1J1Oxoro ynPaBJlCHHlI H C.llCplKHBaCT l1p03pa'iHOCTb H 110.ll0T'lI!THOCTb.       3TH   ljlaKTOPbI CHCTeMaTH'IHO
YBcnH"IHBaJOT BCPOllTHOCTb KOppynUHH, ICOTOPYlO TPY.llHO paC1103HaTb, C.llCPlKHBaTb H HaKalblBaTb. OHH TaKlKC
C.IlCPlKHIIaJOT palBHTHe CBo60.llHoro PbIHKa, 1100lUPll11 HeJaKOHHOC 110Be.llCHHC.      eM. Savedoffand Hussmann (2006).

                                                                        1

1.4         ,lJ,aHHaH       OU;CHKa          HanpaBJlCHa             B    OCHOBHOM         Ha       H3yqCHHC              MCCTHblX          opraHoB
rocY,LI;apCTBCHHoro ynpaBJICHIDI: H HX o6H3aHHocTcH no npC,LI;OCTaBJICmnO o6mCCTBCHHbiX ycnyr.
3To HBJIlIeTClI YMCCTHblM B OTHomCHHH Y36cKHcTaHa no HCCKOJIbKHM npHqHHaM. Bo-ncpBblx,
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3JICMCHTbi ynpaBJICHIDI:, TaKHC KaK nOJIHTHqCCKM CTa6HJlbHOCTb H BepxoBeHcTBo 3aKOHa, JIClKHT
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                                                                                    5
OCHOBHOM            HCCYT      OTBeTCTBCHHOCTb 3a ynpaBJIeHHe CBOHMH cpHHaHcaMH       -   ,LI;OBe,Ll;eHHe
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                          6
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orpaHHqeH,           a    Ha    MeCTHOM          H      06JIaCTHOM          ypOBHlIX       qerKOrO           onpe,Ll;eJIeHIDI:     KOHKPeTHbIX
06lI3aHHOCTeH He Ha6JIlO,LI;aeTClI HJlH HX nOHHMaHHe OTCYTCTBYeT. B                                             pe3YJIbTaTe, cymeCTBYeT
B03MOlKHOCTb :uy6JIHpoBaHIDI: OTBeTCTBeHHOCTH H YCHJlHH. nOCJIe,Ll;HlIlI npH"IHHa 3aKJIIOqaeTClI B
TOM,      "ITO   B CTPaHe YJKe               cymeCTBYIOT MeXaHH3Mbl,                 KOTopble MOfYT 6bITb ,LI;OnOJIHHTeJIbHO
YCOBepmeHCTBOBaHbI Mll Toro, "IT06.bI n03BOJIHTb MeCTHbiM coo6meCTBaM BblPaJKaTb CBOH
nQTPe6HOCTH B OTHomeHHH Heo6xo,Ll;HMblX HM 06meCTBeHHbIX ycnyr H OTCJIeJKHBaTb HaJIHqHe H
KaqeCTBO TaKHX ycnyr Cpe,Ll;H nOCTaBmHKOB, ,LI;eJIruI HX, TaKHM 06Pa30M, 60JIee nO,Ll;OTqerHblMH
nOTPe6HTemIM.


1.5         ,lJ,aHHruI     ou;eHKa          HaueJIeHa       Ha       aHaJIH3     nepBH"IHOH          Me,Ll;HKO-CaHHTapHOH                 nOMOmH,
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OKa3.bIBaJOT        nepBHqHYIO              ,LI;HarHOCTHqecK)'lO          H     KOHCYJIbTaTHBHYIO              nOMOIlU>,       ocymeCTBJIlIIOT
pa60ry no npocpHJlaKTHKe H JIeqeHHIO 3a6oJIeBaHHH, OKa3blBaJOT 3KcTPeHHYIO nOMOmb, npOBO.LllIT
06pa30BaTeJIbHYIO pa60ry H Be,LlYT nponaraH,LJ;y 3,L1;OPOBOro o6pa3a JKH3HH H Ha6JIlO,LI;eHHe 3a
COCTOlIHHeM          3,L1;OPOBblI       B    paMKax       MCCTHblX         coo6meCTB),          a   TaKJKe        HX      HenOCpe,Ll;CTBeHHblx
BbimeCTOlImHX yqpeJK,Ll;eHHH                    paHoHHoro            H   ropo,Ll;CKOrO     ypOBHlI.          Ham         aHaJIH3   Hau;eJIeH        Ha
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naU;HCHTaM          H,   nOTIoMy,           MOfYT       lIBJIlITbClI     HaHJIyqmHM        KaHaJIOM           npHBJIeqeHHlI          rpaJK,LJ;aH      K
pa3pa6oTKe          H    MOHHTOPHHry             cpaKTH"IeCKOrO             OKa3aHIDI:     yCJIyr.       B     XO,Ll;e    3TOH     ou;eHKH,        MbI
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CaHHTapHOH           nOMOmH,            KOTopble        MOfYT        OKa3aTbClI     nOJIe3HblMH          Mll       6Y.LlYlUeH        nporpaMMbI
pecpopMHpoBaHHlI 3,L1;paBOOXpaHeHIDI: B u;eJIOM.


1.6         i'b-3a orpaHHqeHHOCTH BpeMeHH H pecypcoB, 6b1JIO npmulTo pemeHHe orpaHHqHTb
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BTOPrul HaqaJIa peaJIH3au;HIO pCCPOPM n03,L1;Hee), a TaKJKC CpaBHCHHeM CHCTeM 3,L1;paBOOXpaHcHIDI B
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06JIaCTb B KaqeCTBe 06JIaCTH C «npo,Ll;BHHyn.IM» OnblTOM pecpOpM, Tal( KaK peCPOPMHpOBaHHe
IIMCn B CeJIbCKOH MeCTHOCTH 3,L1;eCb HMeeT ,LI;aBHIOIO HCroPHIO. CaMapKaH,LI;CKM 06JIaCTb 6bIJIa
BbI6paHa B KaqeCTBe 06JIaCTH, HaqaSmeH pecpopMbI OTHOCHTeJIbHO He,Ll;aBHO. ECJIH rOBOpHTb 0
cpaBHeHHH           IIMCn           B       rOpO,Ll;CKOH      H      CeJIbCKOH       MecTHocTH,               6bIJIO       06HapYJKeHO,            "ITO



5 JIHllib OICOJlO   20%   HauHOHaJlbHOro rocY.llapCTBCHHoro 61OJl)I(eTII nCpCqHCillIeTCli OpraHaM rocY.llapCTBeHHOR BJlaCTH
Ha MCCTax.

      K   npHMCpy,       nOJlOlKCHHC,       COrJlaCHO     KOTOPOMY       nOJlblOBaTem!     61OJl)I(eTHbIX       CPC.llCTB    MOryT       IlCPC'lHCJlJlTb
C3KOHOMJlCHHbiC HMH Ha KOHCU KBapraJla CPC.llCTBa BO BHe6IOJl)I(eTHble q,OH.llbl .llilll HCnOJlblOBaHHJI no C06CTBCHHOMY
YCMOTpeHHIO.


                                                                           2
pelPOpMMpOBaHMe IlMCTI B CeJIhCKOH MeCTHOCTM npO,uBMH}'JIOCh ,uaJIhWe pelPOPM B rOpO,uCKHX
YCJIOBIDIX.     PelPOpMMpOBaHMe          IlMCTI       B    rOpO,uCKOH           MeCTHOCTM                       HaqaTO       B    lPOpMe
3KCnepMMeHTa JIMWh B          2006      ro,uy B <I>epraHcKoH 06JIacrn (r. MaprHJIaH) M B                            2007          ro,uy B
CaMapKaH):tCKOH 06JIaCTM (r. CaMapKaH):t). B                               06nacTM 6hIJIO BhI6paHo no TPM paHoHa,
O,uMH roPO,uCKOH M .usa CeJIbCKHX. B <I>epraHCKOH 06JIacrn, Bhl6paHHhIe paHoHbI BKJIlOqaJIM r.
MaprMJ1aH,                          M TaumaKcKMH                            B       CaMapKaH):tCKOH                           BhI60pKa
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                B03MO)l(HOCTb                     rocy,uapCTBeHHoro ynpasneHIDI H KaqeCTBa OKaJaHIDI ycnyr
B 06JIaCTM,                                   PelP0PM                  C 06JIaCThlO, HaqaBWeH pelPOpMHpoBaHMe
n03JKe.



                                                  B. METO)(OJIOnrn:

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OKaJaHMe Me,uH!lHHcKOH nOMOID,M                SlBJIJleTCSI KOMnneKCHhlM                   npoueCCOM,                                  6b1JIO
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1.8       HawH pe3ynbTaTbI OCHOBaHbI Ha JlByx rnaBHbIX HCTO'lHHKax HHlPOpMaUHH:                                                  (i)    Haw
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(BbIJleneHHe pecypCOB, ynpaBJIeHHe rocYJlapCTBeHHbIMH lPHHaHCaMM, 3aKynKM, ynpaBneHHe
Ka,upaMH H CMCTeMa OnnaThI TPYJla) H                      (ii)                             HHTePBhlO cpeJlH nOCTaBID,HKOB
Me,uMUHHCKOH nOMOIUH M JlOMOX035lHCTB, a TBKJKe                                     rpynnoBhle                                   nepBOM
3Tane     Mbl     npOBenM     aHaJlH3        KaqeCTBeHHbIX           JlaHHbIX          M     aHaJlHTHqecK}'lO        pa60ry               no
                                         H                                          6aJe,    npeofina,ualOlD,eH          B       ceKTope
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ynpaBJIeHIDI npHMernuOT ee K OKaJaHMIO MeJlHUHHCKOH nOMOID,M.


1.9       BTOPhIM MCTOqHHKOM HHlPOpMaUMM Jl1ISI Hac 5lBHJIOCh COUHOJIOrHtfeCKOe 06cne,uoBaHMe
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yrny6neHHhIe HHTepBblO C nOCTBBID,HKaMH                                                        B lPOKYC                          onpOCbI
MeJlHUHHCKHX                                                                    npeJlnpMHlITOH B                              npoeKTOB
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MeJlMUHHCKHX ycnyr, 'ITO OKaJaHHe IlMCn CO CTOPOHbI MeCTHhIX opraHOB rOCYJlapCTBeHHOH
Bnacrn JlBJISIeTCli 3lPlPeKTKBHbIM M pe3ynbTBTHBHblM Jl1ISI rpaJK):taH H HaCKOJIbKO OHM nOJlOTtf/hHbI.
(TIOJlp06HaSI     HHlPOpMaUHll      0   MeTOJlOnOrHM             onpocoB        H    BonpocHHKax,           a    TBKJKe       npolPHJIe
peCnOH,[teHTOB H yqacTHMKoB npMBOJlHTCli B                                      D).


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          II   npHBo,uHTCJI     OnHCaHHe       ceKTopa           3JlpaSOOXpaHeHIDI            B    Y36eKHCTaHe,           H      JlaIOTCli
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                                                                 3
1.11    B   cneJlYlOlUHX TPex fJIaBax cO)lep:IKHTcjI aHaJIH3            KJIIO'IeBbIX BonpocoB, HMelOlUHX
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pacnpe)leneHHe pecypcoB, ynpaBJIeHHe rocY)lapCTBeHHhIMH $HHaHcaMH H 38.K}'nKH, ynpaBneHHe
qeJIOBe'leCKHMH                H onnaTa TPY)la.      B   rnaBe                 BonpocbI pacnpe)leJIeHH5I
pecypcoB B CHCTeMe                                                                 CB5I3aHHbIe c HH3KHM
            $HHaHcHpOBaHH5I                              B 'IaCTHOCTH            OKa3h1S8eMOH CBn. B
       N    )laeTCjI 0630p CHCTeMbl ynpaBJIeHIDJ                                           H
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Ha ypoBHe MeCTHOM ypOBHe.      B            V   06C)'JKJlaeTC5I ynp8BJIeHHe Ka)lpaMH H CHCTeMa OnnaThI
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onpe)leJIHTh,   cnoc06cTBYeT    JIH   OHa   HJIH     MemaeT      MeCTHbiM   opraHaM   rocYAapcTBeHHoro
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CYlUeCTBYlOlUHX B03MO:lKHOCTeH H orpaHH'leHHH.


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OXB8T8, CTOHMOCTH H                             Me)lHl\HHCKHX ycnyr. B      nOCne)lHeH rnaBe     VII,   Mbl
nOCTapaJIHCb 0606lUHTb                  Hamero aHaJIH3a                       cymecTBYlOlUHX B CHCTeMe
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                                                      4

                         II. CTPYKTYPA H CHCTEMA ynPABJIEHIDI3WABOOXPAHEHIDI


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nOlpe6HOCTH HaCeJIeHHH.                   MOMeHT 06pereHH1I He3aBHCHMOCTH B                                                     OKOJIO
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                                                                 5
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                                                             7
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3AopOBbe-2, TorAa KaK Ha oxsaT pe$opMOM BceM <I>epraHcKOM                                                       YWJIO             nJJTH JIeT.
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naKeT (BMecTo nOOqepeAHoro BHeApeHHJJ, KaK 3TO 6bUlO B <I>epraHcKoM 06JIacTH).

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10 HapruIY C JlpyrnMH TpeMlI o6naCTHMH, cornaCHO nOCTaHOBJIeHHIO                       217, OT 28   CeHTJl6pH   2005 r.
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                                                                             8
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HCro'lHHK: CHCTeMbl 3.upaBOOXpaHemrn B nepeXO,nHOM nepHOtle, Y36eKHCTaH                                   2001   r. H   M3   (tlaHHhle   2006
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13 J.b HHTepBblO C MHHHCTpOM 3.!lpasooXPaHeHIDI B r83eTe "3.!lpasooXpaHeHHe Y36eICHCTaHa" OT 4 anpeJUI 2007 r.; •
pa3MellleHHoM B HHTepHeTe no Mpecy: http://www.press-uz.info/ruiprintscm?topicId=2803&contentId=56828.
14 CaHHTaPHM llBHaIUfJI lIBJUleTCli 3KCTpeHHoti CJI}')KOOA, OCHOBHOA 3MS'IeA KOTOpoA lIBJUleTCli TPaHCnoprHpOBlCa
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                                                                        9
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cneUHaJIH3HpOBaHHoro J1e"leHHJI H HCn0J1b30BaHHJI nepe.z:toBblx TeXH0J10rHH, B JlHBape                        2003    ro.z:ta
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                                                             11
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                                                                          13 

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17 B nJrrepa-rype,   3aHJITOcn.   Ha JlByx DatKn:l:LX CliJITaeTCJI      "MCXIIHH3MOM MarrrIUlHH", a             He KoppynuHcR.             eM.   Vian,
2006.

                                                                   14 

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O)].HH H Te :IKe neKapCTBa, 18 a cpapMaueBTHqeCKHe KOMnaHHH                                         C03)].alOT cnpoc Ha CBOH
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                                                                 15
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                                                     16 

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                                                                    17 

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19   03CP, 2006.

                                                                                18
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20 B IIHBape    2008   roJIa OblJlO npHHlITO pemeHHe npaBHTenbCTBa, comaCHO KOTOpOM)' onpeJIeneHHble «PYHKUHH
nCpC)laBMHCb Ha paROHHbdt ypOBCHb, npH :nOM, coxpalUlJl                                       npHHUHn Ha OCHOBe '!HcneHHOCTH H
reH)lepHoro    pacnpeJIeneHIUI      HaceneHIUI,    OXBaTblBacMoro         CBn.      npH     :nOM   rapaHTHpOBaJlOCb,    'ITO         Cpe)lCTBa
Bblll.eIDIiOTCIi B nonHOM ofu.eMc H cornaCHO yrnep'llCllcHHoA CYMMe                  6e3     BlllelliaTenbCTBa H8 paAOHHOM ypOBHC.
MHHHCTepCTBO      3JIPaBOOXpaHeHID!        Ofu.JlCIUICT    ucnecoo6pa3HOCTb         JIaHHoA    Mepbl   no    npH'lHHC    (I)         6onbmoA
3arpy;KCHHOCTH COTpYJIHHKOB 06naCTHbtx ynpaBneHHA 3JIPaBOOXPaHeHID! H «pHHaHCOB B CBJI:!H C Heo6xo)lHMOCTblO
paCCMOTpeHHJI H perHCTpaUHH CMCT CBn, npOBepKH HX OT'lCTHOCTH;                       (2)   CJ10XCHOCTeR, C KOTOPbJMH CTaJlKHBaIOTCJI
«pHHaHCOBble lIIeHe)lXCCpbl H3 YJIaJleHHbtx CBn npH nOe3)lKax B 06naCTHble ynprumCHID! H He06xoJIHMOCTblO
060CHOBaHID! HX KOMaH./lHPOBO'!Hbtx paCXO)lOB (KBHTaHUHH, 6HnCTbi H                          BblCOKOA CTOHMOCThIO TaKHX pacxOJIOB.
(3)   OTcyrCTBHe MexaHH3MOB JlIDI onpC)lCneHID! 61OJl)KCTHbtx acCHrHOBaHHA JIeACTBHTenbHO Hc06xOIDfMbtx CBn )lIlJl
ocymeCTBneHID! CBOHX <PYHKUHA, a TaKXCe MexaHH3MoB, n03BOIDllOIIlHX 06I1aCTHbJM ynpaBneHHJlM npOBOJIHTb HaJl30p
HaJl HX .IlClITeJlbHOCThIO H uenCBI>IM HCnOIlbJOBruUteM cpe.llCTB.


                                                                   19
C~Oielllle:HI![e DpHOpHnrr3 DO OTHOWeHHIO K DepBH"lHOMY 3BeHY


3.9      npH         aHaIIlf3e  pacxo.z.OB      Ha
3.z.paBooxpaHeHHe B palpe3e 3BeHbeB, Mbl                   Ta6JUfua 111.2: PacxoIlbl Ha OMen B
npHwnH K 3aKJIIO'teHHIO, q'fO                                           cpaBHeHHH
pacnpe.z.eneHHH pecypcoB B8YTPH ceKTopa
CMell(eHa He B nonb3Y nepBH'tHoro 3BeHa.
,l(onH pacxo.z.OB Ha flMCn cnerKa BbIpocna B          EOJIbHHUbI
2006 r., B OCHOBHOM H3-3a pacxo.z.oB                  TIMCTI                                    22
                                                      C3C                                        5
(Ta6nHua 3.3). P33Mep cpe.z.CTB Bbl.z.enHeMblX
Ha flMCn         'taCTJfqHO 3aBHCHT OT 06ll(ero
         Cpe.z.CTB Ha 3.z.paBooxpaHeHlfe, a TalOKe
qaCTH'tHO OT Toro, KaK 9TH cpe,nCTBa
pacnpe,nenHIOTCH B8YTPH caMoro ceKTopa.
,l(pyrHMH cnOBaMH, flMCn npHXo.z.HTCJI KOHKypHpOBaTh 3a cpHHaHCHpOBaHHe C .z.pyrHMH
no,nceKTOpaMH, B 'taCTHOCTH co CTaUHOHapHbIM 3BeHOM. Pacxo,nbI Ha flMCn, KOTOPaJI C'tHTaeTCH
            3cpcpeKTHBHOH B                        3a6oneBaHHH H OXPaHe 3.z.0POBbJl, COCTaBnJlnH
Bcero nHWb 22% OT Bcex pacxo.z.OB Ha 3,npaBooxpaHeHHe, Tor,na KaK              6bIJlO HanpaMeHo Ha
cTaUHoHapbl.

3.10     YMeHbweHHe ,nonH CTaUHoHaPHblX paCXO,nOB MO:IKeT 6bITh OTHeceHO Ha c'teT
COKpall(eHHJI TeKYIl(.HX pacxo,noB. B pacnpe.z.eneHHH TeK)'ll(.HX pacxo.z.oB Ha CTaUHoHapHble H
aM6ynaTOpHbie yCnyf c TeqeHHeM               npOH30lllJIH H3MeHeHHJI. Ta6nHua          nOKalblBaeT,
q'fO            pacxo,l{bl Ha CTaUHoHapHble            ynMH C 72% OT o61l(.HX pacxo,noB Ha
3,npaBooxpaHeHHe B 1998r. ,no 43.6% B 2005 f. TaKHM :IKe                    TeK)'Il(He paCXO,l{bI Ha
aM6ynaTopHbie YCJTyrH YBenH'-IHnHCb 60nee qeM B 2 p33a C 20.3% B 1998 r. ,no 45.3 B 2004 f.
                  oTPa:lKaeT onpe,neneHHblH c,nBHr npHOpHTeTOB OT .z.opororo CTaUHOHapHoro
ne'teHHJI B CTOpOIi)' MeHee 3aTP3THoro aM6ynaTopHoro yxo,na.

                        TaMHua 3.4: TetcywHe pacxoIlbl ceKTopa lIlpaoooxpaHeHHH
                              (% OT o61.1lHX pacxO}lOB Ha 3}lpaBooxpaueHHe) .


  panOJ.lOB

OrauuoHapHhlit yxOJl.            72.0   68.4    46.4    45.7   46.8    46.0    45.3     43.6
AM6ymrropHbtli yxOJl.            20.3   23.7    42.8    44.8   43.7    43.2    44.2     45.3
npo<P HJI!1ICTHK8                 4.2    4.8     4.9     4.9    5.0     4.9       4.9    5.1
npoTHB03nHJl..                    0.6    0.7     0.4     0.4    0.4     0.4       0.4    0.5
MeponpmrrIDI




   HcrOI.fHHK: UNDP, "3.z.0pOBbe JlJlSl Bcex           OCHOBHajl uenb MJI Y36eKHCTaHa B HOBOM
ThlcJlqeneTHH," 2006.

3.11    ,LVJjI              nOHHMaHIDI npo6neM B CHCTeMe ynpaMeHIDI, CBJl3aHHbiX C
He.z.OCTaTOqHbIM cpHHaHcHpOBaHHeM             MbI npoaHaIIH3HpOBMH COCTaB pacxo.z.oB              3a
C'teT, KaK 6IO.ll:lKeTa, Tax H <I>oH):{a P33BHTHJI. <I>OH):{ onnaTbl TPy.z.a (3apa6oTHaJI nnaTa H
OT'tHCneHIDI pa6oTo,naTeneH) COCTaBHn OKono 80% Bcex pacxo.z.OB              B 2005 H 2006 rr. ::fro
COOTHoweHHe OCTaBMOCb HeH3MeHHhlM ,na:lKe Tor,na, Kor.z.a CPOHJ{ 3apa6oTHOH MaThI
3Ha'tHTenbHO B03POC Ha 70% B 2006 r. B TO :IKe BpeMJI, CBn Hcnonh30BMH Bcero nHWb 15%
6fO)lIKeTa rpynnbl      4 B TetfeHHe TeX )f{e nByx JleT. AHaJIOrHtfHblM 06pa30M paCXOnbJ Ha oWIary
Tpy,lla 3a CtfeT <j:l0H,ll8 pa3BHTIDi TalOKe BbIPOCJlH                 tfeM B   1,5 pa3a B 2006         roJlY•


                     . TaMllua 3.5: PacxoAhl CDn II:J 61OA)f{eTa II 4»ollAa pa:JBIITIIH (%)




                                                        T           palBHTH         0                     palBHTH

              I1Jlara
  OrIHcnemm pa6oTollareneii                                 20                          19         17                 5        16
  rpynna IV, B VI.:                                          9                          15         10                72        15
  TeK)'UlHA peMOHT H 06CJl)">KHBaHHe                         2                           5          3                30         5
  DpotlHe onepaUHoHHhle 3arpaThl                             2                           3          2                19         3
  MellHKaMeHThI H nepeBJl30QHble                             2                           2          2                 0         I
  MarepHaJIhl
  KanHTaJIhHhIA peMOHT                                       0            0             0           I                3          I
  DOK)'nKa OCHOBHhIX CpellCTB                                0           18             I           0                2          0




3.12     C03,llaHHe     <j:loH,lla pa3BHTIDI       nOMomo        CBn tfaCTHtfHO cKoMneHcHpoBaTb
Cpe,llCTB Ha pacXO,llbI rpynnbI         4.         HCnOJlb30BaJIH 60JlbllI)'IO ,1l0JlfO peCypCOB <j:lOH,lla pa3BHTIDI
Ha CT8TbH rpynnbl          4,   B TOM tfHCJle H H8 TeKYUUfH peMOHT H TeXHHtfeCKOe 06CJJY)KHBaHHe, a
TalOKe 3aKYnKH KOMnbfOTepOB, O<j:lHCHOro 060pY,llOBaHIDi H CB$l3aHHbIX C HHMH paCXO,llHblX
MaTepHaJIOB (Ta6J1Hua           3.5). Pacxo,llbl Ha rpynnbl 4        H3 <j:loH,1la pa3BHTIDi CBn COCTaBHJlH                82% OT
Bcex pacxonoB <j:loH,lla B         2005 r. H 72% B 2006              r. Cpe,llH paCXO,llOB rpynnbl               4   OKOJlO  40%
pecypcoB <j:loH,lla pa3BHTHlI CBn 6blJIO nOTpatfeHO Ha peMOHT H TeXHHtfeCKOe 06CJJY)KHBaHHe.
nOKYnKa OCHOBHblX CpenCTB CBn cymecTBeHHO nOHH3HJ18Cb c                                      18%   Bcex pecypCOB <j:lOH,lla
pa3BHTIDi B   2005   L ,ll0     2% B 2006 r.

 B. DPOIJJIEMhI YDPABJIEHIDI, CB.H3AHHLIE C .UHAHCHPOBAlIHEM DMCn

3.13     liH3KHH      ypoBeHb          <j:lHHaHCHpOBaHIDl        ceKTop~        B   tfaCTHOCTH          nepBHtfHOrO           3BeHa
3,1lpaBoOxpaHeHIDl,                   K B03HHKHOBeHHfO HeCKOJlbKHX cepbC~3HblX np06J1eM ynpaBJIeHIDl B
ceKTope 3,1lpaBOoxpaHeHIDl Y36eKHCTaHa. CfO,lla MO)l(HO OTHeCTH He<j:lopMaJIbHble nnaTe)KH, H
,llOnOJlHHTem,HYJO pa60ry H3-3a HH3KOH 3apa60THoH nnaTbl,                           He,1l0CTarotfHOe <j:lHHaHCHpOBaHHe
TeKymHX paCXO,llOB H 3aTpaT Ha 06cJJY)KHBaHHe, a TaIOKe <j:lHJlYUHapHbIe pHCKH.                                  3TH      Bonpocbl
paccMaTpHBafOTC$I B HIDKecJle,llyfOmHX pa3,lleJlax.



HH:undi yposeHb OllJl8Tbi Tpytl8

3.14          npJRHHe He,1lOCTaTOtfHOCTH pecypcoB, BbI,lleJlJieMblX Ha I1MCn, 3apa6OTHWI WIaTa
Me,1lpa60THHKOB B Y36eKHCTaHe OCTaeTCJI HH3KOH. HecMOTp$l Ha ee "HeO,llHoKpaTHOe nOBblmeHHe
                       B       2006   L,     ee   npHpoCT    OCTaeTCSI     He,1l0CTarotfHbIM,                        06eCnetfHTb
npO)l(HTOtfHblH MHHHMyM. COrJlaCHO                OKIIY     O<j:lHUHaJIbHWI 3apa60THWI WIaTa Me,1lpa60THHKOB B
cpe,llHeM nOKpblBaeT TOJlbKO          30-40% HX e)f{erO,1lHblX paCXO,1l0B Ha npo:IKHBaHHe. Hx ,llOXO,ll, ,ll8)f{e
BKJlfO'IWi   npeMHH        B    pa3Mepe   15% MeC$ltfHoro OKJIa,lla, Bce paSHO He ,llOCTaTOtfeH WHI
MaTepHaJIbHOrO ofieC]rle',efIIDi ceMbH.




                                                             21 

3.15      OC03H3BWI .n3HHhIH CP3KT, llP3BHTeJIbCTBO Bseno <l>OH}lbI pa3BHTH9 B                                       1999   r. KIDK}loM)'
Me.nHUHHcK0M)' yqpe)KJleHHIO 6bInO pa3pemeHo OTKPblB3Tb TaKHe <l>OH}lbl, H3 KOToporo OHH
MornH 6bI CPHH3HCHPOB3Tb paCXOJlbI Ha 3KcnnyaTaumo H TeXHlflIecKoe 06cJIYlKHBaHHe. B                                                  2006
ro.llY   6hInO    BBe.neHO nOnO)l(eHHe,                                comacHO   KOTOPOM)'     MeJlY'lpe)KJleHH9M     npe.nmlCblBMOCb
                 .no                              <l>OH}la Ha                                CTHM)'nHpOBaHHe                    C uenblO
nOBblmeHH9         UX      MOTHBaUHH                    H        MOPMbHOro         .llYXa.    TaKHe      BbinnaThI   MOryr    BKnlOqaTh
e)l(eMeC9qHbie         Ha.n6aBKH                B         npOueHTHOM             COOTHomeHHH           K    6a30BOM)'     OKna.ll}'   HnH
e.nHHOBpeMeHHYID npeMHIO B pa3Mepe .no MeCaqHorO OKna.na.


3.16      COTPy.nHHKH OTHOCHTenbHO KpynHblX yqpe)KJleHHH nonyqHnH                                                     Bblro.n OT TaKOro
po.na noompeHHH H3 cI>oH}la Pa3BHTH9, nocKonbKY HMeHHO KpynHble yqpe)KJleHH9 nonyqalOT
60nbme nocrynneHHH H3 .npyrHX HCTOqHHKOB B CBOH <l>OH}lbJ. .D;n9 MMblX yqpe)KJleHHH, TaKHX
KaK CBll, npeMHH H HMHlIHbIe nocrynneHH9 OCTalOTCli He60nbWHMH B .neHe)l(HOM BbIpIDKeHHH,
HO     Hocn 60nee          CHMBOnHqeCKHH                           xapaKTep,     nOCKonbKY OHH           nOBblwalOT MOPMbHhlH .llYX
nepcOHMa H                        .nOKa3aTenbCTBOM npIDHaHH9 UX xopoweH pa60ThI. C06ece.nosaHHlI C
PYKOBo.nHTenllMH CBll, npOBe.neHHble B paMKax OKTIY, nOKa3MH, "ITO TaKOe
C03.naeT npeCTH:>K Me.npa6OTHHKaM, oco6eHHO ecnH peweHHe BbI.naTh npeMHIO 06cy)KJlaeTc}I H
06'bllBn}leTC9


3.17      HH3KWI 3ap360THWI nnatl Me.npa6OTHHKoB HMeeT Her3THBHOe BnH}lHHe H3 cHCTeM)'
ynp3BneHH9, nocKonbKY pa60THHKH BbIHy)KJleHbl npH6er3Tb K                                                                    cTP3TerH}lM
peWeHH9 np06neMbi HH3KOH onnaTbI TPy.na. 3TH CTP3TerHH B3pbHpyroTC}I OT nOnbITOK .n06HTbC9
HeocpHUHMbHblX .nOXO.nOB H3 pa60Te (B                                                             nyreM TPe60SaHH9 OT naUHeHTOB
HecpopMMbHOH onn3Tbi HX ycnyr) .nO BOBneQeHH9 B .npyrHe .nOxo.nHble BHJlbl .nenenbHOCTH,
TaKHe KaK HO"fHble .ne:>KYpCTBa Ha CTaHUH9X CKOPOH nOMomH HnH PO.nHnbHbIX .nOMax, pa60Ta B
q3CTHblX KnHHHKax HnH H3 c06CTBeHHblX npHYca.ne6HblX                                                         C uenblO nocne.nyromeH
peMH3aUHH Bblpam.eHHoH np0.llYKUHH.


3.18      HH3KHH ypoBeHb 33P360THOH nn3Tbl nOBbIW3eT BepO}lTHOCTh TOro, "ITO Me.nnepcoHM
MO)l(eT TPe60B3Tb           HecpopMMbHbIX nn3Te)l(eH y                              n3UHeHTOB         3a ycnyrH,     KOTopble .nOn:>KHbI
npe.nOCTaBnfibC}I 6ecnn3THo.                                                          nnaTe)l(H MOryr ocymeCTBn}lTbC}I                   B
.neHe:>KHOH cpopMe, nH60 B BHJle no.napKoB (KOTOpble TPy.nHo .n0KYMeHTHpOB3Th). O.nHaKO
Hccne.nOBaHH9, npoBe.neHHble B CB}l3H C H3CTO}lmHM OT"feTOM, Bbl9BHnH WHPOKHH cneK1"p
06CTOHTenbCTB, npH KOTOPblX naUHeHThI .naBanH no.napKH (B H3TYPMbHOM BHJle HnH B .neHe:>KHOH
cpopMe) nOCTaBIUHKaM                              B KaqeCTBe .n06poBonbHoro BblpIDKeHH9 6naro.napHocTH HnH )l(e
nnaTHnH 3a MaTepHMhl HnH yCnyrH 6e3 BbmaqH K8HTaHUHH. HHcpopMaUH9 06 OTHOCHTenhHOM
sece     no.n06HbIX       no.napKOB               H        nnaTe)l(eH        B   06IUHX      .noxo.nax     Me.nHUHHCKHX      pa60THHKOB
OTCYTCTBYeT.


3.19      ,lJ;ononHHTenbHbTe BHJlbl .nenenbHOCTH, KOTOPhIMH 3aHHMalOTCH Me.npa6OTHHKH C uenblO
nOBblWeHH}I CBOHX .nOXO.nOB, 3aqaCTyIO HlMaThIBaIOT HX H BnHHIOT Ha HX TPy.nocnoc06HOCTb. Y
HUX OCTaeTCH MeHbme JJ.onOnHHTenbHOrO BpeMeHH, "IT06bl 3aHHMaTbCH caMo06pa3oBaHHeM H
npocpeccHoHMbHblM pa3BHTHeM. B pe3ynbT3Te, cTPa.n3eT K3QeCTBO ycnyr 3JJ.P3BooXp3HeHH}!, TaK
KaK MeJJ.nepcoHM                                YCTaeT H He B COCTOHHHH COBepweHCTBOB3Tb CBOH HaBbIKH. KpoMe
Toro, ecnH B MeJlY'lpe)KJleHH9X OTCYTCTBYeT 60nbwoe KOnHQeCTBO pa60THHKoB B TeQeHHe
pa60Qero     BpeMeHH,           nbITaJlCb              nOJJ.3apa60TaTh H3             CTopOHe,     3TH     yqpe)KJleHH9
                 Ih<oIt"r,u!u"I"It....   (',""'''''''...........'1..   CBOH p360QHe QaCbJ, TeM CaMblM, Orp3H1fl1HB JJ.OCTY" K
                        YQaCTHHKH                  06cy)KJleHHH cpoKYc-rpynn,                   npOBOJJ.HBmUXCH       JJ.J1}1 HaCTOHmero
OTlIeTa, nOJJ.TBepJJ.HnH, liTO BblweonHcaHHoe npoHcxoJJ.HT Ha C3MOM JJ.ene.
HeaaeKS8THoe ClmH8HCHpOS8HHe p8CXO~OB H8 3KCllJl)'8T8QHIO II TeXHH'IeCKOe




3.20      CBn, QerrrpaJIbHbIe PaHOHHble 60JIbHHQbI H nOJIHKJlHHHKH Tpa.QHQHOHHO CTaJIKHBaIOTC$I
C   He.QOCTaTOqHbIM         tPHHaHCHpOBaHHeM          CBOHX    TeK)'lllHX     pacxo.QoB    (fpynna       4)   H    HOBbfX
KamUaJIbHblX BJIO)KeHHH. ECJIH                           tPHHoT.QeJIbI Bbl.QemnOT 3THM                            MeHbwe
YTBep)KJ.leHHoro      06'heMa 61OJ.l)KeTa, yqpe)KJ.leHHll          BbI"Y)KJ.leHbI    B   nepBYIO Oqepe.Qb pewaTh
Bonpocbl, CB1l3aHHbie C                         nJIaTOH H BblnJIaTaMH, a He C TeKYlllHMH H KanHTaJIbHblMH
paCXO.QaMH. no CYTH, fpynna 4 tPaKTHqeCKH llBJIl1eTCl1 OCTaTOqHOH CYMMOH B 3THX 61OJ.l)KeTax,
KOTOpaH onpe.QemleTCl1 TOJIbKO nocne nOKpbITHl1 BceX 06l13aTeJIbHb(X pacxo.QoB. B                                       B
qaCTHOCTH, Ha pacxo.Qbl fpynnbl             4   npHXo.QHTCl1 Bcero JIHWb         10% OT HX rO.QOBb(X 61OJ.l)KeTOB
(He BKJllOqaH <i>OH.Q Pa3BHTHll).


3.21      B    Ta6JIHue      3.6   npHBO.QMTCl1       TA6JlHUA 111.3: )l.OJUI SIOJljKETA CDD, BLI)lEJlEHHOro
paCXO.QOBaHHe cpe.QcTB BceMH                     B
<i>epraHcKoH 06JIaCTH B TeqeHHe 2006                     PACXOJU>llPynlThl           JiIOJljKET      CIlOH.Q PA1BHTWf
tPHHaHcoBoro       rO.Q8.     qeTBePTb      Bcex               IV

CBn HCnOJIb30BaJIH MeHee                   CBOHX
perymtpHbJX       61OJ.l)KeTOB     no    CTaTbl1M
                                                      5%-10%                                                       37
fpynnb( 4, a              n0Tp8THJIH MeHee
                                                      10%-15%                                                      26
10%.      11     Ha06opoT,                            15%-20%                                                      16
n0Tp8THJIH       60JIee      15%        peCypCOB      20%-25%                                                      8
CBOHX tPOH.QOB pa3BHTHl1 H8 D8(~XO!.Qbl               250/0-30%                                                    3
fpynnbl 4,8 OCT8BWHeCll CBn - MeHee                                                                                5
15%.                                                  HYDrO
                                                                   MliHHCfEPCTBO <t>HHAHCOB, PY3.


          npoBO.QHTb        nOJIHblH     8HaJIH3               p8CXO.QOB,     Heo6xo.QHMoro         H8   TeXHHl.leCKOe
06CJIy)KHBaHHe CBn, ITpe.QCTaBJIl1eTCl1 HeueJIeco06pa3HblM, no nOH npHqHHe Mbl onpe.QeJIHJIH
              P8CXO.QOB Ha TeXHHqeCKOe                                HCXO.Ql1 H3 .QaHHblx,                             B
KOHCOJIH.QHpOBaHHoM tPHHaHcoBoM OT'Iere CBn H nO.QrOTOBJIeHHblX tPHH8HCOBbiM ynpaBJIeHHeM
<i>epraHcKoH       06JI8CTH        3a   2004     r.   (Ta6JIHua       3.7).    ComaCHO       npe.QnOJIO)KeHHl1M         B
                            Ta6JIHUe,     e)Kero.QHble    P8CXO.Qb1    CBn      Ha   peMOHT       COCT8BJIl11OT     3.6%
CTOHMOCTH Bcex 3.QaHHH H 060pY.QoBaHHl1. 3TOT nOKa3aTeJIb OTHOCHTeJIbHO HHJOK CT8H.QapTHOH
          aMOPTH3alUiH Ha Bce THnbl                        B pa3Mepe OT 5% .QO 10%, T.e. HOPM, KOTopble
OTpIDKaJIH 6bl 20- H 10-JIeTHHe CpOKH cJIy)K6b1 (cOOTBeTCTBeHHo) .QJIH ynoMl1HyrbIX 3,naHHH.
O.QH8KO           HaJIHqHH                      KOJIHqeCTBa OCHOBHbfX cpe.QcTB, Tpe6Y10111HX peMOHTa H
TeXHHqeCKoro 06cJIy)KHBaHHl1, qeM npe.QCTaBJIeHO B pacqeTax; .QaHHbIH npoueHT 6b1JI 6bI
COpa3MepHO YMeHbweH.




                                                            23 

               Ta6J1HQ3    3.7:    nOTpe6HoCTH Ha e~erO.llHOe TeXHH"IeCKOe 06CJ1Y~HBaHHe eBn



                       CTATbJl


                       BCEro OCHOBHbIX CPE,QCTB HA KOHEL< 2005                                   7 .7 MIlPIl

                       npE,QnOllOlIMTEIlbHO 80     % OTHOCRTCR K 3,llAHI1RM 11 060PYIlOBAHI1IO 6 .2 MIlPIl
                       61O,WKETHOE PACXOAOBAHIo1E
                       rollOBblE PAcxollbl HA TEK.PEMOHT 3A 2005                               85.4 MnH
                       20% /lP.PACXOIlOB HA TO. PEMOHT 11 npO'lEE                              16.6 MnH
                       3ATPATbl (.20' 82.8)

                       PACXOllbi   cI>OHJlA PA3BI1TI1R
                       TEKYUlI1H PEMOHT                                                       115.5 MIlH

                       20% np0411X PACXOIlOB HA TO (0.20' 37.5)                                 7 .5 MIlH

                       BCEro HA PEMOHT 11 TO                                                      225
                       rOIlOBblE PACXOIlbi HA PEMOHT B % OT CTOI1MOTCTI1                        3.6%
                       060PY/lOBAHI1R 11 3,llAHI1H




PaCXO.llbl Ha Japa60THyIO nJlaTY H +H.llYQHapHble PHCKH


3.23       B 0630pe rocy.napCTBeHHblX pacxo.noB Y36eKHcTaHa, npoBe.neHHoM BceMHpHblH 6aHKoM
B 2006     r., Bblp!l)l(aJIaCb 03a60qeHHOCTh no nOBO.ny Toro, 'ITO B03MO)I(H0 pacxo.nbl Ha nepCOHaJI
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CBn H nOJIHKJIHHHK B CaMapKaH.l{CKOH H <I>epraHCKOH 06JIaCTJlX YKalblBalOT Ha TO, "ITO pacxo.nbi
Ha nepCOHaJI COCTaBJIJlIOT             80-90%            TeJ<YI.UHX paCXO.nOB 60JIbmHHCTBa Me.nyqpe)K.l{eHHH. J-rOT
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no.nTBep)K.l{aeT,    'ITO CBn HaxO,l{JlTCJI                 no.n 60JIbmHM           q,HHaHCOBbIM .naBJIeHHeM, qeM 60JIee
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3.24       OqeBH.l{HO, 'ITO OT.neJIbHble yqpe)K.l{eHHJI caMH no ce6e He B COCTOJlHHH KOH-rpOJIHpOBaTb
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npoq,C01030B Ha YSOJIbHeHHe H npHHJlTHe .npyrnx. Mep B OTIlOmeHHH nepCOHaJIa,                                                TaK)f(e KaK H
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21 Cpe.llCTBa 3apa60THoA nnaTbl BbllleJlj[IOTCJI H nepe.llaJOTCJI Y'lpeJlC.lleHHJlM Ha OCHOBaHHH WTaTHblX HOPMaTHBOB, a He
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nOn}"laTb MeHbwe 61O.ll)f(eTHblX aCCHnfOBaHHA.


                                                                     24 

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                                           C. BbIBOJ.{b1 II PEKOMEH)J.AUHH

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B03MOIKHOCTH yqpe)KJJ.eHHH 3}:{paBooxpaHeHIDI npe}:{OCTaBJIHTb Ka'lecTBeHHble ycnyrH.


3.27      CymecTBYeT He06xo}:{HMOCTh                       nOMeplKaHH.sI           B                   yqpe)l(JleHHH }:{eJlHKaTHOro
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llJIaTHblX ycnyr H He HMeJOT npaKTH'IeCKH HHKaKHX }:{pyrHX HCTO'lHHKOB KpOMe 6JO)l)KeTa. B
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pa3Mep                     llJIaThI, HBJIJlIOlUHHCJI OTC'IeTHOH TO'lI(OH B TaPH$HOH CeTKe.                                                3TOM
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3.28      HH3KHH        ypoBeHb       $HHaHcHpoBaHIDI                 ceKTopa          3}:{pasooxpaHeHHJI,             B    qaCTHOCTH         ero
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22 CVlllle(:TB'1lOT I1JlaHM 110 Ime,npeHHIO 3JlelCTpOHHWX nJiaTelKeR HS ,ne6eToBLle KapTLl, npHIUI3SHHLle K OaHKOBCKHM
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                                                                     25 

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3.29     CyruecTBYeT    .nBa   BapHaHTa    )'BenH1.feHIDI        peCypCOB       Ha   nepBH1.fHoe    3BeHO
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                                                26 

                 IV. YIIPABJlEHHE 4»HHAHCAMH II                                             3AKYDOK

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BTOPblM KJII01.feBbIM aCneKTOM Ha.n.ne:>Kalllero ynpaBJIeHHS SBJISeTCS SCHOeTb H OTKPblTOCTb B
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          3a nOCJIe.n.Hee .n.ecSTHJIeTHe .n.OHopaMH, B napTHepcTBe C npaBHTeJIbCTBOM Y36eKHCTaHa,
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                                23
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           24
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                                 25

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23 3TH HCCJIe,ll,OBaHHS BKJOO'laJIH Ouem<y CHCTeMl.I <i>HHSHCOBOA 1l011OT'leTHOCTH (BceMHpHLlA 6am<:, 2004), 

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2$ Ha caATe Mel> 6l.1JIH ony6J1HKOaaHbI srpempoBaHHble napaMeTpl.l                         Ha 2003·2006

                                                            27 

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                             A. ynPABJIEHHE B CUCTEME 3.l1.PABOOXPAHEHIUI


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4.7       npH     TaKOM     nOJIO)KeHHH        BemeH     B03HHKaeT           PaJPblB        Me)l(JJ.y    cpHHaHcHpoBaHHeM            H
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co CTOPOHbI paMJ.llP8BOB H era Me.llHUHHCKHX CneQHaJIHCTOB. C CPHH8HCOBOH CTOPOHbI CBn
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ocymeCTBJIJleTcJI P8HOHHbiM KoopJl,HHaTOpoM CBn. no HCnOJIHeHHIO                                                    KaK 06JIaCTHOH
cpHHaHCOBbJH OT.lleJI, TaK H paHOHHbJH OT.lleJI KaJHa'leHCTBa npHBJIeKaIOTCH .llJlJI BbInOJIHeHHJI
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YCJIO)KHeHHOH H KocBeHHoH, H HHKOHM 06paJOM He CBJl3aHHOH C uenO'lKOH OTlJeTHOCTH 0
pe3YJIbTaTax CBoeH Henocpe.llCTBeHHOH .lle.llTeJIbHOCTH.


4.8              MHorO'lHCJIeHHLle uenO'lKH KOHTpOJl.ll H ynpaBJIeHH.II He cnOC06CTBYIOT 60JIbWeH
nO.llOTlfeTHOCTH. nepeXO.ll CBn Ha HX HOBYIO, MO.lleJIb cpHHaHCHpoBaHml He conpOBo)KJl,aJICJI
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CPYHKUHH H8.ll30pa.         npaBHTeJIbCTBY        He06xo.llHMO 06eCne'lHTb                  ry    CHTYaUHIO,         npH     KOTOpoH
Ha.u30pHbIe      MexaHH3Mbl      H8.ll   pe3YJIbTaTaMH          .lle.llTeJIbHOCTH      H      cpHHaHCHpoBaHHeM               BJaHMHO
YCWIHBalOT .llpyr              H Bee Me.llHQHHCKHe yqpe)I(JJ.eHHJI MOryr 6bITb nO.llOTBeTCTBeHHbJMH 3a
Bce HanpaBJIeHHJI MeJl,HUHHCKHX YCnyf, KOTopbIe OHH npe.llOCTaBJI.lllOT.




                                                            28
 4.9         B   COOTBeTCTBHH         C    npOIllJlhJM                            KaK                                          IUIaHoBoH
 3KOHOMHKH,          !pOpMyJIHpoBaHHe              crpaTerH"'leCKoro            BH)l.eHIDI            H        C-rpYKTYpbI       ceKTOpa
                                                                                             26
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 npHOpHTeTHOCTH !pHHaHcHpOBaHHlI B paMKRX 06III.HX paCxo,llOB HRXO,llHTClI B ueHTPanhHoro
 npaBHTeJIbCTBa.       MHH!pHH       H    MHH3,1lpaB BIUIOTH)'IO 3aHHMalOTCJI                                               nOJIHTHKH     B
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 orpaHH"IeHHblM.       B     TPaJ].HUHOHHOM UHKJIe nOJ].rOTOBKH 61OJl:IKeTa MHHHcTepcTBO <I>HHaHCOB
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                                                                            27
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                                                         28
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 J].eJlTeJIbHOCTM CBOHX yqpe:lKJ].eHHH, H3MeplleMOH nOKa3aTeJIlIMH 3J].OPOBbJl HaCeJIeHH.II.




,26   3TO 06me!1pHRllThIt\   nOJU{O}l B COBeTCKOA MO}leJIH rocynpaBJIeHIDI H !1pHMeIDICTCJl K
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27 OnHcaHO B World       2003
28 OHO TalOke tPHHaHCHpyeT CCTb                  HaUHOHaJIbHOrO UeHTpR HeOTJIo)KHot\ MeJlHUHHcKoit nOMOIUH,
CneUHaJIHlHpOB8HHLle ueHTpbl TpeTH'lHOro 3seHa, R TaK)Ke Y'lpe)K}leHH1I peCny6JIHK8HCKOro ypOBIDI.

                                                              29 

IIon~HU:HaJI 9HHaHCOBOrO ynpaBJJeHHH II KOBTPOJlb B~ OneTBOCTblO


4.12       Me.nHUHHcKHe             )"-IpeiK.ll:eHIDI    (CBfI    H     ceMeHHble           nOJlHKJIHHHKH),            KOTopble         6blJlH
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                                                                                                           EAHK,
                                                                         2007.




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                                                                  30 

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                                                                                 31 

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KaK npe,[(BapHTeJlbHblH KOHTPOJlb pacxoAoB CBn OrpaHHlIHT caMOCTO.!ITeJlhHOCTh CBn, H                                  (ii) KaK
KOHCOJlHAaUIDI                                CpeACTB, BKJIIOqM <bOHAhl Pa3BHTIDI, B eAHHblH Ka3HalIeHCKHH
ClieT MO:JKeT COKpaTHTb mfiKoCTh CBn B paCXOAOBaHHH cpeACTB <boHAa pa3BHTIDI. Pe<popMa
Ka3HalIeHCTBa          paUHOHaJIH3HpYeT           <pyHKUHH          Ka3HalIeHCTBa,          cOBepmeHCTBYeT           K8CCOBoe
nJIaHHpOBaHHe H ynpaBJleHHe nocpeACTBoM Ofi'LeAHHeHIDI Bcex ClieTOB Ka3HalIeHCTBa, BKJ1lOlIM
                           cpeACTBa,     yxpenmleT       KaccoBYIO       AHCUHnJIHHy,             <pHHaHCOBhIH      KOH1'pOJlb,
filOA)KeTHblH MOHHTopHHr H yqeT. O)KfIAaeTClI, liTO AaHHbIe Mephl nOBblClIT np03paliHocTb H
nOAOTlIeTHOCTh         ynpaBlleHIDI       rocYA8pCTBeHHhIMH             <pHH8HcaMH          H    nOBhIClIT     3<p<peKTHBHOCTh
HCnOJlb30BaHIDI pecypcoB.




          EIOA)KeT ceKTopa 3ApaBooxpaHeHIDI Y 3fieKHCTBHa COCTOHT H3                                         KOMnOHeHTOB -
OfibllIHblH filOA)KeT H BHe61OA)KeTHble CqeTa. 06hIqHblH 61OA)KeT COCTOHT H3 06bP1HOro nJIaHa
ClieTOB, KaK All.!!: nOAroToBKH, TaK H All.!!: HCnOJlHeHIDI 61OA)KeTa. PaCXO.!l.b1 perHCTPHpYIOTC.!!: no
<PYHKUIDlM     (TaKHM        KaK   3AP8BooxpaHeHHe            rum    06pa30BaHHe),          OpraHIDaUMJIM         (TaKHM      KaK
MHHHC"rePCTBO 3ApaBooxpaHeHIDI, onpeAeneHHM 06JlacTh HJlH onpeAeJleHHOe CBn), HJlH )Ke no
3KOHOMHlIeCKOH KJ1aCCH<pHKaUHH (TaKOH KaK 3apa6OTHM nnaTa HJlH pacxOA Ha KOMMyHaJIhHhIe
ycnym).


4.22      nOCJle oAofipeHIDI napJlaMeHTOM arpempOBaHHOrO 61OA)KeTa All.!!: Bcere npaBHTeJlhCTBa,
KIDK;laJI 6fO,wKeTHaJI opraHH3aUIDI npe.n;CTaBJUleT <pHHaHcoBbIM OpraH8M                                     pacxoAoB (AaJIee
CMeTa) Ha 0.n;06peHHe. CMeTa npeACTBBJllIeT c060n AeTaJIhHoe                                     pacnpeAeJleHHe CpeACTB a
COOTBeTCTBHH           C    KJ1aCcH<pHKaUHeH          npaBHTeJlhCTBa.       COTPYAHHKH              <pHHaHcoBhIX      oprauOB
HCnOJlb3YIOT yTBep)KAeHHhIe CMeThI B ueJl.HX 06eCneqeHHlI Toro, liT06hI KIDK.llaB 3aBBKa Ha
nonyqeHHe CpeACTB H3 mo60H 61OA)KeTHOH OpraHIDaUHH 6hIJla                                                        a TaK)Ke A.lUI
o6ecnelieHIDI AOCTBTOlIHbIX cpeACTB AlllI                  nOKpblTHlI pacxoAoB, nOAp06HO pacnHcaHHblX B
CMeTax.


4.23      BTOphIM KOMnOHeHTOM 61OA)KeTa ceKTopa 3ApaBooxpaHeHHlI .!IBJllIlOTCH BHe6IOA)KeTHble
cpeACTBa HllH <bOHAbI Pa3BHTIDI, KOTophIe MO:JKeT C03AaTh mo60e yqpe)KAeHHe AllH YBeJlHlIeHHlI
cpeACTB       Ha   <pHHaHCHpOBaHHe             onpeAeJleHHhlX        aCneKTOB      caoon          AelITeJlbHOCTH.    BnepBble
napJlaMeHT yrBepAIDI C03AaHHe AaHHhlX <pOHAOB B                          1999   r. A)Ul TOro, liT06hI npeAOCTBBHTh
61OA)KeTHblM opr8HH3aUMJIM 60JlhmyIO cBo60AY AeHcTBHH B YCJlOBIDIX :JKeCTKoro KOH1'pOJl.!l
pacxoAoB co CTOPOHbI <pHH8HCOBbIX opr8HoB,                          a   ~K)Ke HeKOTopoH CTeneHH                                 B
pacxoAoBaHHH CBOHX CpeACTB (BceMHpHbIH 6aHK,                             2004 r.).     TaKHM 06pa3oM, 61OA)KeTHbIe
opraHH3aUHH nOJIyqaJIH MaKCHMYM rH6KocTH npH pacnpeAeJleHHH OCTaTKOB Ha CqeTax <boHAa
pa3BHTHH AO TeX nop, nOKa OHH CJIeAOBaJIH BceM npeAnHCaHHblM npHOpHTeTaM MHHHCTepCTBa.
4.24       KaK:no            06CY»<:lJ.aeTCR    B   fJIaBe       III,   )l8HHhIe      $OH)lbl       pa3BHTIDI     B     OCHOBHOM
Q>HHaHCHpYJOTCB 3a Cl.feT 5%, Bbl)leJIjleMblX H3 o6mero rO)lOBoro                                                 nmoc mo6oH
HeHCnOJIb30BaHHbfH OCTaTOK Cpe)lCTB OCHOBHoro 61OJl)KeT8 yqpe:lK,ll.eHIDI H8 KOHeu Ka:lK)].OrO
KBapTaJI8.

4.25       B )leKa6pe 2005 ro.lIa Ka6HHeT yrBep)lHJI nOCTaHOBJ1eHHe, B COOTBeTCTBHH C KOTOPblM
paCIllHpJIJIOCb           HCn0J1b30BaHHe       )l8HHblX    $OH)lOB          pa3BHTHJI    .llJ1li   nOKpblTHB      P8CXO)lOB     Ha
MaTepHaJIbHOe             CTHM)'J1HpoBaHHe       MC)lHUHHCKHX           H    Q>apMaueBTHl.feCKHX         p86oTHHKOB.        lJ,CJ1b
3al<JllOl.faJI8Cb B nOBblllleHHH onnaTbl                       Me)lHUHHCKHM H Q>apMaueBTHl.fCCKHM pa6OTHHK8M C
UeJIblO npH3HaHHJI pe3YJ1bT8THBHOCTH HX pa60ThI H npe)lOCT8BJ1CHHli 60J1b1llHX CTHM)'J10B                                     .llJ111
nOBblllleHHJI KBaJIHQ>HK8UHH H aTTeCTaUHH. Bee 3TH Mepbl 6y.llYT                                                   nOBblllleHHIO
Ka'leCTB8 H HCnpCPblBHOCTH B npe)lOCTaBneHHH Me)lHUHHCKHX ycnyr.

4.26       P8CXO)lOB8HHJI H3 Q>OH)lOB «MaTepHaJIbHoro nOOlUpeHHJI» )lon)KHbI npH.llepJKHBaTbCli
onpe)leneHHblX                            Bo~nepBblx, Heo6xo)lHMO Hcnonb30B8Tb onpe)leneHHblH npoueHT
Ha M8TepHaJIbHOe CTHM)'nHpoB8HHe Me)lHUHHCKHX p86OTHHKOB, nocne tJero yqpe:lK,ll.eHHe MOJKeT
Hcnonb30B8Tb Cpe)lcTB8 MHHblX Q>OH)lOB Ha norallleHHe 3a)lOIDKeHHOCTeH H Q>HHaHcHpoBaHHe
paCXO)lOB Ha 3KcnnyaTauHIO H 06cnyJKHBaHHe tJeTBePTOH rpynnbl paCXO)lOB.

           ,l{aHHble $OH.llb1 CblrpaJIH Ba)KH}'IO pOJ1b B MOTHBauHH Me)lHUHHCKHX pa6oTHHKOB Ha
Ka:lK)].OM ypoBHe CHCTeMbI 3)lpaBOOXpaHeHHJI, 'fTO O'leBH.llHO H3 OTBeTOB, KOTopbre MbI nonyqHJIH
B XO)le yrny6neHHbIx HHTepBblO C nOCTaBmHKaMH ycnyr H B XO)le 06cY»<:lJ.eHHH B Q>OKyc~
rpynnax, npOBe)leHHblX.1VUi )laHHOrO OTtJeTa (CM.                             VI).


HCnOJlHeHHe 61O)VKeT3 II KOllTPOJIb


4.28       CTPYKTYPa BHYfpeHHero KOHrpOJ1li, YCTaHOBJ1eHmUI 3aKoHoM 0 61OJl)KeTHOH CHCTeMe
2000r.      (3EC)         onpe)leJUleT   OTBeTCTBeHHOCTb           Bcex      CTOPOH      H   npoueccbl      npH       nO)lrOTOBKe,
yrBep:lK,ll.eHHH,         HcnonHCHHH,       OTtJeTe       06    HCnOJ1HCHHH          H   KOHrpOJ1e       Ha)l     HCnOJ1HeHHCM
rocY)lapCTBeHHOro 61OJl)KeTa. (BceMHpHblH 6aHK, 2002a).

4.29       KOHTpoJ1b           Ha)l      HCnOJIHeHHeM           61OJl)KeTa       npe,nCTaBJ1J1eT         C060H         CO'leTaHHe
npe)lBapHTenbHOrO H Q>aKTH'IeCKOrO                                B ceKTOpe                                 npe)lBapHTenbHbIH
KOHrponb B03naraeTCJI Ha Q>HHaHcoBbIX KOHrponepoB MHHQ>HHa, HaxO.llJllUHXCJI B Q>HHaHcoBblX
OT,neneHHJlX paHoHoB,             o6nacTeH H        B ueUTpaJIbHblX opraHH3aUHJIx.                    OHH   YTBep)K.llalOT Bce
paCXO)lbl, y,nocToBepHBIllHcb B HaJIH'IHH )lOCTaTO'lHhlX cpe,nCTB B nO)lCTaThe CMeTbl Ha nOKphITHe
....'..'AU'A<:l, H 'fTO                    paCXO.llOB8HHe He BbIXO.llHT 38 paMKH                                yY'Bep»<.ZleHHOrO
napnaMeHTOM. nOCJ1e o,n06peHHJI KOUTpOJIepa yqpe:lK,ll.CHHe MO.IKeT ocymeCTBJlJlTb nOKynKy HJIH
nO)lnHCblB8Tb KOUTpaKT. no nonyqeHHH TOBapOB H                                       KOUTpOJ1ep                        B TOM, 'fTO
nonyqeHHble TOB8pbl              COOTBeTCTBYJOT 3aKa3aHHbIM, H, eCJ1H                    Bce y,nOBJIeTBOPJieT ero, )laeT
Pa3PCIllCHHC H8                           nnaTe.lKa.

4.30       ,l{aHHbIC       MexaHH3Mbl      KOUTpOJIJI     HCnOJ1HeHHJI         61OJl)KeT8     06ecne'lHB81OT yqpe:lK,ll.eHHJI
HeKOTOpoH CTeneHblO rH6KOCTH. Me)lHUHHCKOe yqpC)K.lleHHC MOJKeT ncpep8cnpe,neJIJiTh )lO                                          IS
npOUCHTOB pecypcoB MeJK,ny OCHOBHblMH CT8ThJlMH paCxO)lOB (3ap86oTHM nnara, HaJIOrn C
3apa6OTHoH          nnaThI,      KOMM)'HaJIbHble        yCnyrH,         npHo6peTeHHe           K8nHTaJIbHbIX       peCYPCOB       H
o60PY)lOBaHHJI, peMOHT, 3KCnny8TaUHJI H TeX06cJIY.lKH8aJIHC) 06mero YTBep)K.lleHHOrO 61OJl)KeTa
,naHHoro yqpe:lK,ll.CHHJI. HanpHMcp, OHH MOryr                                                     cpe,nCTB8 C nO)lCTaThH H8
3neKTpo3HeprHH H8 no,nCTaThIO ra3. O,nHaKO OnpOCbl, npOBe)leHHbIC HaMH C P)'KOBO)lHTeJ1J1MH
CBn H nOJ1HKJIHHHK, )'Ka3bIBaIOT H8 TO, 'fTO 60nblllHHCTBO H3 HHX, nO-BH.llHM0M)', HC nOHHM8eT,
'ITO HMCIOT Ha :no npaso.




                                                                 33 

4.31        Bo BpCMH npOBcJlCHHH JlaHHorO HccnCJlOBaHHSl, KOHTpOJIb Hall C"IeTaMH <l)oH,lla pa3BHTHR
6blIl MeHeC )KeCTKHM, qeM Hall CqeTaMH                                  61OJl)KeTa. OJlHaKO npaBHTeJIbCTBO H}.leT K
TOMY, ")T06b) KOHCOJIH}.lHpoBaTb BCe BHe61OJl)KeTHble CqeTa pa3BHTHSl B OCHOBHOH 61OJl)KeT C
ueJIblO nOBbIWeHHSl 3cpcpeKTHBHOCTH paCnpeJleJIeHHSl CpeJlCTB H COKpamCHl-HI CPHJ{)'UHaPHOro
PHCKa,      KOTOPblH        MO)KeT B03HHKHYI'b          H3-3a                     npCJlBapHTCJIbHOrO      KOHTpOJIH      Hall
,[(aHHbIMH         paCXO,[(aMH.             paCWHpHT         06JIacTh      OXBaTa      npeJlBapHTeJIbHOrO         KOHTPOJIR
MHHHCTepCTBa $HHaHCOB Ha Cpe,[(CTBa <l)OHJlOB pa3BHTHSl. ECJIH JlaHHOe                                             HC 6YJleT
TlUaTeJIbHO        OpraHH30BaHO,       OHO      MO)KeT 3HaqHTeJIbHO          OrpaHIf'IHTb       cpHHaHCOBYID      rH6KOCTb,
npeJlOCTaBJIeHHyw CBn B                         pe$OpMbI CeKTOpa 3JlpaBOOXpaHeHHSl.

4.32        CymecTBYeT ,[(Be CPOPMbl KOHTpOJIH no cpaKTy                      3TO BHYTPeHHHH ay,[(HT H
            B   Y36eKHcTaHe cymecTBYIDT 06e 3TH CPOPMbl, OJlHaKO HM He06xo'[(HMO JlaJIbHeHWee
COBepweHCTBOBaHHe It YKpenneHHe: MepOnpHRTHH no BHYTPeHHeMY                                               B   Y30eIKH~;;Tl:IHe
ocymeCTBJIRIOTCR KOHTpOJIbHO • PCBH3HOHHblM ynpasJIeHHCM (KPY) MHHHCTepCTBa $HHaHCOB,
OJlHaKO OHH                                B OCHOBHOM, npoBepKaMH Ha npeJlMeT COOTBeTCTBIDI. TIpoBepKa
$HHaHCOBbIX onepaUHH (KaK nOCTYnJIeHHH, TaK H paCXOJlOB), npOBO,[(HTCH B UCJI.liX 06eCneqeHHH
C06mOJleHHSl          Bcex    TPe60BaHHH,         KacaIOmHXCH          Ha,wIe)Kamero      HCnOJIb30BaHHSl         pecypcOB.
MeponpIDITHSl          no    BHYTPeHHeMY        aYJlHTY,    BblHBJIHIOmHe         np06JIeMbI,                 PYKOBO,[(CTBO
JlOJI)KHO peWHTb (BbICryIIWl, TaKHM 06Pa30M, CHCTeMOH 3a6JIarOBpeMeHHoro npeJlYOpe)K)."(eHHR),
HY)KJlaIOTCR B                                      H   YCI[)B€~plllleIICTBO:BaIIHH


            MHHHCTepCTBO cpHHaHCOB 3aBepWHJIO TeXHHKO-3KOHOMH'ieCKHe                                          no C03JlaHHlO
COBpeMeHHOH $YHKUHH BHYTpeHHero aYJlHTa, KOTOPaR MO)KeT nOCTeneHHO B06paTh B ce6B
06B3aHHOCTH HHcneKUHH (H HeKOTopblX ero COTpy,[(HHKOB), O,[(HaKO,                                             npoiiJleT eme
HeKoTopoe BpeMR,             npe)K)."(e ""IeM   OHa 6YJleT C03JlaHa.                  noro nOTPe6YeTCR            OTBeJleHHe
3HaqHTCJIbHOrO                        Ha   HaeM         H   06yqeHHe       COTpYJlHHKOB         COBpeMeHHbIM       MeTOJlaM
BHYTPeHHero           aYJlHTa,    a   TaK)Ke     MR     C03JlaHIDI     OT,[(eJIOB     BHYTPcHHero     aY,[(HTa     BO   Bcex
MH[HH[CT,eDI~Elax      H BeJlOMCTBax.

4.34        <I>yHKwrn BHewHero aYJlHTa BbmOJIHSleTCH CqeTHOH naJIaTOH, KOTOPaR JleHcTBYeT 3a
paMKaMH npaBHTeJIbCTBa Hero CTpyKTypbI BHYTPeHHero KOHTpOJIH. OHa npOBOJlHTperyJIBpHblH
            Bcex                                                 nonyqaIOmHX                                               Ha
UHKJIlf'leCKOH OCHOBe, H coo6maeT               ° JII06bIX HapyweHHSlx caMOMY yqpe)K)."(eHHlO H napJIaMeHTY.

HeCOOTBeTCTBIIR              M~y      pe..,opMoH        Ka3UaQeHCTBa         II     pecI»opMaMII,    npOBOJlIIMhlMIl        B
nCpBUQUOM 3BCIIC 3JlpaBOOXpallcIIIIR


4.35                         3JIeMeHTbI,                               Ka3Ha"leHCKOH pe$opMoH,          HJ.lYT              C
uemlMH $HHaHcoBbIX pe$OpM nepBH"IHOrO 3BeHa 3JlpaBOOXpaHeHHR, OCHOBHaR H'[(eR KOTOPbIX
3aKJIIO"IaJIaCb B                            MeCTHblM                         nepBH"IHOrO 3BeHa 3'[(paBooxpaHeHIDI
60JIbWeH $HHaHcoBoH rH6KOCTH H aBTOHOMHH. KpHTH'1eCKH B8)KHO pa3pewHTh                                 3TY     np06JIeMY, C
TeM,               He nOCTp8JlaJIH pecpopMbI nepBIf'IHOrO 3BeHa 3JlpasooxpaHeHHR. K npHMepy, eCJIH
<l)OHJlbI                6yIlYT HHTerpHpoBaHbI B                                         Cl.feT, OHH 6yllYT nOMe)KaTh
TaKOMY )Ke npeJlBapHTeJIbHOMY KOHTpOJIIO, KaK H 06bPiHblH 6IOJl)KeT. TaKoH KOHTpOJIb <l)OHJlOB
pa3BHTHR        6YJleT      HanpRMYIO      npOTHBOpel.fHTb         ueJIH   pe$opMHpoBaHHR           nepBHl.fHOrO        3BeHa
                              nOBblCHTh         C8MOCTOwreJIhHOCTh           yqpe)K)."(eHHH        nepBH"IHorO          3BeHa
3,ll.paBooXpaHeHHR nOcpe,ll.CTBOM npHMeHeHHR $OPMYJIbl no.n.yweBoro $HHaHCHpOBaHHR.
COKpaTHT H 6C3 Toro orpaHHl.feHHyw rH6KOCTb, KOTOPYID HMelOT yqpe)K)."(eHHR 3,[(paBOOXpaHeHHR,
MR YCTaHOBJIeHHR co6CTBeHHbIX $HHaHCOBbIX npHOpHTeTOB H HCnOJIb30BaHHR cpe,ll.CTB <l)OHJla
pa3BHTHR        B .uemlx       MaTepHaJIbHoro         CTHMYJIHpOBaHHR         CBOHX      COTPY,ll.HHKOB       H   nOKpbITHR
onepaUHoHHbIX paCXOJlOB H paCXO,ll.OB Ha TeXHlf'lecKoe 06cJIy)KHBaHHe.



                                                                34 

4.36       il,    HaKOHeu, B KIDK,llOM p3HoHe C03,ll3eTCJI OT,lleJleHHe Ka3HaQeHCTBa, KOTopoe 6Y,lleT
perncTpHpOBaTh H 06pa6aThIBaTh Bce ,llOrOBOpa CBIl OHO TalOKe ocym;ecTBJIJleT <PYHKUHIO
BepH<pHKaUHH ueH MJI 06eCne'leHHJI ueJleBoro HCnOJlh30BaHHJI cpe,llCTB. Ha ,llaHHOM 3Tane
CBOOro         Pa3BHTHJI,    Ka3Ha'leHCTBO       CTaJIKHBaeTCJI      c    cephe3HblMH      npo6J1eMaMH         He,llOCTaTKa
nOTeHUHaJIa MJI             BblnOJlHeHHJI ,llaHHOH      <PYHKUHH         BBHJlY   BbICOKOH    TeKY'leCTH      Ka,ll,POB.   Ha
npaKTHKe 3TO, nO-BH,llHMOMY, nO,llpbIBaeT TOT OrpaHH'leHHbIH ypOBeHb nOJlHOMO'lHH Ha,ll, CBOHMH
<pHHaHCOBhIMH ,lleJlaMH, KOTOPhlH ,llaJIa pe<pOpMa CeKTOpa 3,llpaBOOXpaHeHHJI CBn.



                                   C. fipAKTHKA rOCY,ll.APCTBEHHLIX lAKynOK

4.37       np03pa'lHhle, nO,llOT'leTHhIe H 3TH'1eCKH 06YCJlOBJleHHbie rocY,llapCTBeHHhIe 3aKYnKH,
MHHHMH3HpyrolllHe             B03MO:>KHOCTH       MJI     KoppynUHH,          JlBmnOTCJI      HeOneMJleMOH           'IaCThlO
H8Me)Kam;eH npaKTHKH ynpaBJIeHHJI. B                    ceKTope 3,llP3BOOXpaHeHHJI 3<p<peKTHBHaJI npaKTHKa
3aK)'lloK HrpaeT B8)KHyro POJlb, TaK KaK OKa3aHHe ycnyr BJIe'leT 3a C060H npHo6peTeHHe TOBapoB
H      ycnyr,    3aK)'llKY   H     TeXHH'leCKOe    06CJJY)KHB3HHe         060pY,lloBaHHJI     H   3,llaHHH,    B   KOTOPbIX
npe,llOCTaBJlJIIOTCJI 3TH ycnyrn. B             3TOH CBJl3H COBepUleHCTBOBaHHe npaKTHKH 3aK)'llOK HMeeT
Henocpe,nCTBeHHoe BJIHIIHHe Ha Ka'leCTBO ycnyr H y,llOBJleTBOpeHHOCTb naUHeHTOB.

4.38       B     2002   roJlY BceMHpHbIH 6aHK H A3HaTCKHH 6aHK Pa3BHTHJI npoBemf B Y36eKHCTaHe
COBMecTHhIH 0630p peaJIH33UHH nOPT<PeJlJl npOOKTOBCTpaHhl (COPn) (BceMHpHbIH 6aHK H
AEP,      2003),    B XO,lle KOTOporo 6blJ10 OTMe'leHO, 'ITO CHCTeMa rocY,llapcTBeHHhIx 33K)'llOK B
                    JlBJlJleTCJI Hepa3BHTOH, MeTO,llb1 3aKYnoK              - 3KOHOMH'fecKH He3<p<peKTHBHhIMH H
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                        eJlbHIi>IMiH np3BHJ1a, peryJlHpyromHMH rocY,llapcTBeHHble 3aKynKH, H He BepHJ1H B
cnp3BeMHBOCTh CHCTeMbI H                   cnoc06HocTb      3aK)'ll3lOUlHX yqpe)KJleHHH           npOBO,llHTb 3aK)'l1KH
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                                                                                   36 

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                                                                          37 

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                                                    38
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                                                               39 

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31 CM. YKa3 npe:nmCHTB Pecny6nHKH Y36eKHCTaH N2 Yn·3321 (26                                 2003r.). nOCTaHOBJlCHHC MB3CHT N!!
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                                                                    40 

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4.56         npoUeJJ.YPbI KOHTpOJl.ll KaqeCTBa H cePTH$HKaUHH TOBaPOB .IIBJlSIOTC.II rpOM03JJ,KHMH.
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MeMUHHCKHe yqpe1KJJ,eHIDI Y 36eKHCTaHa.


                                                                         41 

4.58      HOBaSi     CHCTeMa     Ka3Ha'leHCTBa      TalOKe        BBena    06S13aTenbH)'lO    pemcTPauHlO          Bcex
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                                  33
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                                                           42 

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                                                            43 

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                                                                          44 

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                                                            45 

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4.75     PblHOqHaJI KOHKypeHUHH orpaHHqeHa nocKonbKY 60nbUlHHCTBO nOCTaBIllHKOB ceKTopa
l.llpaBOOxpaHeHHH, TaK )Ke KaK H CKn3.llCKHe nOMellleHHJI pacnOJlO)KeHbI nH60 B TaUlKeHTe, JlH60
B KpynHbIX 06nacTHblX ueHTPax. TonbKo HeMHorne Hl HHX BnO)K}{JlH Cpe.llCTBa B paCIIJHpeHHe
CBooM .lle.srren:bHOCTH MJI COl.llaHHH c06cTseHHoH CeTH                                                DonbUlHHCTBo H3 HHX


34 O,lUlaKO, TeH.nephl Ha 3aKYTIKJ' Me.ll.HUHHcKoro 060pY.ll.oBaHHH H lPapMan;eBTH"IeCKHX npenapareB,
IPHHaHCHpyeMhle BCeMHpHbIM 61lHKOM H A6P, aCB06olK.ll.eHbI OT ype60BaHHH perHcypamm BO BpeM.Il
npe.ll.CTaBJleHH.ll npeMolKeHHH. fiocneJlYlOrnrui KBaJIHIPHKaUIDI yq3CTHHKOB reproB, ype6yeMruI npaBHJlaMH
38KynoK 060HX .nOHOPOB, cny:IKHT cpe.n:cTBoM KOHYpOJ1.Il KaqeCTBa, He OrpaHH'lHBrui KOHKyPeHUDIO. TOJILKO
ycnemHble yqacTHHKH ToprOB .ll.OJIlKHbI 3aperHtypHpOBan TOBaphl. KOTophle 0811 HaMepeBaIOTC.II
nOCTaBHTb.

                                                                   46 

npeAnOl.JHTaJOT             BcrynaTb         B     napTHepCKHe           OTHOUJeHHJI       C    KOMnaHHJlMH             ,L{0pH-,L{apMoH             H
Y3TH6TeXHHKa Ami pacnpeAeJIeHHJI CBOHX TOBapoB no BceH cTpaHe.


4.76        HecBoeBpeMeHHble                     I1J1aTe)J(H      H     He60JIbllJHe      3aKaJbI        eme       60JIbUJe          CHH)J(aIOT
KOHK)'peHUHIO. lliaTe)f<H nOCTaBID.HKaM co CTOPOHbl )'1.Jpem.neHHH 06bIl.JHO 3a,nep)f<HBaJOTCli Ha
30-45     AHeH (HopMa). KaK npaBHllo, )'1.Jpem.neHHJI 3aKa3blBalOT TOJIbKO He60JIbUJHe KOJIHl.JeCTBa
JIeKapcTBeHHbix             cpeACTB          H      H3AeJIHH           MeAHQHHCKOro        HaJHal.JeHHJI,        oc06eHHo            Te,       1.JTO
pacnOJIo)J(eHbl OT OTAaJIeHHOH MeCTHOCTH . liOJIbUJHHCTBO nOCTaBID.HKOB 1.JaCTHoro ceKTopa (Aa)J(e
                                       B aTb B TaKHX YCJIOBHHX. JII060H nOCTaBID.HK, KOTOPbIH
MeCTHble) He 3aHHTepeCOBaHbI KOHK)'pHpO.
cornaUJaeTCli OCYID.eCTBJIlITb nOCTaBKH MeAHUHHCKHM )'1.Jpem.neHHJlM, KaK npaBHllO, nOBblUJaeT
6aJOBYIO QeHY JIeKapcTBeHHbIX cpeACTB Ha Bce                             20    npoQeHTOB, paJpeUJeHHbIX npaBHTeJIbCTBoM.


4.77        3aKJllOl.JeHHe           npllMblx                KOHTpaKTOB               Ta6J1HQa    0.4: npHMeHeHHe npOue)lyp
HCnOJIb3YeTCli                 npeHMYmeCTBeHHo                          Ha              KOHKypCHblX laKYnOK cj)HH8HCOBO
06JIaCTHOM                  ypoBHe.                     06cJIeAoBaHHe                 Hel8BHCHMblMH yl.Jp~eHHHMH                     (%)   B
                                                                                               C8M8pK8Hlle H Cl>epr8He
)'1.Jpem.neHHH         nOKaJaJIO,       'ITO       100        npoQeHTOB
CBn          B         CaMapKaHACKOH                     06JIacTH        H
npH6JIH3HTeJIbHO             70    npoQeHTOB B <I>epraHe, a
TaK)J(e      HeKoTopble            QeHTpaJIbHble              paHoHHble
                                                                                                          nOnHKJI.
60JIbHHQbl,            He     HCnOJIb3YJOT                  KOHKypCHbIX         JIeKapCTBa
npoQe,nyp AJIli 3aKynKH JIeKapcTBeHHblX cpeACTB                                   CaMapKaH){           3       38                                   o
H       H3AeJIHH            MeAHQHHCKoro                    HaJHal.JeHHJI.        <I>epraHa           33       42        67
HanpHMep,              pecnOHAeHT            H3         lJ,eHTpaJIbHOH          I11)lenHJI MeJlH. ·
paHOHHOH              60JIbHHQbl         B         CaMapKaHACKOH                HalHal.JeHHlI.
06JIaCTH              OTBeTHll,          'ITO               HCnOJIb30BaJI         CaMapKaH){           3       31                                   o
3aKJIIOl.JeHHe npliMbIX AorOBopoB Ha nOCTaBKY                                     <I>epraHa           27       25        67
                                                                                I1cmo'lHuK: BceMHpHLlii 6aHK, 06Cne)lOBaHHe
JIeKapcTBeHHblX                cpeACTB                  H       H3AeJIHH
                                                                                Y'lpe)KJleHHii, 2007.
MeAHUHHCKoro                HaJHal.JeHHlI,           HeCMOTpli          Ha
HaJIHl.JHe, no KpaHHeH Mepe, 1.JeTbIpeX nOCTaBID.HKOB B TOM paHOHe. B Ta6JIHQe                                                 4.6   nOKaJaHa
CTeneHb          HCnOJIb30BaHHJI             MeAHUHHCKHMH                )'1.Jpem.neHHJlMH       KOHKypCHbIX              npoQe,nyp            AJIJI
npH06peTeHHlI HaH60JIee 1.JaCTO 3aKynaeMbix TOBapoB -                                     JIeKapCT~eHHblx cpeACTB H H3AeJIHH
MeAHQHHCKOrO HaJHal.JeHHJI.


4.78        KOH<pJlHKT HHTepecoB AaeT HeKOTopblM KOMnaHHJlM He3acnymeHHoe npeHMYID.eCTBO H
MeUJaeT KOHK)'peHQHH. CHCTeMa rocYAapcTBeHHbIX laKYnoK Y36eKHCTaHa He OnpeAeJIJleT H He
peryJlHPYeT KOH<pJlHKT HHTepeCOB. Bo BCTaBKe                             4.1   npHBeAeHbl ABa npHMepa C.Il)"faeB KOH<pJ1HKTa
HHTepeCOB



                                                  BCT8BK8       0.1:   KOHcj)J1HKT HHTepeCOB

    OpHMep       1:   AKUHoHepHWI KOMnaHHlI «)1.0PH )1.apMOH» npHHHMaCT }"faCTHe B nOJlroToBKe pac'lCTOB roJloBoA
    nOTPe6HOCTH MeJlHUHHCKHX )"IpClKJleHHA B JleKapCTBeHHbIX CpeJlCTBaX (KOJlH'IeCTBO H 6IO.IOkCT).                        B   TO lICe BpeMlI,
    OHa }"faCTByCT B Ka'lCCTBe nOCTaBlllHKa JleKapCTBeHHLlX CpeJlCTB H MeJlHUHHCKHX npHH3JlJlellCHOCTeA no TeM lICe
    ueHaM, no KOTOPblM 6blJla COCTaBJIeHa 61O.IOkCTHWI CMeTa. KpOMe TOro, «)1.0PH )1.apMOH» JleACTBYCT B Ka'lCCTBe
    nOKynareJUI (OT      HMeHH MHH3JlpaBa), nOJlnHCLlBali                KOHTpaKTbl    Ha noCTaBJ.Cy. MeJlHKaMeHTOB,           3aKJ11O'IeHHbIX
    comacHo ellCeroJlHLIM UeHTpaJJH30Ba/lHblM OTKpblTbIM TOPraM. OJlHOBpeMeHHO, «)1.0PH TlI1>MHHOT», JlO'lepHlili
    KOMnaHHlI,     HaxolVllllali   nOJlHOCTbIO B nOJl'lHHeHHH            «)1.0PH )1.apMOH»,    }"faCTByCT KaK          nOCTaRIUHK B TaKHX
    KOHKYPCHLIX TOprax, a 3aTeM nOJlnHCbIBaCT KOHTpaKTbl Ha nOCTaBk)' neKapCTB co cBoell roJlOBHOA KOMnaHHH.

    OpHMep    2:      AKUHoHepHWI KOMnaHHlI «Y3TH6TeXHHKa» (rocYJlapCTBeHHoe npeJlnpHllTHe) lIBnllCTCli '1J1eHOM
    npaBHTenbCTBeHHoro KOOPJlHHlUlHOHHOro COReTa no MeJlHUHHCKOMy 060PYJlOBaHHIO. OHa TaIOKe npeJlCTaBJUlCT
    MHHHCTCPCTBO        3JlpasooXpaHeHHlI           B       nONOTOBKe    paC'IeTOB    nOTPe6HOCTH    MeJlHUHHCKHX          }"fpClK1leHHA        B
    MCJlHUHHCKOM o60PY.lIOBaHHH.         B TO lICe CaMoe        BpeMli «Y3TH6TeXHHKe» npHHaJlnellCHT '1aCTHal! KOMnaHHlI, KOroPal!
    }"faCTByeT H BblHrpbIBaCT Toprn Ha nOCTaBk)' MeJlHUHHcKOro o6opYJlOBaHHlI }"fpe)l(JleHHlIM 3JlpasooXpaHeHHlI


    /1cmO'IHUK: nOCTaHOBJleHHe     KM Jof! 490, npHKaJ M3 N2 158 (14 anpeJlll 2006 roJla),     npHKaJ   M3 Jof! 506.
4.79      MOHOnOJIHCTHqeCKHe cwryalU:1H TalOKe no.npblBalOT KOHKYPeHUHIO. HanpHMep, KaK 31"0
ynOMHHaJIOCb paHee B .naHHoH rJIaBe, AO «Y:rm6TexHHKa», OTBeqaeT 3a oueHK)' nOTpe6HOCTeH
Me.nHUHHCKHX         yqpe~eHHH        B       Me.nHUHHCKOM           060py.n:oBaHHH          H   pa3pa6OTKe        TeXHHKO­
3KOHOMHqeCKHX         060CHOBaHHH         H    HHBeCTHUHOHHbIX               npOeKTOB       OT   HMeHH        MHHHCTePCTBa
                       KpoMe TOro, KOMnaHHR HMeeT MOHOnOJIHJO Ha nOCTaBK)' H ynpaBJIeHHe
YCTaHOBKOH     H     TeXHH'-IeCKHM     06CJ1)'JKHBaHHeM              3aKynaeMoro       o6opy.n:oBaHHR,         noTOMY   qTO
KOMnaHHR HMeeT CeTb cepBHcHbIX ueHTpoB no BceH CTpaHe, YHaCJIe.noBsHHYJO C COBeTCKHX
BpeMeH,    C OT.n:eJIeHHRMH       B   K~OH            06JIaCTH.      Be   MOHOnOJIHR         6bIJIa   YCHJIeHa    fiPHKa30M
MHHHCTepCTBS 3.n:paBooxpsHeHHR                N!!    158 (snpeJIb 2006r.), npeMHcblBaIOIUHM 06JISCTHhIM
ynpaBJIeHHRM 3.n:PSBooXpSHeHHR, Me.n:HUHHCKHM yqe6HbiM 3SBe.n:eHHRM H KOJIJIe,wKaM 3aKJIJOqSTb
             C MeCTHblMH cePBHCHblMH no.n:pa3.neneHHRMH AO «Y3TH6TeXHHKa» Ha npoBe.n:eHHe
nocJIerapaHTHHHOrO 06CJI)'lKHBaHHR Me.n:HUHHCKoro 06opy.n:oBaHHJI, nOCTaBJIeHHOrO B paMKax
HHBeCTHUHOHHblX                   $HHaHcHpyeMblX BceMHpHblM EaHKoM H AEP


4.80    TaKoro po.n:a OTCYTCTBHe KOHKYPeHUHH, HeCOMHeHHO, CBR3aHO C 3aSbHneHHeM ueH Ha
JIeKapcTBeHHble Cpe.n:cTBa, XOTJI HeT HHKSKHX KOHKPeTHbJX .n:aHHhJX,                             nO.ll:TBep~aIOlI.UfX   3TO
YTBep~eHHe. B         COOTBeTCTBHH C OT.neJIbHbIMH KOMMeHTapHRMH HeKOTopbIX HHCneKTOpOB,
OTcyreTBHe KOHKYPeHUHH nOBblmaeT CTOHMOCTb                                                 Cpe.ncTB, KOTOPYJO nOKynalOT
Me.nHUHHCKHe       yqpe~eHHR.         AHaJIoruqHoe           3aKJIJOqeHHe         6bIJIO    c.neJIaHO    no     pe3YJIbTaTaM
o6CJIe.n:oBaHHH 3aKynOK $apMaueBTHqeCKHX                                                    B .n:pyrHX cTpauax perHoHs.
HanpHMep,     06CJIe.n:OBaHHe     ceKTOpa           3.n:paBooXpaHeHHR         Cep6HH,        npoBe.n:eHHoc      BceMHpHbIM
6aHKoM, 06HapY)KHJIO, '-ITO 3aKJIJOQeHHe KOHTpaKTOB Ha KOHKYPCHOH OCHOBe MO)KeT COKpaTHTb
ueHbl H C3KOHOMHTb 25% 61O,wKeTa (BceMHpHbIH 6aHK, 2002b).




4.81    fip03paQHOCTb CHCTeMbI rocy.napCTBeHHblX 3aK)'noK MO)KHO H3MepHTb CTeneHblO, B
KOTOPOH OHa:   (i)   06eCneQHBaeT yqaCTIIHKaM ToprOB .n:ocryn K HH<P0PM8UHH;                            Oi)   HMeeT CHCTeMY
paCCMOTpeHHR       )KaJI06   Ha   npOl.~ecc         3aK)'nKH,     BKJIIOQalOmyJO       aJJ:MHHHCTpaTHBHble          MepbI   H
yrOJJOBHOe    npeCJJe.n:OBaHHe.       Mbl      06Hap)'JICHJIH,       '-ITO   CHCTeMa        rocy.n:apCTBeHHblX      3aKynOK
Y36eKHCTaHa        xaPaKTePH3YeTCJI         orpaHHQeHHhJM            .n:OCTynOM      HH<popMaUHH          H     OTcyrcTBHeM
3$<peKTHBHOH CHCTeMhJ )K8JI06 H aneJJJJJlUHH.


4.82    j.{ocryn K HH<pOPM8UHH JlBJIReTCJI B8)KHOH QaCTbJO OTKPbITOH H np03paQHOH CHCTeMbl
ynpaBJIeHHJI H KJIJOQeBblM 3JIeMeHTOM onepaUHH no 3aK)'nKaM. MHHHCTepCTBO 3.npaBooXpaHeHHJI
npHJIaraeT Bce He06xo.nHMbIe yCHJIHJI B npe.o;eJJax HMelOIUHXCJI pecYPCOB .o;JIJI 06eCne'feHHR
Me,llHUHHCKHX yqpe~emlH H 06meCTBeHHOCTH                                      KO BceH HH<popMaUHH, KOTOPM HMeeT
OTHOmeHHe K ceKTopy 3.n:paBooxpaHeHHJI, BKJIIO'fM 3aKynKH. Be6-caAT MHHHcTepcTBa HMeeT
                             B    KOTOPOM           CO.n:eP)K8TCJI                               nOJJO)KeHHR,      YKa3b1   H
HHCTpYKUHH MHHHCTePCTBa, a TalOKe HeKOTopble YBe.o;OMJJeHHJI 0 Toprax. HecMOTpJl Ha TO, '-ITO
peWeHHJI 0 npHc~eHHH KOHTPaKTOB He ny6JJHK)'IOTCJI, 06'bllBJleHHe 0 TeH,D;epax C 61O,wKeTOM
CBblwe 100 000 . .n:OJIJIapOB CIlIA, a TaJOKe npHmameHHJI K no.n:aqe npe.o;JIO)KeHHH .o;OJI)KHbJ
ny6mIKoBaTbCJI B MeCTHbIX ra3eTax.                   HHor.o;a MmrnCTepCTBO 3.npaBooxpaHeHHR pa3MeIUaeT
yse.o;OMJJeHHR 0 TOprax Ha CBoeM                           YQaCTHHKH ToproB C'fHTaIOT CTOHMOCTb TeH,D;epHblX
.n:oK)'MeHTOB, KOTOPM QaCTO .nocmraeT 600 .noMapoB CIlIA, He06ocHoBaHHo BbICOKOH.


4.83   OTcYTcTBHe         KOMnbJOTepHOfO               o60py.o;OBaHHJI        H    orpaHH'-IeHHaJI        HH<ppaCTpYKTYpa
HH<pOPMIlUHOHHbIX                      B ceKTope 3.n:paBooXpaHeHHJI orpaHH'fHBaIOT CTeneHb .n:oCTyna K
HH<p0pMaUHH. CeKTOp 3.npaBooxpaueHHR BKJIIO'feH B HaUHOHaJIbHYJO nporpaMMY Y36eKHCTaH8
no pa3BHTHIO       tfH<p0pMaunoHHblX TeXHOJIOfHH,                 H Be.n:eTCJI     pa3pa60TKa nnaHa                     .o;JIR


                                                             48 

cmM)'nHp08aHIDI HCnOnb308aHH.lI C08peMeHHbIX HH.popMaUHOHHblX CHCTeM B ceKTope.                                    PlU{
npOeKTOB, .pHHaHcHpyeMbIX ,nOHopaMH, nOMoraIOT B 06eCne"feHHH ceKTopa 3,npaBOOXpaHeHH.lI
                         o6opy,nOBaHHeM.       npoeKT          BceMHpHoro    6aHKa        «3,nopOBbe-b>      nOCTaBHJI
KOMnblOTepbl        B   06naCTHble H        paHOHHble      CTaTHCTK'leCKHe    opraHbl,       OKa3aJ1   no,n,nep:lKKY   B
npOBe,neHHH                       no                       nporpaMMHbIX 06eCne"feHHH, a npoeKT «3,n0poBbe­
2»     OKa3aJ1    co,neHCTBHe       MHHHCTepcTBY        3,npa800XpaHeHH.lI    B     C03,naHHH    HH.p0pMaUHoHHoH
CHCTeMbI ynpaMeHH.lI 3,npaBooxpaHeHHeM. nOTeHUHaJI HH.ppaCTpYKTYPbI HT B nOBblweHHH
3.p.peKTHBHOCTH 3aKYnKH .papMaueBTH"feCKHX npenapBTOB MO:lKHO paccMoTPeTb Ha npHMepe
          r,ne B ceKTope                               B    1999   ro.ny          C03,naHa 3neKTPoHHWI CMCTeMa
OTKpbITbIX KOHKYPCHbIX ToproB. 31'0 npHBeno K cywecTBeHHoH 3KOHOMHH rocy,napcTBeHHbIx
              BbI,neneHHbIX Ha                npH 3TOM, 3KOHOMH.lI, ,nocmrHYTWI 60nbHHuaMH, COCTaBHJla
no paC"feTaM OT         5   ,no7% (4 MJIH. ,nOJIJ1apoB)         no Me,nHKaMeHTSM H H3,neJIH.lIM Me,nHUHHcKOro
Ha3Ha"feHIDI. (Cohen         and Montoya, 2001).

4.84      B      Y36eKHCTaHe           OTcYTCTBHe    I.feTKO     c.popM)'nHpOBaHHblx        KpHTepHeB       oueHKH     H
OTcYTcTBHe Tpe60BaHHH no KaI.feCTBY TOBspa B TeH,nepHbIx ,noKYMeHTaX MOfYT npHBeCTH K TOM)',
"fT0 TeH,nepHWI KOMHCCH.ll npHHHMaeT peme""" 0 npHCY:JK.neHHH KOHTPaKTa Ha CBoe YCMOTpeHHe.
OueHO"fHWI KOMHCCH.lI MO:lKeT no,nBeprHYTb COMHeHHIO HJlH 0TKJ10HHTb ,na:JKe neKapCTBeHHble
cpe,nCTBa, 3aperHCTpHp08aHHbIe 8 Ha,nne:lKameM nOp.ll,nKe. HanpHMep, B 2005r. 80 8peMS
06'be,nHHeHHoro TeH,nepa Ha                         neKapCTBeHHblX _                O,nHH H3 yqacTHHKOB Topr08
npe,nCTaBHn        npe,nnO:lKeHHe,       nonHOCTblO     OTBe"falOIUee      BeeM     TPe60BaHH.lIM,     Ha    nOCTaBKY
HenaTeHTOBaHHOro HHcynHHa,                 KOTOPblH    6bID                           ,no   no,na"fH npe,nnO:lKeHH.lI.
TeH,nepHWI (oueHO"fHWI) KOMHCCH.lI npHcy,nHJIa KOMnaHHH, npe,nnO:lKHBWeH caM}1O HH3KY1O UeHY,
KOHTPaKT Ha nOOTaBKY TOnbKO                                 OT 06IUero KOnH"feCTBa. 31'0 6bIDO c,neJIaHO nocne
Toro KaK KOMHCCH.lI BCKpbIna H npOaHaJlH3HpoBaJla npe,nnO:lKeHH.lI, H, HeCMOTP.lI Ha TOT .paKT, "fT0
8                  ,n0KYMeHTax He 6bIDO YKa3aHO npaBO nOKYllaTeJ1.l1 YBenH"fHBan. HnH YMeHbWBTb
KOJIH"feCTBO BO BpeM.ll npHCY:JK.neHH.lI KOHTPaKTa. 3a.Ka3                 Ha nOCTaBKY ,npyrHX ,nByx TPeTbHX
                 6bID   nepe,naH ,naBHHWHeM)' nOCTaBIUHKY                             B                     TeHJl.epHWI
KOMHCCH.lI 06OCHOBaJla CBoe peweHHe He06xoJl.HMOCThIO CHH:lKeHH.lI pHCKa npH06peTeHH.lI TOBapa,
KOTOPblH paHee He HcnOnb308aJ1C.lI 8                           apryMeHTHpy.ll 3T0 TeM, 'ITO onaCHO 3aKa3bIBan
"HeH3BeCTHbIH" TOBap Ha nOKpbITHe nOTPe6Hoom B HHcynHHe Ha BeCb ro,n. HeCMOTp.ll Ha TO, "fT0
:lKenaHHe KOMHCCHH "3aIUHTHTb" n0Tpe6HTeneH                                  o,n06peHH.lI, cnoc06, KOTOpblM 3TO
6bIDO c,nenSHO, OT6M8aeT :lKeJIaHHe nOCTa8IUHKOB                      yqacT80BaTh B TeH,nepax, H no,npblB3eT
YBepeHHOCTb yqacTHHKOB ToprOB B 6eCnpHCTPaCTHOCTH, npo3pa"fHOCTH H nOCJIeJl.OBaTeJIbHOCTH
npouecca 3aKYllOK.


4.85      OTcyrcTBHe          'IeTKHX     npoue.nyp     BepH.pHKaUHH       ueHbl,     npH     3TOM,    o6eCne"fHBaeT
)l.OCTaTO"fHO npoCTPaHCTBa ,nn.ll cy6'beKTH8HbIX HHTepnpeTaUHH. DooJIe npHcY:JK.neHIDI KOHTPaKTa,
Ka:JKJJ.WI 3aKYllaIOIUWI opraHH3aUH.ll ,nOJI:lKHa npe,nCTaBHTh 3aKJIlOI.feHHbIH KOHTPaKT B MB3CHT
Ha o,n06peHHe. H3BeCTHbI C.rty'1:8H, Kor,na MB3CHT Tpe60BaJI OT 3axynsIOIUeif opraHH3aUHH
npoBeCTH nOBTopHble nepcroBopbl no 06CY:JK.nCHHIO ueH, KOTOpble                              YKa38Hbl B KOHTPaKTe,
npHCY:JK.neHHOM Ha KOHKYPCHOH OOHOBe "YTCM OTKpblTblX ToprOB, a B HeKOTopblX C.rty'1:WIX
MB3CHT            npoBo,nHJI      6e30roBopOI.fH}'ID       perHCTpau.HlO    KOHTPaKTOB,        npHcY:JK.neHHblx        Ha
6e3aJ1bTepHamBHoH OCHOBe. BJIH.lIHHe ueHOBOH 3KcnePTIDbI Ha MeCTHOM ypOBHe He B03MO:lKH0
6bIDO OueHHTh, nooKOJIbKY He 6bID                       Ha npaKTHKe Ha MOMeHT npOBe,nCHH.ll Hccnc,nosaHH.lI.


4.86      HecMOTpJl Ha TO, I.fTO CymeCTBYeT O.pHUHaJlbHblif MexaHH3M no,naI.fH :lKaJlo6 Ha peweHH.lI
no 3aKYJIKaM, OH MO:lKeT 6bITb He COBceM 3.p.peKTHBeH. KOHTPOJIbHWI HHCneKUH.lI MHHHCTepCTBa
3,npaSOOXpaHeHH.lI OTBeI.faeT 3a paCCMOTpeHHe Beex aneJIJIJlUHif H :JKaJ106, B TOM I.fHCne H OT
yqacTHHKOB                  H nOCTaBIUHKOB. Do CJIOBaM PYKOBOJl.HTeJIJI KOHTPOJIbHOH HHcneK1UtH, 3a
nocnc,nHHe I.feTbrpC        rolla   He 6bIDO no,naHO HH O,nHOH :lKaJl06bl Hnll npoTecTOB co CTOPOHbl


                                                            49 

yqacTHHKOB TOprOB HJlH nOCTaBll(HKOB. O)lHaKO OTCyrcTBHe )IGUl06 He 06H3aTeJlhHO HBJlHeTCH
nOKa3aTeJleM         XopOWO   <PYHKl.{HOHHpyroll(eH        CHCTeMhl.      Me)I(J{}'HapO)lHhlH      OnhlT H       npaKTHKa
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ToproB     B   OTHoweHHH       3<p<peKTHBHOCTH         CHCTeMhl     yperyJlHpOBaHHH         )KaJI06,    (ii)    oTCyrCTBHH
HH<popMaUHH y yqacTHHKoB TOproB 0 TOM, KaK )lOJl)KHhI 6hITh npe)lCTaBJleHhl )KaJI06hI H KaK OHH
6y.llYf paCCMaTpHBaThCH, H          (iii)   oTcyrCTBHe COOTBeTCTByroll(ero 3aKOHO)laTeJlhCTBa WHJlH ero
npaBonpHMeHeHHH.




Ol{eH1(.a tjJui)yl{Uapn6lX PUC1(.08

4.87     CYll(eCTBYeT PH)l <pHJlYllHapHhIX PHCKOB, CBH3aHHhiX C Hea)leKBaTHOH CHCTeMOH WeI> C
orpaHHlJeHHOH           np03palJHOCTbIO       H      CJla60H     nO)lOTlJeTHOCThIO.         no     BceH        BH)lHMOCTH,
cymeCTByroll(aH         CHCTeMa     He      MO)KeT    06ecnelJHTh        TOro,    qro6hI     cpe)lCTBa         yqpe)K)leHHH
paCXO)lOBaJIHCh Ha npe.ll)'CMOTpeHHhle l.{eJlH, H cnoc06cTBYeT He3<p<peKTHBHOMY HCnOJlh30BaHHlO
cpe)lCTB. He)lOCTaTOK HaBhlKOB no <pHHaHCOBOMY ynpaBJIeHHIO Cpe)lH COTpY)lHHKOB CBn H
npe06pa30BaHHhIX          nOJlHKJlHHHK      03HalJaeT    OTCyrCTBHe        )lOJDKHOrO      KOIITpOJlH     Ha)l   )laHHhIMH
61O)l)KeTHhIMH        onepaUHHMH.    B03MO)KHO H         TO, 'ITO CJla6hIH        npe)lBapHTeJlhHhIH KOIITpOJlh H
OTlJeTHOCTh      no    paCXO)laM    eI>OH)la pa3BHTHH          MOrJlH    npHBeCTH     K    TOMY,   lJTO   3TH     Cpe)lCTBa
TpaTHJlHCh Ha CTaThH H l.{eJlH, Ha KOTophle OHH He· npe)lnOJlaraJIHCh. AHaJIOrHlfHhIM 06Pa30M,
CJla6hle HJIH HeCYll(eCTByroll(He MexaHH3MhI BHYTpeHHero KOHTpOJlH C03)lalOT cYll(eCTBeHHhle
<PHJlYUHapHhle PHCKH Ha Bcex YPOBHHX ynpaBJleHHH, a TaK)Ke B Me)lHUHHCKHX yqpe)K)leHHHX H
opraHH3al.{IDlX. npH 3TOM, cymeCTByroll(He npOl.{e)lyphI 3aK)'IIOK B ceKTope 3)lpaBOOXpaHeHHH
npe)lCTaBJIHIOT C060H HCrolJHHK cYll(eCTBeHHOrO <pH.llYUHapHoro pHcKa, OCTaBJlHH                                  60JlhWOH
npocTop AIlH MOWeHHHlJeCTBa H Koppynl.{HH KaK Ha l.{elITpaJIhHOM, Ta H MeCTHOM ypOBHHX.




E. BblBO,l(LI " PEKOMEHMUHH

4.88     B KalJeCTBe pe3YJlhTaTOB npoBe)leHHOrO HaMH aHaJIH3a ynpaBJIeHHH rocY)lapcTBeHHhIMH
<pHHaHCaMH       B    ceKTope 3)lpaBOOXpaHeHHJI Y36eKHCTaHa,                   B )laHHOM     pa3)leJle    npe)lCTaBJleHhl
HeKOTOphle peKOMeJU{aUHH no peweHHIO BonpOCOB B 06J1aCTH rocynpaBJIeHHH, B03HHKaJOll(HX B
H3-3a HecoBepmeHHoH CHCTeMbl ynpaBJIeHHH 61O)l)KeTOM H 3aK)'nOK, onHcaHHOH B npe)lhIJlYUlHX
pa3)leJlax.


Ynp(UJJlenue olOi):»eemoM
4.89     3a.n.ep)KKH      <pHHaHCHpOBaHHH            OKa3hlBaIOT        npHMoe     OTpHl.{aTeJlhHoe        BJlHHHHe     Ha
3<p<peKTHBHOCTh HCnOJlh30BaHHH pecypcoB H KalJecTBO Me)lHUHHCKOH nOMOll(H. OHH npHBO)lJlT K
H3JlHUIHeMY pocry CTOHMOCTH Be)leHHH )leJlTeJlhHOCTH H 3aTpaT Ha TOBaphI Me)lHUHHcKOro
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MaTepHaJIOB H HeraTHBHO CKa3hIBaeTCH Ha MOPaJIhHOM .nyx.e Me)lHUHHCKHX pa60THHKOB, KOTophle
He nonyqalOT ormary BOBpeMH. DOJlhWaH lJaCTh )laHHhIX 3a.n.ep)KeK Bbl3BaHa HeXBaTKOH Cpe)lCTB
Ha l.{eHTpaJIhHOM HJIH MeCTHOM ypOBHe <pHHaHCOBhlX OT)leJlOB BBHJlY 60Jlee HH3Koro YPOBHJI
nOC1)TI1IeHHH, lJeM npe)lnOJlaraJIOCh, HJlH )Ke B CHJIY CJla60H CHCTeMhI ynpaBJleHHH )leHe)KHblMH
Cpe)lCTBaMH. TIp06J1eMa HH3KHX HaJIorOBhlX nOC1)TI1IeHHH Tpe6yeT OT rocy)lapCTBa YKpermeHHJI
CHCTeMhI       HaJIoroBoro     a)lMHHHCTpHpOBaHHH,             TOr)la    KaK     np06J1eMY     cJla60ro        ynpaBJleHHH
)leHe)KHhIMH         cpe)lCTBaMH    MO)KHO        peWHTh       TOJlhKO    nocpe)lCTBOM        YKpermeHHH          CHCTeMhI
Ka3HalJeHCTBa H nOTeHl.{HaJIa no KaCCOBOMY ynpaBJIeHHIO.




                                                           50 

4.90      Pe<popMa B <pHHaHCHpoBaiUrn CBIT 6bma UeJ1eHanpaBJIeHHoit nOJIHTHKOIi BblBe,1leHliH
CBIT H3 na)'THHhI <pHHaHcOBo-6IOJVKeTHoro KOHTpOIDI, KOTOPOit OHa                                               On)'TaHa. OHa 6blJIa
HanpaBJIeHa Ha TO, tfI'06bI CTaTb oCHoBHOIi nepeMeHoli B K)'JIbrype CHCTeMbl 3,1lpaBOOXpaHeHHSI,
HO KYJIbl)lpbl TPY,1lHO nOMalOTCJI nepe,1leJIKe.                                 H ceMellHble          nOJIHKJIHHHKH JlBJlJlIOTCJI
e,1lHHCTBeHHblM           nOJIHOCTblO             pe<popMHpoBaHHbIM                KOMnoHewroM                   BH)'TpH         ceKTOpa
3,1lpaBOOXpaHeHHJI, O,1lHaKO TO ,1laBJIeHHe, OCHOBaHHOe Ha 6JIarHX HaMepeHHJlX coxpaHeHHSI
CTSryC-KBO, Ha'lHHSeT 3STaJIKHBaTb CBIT 06paTHo B HX npe)l(Hee COCTOSlHHe Ha HepapxH'IecKoli
JIeCTHHue ynpaBJIeHHJI H KOHTPOJISI B ceKTope 3,1lpaBOOXpaHeHHJI. }J.aHHoe ,1laBJIeHHe 6epeT CBoe
Ha'laJIO OT BHe,1lpeHHJI HOBOIi CHCTeMbI KMHa'lellcTBa, KOTOPM BBeJIa CTpOrHlI                                          KOHTpOJIb HM
<pHHaHcoBbIM           ynpaBJIeHHeM           pe<popMHpoBaHHbIX                 yqpe)l(JleHHII        3,1lpaBOOXpaHeHHJI.             3m
MexaHH3MbI        KOHTpOJIJI        HJl)'T   B    pMpe3       npHHUHnaM           pe<popMHpoBaHHJI              nepBH'IHOrO         3BeHS
3,1lpaBOOXpsHeHHSI,             KOTOpoe           npenycMaTPHBaJIO               <pHHaHcoBYIO              H          ynpSBJIeH'IecKYJO
caMOCTOSlTeJIbHOCTb            B     KalieCTBe      SIJlpa    Ha.IlJIe)l(amero       ynpSBJleHHSI,             liTO    nO,1lpMYMeBaeT
np03pa'l.fHOCTI>, nO,1lOT'l.feTHOCTb H 3<p<peKTHBHOCTh npe,1l0CTaBJIJleMbiX ycnyr nepBH'l.fHOrO 3BeHa
3JJ.PSBooxpSHeHHJI.

4.91      ITpaBHTeJIbCTBY He06xo,1lHMo COXpaHJITb 6aJIaHC Me)l(JlY KOHTPOJIeM H rH6KOCTblO C
ueJIblO       ,1l0CTH)I(eHHJI        3<p<peKTHBHOCTH            HCnOJIb30BaHHJI               peCYPCOB.          ITPH       BHe,1lpeHHH
<pHHaHcHpOBaHHJI no nOJJ.YIIIeBoM)' npHHUHny <pHHaHcoBble pe<pOPMbl oc060 nO,1l'l.fepKHYJIH
npe,1l0CTaBJIeHHe        CBIT       <pHHaHcoBoli       C8MOCTOJlTeJIbHOCTH,               C    TeM,    ~1T06b1
nOBblllleHHIO         3<p<peKTHBHOCTH,             O,1lHaKO      pe<poPMbl            KMHa'l.feHCTBa             OTHHM)'T         TaKYJO
caMOCTOJlTeJIbHOCTb B ueJIJIX COKpameHHJI <pHJJ.YUHapHbIX pHCKOB. He06xoJlHMO
JJ.aHHble nO,1lXO,1lbl )VIJI MaKCHMH3aUHH 3<p<peKTHBHOCTH H COKpameHHJI <PHJlYIJ.HapHblx pHCKOB.
CJIHIIlKOM                    CaMOCTOJlTeJIbHOCTh H orpaHH'l.feHHblH KOHTpoJIb HM paCXO,1laMH C03JJ.aeT
B03MO)l(HOCTH )lllJl KoppynUHH. AHaJIOrHliHblM 06PMOM, orpaHH'l.feHHM CaMOCTOJlTeJIl:'HOCTb H
'l.fpe3MepHblH                     CBJI~ yqpe)l(JleHHJI no PYKaM H HoraM, npenJITCTBYJI HOBOBBe,1leHHJlM,
KOTopble MOr)'T nOBblCHTb 3<p<peKTHBHOCTb.

4.92      B03BpameHHe              KOHTpoJIJI     HM paCxO,1l8MH                     B    BH,1le    KMHa'l.feHCTBa JJ.O          ypOBHJI
MeJIbliSHIIIHX nOJJ.CTaTeH orpaHHliHT rH6KoCTb ,1laHHbIX yqpe)l(JleHHH B pacnOpJl)l(eHHH CBOHMH
pecypCaMH        C     yqeTOM        co6CTBeHHbIX            nOTPe6HOCTeH.          }J.JIJI    Y,1l0BJIeTBOpemtJl          TPe60BaHHH
MHHHCTepCTBa <pHHaHCOB B KOHTpOJIe, o,1lHOBpeMeHHo YJJ.OBJIeTBOPHB He06xo,1lHMOCTb CBIT B
vv,,,.,,,....."'.. rH6KOCTH, MHHHCTePCTBO MO)l(eT nOHm no                   nym Be,1leHHJI KOHTpOJIJI TOJIbKO ,1l0 YPOBHJI
CTaTeH (HanpHMep, KOMM)'HaJIbHble YCJIYrH B ueJIOM), 'l.feM nO,1lCTaTeH (OT,1leJIbHO rM MH
3JIeICTpH'l.feCTBo).               B nOM cnyqae Y MHHHCTePCTBS 6YJJ.eT nOJIHM HH<PoPMaUHJI 0 pacxoJJ.ax
JJ.O nO,1lCTaTeHHOrO YPOBHJI, nOCKOJIbK)' nOCJIe BHe,1lpeHHJI YHH<pHUHpOBaHHOH CHCTeMbI 610JVKeTa
H yqeTa, ee B03MO)I(HOCTH n03BOJIJIT Y'lHTbIBaTb, 3anHCblBaTb H npHCSaHSaTh KO,1lbl Ka)I(JlOH
OT,1leJ1bHOH onepaUHH H                              OTlieTbl JII060ro ypOBHJI arperaUHH, B                               BpeMJI.

4.93      AHaJIOrHliHbIM            06PMOM,        KorJJ.a     ¢>OHJl      pMBHTHJI           Ka)I(JlOrO       Y'lpe)l(JleHHJI      6Y,1leT
KOHCOJIHJJ.HpOBaH B ero OCHOBHOH                                MHHHCTePCTBO <pHHaHcoB MO)l(eT TSlOKe B.bI6paTb
BapHaHT Be,1leHIDI KOHTPOIDI TOJIbKO JJ.O YPOBHJI CTaThH. DOJJee Toro, npaBHTeJJbCTBO MO)l(eT
nOCTaHOBHTb,         l{T06hl       ,mo60H        HeHCnOJIb30BaHHbIH             OCTaTOK        Ha     Clie-ry     <pOHJlS     pMBHTHJI
SBTOMaTHlieCKH nepeHOCHJICJI B                                       CBIT Ha                               <pHHaHcoBbIH ro,1l.

4.94      B    ueJJOM, MHHHCTePCTBY <pHHaHcoB CJIe,1l0BaJIO 6b1:                              (i)   OnTHMH3HpOBaTh HOBbie H
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CaMOCTOJlTeJIbHOCTb 61OJl)I(eTHbIX OpraHH3aUHH                       .s    paCXO,1l0BaHHH c06CTBeHHbIX cpe,1lCTB;                      (ii)
06ecne'l.fHTb TO, l{T06bI HOBM CHCTeMa ymf<pHUHpOBaHHoro 61OJl)I(eTa H yqeTa n03BOJJJlJJa BeCTH
3<fJ<fJeKTHBHbIH 610JVKeTHblH KOHTpOJIb B PSMKax nepe,1lSHHbIX nOJIHOMO'l.fHII H nOJJ.OTlieTHOCTH Ha
ypOBHe yqpe)l(JleHHJI;          (iii)   n03BOJJHTb JII06blM OCTaTKaM ¢>OHJlOB pMBHTHJI                                       Ha KOHeu
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<pHHSHCOBbIH ro,1l; H (iv) n03BOJIHTb CBIT H ,1lpyrHM MeJlHUHHCKHM yqpe)l(JleHHJlM, npOIIIeJllIIHM


                                                                 51 

peq,opM)', BeCTH H H3MelUffb B Te'leHHe q,HHaHcoBoro ro,na CBOIO 61OJDKeTHYJO CMe1)' no <l>oH,naM
PaJBHTHR, 6e3 paCCMOTPeHHJI H o,n06peHHJI co CTOPOHbI HHCneKTOpOB MHHHCTepCTBa q,HHaHcoB.

4.95     <l>H.nYUHapHble    PHCKH      MOryr        B03HHKHyrb           npH    He,nOCTaTO'lHOCTH            HllH      CJJa60CTH
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He,nOCTaro'lHOrO     nocJJe.nyIOlI.{ero KOHTPOJIJI          Bcex HCTO'lHHKOB             q,HHaHCHpOBaHHR             (06bI'IHbIH
610JDKeT H <l>0H.l{ paJBHTHJI). ~R COKpalI.{eHHJI <j>H.n)'UHapHbIX PHCKOB, B03HHKaJOlI.{HX B CBR3H C
pacxo,noBaHHeM       H3 <l>OH.l{OB PaJBHTHJI,        npaBHTeJJbCTBY            He06xo,nHMO npHMelUffb TaKOH :>Ke
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npHMeIDIeTCR no OTHoweHHIO K 06bI'IHOM)' 6IOJDKe1)'. AHaJJorH'IHbIM 06PaJOM, YKpenneHHe
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PHCKH no BceM BH,naM rocy,napCTBeHHbIX cpe,nCTB.


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3aKynoK CTPaHbI B u,eJJOM. CHCTeMa, xaprucrepIDyIOlI.{aRCJI cJJa60 PaJBHTOH 3aKOHo,naTeJJbHOH
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np03pa'iHOCTbIO, He,nOCTaTO'lHOH KOHKYpeHu,HeH, npHIDITHeM KOH<j>JJHKTOB HHTepeCOB 3a HOPM)',
a TaK:>Ke OTcyreTBHeM CHCTeMbI paCCMOTPeHHJI H paJpeweHHJI :>KaJJ06 H npeTeIDHH, OCTaBJJReT
,nOCTaTO'lHO B03MO)KHOCTeH .l{JJJI He3<j><j>eKTHBHOrO HCnOJJb30BaHHJI pecypcoB, nOTeHUHaJJbHoro
Heu,eJJeBoro HCnOJJb30BaHHJI rocy,napCTBeHHbIX Cpe,nCTB H KOPPynlJ.IDl. Y'IHTbIBaR OTCYTCTBHe
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nOJJHOtwtO'lHH PYKOBo,nCTBa ceKTopa 3,npaBOOXpaHeHHJI.


4.97     MbI peKoMeH.nyeM MHHHCTepcTBY 3,npaBooxpaHeHHJI YCKOpHTb paJpa60TKY ,neTaJJbHOrO
PyKOBo,ncTBa no 38KYnKaM .l{JJJI Bcex 3aKYnaJOll{HX opraHH3aUHH B ceKTope 3,npaBooXpaHeHHJI.
npoeKT MO:>KHO OCHOBaTb Ha:      (i)   3KcnepHMeHTe CaMapKaH,na B paJpa60TKe runoBblx TeH.l{epHblX
,noKYMeHTOB H npe,noCTaBJJeHHH KOHCYJJbTaU,HOHHblX yc.rryr 3aKynalOlI.{HM OpraHH3aUHJlM,                                        (ii)
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4.98     PeKOMeH,nyeTCR     paJ,neJJHTb         PyKOBO,nCTBO       Ha     TPH     TOMa,    BKJJIO'IalOlI.{HX:        (i)    06lI.{He
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4.2.




                                                            52 

                                                              BCTaBK'8             4.2
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       •	   ,lJ.eTaJIhHOe Ol1HCaHHe npouecca 110)laqH H paccMoTpeHliS! .:lI<aJIo6 H npeTeH3Hii yqaCTHHKoB
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4.99        ,lln1l YKpeTLlleHIDI HHcTHTYUHoHanbHoH 6a3bl }.VI1I 3aKYfloK S ceKTope 3,ll.paSOOXpaHeHIDI,
MHHHCTePCTBY            3,ll.paBOOXpaHeHIDI            npe}.VIaraeTC1I               ocymecTBHTh           c1IeJJ.YIDW:He        ,ll.eHCTBH1I:    (i)
C03,ll.aTh nO,ll.pa3,ll.e1leHHe nOnHTHKH 3aKYfloK (HIlH B03RO)KHTb                                         :ny   CPyHKUHIO Ha O,ll.HO H3
cymeCTBYlOlUHX            nO,ll.pa3,lleneHHH          MHHHCTCpCTBa                   3ApaBOoxpaHeHIDI),              B   uenID{      BHeJlpeHIDI
HaJlRe>Kaw;HX         MeTOAOB        Be,lleHIDI      3llKYflOK      H      pa3pa60TKH              OTpacJ1eBOH       HopMamBHoH             6a3bl,
KOOp,llHHaUHH         ,ll.eJITeJIbHOCTH         no                         pa3pa60TKH            H   06HOBJIeHIDI         PyKOBO,llCTBa           no
3aKYnKaM:      (ii)   C03,ll.aTh ueHTpanbHblH 3aKYflO'lHbIH opraH .!lnSi ceKTopa 3,ll.paBOOXpaHeHIDI (HIlH
B03JIO>KHTh :ny CPyHKUHIO Ha cyw:eCTBYJOw:ee Be,ll.OMCTBO BHe MHHHCTepCTBa), KOTOPoe 6Y,ll.eT
OTBeqaTb 3a KOHC01lH,llHpOBaHHble                    3~,            ocyw:ecTBJI1IeMble B COOTBeTCTBHH C npoue,llypaMH,
YCTaHOBneHHhIMH B PyIcoBO,ll.CTOe no 3aKYnKaM.


4.100,lln1l           nOBblllieHIDI           np03pa'iHOCTH                 Ha           OTpacnesoM          ypoBHe,           MHHHCTePCTBY
3,ll.pasooxpaHeHIDI           npe}.VIaraeTCSI:         (i)   HHCPOpMHpOSaTh                     'IaCTHblH        ceKTOp     H      rpa>K,ll.aH        0
npe,ll.CT01llUHX      TOprax         H    0     pe3ynbTaTaX          npHcY>K,!J.eHIDI            KOHTpaKTOB                        ny611HKaUHH
yse,llOMneHIDI 0                          Ha oe6-caHre MHHHCTepCToa 3,llpaBooxpaueHIDI H pe3ynbTaTaX no
BceM    TeH,ll.epaM       CBbIllie        100    000     ,llonnapOB                ClllA.     Ha     06naCTHoM           ypoBHe,       BHe,llpHTb
aHanoru'lHble ny6JlHKaUHH (1IH60 Ha Be6-caHTe, 1IH60 Ha ,[{OCKax OO'bSiBneHHH) no KOHTpaKTaM
HH>Ke :noro nopora Ha 06naCTHoM, paHoHHoM, H yqpe)l(,!leH'IecKoM YPOBH1IX;                                                (ii)   CHH3HTh ueuy
npO,ll.a)KH TeH,llepHblx ,lloKYMeHTOB, KOTOPa1l ,llOJI)KHa nOKpbIsaTb TonbKO CTOHMOCTb ne'lam H


                                                                        53 

paCCbIJIKH no no~e, a He npHHOCHTb npH6blJIb.                   (iii)    YCTpaHHTb KOHCPJIHKT HHTepeCOB B cnyqae
«.n0PH ,l{apMOH» H           AO   «Y3TH6TeXHHKa».


4.101    ,Z:VUI       ycoBepllleHCTBoBaHIDI       CHCTeMbI         Ha,lI,30pa     H       KOHTpOJIJI       Ha,lI,     3aKYnKaMH,
MHHHCTePCTBY            3Jl.paBooXpaHeHHJI     npeMaraeTCJI         pa3Jl.eJIHTb      CPYHKUHH       BHelllHero           (KPY)   H
BHyTpeHHero (KOJrrpOJIbHlUI HHCneKQIDI) aYJl.HTa. BHyTpeHHHH aYJl.HT (HHcneKLUrn) Jl.OJDKeH 6bITb
npe06pa30BaH B HHCTpYMeHT ynpaBJIeHIDI MJI BbIJlBJIeHIDI HeJl.OCTaTKOB BO BHyTpeHHeH CHCTeMe,
HHCPOpMHpOBaHHJI PYKoBoJl.CTBa 0 cnoco6ax HX YCTpaHeHHJI, H MOHHTOpHHra HX peaJIH3auHH.


4.102    ,l{JIJI      nOBbIllleHHJI     KOHKYPeHl..{HH     3a    rocYJl.apCTBeHHble            KOHTpaKTbI             B    ceKTope
3Jl.paBooxpaHeHHJI, MHHHCTePCTBY 3Jl.paBOoXpaHeHHJI npeMaraeTCJI npHHJlTb CJIeJl.YlOIUHe MepbI:
(i)   YlJeCTb       OnbIT     npoeKTOB,    CPHHaHCHpyeMblx         IOllliCE<I>        H   Jl.pyrHMH        Me»myHapOJl.HbIMH
Jl.OHOpaMH, B nepecMoTpe MexaHH3MOB KOHTpOJIJI KalJeCTBa, B "IaCTHOCTH, nyreM YCTpaHeHHJI
Tpe60BaHIDI         perHCTpaQHH TOBapa MJI            npeJl.cTaBJIeHIDI         npeMO)f(eHHH,          a   TalOKe         npaKTHKH
BepHcpHKaQHH           QeH;    (ii)   HHHQHHpOBaTb       BHeJl.peHHe       npoQeJl.YPbI      nonyqeHIDI             06J13aTeJIbHOH
cePTHcpHKaQHH TOBapa no npHHQHny «eJl.HHOrO OKHa» nyTeM ee o6c~eHHJI C Jl.pyrHMH
rocYJl.apCTBeHHbIMH OpraHaMH BHe ceKTopa 3Jl.paBOOXpaHeHHJI.


4.103    B         QeJIJlX    nOBbIllleHIDI   KOHTpOJIJI     KalJeCTBa        MbI     peKoMeHJ{)'eM            MHHHCTePCTBY
3.npaBooxpaHeHHJI H3yqHTb OnbIT Jl.pyrHX cTpaH B 06JIaCTH 3aIUHTbI BHyTpeHHero pblHKa OT
KOHTpacpaKTHOH           npo.l{yKQHH      (oco6eHHo      cpapMaQeBTHlJeCKHX           npenapaToB)           nyTeM         C03.naHHJI
3cpcpeKTHBHbIX H 3KOHOMH"IeCKH Jl.OcrynHbIX CHCTeM KOHTpOJIJI KalJeCTBa H3.neJIHH.


4.104    B QeJIJlX nOBbIllleHIDI np03palJHOCTH B rocYJl.apCTBeHHbIX 3aKYnKax MbI peKoMeHJ{)'eM
MHHHCTePCTBY             3Jl.pasooxpaHeHIDI     pa3pa60TaTb          H     06HOBJIRTb        Ha      Be6-caHTe            OCHOBHble
TeXHH"IeCKHe CneQH<j>HKaQHH H Tpe60BaHIDI no TeM n03HUIDlM, KOTOpble HaH60JIee lJaCTO
3aKYTIalOTCJI HHJl.HBH.nyaJIbHbIMH MeJl.HQHHCKHMH yqpe)l(,l{eHIDIMH, B 3aKYnKax CTOHMOCTblO HIDKe
100 000 Jl.OJIJIapOB ClllA.

4.105    ,l{JIJI    YKpeIUIeHIDI lJeJIOBelJeCKOrO nOTeHQHaJIa B 06JIaCTH rocy.napcTBeHHbIX 3aK)'1l0K,
MHHHCTePCTBY 3Jl.paBOOXpaHeHIDI npeMaraeTCJI                       (i)    pa3pa60TaTb nporpaMM)' o6yqeHIDI MJI
MHHHcTepcTBa 3Jl.paBooxpaHeHIDI H MeJl.HUHHCKHX yqpe>KJJ.eHHH (3aK}'IIaJOIUHX OpraHH3alUiH)
COBMeCTHO C yqe6HbIMH 3aBeJl.eHHJlMH CTpaHbI, 06paTHTbCSI K .nOHOPCKHM opraHH3aUIDlM C
npocb60H 0 BbI}l.eJIeHHH cpHHaHcHpoBaHIDI yqe6HbIX nporpaMM, H                                (ii)   opraHH30BaTb KYPCbI
o6yqeHHe HHCneKTOpOB KOHTpOJIbHOH HHcneKllHH MHHHCTepCTBa 3Jl.paBOOXpaHeHIDI no KYPcaM
npOBeJl.eHIDInpOBepoK no CPaKTY npoBeJl.eHHbIX 3aKYnoK. B                             KalJeCTBe OCHOBHoro yqe6Horo
MaTepHaJIa Jl.OJDKHO HCnOJIb30BaTbCJI PyKOBO.nCTBO no 3aKYTIKaM.




                                                            54 

         V.             YIlPABJlEHHE 'IEJIOBE'IECKHMH PECYPCAMH" BOnpOCbI OnJlATbl TPY./.lA

5.1       B                     cTpaHe ceKTop 3.llpasoOxpaHeHIDI CTaJUGlSaere» C MHO)KeCTSOM CnO:>KHbIX
np06ncM, CS»:3aHHblX C '1CnOBeqeCKHMH pecypcaMH, B qHCnO KOTOPblX BXO.llfi Heo6xo.llHMOCTb
KOMnJJCKTaUHH COOTBeTCTByroLUHMH npOCPCCCHOHBJ1aMH (KaK no                               mny,   TaK H no KOnHqCCTBY),
coxpaHcHIDI H COBCPWCHCTBOBaHIDI Ka'lOOTBa HaBblKOB pa60THHKOB                                     CHCTeMbI 06pa30BaHH»:
H                        oTpblBa OT npoH3BO.llCTBa H ynpaBJ1CHIDI CBOCH nOBCC.llHCBHOH pa60'leH Cpe.llOH
MHHH'ICCKOrO, H HCMe.llHUHHCKOro (a,n:MHHHCTpaTHBHoro) nCpCOHBJ1a.                                 B   .llaHHOH maBe MI.l
aKUeHTHPYeT BHHMaHHC Ha                                            MeTO.llax, KOTopble CPOPMHpyroT nOBCe.llHeBHyro
pa6oqyIO cpc.ny Cpe.llH COTpY.llHHKOB CHCTeMbl nepBH'IHoro 3.llpaBooxpaHeHHlI, JiIX 3apfIJlaTY H
CPHHaHCOBbIC noow;pCHH»:, BMIO'Ia!I HaCM, oueHKY pC3ynbTaTOB .lle»:TenbHOCTH, KOHTponb H
OT'leTHOCTb              BHYTpH          opraHH3aUHoHHoH          HepapxHH.      MI.l    BKpaTue       H3J1araCM      o6w:yro
HHCTHTYUHOHBJ1bHyro                 CTpYKTYPY,        Ha    KOTOPYlO   onHpaIOTC.fI     3TH   MeTO.llbl,    H    KOTOpa!l     B
Y36eKHCTaHe, 60nbweH '1acTbIO, npC.llCTaBJ1CHa nOnHTHKRMH, onpC.lleJUfeMblMH Ha UCHTpBJ1bHOM
           aKUeHTHpy»: BHHMaHHe Ha TOM, KaK                                            nOnHTHKH                       MeTO.llbl
ynpaBJ1eHIDI H npaKTHKY Ha MeCTax, H, B nocne.nyrow;eM Ha 3CPCPCIITHBHOCTb H nO.llOT'leTHOCTb
nepCOHBJ1a. npe.llMeTOM oc06oro HHTepeca »:BJ1»:eTC.fI TO, B KaKOM CTeneHH caMH pa60THHKH
ccpepbI 3.llpaBOOxpaHeHIDI MOryT BJ1ID1Tb Ha CBOI{} Henocpe.llCTBeHH)'lO pa6oqyIO cpe.ny, 'ITO B
)KeCTKO                                   cpe.lle Y36eKHCTaHa HOCHT O'leHb orpaHH'ICHHbIH xapaKTCp.


5.2                                nJJoxoro ynpaBncHIDI Ka,n:paMH MOryT nO.llopBaTb                                      BCCX
peCYPCOB           cpHHaHcoBblX, MaTepHBJ1bHblX HRH '1enOBCqeCKJiIX, TeX, KOTOPblMH pacnonaraeT
           3.llpaBooxpaHeHHlI.             XOT»       TpY.llHO    co6paTb    »:BHble    CBH.lleTenbCTBa     CB1I3H     Me)l()])'
ynpaBJ1eHHCM nepCOHBJ10M H Ka'lCCTBOM 3.llpaBOOXpaHeHH»:,                         3KcnePTHbIc oueHKH H MHO)KeCTBO
npHMepoB H3 )l{H3HH rOBop»T 0 BIDKHOCTH nOM npo6neMbi .lla:>Ke B pa3BHTbIX cTpaHax.


5.3                          npOBC.lleHHOe HccnC.llOBaHHe         (Lewis, 2006)   BbUIBHRO B Me)I()])'Hapo.llHOM onblTe
HeKOTopblC npo»BJ1eHIDIX Hea,n:eKBaTHOrO ynpaBJ1eHIDI '1CnOBe'leCKHMH pecypcaMH, 6onbwa!I
'1aCTb    KOTOpblX             OTlIrOW;aeTC'f      TaKHMH        CPaKTOPaMH,    KaK      cna6a!1    HHcppaCTpYKTYPa           H
3KOHOMH'lCCKHe TpY.llHOCTH.                    K   JiIX '1HCny,    HaplI.llY C .llpyrHMH, OTHOCJITC'f:           a6ceHTeH3M
                        Ha     pa60'lCM       MOOTe     Boo6w;c     HRH     cOKpamcHHc        pa6o'lero     JlH1I);    HH3Ka!I
npOH3BO.llHTenbHOCTb TpY.lla; He.llOCTaTO'IHa!I 3a6oTa 0 MHeHTax; OTCYTCTBHe KOHTponli Ha,n:
                   MRa,n:wero Me.llnepCOHBJ1a, npe.llOCTaBJ1.HIOW;HM ycnyrH, BblXO.ll.fllUHe 3a paMKH JiIX
HaBbiKOB H onbrra; HecnpaBe.llJlHBalI npaKTHKa HaMMa; HenpaBHRbHOe HCnOnb30BaHHe paCXO.llHbIX
MaTepHBJ10B. MacwTa6 H cePbc3HOCTb 3TJiIX npo6ncM :ma'lHTenbHO sapbHpyroTCR B 3aBHCHMOCTH
OT cTpaHbI H cnoiKHBweHcli CpC.llbI, H cyw:eCTBYeT C'lHTaHHOC KOnH'leCTBO 6eccnopHo ycncwHbIX
MexaHH3MOB,             ecnH TaKOBble cyw:eCTByIDT Boo6w;c, .llJl1I JiIX pa3peWeHHlI. Cyw:eCTBYeT BeCKa!I
npH'IHHa      .llJl»:    TOro,      'lT06bl    H36eraTb      '1pe3MepHo     ynpow;eHHbIX      peweHHM,          BHHMaTcnbHO
OTHOCHTbC» K JiIX peBJ1H3aUHH H 06oone'lHBaTb COOTBeTCTBHe nlO6bIX .lleMCTBHM C OCTOPOiKHbIM,
Bce061.eMRIDW;HM PCCPOpMHpoBaHHeM, THna TOro, KOTopoe OCYW;ecTBnllereR B Y36eKHCTaHe.




5.4 B    .llaHHOM            pa3.llene   06CYiK.llaIOTClf    OCHOBHblC      CPYHKUHH     ynpaBJIeHIDI      '1enOBe'leCKHMH
pecypcaMH. OH Ha'lHHaere'f C OnHCaHIDI                      HHCTHTYUHOHBJ1bHOM H 3aKOHO.llaTenbHOH crpYKTYPbl,
KOTOPalI perynHpyeT ynpaBJ1eHHe qenOBe'leCKHMH pecypcaMH B ceKTOpe 3.llpaaOOXpaHeHIDI B
Y36eKHCTaHe• .D:BJ1ee paccMaTpHBaere'f HcnonHeHHe .llaHHbIX 3aKOHOB H 3aKOHO.llaTenbHbIX aKTOB
MeCTHblMH opraHaMH BJ1aCTH                    H Me.llHUHHCKHMH Y'lpC)K,l{eHIDIMH, a TaIOKe JiIX B03.lleHCTBHe Ha
3CPCPCIITHBHOCTb H nO.llOTlfeTHOCTb COTpY.llHHKOB B npouccce OKaJaHIDI Me.llHUHHCKHX yCnyr.


                                                                  55
HHcmumYU;UOHtlllbHaJI cmpy«mypa

5.5   Tpy,nOBOH        Ko,neKC                        C060H    06I1(y1O cTpYKfYPy            ynpaBJIeHIDI    pa60THHKaMH
ceKTopa      3,npaBooxpaHeHHJI.            ,[(onOJIHeHHeM      K     HeMY   CJl)')KHT        MHO:>KeCTBO    CneUHaJIbHbIX
oTpaCJIeBbIX yKa30B, nOCTaHOBJIeHHH H HopMaTHBoB, H3,naHHbIX npe3H,1leHTOM, Ka6HHeTOM
MHHHCTpOB, MHHHcTepcTBoM 3,npaBooxpaHeHIDI H ,npyrHMH Y'fpe:>K,lleHIDIMH, BKJIIO'IM npHKa3
MHH3,npaBa        N2         (OT ,neKa6pJl       2004         ,[(aHHbIH npHKa3 onpe,neJIJleT OCHOBHbIe BH,IlbI
,neUeJIbHOCTH .ceJIbCKHX Bpa'le6HbIX nyHrcrOB (CBn), a TaJOKe THnbl H KOJIH'IeCTBO mTaTHbIX
                   KOTopbIe                 HMeTb 3TH Me,nHUHHCKHe Y'fpe:>K,lleHIDI, BKJIIO'IM ,nOJI:>KHOCTb
3aBe.nywm.ero CBn (rJIaBHOrO spa'la), cpHHaHcosoro MeHe,ll:>Kepa, Bpa'ieH 06m.eH nparcrHKH H
Pa3JIH'lHbIe ,nOJI:>KHOCTH )lJIJI Me,nceCTep.          C Y'feTOM 'IHCJIeHHOCTH HaceJIeHIDI, npO:>KHBalOm.ero B
30He    06cny:>KHsaHH"1          CBn,      ,naHHbIH     npHKa3      YCTaHaBJIHBaeT          MaKCHMaJIbHOe     KOJIH'leCTBO
nepCOHaJIa, 3aHUoro nOJIHblH                          ,neHb no Ka:>K)lOH ,nOJDKHOCTH H Y'fpe:>K,lleHHIO. KpoMe
TOro, MHHHcrepcTso 3,npasooxpaHeHIDI, no comaCOBaHHIO C MHHHcTepCTBaMH cpHHaHcoB H
Tpy,na, YCTaHaBJIHBaeT mTaTHble HopMaTHBbI. ,[(aHHbIe HopMaTHBbI onpe,nemnoT KOHKPeTHblH THn
,nOJI:>KHOCreH H MaKCHMaJIbHoe KOJIH"-IeCTBO WTaTa (BbIpa:>KeHHLIe B CTaBKaX HJIH Harp)'3Ke Ha
nOJIHbIH pa60'lHH ,neHb), KOTOpbIe MO:>KeT HMeTb Ka:>K)lbIH BH,Il Y'fpe:>K,lleHIDI B COOTBeTCTBHH C
'IHCJIeHHOCTbIO HaCeJIeHIDI, npO:>KHBaIOm.ero B 30He ero OXBaTa. K npHMepy, Ha Ka:>K)lbIe                              2000
iKHTeJIeH B 30He CBoero 06cny:>KHBaHIDI CBn MOryT HaIDITb ,no                           1,5   CTBBKH BOn,      0,5   CTaBKH
Me,ncecrep )lJIJI cpH3HorepanHH H T.,n.


5.6   Bo Bcex CBn, maBBpa'i Ha3Ha'iaeTCH H CHHMaeTCJI C ,nOJI:>KHOCTH PYKOBo,nHTeJIeM paHoHHoro
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paHoHHoH 60JIbHHQbI), nepe,n KOTOpbIM CBn OT'IHThIBalOTCR no KJIHHH'IecKHM BonpocaM. B
IOpH,lllflleCKH CaMOCTORTeJIbHbIX CBn, r,ne pemeHIDI, npHHHMaeMbIe no HaHMY nepCOHaJIa,
comaCYWTCR         C MeCTHLIM c06paHHeM                rpa:>K)laH    (MaxaJIJIeH),   maBBpa'l,       B   COOTBeTCTBHH C
3aKOHo,nareJIbCTBOM, OTBe'laeT 3a Bce aCneKTbI ynpaBJIeHHH                           nepCOHaJIOM, TaKHe KaK HaeM
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npeMHpoBaHHe B COOTBeTCTBHH C ,neHCTBywm.HM 3aKOHo,naTeJIbCTBOM. rJIaBBpa'i TaK:>Ke OTBe'laeT
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CBJl3aHHble c nepcOHaJIOM, maBHbIM 06pa30M, a,nMHHHCTpaTHBHoro nJIaHa.


Ynpa6JleHUe K(U)PaMU Ha npa«mUKe

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                                                              56 

                                                                                    35
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       Pe<POPMbl nepBHtfHOro 3BeHa 3ApaBooxpaHeHIDI, npOBOAHMbIe npH nOMep>KKe BceMHpHoro
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B                      rAe 6blJIa npOBeAeHa              pe<popMa.       nOHRTHO,        tfTO   TaM,   rAe      pe<popMhI TOJIbKO
HatfHHaJOTCH, Bce elll.e SblHBJIHeTCSI OTHorneHHe K MeHH:lOlUeHCSI BJIaCTH H POJISIM Pa3JIHtfHbIX
HrpOKOS.        HHorAa        peaJIbHOe HJIH Ha.nyMaHHoe 6ecnOKOHCTBO CO CTOPOHbl paHOHHblX HJIH
06JIaCTHbIX                    3ApaBooxpaHeHHSI 0 cnoc06HocTH yqpelKAeHHH                                                B HOBOH AJIfI
ce6H POJIH, K npHMepy, 3aMeAJIHeT nepeAaqy JIHtfHbIX AeJI COTpYAHHKOB. TaM, rAe pe<pOPMbl
HatfHHaIOTCH:, paiioHHbIe H 06JIacTHble                                    Hac-rpoeHhl CKemHtfeCKH no OTHoweHHIO K
BepORTHOH          3<p<peKTHBHOCTH            HOBblX     <pHHaHCOBbIX       MeHeAIKepOB             CBn     H    COOTBeTCTBeHHOH
nepeAatfe <pHHaHCOBOH OTBeTCTBeHHOCTH.


5.9         TeM He MeHee, pe<POPMbl HMeJIH nOJIO)KHTeJIbHOe BJIIDIHHe Ha pe3YJIbTBThI AeH:TeJlbHOCTII
H nCHXOJIOrHtfeCKHH Hac-rpOH MeAHUHHCKoro nepCOHaJIa. <I>HHaHcoBble MeHeAIKepbI CBn H
BpatfH      06lll.eH      npaKTHKH,       npOlliJIH      (XOTh   H   He    COBceM         rJIy6oKOO)                         BonpocaM
ynpaBJIeHIDI nepCOHaJIOM, CO-rpYAHHKH BOCnOJIb30BaJIHCh -rpeHHHraMH, npOBOAHMbIMH Ha MecTax
H 3a Py6eJKOM, H B XOAe onpocoB, nposeAeHHblx B PaMKax AaHHoro OTtfeTB, 3aseAYJOlll.He H
                     OTMetfaJIH,       tfTO                   HOBOMY                     CBn H                           06eCnetfeHHIO
060pYAoBaHHeM, OHH nonyqaJOT 60JIbWe YAOBJIeTBOpeHIDI OT CBoeH pa60ThI. AHaJIOrHtfHO,
COTpYAHHKH BblCOKO ueHH:T yCHJIIDI no nOBbimeHIDO OflJIaThI -rpYAa H BHeApeHHIO <I>OHAOB
pa3BHTIDI. XOTH: np06JIeMbi OCTaIOTCH:, cYlll.eCTBYeT CHJIbHOe om.ym.eHHe Toro, tfTO ABHJKeHHe
HAeT B npaBHJIbHOM HanpaBJIeHHH AJIH: TeX, KTO pa60TaeT S paHoHax, nperepnesmnx pe<P0PMbl.


HaeM compyoHul<OIJ U CIJR3aHH6Ie lJonpocw

5.10        B COOTBeTCTBHH C PYKOBOACTBOM no                     CBn     H ApyrHMH AOKYMeHTBMH, HaeM COTpYAHHKOB
AOJ1)KeH npOSOAHThCH: Ha KOHKYPCHOH OCHOBe, H 3aBeAYJOlll.He YJK:e HMeJO npeACTaBJIeHHe 0 TOM,
tfepe3 KaKHe 06lll.He 3Taflbl npH 3TOM He06xOAHMO npOXOAHTb. Ha npaKTHKe, 3aBeAYJOlUHe
3MBJIH:JOT 0 TOM, tfTO HaeM COTpYAHHKOB, H:BJIH:eTCH OTHOCHTeJIbHO peAKHM C06bITHeM, oc06eHHO
B MaJIeHbKHX CeJIbCKHX                                      rAe HaceJleHHe HBJIH:eTCH nOCTOH:HHbIM H TeKY'-IeCTh
Ka.n;POB HeBeJIHKa. B           OCHOBHOM, OTAeJIbHbIe cnyqaH H3MeHeHHH B mTBTax npoHcxOART, no­
BHAHMOMY, H3-3a nepee3Aa MOJIOAbIX MeACeCTep nocne 38MYJK:eCTsa HJIH (B 60JIbmHHCTse
cnyqaeB)                  B AeKpeTHbIH OTnyCK. npH yxoAe lliTaTHblX CO-rpYAHHU B AeKpeTHbIH OTIIyCK
HJIH nOSlBJIeHHH BaKaHCHH, 3T0 MeCTO 3atfacTyw 3aHHMaeT APYTM CO-rpYAHHua,                                                             H3
AeKpeTHoro OTIIyCKa. KaK aJIbrepHaTHBHoe pemeHHe, HarpyJKa MOJKeT pacnpeAeJIRTbCH cpeAH




35   PyKOBO,LlIfI'eJII,   paliOHHOro    OT.aeJlIl   3.apasooXpaHeHHlI,   KOTOPbl~   o.aHOBpeMeHHO         lIBJIJ1eTCli   PYKOBOJlIfI'eJleM
uempaJIl>HoA pa~OHHoA 6onl>Hluw, OTBe'laef 38 BonpOCbI :l.lIpasoOXpaHeHilli HIl BeeA reppHTOplfH paliOHIl. no.a06Ho
::rrOMY, PYKOBo.aHTenl> roPO.1l.CKOro OT.aena 3,LlpasooxpaHeHHJI IIBJllIeTClI PYKOBO.llHTeJIeM uempaJIl>Hoft ropo.aCKoft
60JIbHHIW H OTBe'l8eT 3a BonpOCbl 3.npaBOOXpaHelfHlI B ropo.ae


                                                                  57 

OCTaBIllHXCSI       COTPy,nHHKOB   ,llJISI   TOro,   "IT06bl    H36eJKaTb    HaHMa    HOBbIX     COTPy,nHHKOB    H
npe,nOCTaBHTb ,nOnOJ1HHTeJ1bHbIH 3apa60TOK YJKe pa6OTaIOmHM IllTaTHblM COTPy.UHHKaM.


5.11      Ha pbIHKe TPy,Ua cymecTBYeT SIBHblH H36blTOK Me,UceCTep (TaK K8K CHCTeM8 06yqeHIDI
Rhlnv('.I<"~~1"T' qpe3MepHoe KOJ1HqeCTBO                   B p8Cqere Ha HMeIOmeeCH B HaJIH'1HH pa60QHe
MeCTa, KpoMe Toro, cymeCTBYeT MHeHHe 0 TOM, "ITO 06yqeHHe Me,nceCTep HBJ1HeTCSI n0J1e3HOH
no,UroToBKoH K 3aMYJKeCTBY), npH YrOM c)'lQeCTByeT HexnaTK8 BpaQeH 06meH npaKTHKH H
HeKoTopblX Me,UHu,HHCKHX CneQHaJIHCTOB. KOHKYPCHblH oroop ,llJIH TaKHX BaKaHCHH lj!aKTH"leCKH
HeB03MOJKeH, nOCKOJ1bK)' Me,UHQHHCKHe yqpeJKUeHIDI CaMH CQHTaIOT, "ITO HM nOBe3J10, eCJ1H
           HaHru XOTSI 6bI O,UHOrO            KaH,UH,U8Ta, JKeJ1aIOmerO 3aruITI, BaKaHcmo, OC06eHHO              B
CeJ1bCKOH MeCTHOCTH, KOTOPaSI CQHTaeTC)1 MeHee npHBJ1eKaTeJ1bHOH, QeM ropO,UCKaSI. CHTyau,H)l
              CJ10JKHWI     B   OT,UaJIeHHbIX        Me,UHu,HHCKHX     yqpeJKUeHIDIX,                            B
«He6J1arOnpIDITHbIX paHoHax»,            KOTOPblM     ,UIDKe He Bcer,Ua y,UaeTCSI          YKOMnJIeKTOBaTb   IllTaT
                B   2006   rotlY, no ou,eHKaM MHHHCTepCTBa 3,npaBooxpaHeHIDI, OK0J10                   300   CBIl
HCnbITblBaJIH oCTPYlO HeXBaTK)' BpaQeH H Me,UceCTep, a                10%    CBIl He HMeIOT B CBoeM WTaTe
BpaQa. IlpaBHTeJ1bCTBO pewaeT ,UaHHYIO npo6J1eMY nocpe,UcTBoM Ha,u6aBoK cneQHaJIHCTaM,
JKeJ1aIOIQHM pa60TaTh B ceJJbCKOH MeCTHOCTH, npe,UoCTaBJ1eHIDI J1bfOT npH nOCTynJJeHHH ,llJISI
cry,UeHTOB npH YCJ10BHH, "ITO OHH BepHyTcSI pa60TaTb ,UOMOH, a TaKJKe TPe6ySI OT cry,UeHTOB,
o6yqaIOIQHXC)1 Ha                                       OTPa6OTaTb TPH ro,Ua no Ha3HaQeHHOH .uOJ1JKHOCTH
B CeJ1bCKHX yqpeJKUeHH)1X nOCJ1e 3aBepweHIDI yqe6Hofo                       3aBe,nCHIDI.    HeKOTopble MeCTHbie
opraHbl    MaCTH       TaKJKe   npc,nnpHHHMaIOT        nOnbITKH     npHMe%        MC'uHllHHCKHX      pa6OTHHKoB,
npe,llJlaraSI, K npHMepy, 3eMeJ1bHble yqacTKH, co,UeHCTBY)1 nocTPoeHHIO ,UOMa, MH Ij!HHaHcnpYH
nJIary 3a o6yqeHHe cry,UeHTOB B o6MeH Ha npo4>eccHOHaJIbHOe 06SI3aTeJ1bcTBo.


5.12      Pa3J1HQHble C'TpaHbI HCnbITbIBaJIH pa3HbIe MeTO,Ubl peweHIDI npo6J1eMbI, CB1I3aHHOH co
CJ10JKHOCTbIO                      Me'uHQHHCKHX         pa60THHKOB      B    OT,UaJIeHHble     CeJ1bCKHe   paHoHbI
(BCTaBKa   5.1).    HeKoTopbIe H3 YrHX peweHHH MOryr Cpa60TaTb H B YCJ10BIDIX Y36eKHCTaHa.




                                                         58 

                                                                 npHMep           5.1
                  np06J1eMhI, KOTopLie CTaBHT HaeM COTPYJlHHKOB B CeJlbCKOii MeCTHOCTH B JlPyrHx crPSHSX


       npofinCMa HaliMa MC.1U!IDIHCKOro nCpCOHaJIa lIml CCJIbCl(oR MeCTHOCTH xapaKTepHa He TonbKO lIJIJI Yl6eKHCTaHa, ce
       nbrraJOTClI peWIITL B OOJIbWHHCTBe, ecJlH HC DO BCeX, CTpaHBX MHPa, BKJlJO'IalI JIWKe palBIITLle CTpaHLl.


    B MCJIC.llYHapOliHOM MaCWTafic, lIJIlI PCWCHIilI ::IToR BCliHO cyweCTBYIOWcR npofinCMLI C KOMnJlCKTatlHeR WTaTOB
       npHMelilllOTCJI palHLle MCTOJIDl - OT noowpeHHR, nOBblWaJOWHX nplITlImrenbHOCTb paOOTbl B HaneJlC.lle npHaJIe'lL
    1I0fipOBOnbHblX npCTCHlICHTOB, 1I0 60Jlce HHTePBCHIDIOHHCTCKHX Mep. nOllXOllLl BKJlJOliaJOT:
    ..      Y6eJ1u~eHue KO.MneHCaIlUu U noiJOep::NCKU. CJOlia BXOllllT nOBbllllCHHLle 3apnnaTLl, COUHaJIbHLle noco61il1,
            HanfiasKH Ha 1l0porOBH3HY, nOCoOlilI, BhmJla'lHBaCMLlC B HRrypaJIhHOR 1jl0pMe 1'IJ11'1 JlI'ICTaHUI'IOHHhlR Jlocryn K
            HHIjlOPMaUHOHHLlM pecypCaM H npoljleccHOHaJIbHLlM CCTlIM, 'ITOfibl yMeHhWlITb H30JlllIDllO. HanpHMCp, 8                              2007
            r0..!lY. ABCTpaJIHJI nHJlOTl'lpOBaJlR «naKCT npHBnC'leHIilI», B KOTOPbrli BXOJlIIT nOMOWb C paCXOJlaMH Ha ncpce3l1
            1'1 lKHJlbC, npcMIilI HaJIl'I'IHLlMH B KOHUC rOlla, onJlaTa np0e311a B cJI)"Iae cCMeflHLIX npofincM, KOMnLlOTep H
           Jlocryn K J!hrrepHCTy, a TaKlKe 6ecnJlaTHOC       .:5:,    ....w
    ..      CJlY::NCe6H1xe mpe606oHWI U ozpaHU'leHWI. CJOlla BXOJIIIT 06113aTeJIbHWl reorpaqm'lecKWl pOTatlHJI (nOJl06HO
           Toli, 'ITO npHMCHJleTCli B MHlIHRcIWM WTaTe AHlIXpa npanew) H JIHMIITLI Ha IjlHHaHcHpyeMLIc rocYJlapCTBOM
           JlOJllKHOCTH B rOpOJIcKHX paRoHBX. HOpsefHJI B palHOC BpCMlI npHHHMaJIa 3aKOHLI no 06eHM, HO HC seeflla
           PCaJIH30BblBaJla HX Ha npaKTl'IKc.
    ..     MemoolH. .MoOufjJulluP06oHHOZO 06CJ1Y::NCu6oHWI. K HIfM OTHOClITCli KPaTKOCPO'lHbIC nOe311KH COTpYJIHHKOB I'IJ1H
           BpeMcHHWl      HHTepHaTypa     (HopBefHJI     H    JIecOTo),       CneIDIaJIbHWl       nOJlfOTOBKa    llJlll       Toro,   '!TOfibl   JlaTh
           B03MO)l(HOCTL MJlanWCMY nepCOHaJIY flJlH MCCTHblM lKHTeJlllM OKalblBaTb yCJlyrn (MpaH,                              CWA, HMHRcKWl
           c.JIYlK6a 3JlpasooXpaHeHHJI), HJIH nepCJlBHlKHhie rocnlITaJIH (KlITaA).


    Y Ka)I(,llOro nOllXoliR CCTL npel'lMymcCTBa 1'1 HCJlOCTaTKH                     Ka)I(,llOMY tlY)l(CH TlUareJlbHblli nJlaH H PCaJIH3aUHlI.
   1l0nJiaTa, He06xoJIlfMaJI lIJIlI roro, 'ITOObl CJleJiaTh OTlIaJICHHLle 1I0JllKHOCTH npHBJleKaTeJlbHLlMH, MOlKeT 6bITL
   CJlI'IWKOM JloporocroJlweli Mepoli HJlH Bhl3BRTh HeliOBOJlhCTBO JlPyrHX COTPYllHHK08 fI KOHKypeHTHLlC TPC608aHHlI.
   DpolflcccHOHaJIOB MOryT OTIOJIKuyTL ofipCMeHlITeJIbHhle Tpe60BaHHlI no pOTauHH, XOTJI pOTauHH MOryT CTaTL
    IIpHBJIeKaTeJIhHblMIi npH HaJIH'iHH COOT8CTCTBYIOwero KOmpOJlll,                         npClIOCTaJlJIeHHH COTpYllHHKaM 1I0JI)I(HOfO
   YBalKeHHJI H pecypco8, II JlaJIbHeliwcro KRpbepHoro pOCTa. AIibTepHaTH8Hble MeTO.!lbl 06cJIYlKHBaHHJI (HanpHMCP,
   CO'leTaHHe       pafiOTbi     06yqCHHblX   MeCTHblX       lKHTeJleA        C     JlOnOJlHHTeJlbHblMH    nCpHO.1lH'IeCKHMH            npHeJ.1IaMH
   npoljleccHOHaJlOB) 80 MHOfHX CJIyqaJIx 6bl1lH ycncwHblMH, HecMOTPlI Ha CKcrrrHIDI3M BJIHlITCnLHhlX MellHIDIHCKHX
   KpyrOB.


   I1cmo~HuKU: lllK.Peful(        2006)           . ti"" n~w anv              .1:                          It ~b in                     IIHJlOTHLIR
   npoeKT no npHBJIC'IeHHlO H YlleplKaHHIO nepCOHaJIa 8 OT.!laJIeHHLle ""'''''''V~'''_                            BCCMHPHblR
   f'.(lOl\h\ u   Rn~   0001\)


5.13       HeCMoTPg Ha 3TH OrpaHH'IeHIDI, BCe PYKOBO,nHlerm CBn, nOnHKJ1HHHK, UelffIt)aJlibHbIX
paHOHHbIX H rOpO,nCKHX 60nbHHU B <l>epraHcKOH H CaMapKaH)].CKOH 06naCTHX Bhlpa:>KaJlH CBoe
6eCnOKOHCTBO H 3alurrepeCOBaHHOCTb no nOBO,lQ' HaMMa KOMneTeHTHhIX, KBaJlH<pHUHpOBaHHhIX
Me,nHUHHCKHX          pa6OTHHKOB          H   npH3HaBaJlH,           1.frO    IDIOXWI        pa6crra      HX    COTpy,nHHKOB              MO>KeT
0TPHuaTenbHO BJUUITb Ha COCTo)1HHe 3,nOPOBbg HX HaCeJleHIDI H nOK83aTenH, no KOTOPblM
yqpeJK.lleHIDI ,nOJDKHbl OT"lHTblBaThCH nepe,n CBOHMH BblweCTOHIUHMH OpraHaMH. nOCKonbK)'
,naHHble HH,lI.HKlITOpbl 3,nOPOSMI BocnpHHHMaJOTCH KaK nOK83aTenH pe3ynbTIlTOB ,neHTeJlbHOCTH
MeJUiUHHCKOro yqpeJK.lleHHSl Hero PYKOBO,n:HTeIlH,                                 fJ1aBHbIH Bpa'l no.rryqaeT, nOMHMO CBOHX
npo<peCCHOHaJlbHblX               06g3aHHOCTeH,          ,nonOJIHHTenbHO                    3aHHTepecoBaH                 B      nOCTOI1HHOM
MOHHTOpHHre pe3YJlbTIlTOB pa60ThJ COTPYJUlHKOB. npol1I.l1hlH aHaJlH3 CHCTeMbl 3,npaBOOXpaHeHHg
B Y36eKHCTIme, TIllOKe KaK H MHeHIDI CneUHaJlHCTOB B CaMOH CHCTeMe, KOTopble BblpaJKeHbl B
                                   )J)111 ,n:aHHoro aHaJlH3a, npe.u.nonararoT, 'ITO HeKOTopble PYKOBO,n:HTeJlH
MOryr npe,n:OCTaBJUITb HenOJlHYJO ()T'qeTHOCTh HIlH <paJlbCH<pHUHPOBaHHYJO CTaTHCTHK)'.



5.14       MHeHIDI, KaCaTenbHO Toro, 3a KeM 6blBaeT nOCJle,nHee cnOBO npH npHHRTHH pemeHHH no
HaHMY COTPy,nHHKOB, paCXO./UITCR. Pe3ynbTIlThI o6cne,noBaHHH yqpeJK.lleHHH nOKa3b1BaIOT, 1.frO
XOTJI pecnOH)].eHTbI BocnpHHHMwoT PYKoBO)UITeneH Me,n:HUHHCKHX yqpeJK.lleHHH KaK OCHOBHblX



                                                                     59 

mm" npHHHMWOmHX peweHHe no HaHM}' Cpe,llHerO H MJIa,llwero Me,llnepcOHana (a TalOKe Bpa'ieH
B     rOpO,llCKHX          Me,llHUHHCKHX        )"Ipe)f()l.eHIDIX),         B    cJl)"Iae     C              paHOHHble              opraHbI
3,llpaBOOXpaHeHH1I npHHHMalOT 3Ha'lHTenbHOe )"IaCTHe B HaHMe Bpa'ieH H q,HHaHCOBbIX
              36
MeHeJl)KepOB.    O,llHHM B03MOiKHbIM 06bllCHeHHeM :noro, MOJKeT CTaTh TO, 'ITO npH 3aTpY,llHeHHH
3anOnHHTb 3TH ,llBe ,l101DKHOCTH, CBn MOJKeT nOTpe60BaTbCJI nOMomb paHOHHblX BnaCTeH
3,llpaBOOxpaHeHIDI )]JIll TOro, '1T06bI HaHTii KaH)lH,llaTOB. TeM He MeHee, B 6ece,llax, npoBe,lleHHbIX
B CaMapKaH)lCKOH H <l>epraHcKoH 06nacTlIx, 60nbwHHcTBO rnaBBpa'leH, no BceH BH,llHMOCTH,
6bIJIH YBepeHo B TOM, 'ITO OKOH'IaTenbHLIH BbI60p 6bIJI 3a HHMH, H 'ITO OHH CMOryr BblCTOJITb no,ll
HaTHCKOM Heno,ll06alOmero BnH1lHIDI CO CTOPOHbl. B OTnH'IHe OT HHX HeKOTOpbIe paHOHHble H
06naCTHble opraHbI, KaK 38mHTHHKH                                                    Ha CBOHX TeppHTOprurx, 'lYBCTBOBanH,
'ITO OHH HrpalOT KnIO'IeByK> ponb npH ymep)f()l.eHHH                             HnH OTKnOHeHHH KaH)lH,llaTYp. npH 3TOM
He JlCHO, lIBJ1JIIOTCli nH 3TH nOnHOMO'IIDI                                      HnH nHWb q,opManbHOH BeJKJ1HBOCThIO B
HHTepecax 6nH3KHX OTHoweHHH.


5.15     OnHcaHHble          BLIwe     WTaTHbIe HOpMaTHBbI,                  KOTopble       Onpe,lleJ1RIOT THn        H      KOnH'leCTBO
                       KOTOpoe        MOJKeT       HMeTb        ,llaHHOe        Me,llIUlHHCKoe      )"Ipe)f()l.eHHe,          B03MOJKHO,
orpaHH'IHBaJOT He3aBHCHMOCTb PYKoBO,llHTeneH Me,llHUHHCKHX )"Ipe)f()l.eHHH,                                                    )]JIJI TOro,
'lT06b1    ,lleHCTBHTenbHO            OTBe'laTh     3a    ,lleliTenbHOCTb         CBOHX       )"Ipe)f()l.eHHH,     ,llOmKHbI         HMeTh
3Ha'lHTenbHbIe nOnHOMO'lH1l no npHIDlTHIO peweHHH, CBJl38HHLIX C 61OJl)KeTOM H KOMnneKTaUHeH
WTaTOB (BKnIO'I8lI HaeM H YBonbHeHHe). B XO,lle nOCemeHHJI )"Ipe)f()l.eHHH MbI 06HaPYlKHnH, 'ITO
MHome        PYKoBO,llHTenH,          no    BceH       BH,llHMOCTH,         6bIJIH    ,llOCTaTO'lHO    Y,llOBneTBOpeHbI              CBOHM
pacnpe,lleneHHeM WTaTOB, nH60 nOToM}' 'ITO OHO 6bIJIO, ,lleHCTBHTenbHO, a,lleKBaTHbIM, HnH                                              JKe,
nOToM}' 'ITO He 6bIJIO CMLIcna JKMOBaTbCJI no nOBO,lly CTporHX HopMaTHBOB. TeM He MeHee,
                     onaCHOCTb        TOro,     'ITO    HeXBaTKa           onpe,lleneHHbIX        HaBbiKOB     B      CHnY         mTaTHbIX
orpaHH'leHHH MOJKeT nOMewaTb Ka'leCTBY H THny ycnyr Me,llHUHHCKOH nOMomH, KOTOP8ll MOJKeT
6b1Tb OKa3aHa naUHeHTaM.


5.16    O,llHa H3 HaH60nee '1aCTO ynoMHHaeMblx np06neM - HeXBaTKa Bpa'ieH 06meH np8KTHKH ­
HCXO,llHT      He     H3     WTaTHbIX      HOPM8THBOB,          a     OT    HanH'-IH1I   TPY,llOBbIX     pecypCOB,            nOCKonbKY
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ee, pacnpe,llemul            H8rpYlKY Cpe,llH          HMelOmHXCJI          COTpY,llHHKOB HnH         JKe    nblTaJlCb nOBbiCHTh
npHMeK8TenbHOCTb               B8KaHTHbIX        n03HUHH.           npH     HaJJH'IHH     >KeCTKO     perynHpyeMoH                 CHCTeMbl
onnaTbI        TPY,ll8,      OHH      06na,llaIOT       Orp8HH'IeHHblMH              nOnHOMO'lHJlMH          )]JIJI     npe,llJ10JKeHHJI
,llOnOJlHHTenbHoro nOOmpeHH1I nOTeHUHanbHbIM Ka.H.,llH,llaTaM Ha CBOH YCMOTpeHHe. .D:aHH8lI
np06neMa            TaIOKe    HMeeT        MeCTO       6bITh     npH        HaHMe      KBMHq,HUHpOBaHHbIX                    q,HHaHCOBbIX
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a PYKOBO,llHTenH )"Ipe)f()l.eHHlI He HMelOT nonHoMOl.lHH nOBbIwan ee, 3a HCKnIOl.leHHeM BLInnaT
npeMHH         H3    61O,llJKeTa     <l>OH)la   Pa3BHTH1I,          'ITO    cnHwKOM         He3Ha'lHTenbHO         ,llJ1J1    OmyTHMblX
H3MeHeHHH.


5.17    nOnO>KeHH1I TPY,llOBOrO KO,lleKca, KOTOpbIe perynHpYJOT HaeM COTpY,llHHKOB, ,llHCUHnnHHy H
ysonbHeHHe, npe,llJ1aralOT nepcoHany 3aw.HTY OT npOH3Bona PYKOBO,llCTBa, OTBOJljl npoq,COlO3aM
ponb B npHIDITHH Ka,llPOBbIX pemeHHH (3a HCKnIO'IeHHeM HaMMa). PyKoBO,llHTenH )"Ipe)f()l.eHHH


36   B OTBeT H8 npocb6y Ha3BaTb Tex, lITO npHHHMaeT neplloe peweHlie no HIillMY IIpa'ieft llIDi ero Y'lPex<lleHHJI,                     50
npOueHTOII peCnOHlleHTOII II CBn CaMapK8H.llCKOIi oonaCTH CKa3aJIH, 'ITO PYKoBOllHTenb MellHUHHcKOro Y'lPex<lleHHJI,
a llPyraJI llonOBHHa Ha3BaJIa           plillOHHblft OTllen 311paaooXpaHeHHlI          I uetrrpaJIbHyK> pIillOHH)'IO 6onbHHUY. B
<f>epraHcKoli oonaCTH        61%   Ha3l1aJIH plillOHHb11i OTllen 311paaooxpaHeHHJI       I uetrrpaJIbHyK> pIillOHH)'IO 60JlbHHUY Ii
TOnbKO    30    npoueHTOB          PYKoBOJlHTen1l Me,llHUHHcKOro yqpe)K,!leHHlI. t.jTO KocaerCR HIillMI\ !j>HHaHCOBblX
MeHCJVI(CpOB,   57    npoueHTOB pecnoHllCHTOB II                            Ha3BaJIH PYKOSOllHTCIDi Y'lpe»meHHlI H            33   npoUCHTa
plillOHHblit YPODeHb, II TO IIpeMll KaK B <f>cPraHe      47   npoueHTOII Ha3BllJ1H palioHHble IIJ1aCTH H TOJIbKO        31    npoUCHTOII­
rnaay MeJlHUHHCKOro Y'lpe»meHHlI.


                                                                     60 

nepBH''fHoro 3BeHa 3}l,paBOOXpaHeHHJI rOBOpWIH 0 CLJHTaHHbIX (WIH Bo06me He BCTpeLJaBlIJHXC1I B
                                                                            37
npaKTHKe) CJI)'LJMX, KOr}l,a OHH       BblH)')K.neHbI YBOJlHTb COTpY}l,HHKa. B m060M cJI)'LJae, no
BceH BH}l,HMOCTH, HM TpY}l,HO 6blJl0 6b1 npe}l,npHHJITb T8Koe }l,eHCTBHe, }l,IDKe npH HaJlHLJHH
060CHOB8HH1I, TaK KaK }l,Jl.ll 3TOro He06xo}l,HMO 6blJl0 6b1 cornaCHe npo<pCOI03a.                                PyKOBO}l,HTemt
MOryI' peKOMeH}l,OBaTh COTpY.IlHHKaM          yWm no c06CTBeHHOMy iKeJlaHHID,                         LIT06bl H36eiKaTb nOTepH
penyTaUHH, 'ITO TaKiKe OCB060iK,llaeT PYKOBO,llHTeJl.ll OT He06xo}l,HMOCTH npe.llnpHHHMaTb KaKYID­
JlH60 0<pHUHMbHYID Mepy.


MOHUnwPUHZ pe3Yllbmanwe Oe»me.JIbHOCmU


5.18       He cymeCTBYeT CTaH}l,apTHoH CHCTeMbI eiKero.llHOH oueHKH pe3YJlbTaTOB .Ile1lTeJlhHOCTH
C0TpY.IlHHKOB,        COOTBeTCTByromeH         TOMy,     LITO      cymeCTBYeT          B       LJaCTHblX          KOMnaHHJlX        H
rocY.IlapcTBeHHhlX opraHH3au,HHX B pa3BHThIX 3KOHOMHK8X, a B X0.lle 6ece.ll C PYKOBO,llHTeJl}lMH
KaiK,IlOrO   YPOBH}]       eeKTOpa    3.1lpaBOOXpaHeHHJI,        .IlIDKe    eaMa    H}l,e1l       npoueeea          0<pHUHMhHOH
                oueHKH       Ka3aJlaeb                                          Bblpa3WIH                                 B    CBOHX
cnoc06HOCTHX          OueHHTh    pe3YJlbTaTbi      .Ile.liTeJlbHOCTH       CBOHX    Me.llHUHHCKHX               YLJpeiK,lleHHH      H
COTpY,IlHHKOB B XO.lle                 np8KTHKH PYKOBO.llCTB8 KJlHHHKOH.


5.19       PyKOBO.llHTeJlH    paHoHHhlX      H    roPO.llCKHX      OT.IleJleHHH      :mpaBooXp8HeHHJI                 HMeIDT,      no
KpaHHeH Mepe, TpH MeTO.lla C60p8 HH<popMaUHH 0 pe3YJlhTaT8X .Ile.liTeJlbHOCTH COTpY,IlHHKOB. Bo­
nepBhlx, cneUHMhHM rpynna H3                                paHoHHhlX                         H                         roPO.llCKHX
60JlhHHU npOBO.llHT KJlHHHtlecKYID npOBepKY KaiK,IlOrO YLJpeiK,lleHH}], no MeHhmeH Mepe, O.llHH pa3
B ro.ll. 3aTeM PYKOBO.llHTeJlh (rJlaBBpaLJ ueHTPMhHoH paHoHHoH WIH ropo.llCKOH 60JlbHHUbI)
H3.1laeT YLJpeiK,lleHHIO pacnopSliKeHHe C YKa3aHHeM BbUIBJleHHhlX He.llOCTaTKOB H CPOKOB HX
YCTpaHeHHJI.      BO-BTOPhIX,        YLJpeiK,lleHHJI    .IlOIDKHbl         npe.llCTaBJlSlTh           eiKeMeCSI'IHble         OTLJeThl
PYKoBO}l,HTemo UeHTpMbHOH paHoHHoH WIH roPO.llCKOH 60JlbHHUbI no                                          30-40      nOKa3aTeJlSlM
3.1l0POBh.ll HaceJleHH}]. HCCMoTpSl Ha TO, LJTO H3MCHCHHJI B .IlaHHblX nOKa3aTemiX MOryI' oTp8iK8Th
MHOiKCCTBO                                   BKJllO'IM Te, '-ITO BblXO.IVIT 3a paMKH KOHTPOJlSl YLJPCiK,IlCHH}],
HCKOTOPblC H3 HHX (TaKHe KaK paHHce BbISlBJleHHe 3a60JlCBaHHH H Pa3'bSlCHHTeJlbHhIC KaMnaHHH
     HMMyHH38UHH)          H8np.llMyro   CBSl3aHhl     C pe3YJlbTaTaMH            .IlCJlTeJlbHOCTH           PYKOBo.llHTeJleH       H
nepCOHaJla.     11,    HaKoHcu,      PYKOBO}l,HTCJlH     UeHTPMbHblX             60JlhHHU             npoBO}l,$lT    c06paHHJI      C
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nO.llBe.llOMCTBCHHOCTH HeCKOJlbKO pa3 B MecSlU, BO BpeMSI KOTOpbIX OHH B38HMO.lleHCTByroT JlHUOM
K JlHUY.


5.20       AHMOfH'IHbIM 06Pa30M, PYKOBO.llHTeJlH                                 Me}l,HKO-CaHHTapHbIX yqpe:1K.llleHHH
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.Ile.liTeJlhHOCTH CBOHX COTpY.IlHHKOB, B HX LJHCJlO BXOJUIT nOKa38TeJlH 3.1lpaBOOXpaHeHH}] C
KaiK,IlOH naTpoHIDKHOH Me}l,CecTpbl, KOJlHtleCTBO JlID.IleH KOTOpble 06paTHJIHcb 38 HMMyHH3aUHeH,
                                      (npOBO.llHMbIe Me}l,CeCTp8MH) H 06cyiK,IleHHe, npOHCXO}l,$lmHe Ha
eiKeHe}l,eJlbHblX COBemaHHJlX. B CHJJy TOro, 'ITO npH KaiK,IlOM nocemeHHH Me.llcecTpa }l,OJliKH8
.IleJlaTh 3anHCH B Kapre no                         naUHeHTY WIH ceMbH, m8BBpaLJ MOiKeT npOBepHTb
cymecTBoBaHHe H npHpoJlY 3THX 3anHceH BO BpeM.li nocemeHHH naUHeHTOM YLJpeiK,lleHHJI, H
HCnOJlb30Ban. HX }l,Jl51 ouemH .IleJITeJlbHOCTH Me.n;cecTpbI.


               He MeHee, B .n;8HHbIX Y"pe)K}.leHHHX, no-BH}l,HMOMy, He cymecTBYeT O<pHUHaJlbHblX
eiKerO,llHblX npOBepoK COTpY,IlHHKOB. OC03HaHHe PYKOBO}l,HTeneM BaiKHOCTH MOHHTOpHHra H


37 3TO OT.n:eJIbHble laKIDO'lfeHH1I, OCHosaHHble Ha OCHOBaHHH nOJIeSblX onpocos.                         B   xo.n:e o6cJIe.n:osaHH.li
yqpe>K.lleHHR, I1pOBe.n:eHHoro B CB1I3H C .n:aHHbIM HCCJIe.n:OBaHHeM, 6blJlO 06Hapyx<eHo HeCKOJILKO cnyqaes
YBOJIbHeHHSI.


                                                          61 

nO.lIJ(ep)l(KH    ,neHTeJIbHOCTH     UITaTHblX           COTpy,nHHKOB         3aCJIY)I(HBaeT       nOXBaJIbl,    O,nHaKO    TO,
HaCKOJIbKO 3$$eKTHBHO OHH6y.nyT npOBe,neHbl, 3aBHCHT TOJIbKO OT caMoro PYKOBo,nHTeJIH.
TaKHM 06PaJOM, JIHua, npHHHM8IOUlHe peUIeHHSI B Y36eKHctaHe, ,nOJl)l(Hbl TpaHcl}>0pMHpOBaTb
cYUleCTByIDUl)'lO         npaKTHKY        B     Ha,ne)f(nyIO         CHCTeM}'     e)f(ero,nHOH       oueHKH      pe3YJIbTaTOB
,neHTeJIbHOCTH,     C TeM,    qT06bl          nOMOqb        PYKOBO,nHTeJlHM       H   IlITaTHblM     COTpy,nHHKaM       B ,neJIe
OKaJaHHSI 60nee KaqeCTBeHHblX ycnyr CBOHM naUHeHTaM. HeCMOTpH Ha TO, ~O C03,naHHe H
BHe,npeHHe 3$l}>eKTHBHOH CHCTeMbl                     oueHKH     pe3ynbTaToB ,neJITeJIbHOCTH HBJIHeTCH CnO)f(HOH
3a.naqeH, Y36eKHCTaH MO)l(eT Hcnonb30BaTb 06UIHpHble Me)KJ{)'Hapo,nHble npHMepbl H OnblT
(HanpHMep, CTpaH BOCTOqHOH EBponbl) B ueJIHX paJpa60TKH caMOH OnTHMaJIbHOH ,nJISI CBOHX
YCJ'JOBHH CHCTeMbl.


5.22     XOTSI     He06xo,nHMOCTb              MOHHTopHHra            ,neHTenbHOCTH         nepCOHaJIa     H     pe3YJIbTaTOB
MepOnpHHTHH no oxpaHe 3,nOPOBbH OqeBH,nHa, OHa TaK)f(e HMeeT PH,n He,nOCTaTKOB. Bo-nepBblX,
BblBe,neHHe      3aKJllOqeHHH    HanpRM)'lO            H3    nOKaJaTeJIeH       3,nOPOBbR    HaCeJIeHHR       MO)f(eT   HHor,na
BblJIHTbCR B HaKaJaHHe opraHH3aUHH HJlH OT,neJIbHOrO qeJIOBeKa 3a C06bITHSI, BbIXO.nRUlHe 3a
paMKH    HX      KOUTpOJIR.   BO-BTOPbIX,             P)'KOBO,nHTeJIH     yqpe)f(,neHHSI      MOryT     6bITb    BblHy)f(,neHbl
npe,nOCTaBnRTb       HeTOqnyIO       HHI}>0PMaUHIO,            KOTOPaJI    HCKaJHT        06Ul)'lO    KapTHHY      COCTORHHSI
3,n0POBbR CTpaHbl. HanpHMep, B O,nHOM H3 yrny6JIeHHblX HHTepBblO C nOCTaBUlHKaMH ycnyr,
npOBe,neHHblX B aBrycTe         2007     ro,na, O,nHH H3 rnasBpaqeH CBO BCnOMHHJl 0 cnyqae, Kor,na OH
npe,nCTaBHJl cBoeM}' PYKOBO,nHTeJIIO ,naHHble KOTopble, XOTR H He 6b1JIH OTpHuaTeJIbHbIMH, HO Bee
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COMHeHHe,        caMblM    npoCTblM       OTBeTOM           CTaJIa   3aMeHa     UHl}>p    TaKHM      06PaJOM,    ~6bl OHH
COOTBeTCTBOBaJIH O)f(H,naeMbIM. XOTSI H3MepeHHe MaClUTa6a ,naHHbIX npo6neM B Y36eKHCTaHe
npe,nCTaBJIReTCR HeB03MO)I(HbIM, OT,neJIbHble ,naHHble CBH,nereJIbCTBYeT 0 TOM, qTO OHH MOryT
B03HHKaTb ,nOBOJIbHO qaCTO.


5.23     TpeTbHM       He,nOCTaTKOM           cYUleCTByIDUleH           CHCTeMbI      RBJIReTCR      3HaqHTeJIbHoe      6peMR,
KOTopoe HaJIaralOT Ha Me,nHUHHCKHe yqpe)f(,neHHSI qaCTble npoBepKH H Tpe60BaHHSI K O~eTHOCTH
pa3.TlHqHble     opraHH3aUHH.        B        xo,ne    rny6HHHblX        HHTepBblO        P)'KOBO,nHTeJIH       Me,nHUHHCKHX
yqpe)f(,neHHH npH3HaBaJIH B8)f(HOCTb H nOJIe3HOCTb MOHHTOpHHra H npaKTHKH O~eTHOCTH, HO
onHCblBaJIH 06'heM BpeMeHH H H3JlHlUHeH 6YM8)f(HOH pa60Tbl, KOTopble CHJlbHO OTBJIeKalOT HX OT
BbInOJIHeHIDI CBOHX Me,nHUHHCKHX 06R3aHHOCTeH.


5.24     00 BceH BH,nHMOCTH, cymecTBYeT MaJIO B03MO)f(HOCTeH .lJ.JlH npo,nBIDKeHHSI no cJIY)I(6e B
Me.lUiUHHCKOM       yqpe)f(,neHHH        Ha    OCHOBaHHH         XOpOUIHX       pe3YJIbTaTOB       pa6OTbl.     COTpy,nHHKaM
npHCBaHBaeTCHKaTerOpHSl B 3aBHCHMOCTH OT HX npol}>eccHOHaJIbHOH CneUHaJIH3aUHH H ypoBHR
aTTeCTaUHH. OOCKOJIbKY Me,npa6OTHHKH MOryT c,naBaTb aTTeCTaUHOHHble 3K3aMeHbl TOJIbKO no
HCTeqeHHH onpe,neJIeHHOrO nepHo,na B HeCKOJIbKO JIeT, a KaTeropHH Bcero TpH, TO cymeCTBYeT
JIHUIb orpaHHqeHHbIH npocrop .nJIR npo,nBH)f(eHHSI no OI}>HUHaJIbHOH HepapXHlleCKOH JIeCTHHue (H
lUKaJIe OlUlaTbI). 00 KpaHHeH Mepe, 1}>0PMaJIbHO, KapbepHbIH pOCT ,nOJl)l(eH 6aJHpOBaTbCR nOqTH
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ypoBHe, ,npyme C 3THM He COrnaCHJlHCb, TaK KaK JIH60 CqHTIlJ1H · 3TO 6eCnOJIe3HbIM, JIH60 He
CqHTIlJ1H TIO He06xo,nHMbIM.


KOHmpOllb u nOOOm14emHOCmb


5.25     CHcTeMa paHoHHblX H ropo,ncKHX OT,neJIOB 3,npaBooxpaHeHHSI OTBeqae-r 3a KOUTpOJIb H
HeCeT   OTBeTCTBeHHOCTb         3a       KaqeCTBO        Me,nHUHHcKOro          yxo,na,    OKaJblBaeMoro        nepBHqHbIMH


                                                                 62 

Me.llHKO-CaHJITapHblMH yqpe)K,lleHHJIMH, TalOKe KaK H 3a nOl(a3aTeJIH 3.ll0POBbll                         HaCeneHHJI.
PyKOBO.llHTenb O.llHOro H3 M)'HHU,HnaJIbHbIX OT.lleneHHH 3.llpaBOOXpaHeHHH, paCCKa3bIBM 0 CBOeH
pOJm no OTHoweHIDO K PYKOBO.llHTeJIJlM nO.llllHHeHHbfX yqpe)K,lleHHH, CKa3aJIa, "ITO «JlepIKHT HX
.n:yWH B ce6H PYKax», nO.llXO.llHLUM MeTa<popa JJ.JIH Toro HeMaJIOrO nOllTeHHJI K ce6e, KOTOPhlM
OHa 06JIa,llaJIa. B    Ka)K,llOM UeHTpaJIbHOH 60J1bHHue paHOHHoro HJlH ropO.llCKorO ypOBHlI eCTb
TalOKe 3aMeCTHTeJ1b rnaBHoro Bpa'la, OTBellWOLUHH: 3a Ha,ll30P Ha,ll CBn,                             H <pHHaHCOBbIH
ynpaBJIHIOLUHH-KOOp.llHHaTOp, KOTOPbIH                               pa60TY                    MeHe,lllKepOB CBn.


        nepe.lla'la <pHHaHCOBbfX nOJIHOMO'lHM B paMKax pe<popMbI Ha 06JIaCTIIOH ypOBeHb Morna,
nO-BH,llHMOM)', nO.llOpBaTb MaCTb paHOHHbIX                                3.llpaBOOXpaHeHH» B KJ1HHH"IeCKOH
HepapXHH. O.llHaKO Ha npaKTHKe 31'0ro He npoHCXO.llHT. 3aMeCTHTeJIb                                        O.llHOM H3
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Me.n:yqpe)K,lleHH»MH     B    ropO.lle,   6bill     nOCTaBJIeH       KOHeu,    KOr.lla    06JIaCTHOO     ynpaBJIeHHe
3.llpalaO<)XI)aIIelmJl BMeWMOCb, 'IT06bI                         TOT <paKT, "ITO OTBeTCTBeHHOCTb 60JIbHHUbi 3a
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<pHHaHCOBble MexaHH3Mbl.


Pe3J'IIbmambl 6 OO/l{lCmU ynpa8JU!HUU Ka()p06b1.MU pecypCQMU


5.27    CHcTeMa        ynpaBJIeHH»        Ka,llpaMH     B        ceKTope   3.llpaBOOXpaHeHH»          HMeeT    MHoro
nOJIOIKHTeJIbHbIX 'IePT. TaKHe BalKHble npHHUHnbl KaK rrO.llOT"leTHOCTb, oueHKa pe3YJIbTaTOB
.lleRTeJJbHOCTH, KOHKYPCHbIM HaeM H ynpaBJIeH"leCKM aBTOHOMH» - Bce npHCYTCTBYIOT, TOM IDIH
HHOM CTeneHH, XOTR cymecTBYIOLUHe nO,llXO.llbl "Y)K,llaIOTcR B cOBepWeHCTBOBaHHH H .llopa60TKe
JJ.JIH TOro, "IT06bI npHBeCTH HX B COOTBeTCTBHe C nporpecCHBHOM npaKTHKoH.


5.28     OTHoweHHe H cYLUeCTBYIOlUHM nOpR.lloK MeJJ.JIeHHO npHBO,llRTCR B COOTBeTCTBHe C
H3MeHeHHHMH <PYHKUHM H nOJIHOMO'l-IHM, Bbl3BaHHbiX                                         pe<p0pMaMH. HecMoTpjJ
Ha TO, "ITO Me.llHUHHCKHe yqpe)K,lleHHJI nepBH"IHOrO 3BeHa nonyqHJlH CTaTYC CaMOCTOKreJIbHOro
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                      MOfYT BblHrpaTb       OT    nOMepIKKH          ueHTpaJIbHhlX       paMOHHbfX     60JIbHHU    npH
pa3peWeHHH HOBhlX JJ.JIH HHX BonpOCOB IDIH IKe TeX, KOTOPblM He06xo.llHMO 60JIbWe pecYPCOB,
qeM OHH HMelOT B CBOHX .llOBOJIbHO orpaHH"IeHHbIX 6IO,llIKeTaX. npH 31'0M, O.llHaKO, qePTa Me)K,lly
nOMepIKKOM H .llOMHHHpOBaHHeM MOIKeT


5.29    Ha,ll CHCTeMOM ynpaBJIeHH» Ka,llpaMH .llOMHHHpYeT ueHTpaJIH30BaHHO YCTaHaBJIHSaeMall
nOJIHTHK3     H        HOPM3THBbl,         MHome            H3      KOTOPbIX         HBJIHIOTCH       IKecTI<HMH    H
Y3KocneUHMH3HPOB3HHbIMH. nOJIOIKHTeJIbHbIM RBJIHeTCH TO, "ITO CJIe.llCTBHeM TaKOrO .llOJIro
cymeCTBYIOLUero KOMaHJlHQ-KOlfrpOJIbHOrO MeHTMHTeTa, KalKeTCR, CTMO TO, '-ITO COTpY.llHHKH H
PYKOBO.llHTeJIH CTaJIH .llOCTaTO"lHO XopOWO 3HaKOMbI C Ka,llPOBOM nOJIHTHKOH H npaKTHKoH.
O.llHaKO KOr.ll3 "IHCTO MeXaHH'IeCKOM)' c06JIIO.lleHIDO Y3KO                                      IKeCTKHX npasH1I
Y.lleJIReTCH CJIHIllKOM MHoro BHHMaHHJI, a Ha He.llOCTaTKH yqpe)K,lleHH» peampYlOT IKeCTKHM
HaKa3aHHeM    (BMeCTo        nOMepIKKH,      'ITO                     HX   pa6QTY),      cTpa,llaeT    . cnoc06HocTb
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nOKa3aTeJIH 3.ll0POBbll HaceneHH», KOTOpbJe, npaKTH'IeCKH, He nOMWOTC$I HX KOlrrpOJIIO.


5.30    B   COOTBeTCTBHH C 3THM, TaKHe OCHOBHble Ka.n:poBble peIlleHIDI KaK HaeM HYJKHoro
KOJIH"IecTBa H THna COTPY.llHHKOB, KOTopble HaH60JIee nyqWHM 06pa30M OTBeqanH 6bl MeCTHbIM
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Me.llHUHHCKHX yqpelK.lleHHH, nOTOM)' 'ITO uelrrpaJIbHO YCTaHOBJIeHHble WTaTHble HOPMaTHBbl


                                                        63 

npe,Z(nHCblBaJOT HM, 'ITO ,Z(eJIaTb C K3,l(paMH. 3T0 Omrrb nO'z(pblBaeT HX B03MO)J{HOCTH npHBeCTH
CBOH YC.nyrH B COOTBeTCTBHe C MeCTHblMH nOTPe6HOCTRMH.




         B. OIUIATA TPY.lI.A It CTltMYJIHPOBAHlIE PA60THHKOB llEPBIf'IHOrO 3BEHA
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                                                                 64 

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5.35    npeMHH H3 tl>oHAa pa3BHTHli (60Jlee no.np06HblH aHaJlH3 npHBo.nHTCH B pa3.neJle no
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                                                    65 

                                                     Ta6JJHua       5.1 

                         npHMepHble Japa60TKH B CeJJbCKHX BpaQe6HbiX nyHKTftX                  (CBll) 

                                       (no     COCTORHIOO   Ha 1 RHBapR 2007 r.) 




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                                                            66 

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39 KOMMeHTapHH 0 nOcne,!lHeM nOBMmeHHH MHHHMaJlbHOit 3apnnaTbl palMemeHbl Ha npaBHTenbCTBeHHOM 

nopTaJle no a.zq>ecy: www.gov.uzJrulcontent.scm?contentId=28384. 


                                                                 67 

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                                                                     68 

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                                                                            69 

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                                                                     70 

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                                                          71 

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       nOHHMaHHSI         caMOH       CYTH        H    npOllecC8        KOHKYPCHoro                oroopa       B    llemlX            ynyqmeHHSI

                                                                       72 

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       CTOHT paCCMOTpeTb, MO)KHO JIH a,narrmpoBaTb KaKOH-JIH60 H3 3THX OnbITOB (llpHMep                                                   5.1)
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                                                                   73 

KHIDKKH COTPY,lUIHKOB) .u.OJDKHbJ 6bITb Cpa3Y nepe.u.aHbJ B Be.u.eHHe COOTBeTCTB)'IOIUerO   CBn.
C :nOH   peKOMeH.u.aJ..{HeH npHJJ.eT BHHMaHHe K TeK)'lllHM .lleJIaM H ysepeHHOCTh.




                                             74 

         VI. 	          KAIJECTBO YCJIyr nEPBH'lHOrO 3BEHA 3,l{PABOOXPAHEHIDI C n03IU(HH
                                  nOTPEEHTEJIEH H nOCTABlUHKOB YCJIyr

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KaqeCTBO nonyqaeMoH nOMOU{H, a TalOKe Ha CTeneHb OTBeTCTBeHHOCTH nOCTaBU{HKOB ycnyr 3a
npe)lOCTaBJlSleM)'lO HMH         nOMOU{b.        B   )laHHOH maBe npe)lCTaBneHbl )laHHble 06cne)lOBaHHSi
KaqeCTBa         npe)lOCTaBJIJleMbIX      ycnyr      (OKIIY),           pa3pa60TaHHoro         )lJ1J1    myqeHHJI           MHeHHJI
nOTPe6HTeneH H nOCTaBU{HKOB ycnyT no pJl)ly BonpOCOB, KacaIDU{HXCll ynpaBneHHJI H KaqeCTBa
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rpynnax, rny6HHHbie HHTePBbID). ,[(aHHM rnaBa COCTOHT m qeTblpex qaCTeH: qaCTh                                          A   H3yqaeT
MHeHHe                           06    yqpeJK)leHHllX IlMCn, CBJl3aHHOe                   C )lOCTynHOCTbID              ycnyr,     HX
KaqeCTBOM, Heo<pHQHMbHblMH B03Harp8JK)leHHJlMH H nO)lapKaMH, a TalOKe BJIHllHHeM He)laBHHX
pe<poPM, npOBe)leHHbIX B ceKTope; qaCTb                  B     paCCMaTPHBaeT KOMnneKC aHMOrH'IHblX BonpocoB C
n03HQHH         nOCTaBU{HKOB ycnyr,          T.e.    rnaBBpaqeH          60nbHHU     H    nOnHKJIHHHK,          BpaqeH       o6U{eH
npaKTHKH, aKyrnepoB H npoqHX CneQHaJ1HCTOB, a Me)lceCTep;                                (c)   B   qacTH C npe)lCTaBJIeHbI
HaWH 3aKJIIDqeHHll no nOBO)ly roro, KaK nOCTaBU{HKH ycnyr B3aHMO)leHcTBYIDT C MeCTHblMH
opraHH3aUHSiMH,         TaKHMH        KaK    MaxanJIHHCKHH              KOMHTeT,    B    uenllX         nOBbllI1eHHJI    KaqeCTBa
Me)lHQHHCKHX         ycnyr;   (d)     B     'faCTH   D       npe)lCTaBJIeHbI       OCHOBHble       3aKJIIOqeHHll        OKIIY      H
peKOMeH)laQHH no npe)lOCTaBneHHID rp8JK)laHaM 60nee II1HpOKHX B03MOJKHOCTeH )lJ1J1 yqaCTHll B
npouecce         pe.popMHpOBaHHll         ceKTopa,       O)lHOBpeMeHHo          nOBbllI1M      CTeneHb        OTBeTCTBeHHOCTH
nOCTaBU{HKOB ycnyr 3a KaqeCTBO Me)lHQHHCKOH nOMOU{H, OKa3b1BaeMOH HMH co06U{eCTBY.


                              A. MHEHHE nOTPEEHTEJIEH 0                      KA IJECTBE nMCn

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rpynnax B )lByx 06nacTSix, 6blJIH HanpaBJIeHbI Ha H3yqeHHe MHeHHll rOpO)lCKHX H cenbCKHX
ntvrn",f\UT'prlPU 0 KaqeCTBe nepBH'IHOH Me)lHKO-CaHHTapHOH nOMOU{H, KOTOPYIO OHH nonyqaIDT,
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OTBeTOB      no pJl.llY   BOnpocoB,         KacaroU{HXC.SI TaKHX .paKTOpOB,                KaK )lOCTynHOCTb,             KaqeCTBO
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nO)lapKOB, a TaIOKe BJIHllHHll He)laBHHX pe<poPM, npOBe)leHHblX B ceKTope.


Homo K oepBulluoH Me.l!UKD-CBUUTapnoii DOMOI!JB

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06Cne.LlOBaHHll      )lOMOX03J1HCTB         3a   nepBHqHOH           Me)lHKD-CaHHTapHOH            nOMOll{bID      06pamaJ1HCb
3HaqHTenbHO 60m,wee qHCnO 'UIeHOB ropO)lCKHX )lOMOX03J1HCTB                              (40-48%),        qeM 'UIeHbl cenbcKHX
)lOMOX03JlHCTB       (25-31 %)    (CM. npHlIOJKeHHe C-l).                 KaK    BH)lHO H3 Ta6nHQbJ             6.1,    OCHOBHOH
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B 06eHX 06nacnrx 6blJI0 nonyqeHHe npe)lSapHTenbHOrO )lHafH03a HlIH neqeHHll, HeJKenH qeM
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aHMmOB H 3a npOqHMH ycnyraMH.




                                                                 75 

                                                            Ta6J1Hua    6.1 

                OCHoBHble UeJJH o6pallleHHH 3a nepBH'IHOA Me.llHKo-CaHHTapHOA nOMolllblO 

                (npoueHT o6mero lJHCna nocemeHHii qneHaMH .Il0MOX03RiicTB B KalK)loii o6nacTH) 


           OCHOBHaH ueJlb                 r. CaMapKaH.Il             r. MaprHJlaH        CaMapKaH.IlCKaH                cDepraHcKaH
             nocellleHHH                                                                          06J1aCTb                o6J1aCTb
       llHaruoCTHKa/Jle'leHHe                       48                    47                           45                    49
        HeOTJlOlKH8H nOMOlQb                        19                    17                           6                     12
        TOJlbKOBaKUHHauHH                           9                     6                            13                     9
           TOJlbKO oxpaHa                           2                     6                            8                      8
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            l1cmO'IHUK:   06Cne.llOBaHHe OKITY. BCeMHIH!hlii 6aHK.

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            TpeX qaCOB. Do nOH npH'lHHe MHorHe naQHeHTbI CTapaJOTCSI He npHXO,ltHTh B

                                                                 76 

          nOJIHKJIHHHKY no nOHe)leJIbHHKaM.-             06cY:JICoeHue 8 ljJOKyc-zpynne, :JICeHUjUHbl
          20POOCKOU MecmHocmu                       Map2W1aH

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3BOHOK.


Bwoop Y'IpeJICiJenuu nep8U'lnOZO 38ena 3iJpa8ooxpanenUR, nOCeU4aeMblX lIJIenaMU
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                                                             77 

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6.11       Tor)la K8K pecnOH,lleHThI B 06JI8CTHX OTMet:fWIM, t:fTO Kat:feCTBO yCJIyr 3)lpaBOOXpaHeHH» 

          H8MMeHee B8)KHbIM cpaKTOpOM (OT                            8    )l0   .14%),       BJIH»lOmMM Ha Bbl60p yqpe)KJleHH», 

Kat:feCTBO    6bIJIO                  B8)KHbIM             MOTMBOM          B    Bbl60pe        yqpe)KJleHH»        nepBMt:fHOro    3seH8 

                        Cpe)lM ropO)lCKHX                                             t:fT0 OTp8)KaeT HWIw'me 60JIbWero t:fMCJIa 

WIbTepHaTMB, a TaK*e 60JIee BblCOKMH ypOBeHb )lOXO)la M 06Pa30BaHHH. B r. C8M8pKaH,lle                                                27% 

naUMeHTOB                     yqpe)KJleHHe Ha OCHOBaHMM BblCOKOro Kat:feCTBa                                                        ycnyr. 

       HaMHoro BbIwe TOro )Ke nOKa3aTeJIH B r. MaprMJIaHe                                      (6%),   f)le ypOBeHb 06pa30BaHMH M 

                                           HM)Ke, t:feM B r. CaMapKaH,lle. npHMepHo nOJIOBMHa ropo)lCKMX
)lOMOX03HHCTB (OT        45    )lO   48%)         npe)lnO'lHTaIOT CBOIO paHOHHYIO nOJIMKJIMHMKY, a )lJIH                24-26%
MecTOpaCnOJIo)KeHMe                                   He MMeeT 3HaQeHH».               H TOJIbKO 11-12% )lOMOX03.1IitcTB OT)laJIM
npe)lnOt:fTeHMe       t:faCTHbIM      BpaqaM,              t:fT0    OTp8)K8eT         06myIO       Y)loBJIeTSOpeHHOCTb         HaCeJIeHH»
Kat:feCTSOM                          nOMOmH,OKa3blBaeMOH MM B yqpe)KJleHH»X llMCn.


6.12       EOJIbWMHCTBO CeJIbCKMX )lOMOX03HHCTB )lJIH nonyqeHHH nepSMt:fHOH Me)lMKO-CaHHTapHOH
nOMOU{M npe)lnOt:fMTaIOT CBn JII06blM )lpyrMM yqpe)KJleHHHM                                    (73%       S CaMapKaH,llCKOH               M
79%      B <l>epraHCKOH: 06JIaCTH).             1-13   OCTaBWHXCH )lOMOX03HHCTB He3Hat:fMTeJIbHOe t:fMCJIO                          (10%)
npe)lnot:fHTaJOT ueHTpaJIbHble                                     60JIbHMUbI, OT        6   )l0   II %   OTMeTMJIM, t:fTO )lJIH HHX He
MMeeT 3Hat:feHHH, r)le OHM noJIyqaJOT nepBMl.JHYIO Me)lMKO-CaHMTapHYIO nOMOmh, npM YCJIOSMM,
t:fT0 ee Kat:feCTBO xopowee. HeCMOTPH Ha )l8HHble WIbTepHamSbI CBn )lJUI OKa38HHH ycnyr
nepBMt:fHOH: Me)lMKO-C8HMTaPHOH nOMOllUt B CeJIbCKOH MeCTHOCTM npaKTMt:feCKH He cymeCTBYeT.


6.13 	     B TO speMH KaK 60JIbWHHCTSO pecnOH,lleHTOB OTMeTMJIM, t:fT0 06pam8IOTCH 3a nepBHt:fHOH
                               nOMOmblO                B     rOCY)l8pCTBeHHble               yqpe)KJleHHH,       3Hat:fMTeJIbHaJI    )lOJIft
nOJIb3yIOTCR ycnyraMM, KaK t:faCTHbIX )lOKTOPOB, TaK M Ta6M60B (ueJIMTeJIeH). B                                         2007   roJlY qyTb      ~
         ,30%   )lOMOX03HHCTB B roPO)lCKOH MeCTHOCTH 06pall\aJIMCb 3a nOMOmhlO K t:faCTHbIM
Bpat:faM (M TOJIbKO OT         8     )l0   21%         nOTPe6MTeJIeH M3 CeJIbCKOH MeCTHOCTM nOCeTMJIM t:faCTHbIX
Spat:feH). ,nOMOX03HHCTBa CaMapKaH,llCKOH: 06JIacm                                     MeHbwe       scero npM6eralOT K ycnyraM
t:faCTHbIX Spat:feH    (8%).    B ueJIOM, TOJIbKO OT                  3   )l0    9%   )lOMOX03HHCTB o6pamWIMcb K Ta6M6aM s
2007 roJlY.

6.14       CpeJlM )lOMOX03HHCTB, 06pamswHXcH K t:faCTHblM Spat:faM, 60JIbWMHCTBO Ct:fHT8JIM, qro
3TH SpaQM OKa3bIBaIOT 60JIee Kat:fecTBeHHYIO nOMOmb no cpaBHeHMIO C TOH, KOTOPYIO OHM


                                                                          78 

nOJIY'laIDT B rOCY,1lapCTBeHHbIX yqpe)KJleHIDIX.                    Cpe,1lH npOqHX ynoMBHYTbfX npH'IHH 6blJIH
HaJIHqHe      KBaJIH<pHIWP0BaHHbIX              CneIWaJIHCTOB              WlH     060pY,1l0BaHHB,       KOTOpOrO       HeT      B
 OC'V1JllDC:TBeHHbllX yqpeX<}.leHIDIX. COBCeM                               qHCJlO naUHeHTOB 06paTWlHCb K qaCTHbiM
BpaqaM       no    peKOMeH,Jlal{HH      CBOHX       3HaKOMbiX          H    pO,1lCTBeHHHKOB.         CpeJlH    ,1l0MOX03BHCTB,
nOCeTHBlllHX Ta6H60B, 60JlblllHHCTBO 3MBWlH, 'ITO C,1leJlaJIH 3T0, TaK KaK OHH ,1l0BepBIDT Ta6H6aM
H   HX   TPa}.lHUHOHHbIM           MeTO,1laM    JleqeHHH.       )lpyrHe          npHqHHbl      3aKJlID'IaJIHCb   B    TOM,    'ITO
peCnOH}.leHTbI      qyBCTBOBaJIH                C HHMH KOM<pOPTHO,                          6blJIH H3Jle'leHbl HMH, 6blJIH
peKOMeH}.lOBaHbl 3HaKOMblMH              H     pO,1lCTBeHHHKaMH            WlH     He 6b1JlH     BblJIeqeHbI 0<pHUHaJIbHOH
Me,1lHl{HHCKOH HaYKoH.


6.15     B nO,1lTBep)l{JleHHe 60Jlee paHHHX BblBO,1l0B 06 y,1l0BJleTBOpeHHOCTM naIWeHTOB ycnyraMH
nepBHqHOH         Me,1lHKO-CaHHTapHoH          nOMomH,          ,1lByMH     OCHOBHblMH         npH'lHHaMH,       no   KOTOPblM
norpe6HTeJlH KaK rOpO,1lCKOH, TaK H CeJlbCKOH MeCTHOCTH He 06pamaIDTCB K '1aCTHbIM Bpa'laM,
6blJIH HaJBaHbl:       (i) OHH MOryT 06paTHTbc.lI K XOpOlllHM Bpa'laM B CBoeM paHoHHoM CBn I
nOJlHKJlHHHKe (OT         51 ,1l0 53% ,1l0MOX03.lIHCTB); (ii)      '1aCTHbIX BpaqeH CTOHT CJlHlllKOM
,1l0poro (OT      23 ,1l0 28%). He60JlblllM ,1l0JlB ,1l0MOX03BHCTB (OT 4 ,1l0 10%) He 06pamaeTCB K
qaCTHblM Bpa'laM, TaK KaK TaKOBbfX HeT B HX                                         A                 no KOTOPOH OHH He
06pamaIDTclI K Ta6H6aM, 3aKJlID'IaIDTC.lI B CJleJlYIDmeM:                  (i) OHH MOryT 06paTHTbCH K XOpOlllHM
Bpa'iaM B CBoeM paHoHHoM                        I   nOJlHKJlHHHKe (OT       41 ,1l0 47 %); (ii) OHM He ,1l0BepBIDT
Ta6H6aM, H Ta6H6bl He HMeIDT coapeMeHHoro                      Me,1lHl{HHCKOrO 060pY,1l0aaHH1I (OT 31 ,1l0 47 %).


OMama 3a yCJlyzu nep6uIIHoZO 36eHa 30pa6ooxpaHeHWI

6.16     OqeHb He3Ha'lHTeJlbHblH npOueHT naUHeHTOB nnaTHT Bpa'laM 3a yCJlym nepBH'IHOH
Me,1lHKO-CaHHTapHOH nOMomH.                    ,1laHHbIM onpoca naIWeHTOB npH BbIXO,1le H3 yqpe)l{JleHHB, B
cpe,1lHeM, TOJlbKO ,1l0      3% 3annaTWlH 3a onpe,1leJleHHblH               BH,1l ycnyr, OKaJaHHblX B yqpeX<}.leHHH B r.
CaMapKaH}.le H CaMapKaH}.lCKOH 06JlaCTH, a TalOKe B ceJlbCKOH MeCTHOCTH                                                06JlaCTM.
HCKJlID'IeHHeM       CTaJI    r.   MaprWlaH, me               10%   nOCeTHTeJleH 3annaTHJlH             0<pHUHaJIbHYID HJlH
Heo<PHIWaJJbHYID nnary. nOCeTHTeJlH CeJJbCKHX                                              B                                 H r.
CaMapKaH}.le OTMeTHJ1H, 'ITO OHH He nnaTWlH apaqy. CpeJlH1lll o<PHUHaJJbHM nnaTa Bpa'laM B
CaMapK3H}.lCKOH                     COCT3BWl3 npHMepHo              500    cYM, B                                     3000   CYM.
Cpe,1lH1l.lI Heo<pHIWaJJbHaH nn3Ta 3a ycnyrH Bpa'la, KOTOPM 6blJI3 npOH3Be,1leHa TOJlbKO                                      1%
naIWeHTOB B                                            COCTaBHJla      2500       cYM. B                               Ha ,1leHb
npOBe,1leHH1I onpoca npH BbfXO,1le H3 yqpe)l{JleHH1I, He 6blJIH ocymecTBJleHbI HHKaKHe nnaTe)l{H.


6.17     nOTpe6HTeJlH HMeIDT npaBo Ha 6eCnnaTHbie ycnym B yqpeX<}.leHH1IX nepaH'IHOrO 3BeHa
3,1lpaBOOXpaHeHH1I,       O,1lHaKO     OHH     ,1l0Jl)l(Hbl    nnaTHTb       3a    onpe,1leJleHHble    npoueJlYPbI.      TaKHM
06PaJOM, HeY,1lHBHTeJlbHO, 'ITO onpoc ,1l0MOX03J1HCTB Bbl.lIBWl, 'ITO                          42%   HaceJleHH1I nnaTWlH 3a
HeKOTopbIe BH,1lbI ycnyr nepBH'IHOrO 3BeHa 3,1lpaaOOXpaHeHHB B npOlllJlOM ro.!(Y.                                 O,1lHaKO B r.
CaMapKaH,Jle H CaMapKaH}.lCKOA 06JlaCTH naIWeHTbI                                 nnaTWlH 3a Me,1lHIWHCKHe                    'IeM
B <l>epraHcKoH 06JlaCTH H r. MaprnnaHe, r,1le pe<PoPMhI HaxOJl.lITCB H3 60Jlee paJBHToA CTaJlHH ­
21-29%   npoTHB       42-40%,       COOTBeTCTBeHMO. DOJlblllHHCTBO nnaTe)I(eH 6bUlH npOH3Be,1leHbl nOCJle
Jle'leHHlI, He)l(eJlH 'IeM nepe,1l HHM, oc06eHHo B ropO,1lax. B                         ceJlbCKOH MeCTHOCTH naIWeHTbl
nnaTHJlH KaK ,1l0, TaK H nocne Jle'leHH1I ropaJ,1l0 'lame, 'IeM B ropo,1lax                    (23-32 %     npOTHB    5-12 %).

6.18     OTHOCHTeJlbHO             He6onbllloe      '1HcnO      pecnomieHTOB            C006mHJlH       0     npe,1lOCTaBJleHHH
nO,1laPKOB    Bpa'iaM     3a nepBH'IHYID Me,1lHKo-caHHTaPHYID nOMOUlb.                            HeKoTopble Cpe,1lH         3THX
peCnOH,JleHTOB OTMeTHJlH, 'ITO BMeCTO ,1leHer 3a HX YCnyTH OHH ,1lapHJlH BpaqaM H Me,1lcecTPaM
nO,1lapKH WlH yromeHHe. CTOHMOCTb nO,1lapKa 6blJI3 pasHa                           7000-8000     CyM Ha O,1lHOro naIWeHTa.
DOJlblllHHCTSO                         C'IHTW1H 3TH nO,1lapKH npOJlBJleHHeM HCKpeHHeH 6narO,1lapHOCTH 3a
xopOlllee ne'leHHe      (60%),      HeKOTOpble nOJlaranH, 'ITO Me,1lpa6oTHHKH O)l(H,1laJIH nO,1lapKOB                    (23%),

                                                                79 

a Jl.pyrHe     (16%)   601lJIHCb, 'ITO 6e3 TaKHX nOJl.apKOB OHH He nOJIyqaT KaqeCTBeHHble ycnyrH B
6YJJ.YmeM.


6.19       llOJl.apKH BocnpHHHMalOTClI naUHeHTaMH KaK npOllBJIeHHe 6JIarOJl.apHOCTH HJ1H <l>opMa
OnJIaTbl, B 3aBHCHMOCTH OT cHTYaUHH H MeCTa OKa3aHHlI ycnyr. B CBll, K npHMepy, nOJl.apKH B
HaTYPaJIbHOH <l>opMe, KaK npaBHJ10, Jl.apllT JJ.Jl1l Jl.eMoHCTpaUHH 6JIarOJl.apHOCTH nauHeHTa. B
rOpOJl.CKHX yqpe)f()leHIDIx 60JIbUl)'lO qaCTb                nOJl.apKOB Jl.apllT B <l>opMe HaJIH'lfHbIX Jl.eHer, B
KaqeCTBe OnJIaTbl 3a TpYJl..


           MOIO CBeKpOBb npOOnepHpoBaJIH . Bpaq HaWero CBll npHXOJl.HJ1 K HaM KIDKJU>IH Jl.eHb B
           TeqeHHe Tpex MeClIueB H Jl.eJIaJI KaneJIbHHUY B                  7   qaCOB yrpa, B 06eJl. H BeqepoM. OH He
           6paJI C Hac Jl.eHer. OJl.HaKO KOrJl.a Y Hac 6blJla CBaJJ.b6a, Mbl npHrJIaCHJ1H 3Toro Jl.OKTopa H
           nOJl.apHJ1H       eMY     xopowee      capno [nOJl.apOK -       KOMnJIeKT           OJl.e)f()lbl   JJ.Jl1l   Hero].­
           06cY:JICoeHue       6 rjJOK)lC   zpynne, :JICeH~UHbl 24 -49, <1>epzaHa

           KorJl.a 3a6oJIeJI MOH M)0K, ero JIeqHJ1 Bpaq -                   Haw COceJl.. MOH M)0K npeJJ.JlO)KHJ] eMY
           Jl.eHer, HO Jl.OKTOP HX He 6paJI. MOH M)0K - MY3bIKaHT, H OH peWHJ1, 'lfTO oroJIarOJl.apHT
           Jl.oKTopa, KOrJl.a ero CblH 6YJl.eT )l(eHHTbClI. OH HrpaJI Ha CBaJJ.b6e ero CblHa 6eCnJIaTHO. -­
           06cY:JICoeHue 6 rjJOK)lC zpynne, :JICeHUlUHbl -24 -49, CaMaplWHO

6.20       KaK npaBHJ10, JIIOJl.H He npHHOCllT nOJl.apKH 3a 06blqHble npoueJJ.YPbl B CBll, TaKHe KaK
nocemeHHe Bpaqa JJ.JlJl BaKUHHaUHH, aHaJIH3a KpoBH, MOqH H KaJIa, Jl.HarH03a HJ1H nepBbIX
HeCKOJIbKHX HHbeKUHH H npoueJJ.YP. lJame nOJl.apKH Jl.ap"TCl, KOrJl.a naUHeHT ~e BblJIeqeH HJ1H
He     HCnblTbIBaeT         60JIH,   nOCJle    KYpca    JIelfeHHJI   HJ1H       HeMeJl.HUHHCKHX       npoueJJ.YP        (MaCCa)l(,
<l>H3HOTepanHJI) -           H TOJlbKO TeMH,         KTO   MO)l(eT n03BOJIHTb         ce6e TIlKHe nOJl.apKH (H eCJIH
MeJl.pa6OTHHK BHJJ.HT, 'fT0 lfeJlOBeK MO)l(eT HX ce6e n03BOJIHTb). HanpHMep, Jl.apHTb nOJl.apKH
nOCJIe KYPca aKyllIepCKo-rHHeKOJIOrH'lfeCKHX ycnyr lIBJIlIeTClI HOPMOH, HO nOJl.apKH He Jl.apllT 3a
OJl.HOpa30BOe 06cJleJl.oBaHHe HJ1H KOHCYJIbTaUHlQ aKyllIep-rHHeKOJIOra B TelfeHHe pa60qero Jl.HJ1 B
CBll.


6.21       B    COOTBeTCTBHH C KOMMeHTapIDIMH yqaCTHHKoB                          <1>0 Kyc-rpynnbl,    nOJl.apKH lIBJllllOTClI
06menpHHlITblMH H pa3JlH'lfaIOTClI B COOTBeTCTBHH C BHJl.OM yCnyf, a TaK)l(e MeCTOM H BpeMeHeM
HX OKa3aHIDI. B CBll nOJl.apKH Jl.apllT B peJl.KHX CJIyqallX, B OCHOBHOM, OHH npeJl.CTaBJIlIlOT c060H
yromeHHe Ha 06eJl. HJ1H ~H. lJeJIOBeK, KOTOPblH npHHocHT yromeHHe, MO)l(eT TalOKe H caM
npHHHMaTb yqacrne Ha Tpane3e. llPHHOCHMblH B nOJlJl.eHb nOJl.apOK MO)l(eT npeJl.CTaBJIlITb C060H
06blqHOe BTOpoe 6JIIOJl.0 K 06eJJ.Y C 6e3aJIKOrOJIbHblMH HanHTKaMH, CTOHMOCTblO npHMepHO Jl.0
10000      HJ1H   20000       CYM . EcJIH )l(e OH npenOJlHOCHTClI BeqepOM, TO K HeMY MOryT Jl.06aBHTb
6YTblJlKY aJIKOrOJIbHOrO HanHTKa. ECJIH nOJl.apOK npHHocHTClI Jl.OMOH K Bpaqy HJ1H MeJl.CecTpe, TO
OH, KaK npaBHJ10, npeJl.CTaBJllleT C060H MOJIOqHble npoJJ.YKTbl, CBe)l(HH XJle6, OBOmH, <l>PYKTbl HJ1H
eJJ.Y Jl.OMaWHero npHfOTOBJleHHlI. B                 0c06bIX CnyqallX naUHeHT MO)l(eT no.uapHTb TKaHb HJ1H
npeJl.MeT OJl.e)f()lbl (py6awKY HJ1H KOCTIOM). :>KJrreJlH ceJIbCKOH MecTHocrn C HH3KHM Jl.OXOJl.OM He
onaCaJOTClI 3a nOCJIeJl.CTBHJI, eCJlH OHH He Jl.apllT nOJl.apOK. OHH CKopee CTeCHRlOTClI Toro, 'ITO He
MOryT ce6e TIoro n03BOJlHTb. OJl.HaKO B rOpOJl.CKHX H POJl.HJ1bHbIX yqpe)f()leHHRX JIIOJl.H 60llTCR He
Jl.apHTb       nOJl.apKH.     DOJlbWHHCTBO         Jl.OMOX0311HCTB     npoTHB        Heo<l>HUHaJIbHbIX        nJIaTe)l(eH        3a
MeJl.HUHHCKHe YCJIyrH, KOTopble Jl.OJDKHbl npeJl.OCTaBJIlITbClI 6ecnJIaTHo (PHCYHOK                                5.2).     B   r.
MaprHJ1aHe         3a<l>HKcHpOBaH           caMblH     BblCOKHH      npoueHT        (80%)    pecnOHJJ.eHTOB,            KOTopble
BblcrynalOT npOTHB nOJl.06HOrO pOJl.a B03Harpa)f()leHHH. PeCnOHJl.eHTbl r. CaMapKaHJJ.a HMeJIH
MeHee HerarnBHoe OTHoweHHe K TaKHM nJIaTe)KaM                           (55%).       OJl.HaKO B CeJIbCKOH MeCTHOCTH
60JIbWHHCTBO Jl.OMOX03J1HCTB                (60%   B CaMapKaHJJ.CKOH 06JIaCTH H          74%   B <I>eprancKoH 06JIacrn)
CqHTalOT Jl.aHH}1O npaKTHKY HenpaBHJ1bHoH.



                                                              80 

6.22    B ueJ1DM, naUHeHThI, D6pamalOmHeClI B CBn HJlH HanpaBJ1.!1eMble H3 CBn B                                 uPo,    KaK
npaBHJ1D, ysepeHbI B TDM, 'ITO nDnyqaT                                 nepBwmylO Me)lHUHHCKYlO nDMDmb, 3a
HCKJ1IO'IeHHeM ycnyr, KOTDpble 06bI'IHO He OKaJblBaIOTCJI )laHHbIMH yqpeJKJleHHJlMH HJlH ycnyrH,
KOTopble He06xo)lHMO DKaJbIBaTb BO                              BpeM.!l Me)lHUHHCKHX pa60THHKDB.


        KaJK)lLle   )lBe       He)lemf    Mbl    npDBD)lHM      aHaJlH3    KpOBH.       Y     MeHJI    HH3KHM       ypOBeHb
        reMorJJ06HHa H 11 6epeMeHHa. MOM Bpa"! CKaJaJI, 'ITo. HanpaBHT MeHlI B 60J1bHHUY JlJJJI
        npDXOJKJleHHjJ JIe'leHHJI.        R   CKaJaJla, 'ITo. y MeHJI HeT Ha 3TD )leHer, Ha 'ITO Bpa'l OTBeTHJ1,
        'ITO J1eqeHHe - 6ecnnaTHoe.              M   3TD npaB)la - J1eqeHHe JleMCTBHTeJJbHO 6ecnnaTHo. BaM
        TDJJbKD He06xoJlHMO npHHDCHTh O)J,HDpaJoBble WnpHUbI.-                                06Cy;JICOeHUe     6    ifJOKJIC­
        zpynne, :»ceHUluHbl 24-49, CaruapKaHO

        KDrJl3 MHe nponHcaJJH BH-yTpHBeHHoe BJlHBaHHe, .II 06paTHJJcjJ B CBn. MeJlceCTpa
        CKaJaJla MHe, 'ITO Bpaq )lOJDKeH JIHI.JHO npoBecnl npoueJlYpy, H 'ITO Bce BJlHBaHHlI JleJJaeT
        Bpa'f. 3T0 06oWJIocb MHe              15 000 CYM. JIe'feHHe B      uPo CTOHJ10 MHe MeHbwe. B             rOpDJle
        HeT                     60JJbHHU - 6YJlb TO                              HJIH qaCTHble OOll'hlfUn
        06cy:»coeHue       6   ifJOKJIc-zpynne, M)I:JIC'lUHbl 24-49, il>epzaHa


        HeKOTopble         yqaCTHHKH            npH3HaJlH,     I.JTO   OHH      CaMM        npOJlBJ1jJIOT     HHHUHaTHBY
B03HarpaJK)leHHJI MeJlpa6OTHHKoB, a nOTOM ynpeKalOT ce611 3a 3Ty npaKTHKY. KaK BH)lHO H3
HIDKenpMBeJleHHbix KOMMeHTapHeB,                 HeKOTOpble 60jJJJHCb, 'ITO 6e3 3THX nnaTeiKeM OHH He
nonyqaT     KaqeCTBeHHblX         ycnyr,      HJlH    He   nonyqaT        HX   Bo06me,       JlpyrMe    nOJJaraIOT,      'ITO
B03HarpaJK)leHHJI 060CHOBaHbI, TaK KaK 3TOJlBJ1jJeTCJI TPaJJ.HUHeM.


        ECJJH He 3anJJaTHTb HM JleHer H OCTaRHTh pOiKalOmyIO iKeHmHHY, TO OHM He 6y.llYT
        JlOJJiKHblM 06paJOM 3a60THThCJI 0 HeM. Hac He nOKH)laeT 3T3 MblCJJb. -                              06cy:»coeHue    6
        ifJOKJIc-zpynnax, :»ceH.UlUH.bl 24-49, il>epzaH.a

        Bbl MOiKeTe )laTb CTOJJbKO, CKOJ1bKO CMOiKeTe M TO, 'ITO XOTHTe, Ha'fHHM OT                          100 cYM    M JlO
        2000 CyM -     06cy:»coeHue 6 ifJOKYc-zpynne, :»C€HUlUH.bl 24-49, CaruapKaH.O

        To, 'ITO Mbl HM JlaeM -          3mo caoaKa, KJlMYC, xaupWl            [noiKePTBOsaHHe].               HM HHl.JerO
        He JlaTb, TO no 6YJleT 6ecnOKOHTb Bac, noTOMY 'ITO B JlaJIbHeMWeM KTO-HM6YJlb eme
        MOiKeT 3a6oJJeTb, H Rac 6Y)leT MyqHTb MblCJJb 0 TOM, I.JTO Bbl He n06JIarOJlapHJ1H Bpaqa.                          M
        Rbi 6YJleTe BCIO iKH3Hb HYJKJlaTbC1I B nOMOlllH Bpa'la.- 06cy;JICoeHue 6 rP01ryc-zpyrme,
        CMeWaH.1UlR 50+, CaruapKaH.O

6.24    B    nO)J,TBepJKJleHHe pe3YJJbTaTOB             onpoca      npH    RblXOJle    H3    yqpeJKJleHHJI     yqacTHHKH
CeJJbCKHX $oKYc-rpynn OTMeTHJ1H, 'ITO B ueJJOM, pa60THHKH 3)lpasOOXpaHeHHJI He BblMoralOT
JleHer H He 6epYT JleHer C n3UHeHTOB CBoero paMOHa.


        R   npHXOiKY JlJJ.!I nonyqeHHJI HHbeKUHii H3-3a nOBbIweHHoro KpOB.!IHOro JlaBJleHHJI.                          R   He
        MOry n03B0J1HTb ce6e nnaTHTb, HO, TeM He MeHee, OHH BCCr)la XopOWO OTHOCJlTCJI KO
        MHe.- 06cy:»coeHue 6             ifJOKJIc-zpynne, :»ceHUluHbl 24-49, il>epzaHa

        R   'faCTO 06pamaIOcb K BpaqaM, y MeHJI MaJleHbKHe JleTH. ECJJH KTD-HH6YJlb H3 HHX
       60neeT,1I BccrJla MOry 06paTHThc1I 38 nOMOlUblO K JlOKTOPY - MoeMY coceJlY. OH
        HHKOrJla He              C MeHJI JleHer, TaK UK Mbl COCC)J,H H iKHBeM B O)lHOM Maxa.rme.­
        06cy:»coeHue 6 ifJOKYc-zpynne, MY:»C'lUHbl 24-49, il>epzaHa


                                                             81 

        >I ruIa'l)' 3a ycnyrH         "'IeM-HH6Y,Ub co cBoero oropo,Ua                 :ITO BblpIDKeHHe MOeH HC1Km:Hf1leH
        6narO,UapHOCTH. KOr,Ua-HH6Y,Ub HM [Bpa"'laM H Me,UCecrpaM] MO:>KeT nOTpe60BaTbCjJ MOjJ
        nOMOl.Ub, H li HHKor,Ua He OTKa:>KY HM.                            HM              MOli MallHHa. -       06cy::»coeHue
        (1   !jJ0KYC-2pynne, My::»e¥lUHbl 24-49, (/Jep2QHQ


6.25                    q,oKyc-rpynn 6blJ1H KaTerOpH"'IeCKH npOTHB BBe,UeHHjJ OruIaTbI 3a Bce YCJJYTH,
,UIDKe ecnH OHH Oq,HUHaJJbHbI H YMepeHHoH CTOHMOCTH. OH nonaralOT, "'ITO MaJJo06ecne"'leHHble
He CMOryT                    YCJJYTH, H "'ITO Oq,HUHaJJbHLIe ruIaTe:>KH el.Ue                                ynenHllaT paCXO,UI.I
naUHeHTOB.


        B 3TOM cJJY"'Iae MI.l 6y,UeM lIJ1aTHTb KaK B KaCCOBblH annapaT, TaK H Ha pyKH pa6OTHHKOB
        3,UpaBooxpaHeHHli. 31'0 He H3MeHHT CHTyauHH, a TonbKO y,UBOHT H8llH paCXO,UI.I. ­
        06CY:JICoeHue (J !jJ0KYC-2pynne, My::»e¥lUHbl 24-49, (/Jep2QHQ

        B m060M                       Bpa"'lH H Me,UceCTpbI 6y.llYT :>K,UaTh OT Bac                                            BLI
        ruIaTHTe      B KaCCOBblH annapaT,                   BbI   Bcer,Ua HaH.ueTe "'IT0-HH6Y,Ub H Jl)1JI Bpa"'la.
        06cY:JICoeHue        (J   !jJ0KYc-zpynne, My::»e¥lUHbl 24-49, (/JepZQHQ

        Bpa"'lH 6y.llYT                                 rOBOpl1Th HaM, "'ITO Y HUX KaKaJI-TO npoBepKa «CBepxy», H
        "'ITO HM ny:>KHbl ,UeHbrH Jl)1JI yrOl.UeHHjJ (HHCneKTopoB] H nO,UHHMYT CTOHMOCTh CBOUX
                  -   06cy::»coeHue 6 !jJ0KYC-2pynne, M)':JIC'IUHbl 24-49, CaMQP1(QHO

6.26    MaJJoo6ecne"'leHHI.le yqacTHHKH C"'IHTaIOT, "'ITO ,UIDKe CeH"'IaC CTOHMOCTb HeKOTopblX
YCJJYT (HanpHMep, aHaJJH30B KPOBH, MO"'lH H KaJJa, He06xo,UHMb1X Jl)1JI YCTaHoBKH ,UHarH03a), 3a
KOTopI.le OHH Heoq,HUHaJJbHO lIJ1aT.IIT He60nI.u:.ryIO CYMMY. Moma 6b1 6I.lTI. HH:>Ke. ,ll.pyrHe rOTOBbl
lIJ1aTHTb 3a ynbTp83BYKoBoe Hccne,UOBaHHe H q,H3HOTepamilo, ,UIDKe ocnH ux CTOHMOCTI. 6y,UeT
Bbllle, "'IeM B ropo,Ue, MH 6y,UeT npaCTo ,UocrynHa no cpe,UCTBaM.


        300 CYM 3a npocTOH aHaJJH3 -                    3TO cnHllKOM MHOro.           3a :ITH ,UeHI.rH MO:>KHO    KynHTI. na"'lKy
        "'1M, KOTOPI.Iii MO:>KHO                     nl1Th                  ,URR. -     06cy::»c'OeHue   6   !jJ0KYC-2pynne,
        :JICeHU/UHbl 24-49, (/JepZQHQ

        ITYCTI. OHH npe,UOCTaBJUIIOT nnaTHoe ynI.Tp83BYKoBoe Hccne,UOBaHHe 3,UecI., "'IeM MI.I
        6y,UeM e3,UHTb Jl)1jJ 3TOro B ropo,U. EcnH CTOHMOCTb 6Y,UeT TaKOH :>Ke, KaK H B ropo,Ue, TO
        nlO,UH 6y.llYT 3KOHOMHTh ,UeHbrH H BpeMJI.-                       06cy::»coeHue 6 !jJ0KYC-2pynne, cMewamwe
        50+, COMapKQHO

HOHllmue KO'leCmIJO


6.27    OCHOBHOH BI.IBO,U 06CJle,UoBaHHJI ,UOMOX03,sdicTB H onpoca npH BblXo,Ue H3 yqpe:>K,UeHHJI
COCTOHT B TOM, "'ITO JlIO,UH B uenOM y,UOBJ1eTBOpeHbI Ka"'leCTBOM OKa3I.IBaeMOH HM nepBH'IHOH
Me,UHKo-CaHHTapHOH           nOMOl.UH.            ITo    ,UaHHbIM    06cne,UoBaHHJI          ,UOMOX03JIHCTB       no,UaBJ1JIIOl.Uee
60JlbllHHCTBO      (93-97%)          6bInH        y,UoBneTBopeHbl         ycnyraMH       nepBHqHOH       Me,UHKo-CaHHTapHOH
nOMOl.UH, OK83aHHbIMH HM MH ux ceMbe 3a npOillJ1bIH ro,U (CMOTpHTe PHCYHOK                                       6.1),   npH 3'!OM
ypoBeHb y,UOBJ1eTBOpeHHoCTH                 6bln    HeMHoro BbIlle B cenbcKoH MeCTHOCTH. ITo ,UaHHblM onpoca
npH Bblxo,Ue H3 yqpe:>K,UeHIDl, 6blJ1 OTMeqeH                                         100%   ypoBeHb y,UOBJ1eTBOpeHHOCTH,
KOTOPblH MO:>KHO OTHOCTH K:                 (i)   KOPOTKOMY BpeMeHH O:>KH,UaHHJI             (10-15   MHHYT) npHeMa Bpaqa
MH Me,UceCTpbI,       (ii)        OTCYTCTBHIO npHBMernpoBaHHoro OTHOlleHHJI K J1K),UJIM C BblCOKHM
,UOXO,UOM MH K ,UpyrHM npHBMerHpoBaHHblM CnOJIM (3a HCKJllOqeHHeM 6epeMeHHblx )KeHl.UHH,
,UeTeH H npeCTapenI.JX),            (iii)    TOMY, "'ITO BpaqH H Me,UceCTpbI Bbl,UemIlOT COOTBeTCTB)'lOl.Uee


                                                                   82 

KOJll14eCTBO BpeMeHI1 Ha KOHCYJlbTaUl111 11 npOue.nyPbl, BHI1MaTeJlbHO BbICJI)'llI"Ball )KaJI06bl
naUl1eHTa 11 npe.l1.0CTaBJlIDI KOMneTeHTHbie OTBeTbl,                             (iv)   06eCne4eHI11O KOHqm.l1.eHUHaJIbHOCTI1
naUl1eHTaM B KOHCYJlbTaUl10HHOH KOMHaTe,                        (V)    a TaIOKe cnoc06HOCTI1 naUHeHTOB npO.l1.0Jl)Kl1Tb
CBOIO    06b1'UfYlO        .l1.ellTeJlbHOCTb      nocJle     BI1311Ta         K       Bpaqy.     Cpe.l1.11   He60JlblllOrO           npoueHTa
He.l1.0BOJlbHbIX    pecnOI-Ul.eHTOB       06CJle.l1.0BaHIDI            .l1.0MOX0311HCTB,           60Jlbllll1HCTBO     OTMe4aJIl1,          'ITO
OCHOBHalI npl1411Ha I1X HeY.l1.0BJleTBOpeHHOCTI1 6b1J1a CB1I3aHa C HeKOMneTeHTHOCTblO pa6OTHI1KOB
3.l1.paBOOXpaHeHIDI        I1JII1   He.l1.0CTaT04HOCTblO          BIDIMamUl,             BbI.neJleHHoro         11M   Bpa4aMI1.        Cpe.l1.11
np0411X    npl14l1H,       ynoMlIHYJ'bIX         B   MeHbllleH         CTeneHI1,          6bIJIa    He06xo.l1.I1MOCTb            nnaTl1Tb    3a
J1eKapCTBa, HeXBaTKa 060pY.l1.0BaHIDI .l1.JIR 06CJle.l1.0BaHIDI 11 .l1.JIl1TeJlbHOCTb o~aHIDI np"eMa
Bpa4a I1JII1 3anl1CI1 Ha np"eM.


                                                            PHCYHOK           6.1 

                  06IUaH Y.llOBJIeTBOpeHHoCTb nepBH'fHOH Me.llHKO-CaHHTapHoH nOMOlUblO 

          (npOQeHT OT o6IUero 'fHCJla naQHeHTOB - 'fJleHOB .llOMOX03HHCTB B KalK.llOH 06JlaCTH) 



                                               iii Y,qoBlleTBOpe Hbl      •    He y,qoBlleTBOpe Hbl


                   94 





                                                                                                                                 2


                  r. CaMapKaHA                   r. Mapll1naH                  CenbCK~e pa~oHbl               CenbCK~e pa~oHbl
                                                                                  CaMapKaHACKo~              <l>epraHcKo~   o6nacTH
                                                                                       o6naCT~




I1cmo~HuK: 06Cne.llOBaHHe .llOMOX0311HCTB, BceMHpHbIH 6aHK, ceHT1I6pb                              2007 r.

6.28      Ha PI1CyHKe          6.2   nOKa3aHbI         OTBeTbI     pecnOH.l1.eHTOB,              CBlI3aHHbJe      C I1X      rOTOBHOCTblO
BepHYTbClI B :ITO )Ke caMoe Me.l1.HUHHCKoe Y'fpe)K.l1.eHl1e B 6y.uymeM .l1.JIlI nOJlY'feHHlI Me,lUlUI1HCKOH
nOMOmH. DOJlblIll1HCTBO np"3Hamf, 'ITO OHM YAOBJIeTBOpeHbI ycnyraMl1, KOTOpble OHH nOJlY'fHJII1,
11 BepH)'J1HCb 6b1        B:nO)Ke CaMOe Y'fpe)K.l1.eHHe. O.l1.HaKO nOJlO)KHTeJlbHble OTBeTbl, B HeKOTOpOH
CTeneHI1, 6blJII1 60Jlee y6eAHTeJlbHbi Cpe.l1.11 CeJlbCKI1X )f(HTeJleH, qeM Cpe.l1.H ropo.l1.CKI1X                                   (69-75%
no cpaBHeHHIO C           58-66%).      XOTlI 113BeCTHO,               'ITO <I>epraHcKall 06J1aCTb .l1.0CTl1rJIa 60JlblIlero
nporpecca     B    npOBe.l1.eHI1H       pe<j>opM        nepBH'lHOrO               3BeHa        3.l1.paBOOXpaHeHIDI,         06CJle.l1.0BaHl1e
nOKa3arIO, 'ITO HaHMeHee Y.l1.0BJleTBOpeHHbIMH norpe611TeJlllMI1 6bIJIl1 naUHeHTbI 113                                      r.   Maprl1JlaHa
(58%),   a caMblMH Y.l1.0BJleTBOpeHHbrMH - H3 CaMapKaH.l1.CKOH 06J1aCTI1                                (75%).




                                                                  83 

                                                         PHCYHOJ<:   6.2 

                       rOTOBHOCTb BepHYTbcH B TO)ICe C8Moe JJe'lefiHOe Y'IpelK,UeHHe 

         (npoueHT OT ofimero 'IHCJla naUHeHTOB - 'IJJeHOB JlOMOX03HHCTB B K8lK,UOH OfiJJaCTH) 





                       E!lAa, TaK KaK Mbl 6blllM AOBOllbHbl     -Aa, TaK KaK6011bwe    HeT Bbl60pa         0 HeT

                                                                        75




                                            r. Mapn1JlaH            CeJlbCK~e paHoHbl      CeJlbCK~e paHoHbI
                                                                 CaMapKaH,QcKoH 06JlaCT~ ct>epraHcKoH 06JlaCT~



  J1cmO'lHUK: 06CneJlOBaHI1e JlOMOx03l1iiCTB, BceM11pHblit 6aHK, ceHT1I6pb              2007 r.

6.29     He3Hal.JIITenbHOe 1.JHCnO peCnOH,L(eHTOB ynoMHHaJIH 0                        np06neMax, C KOTOPblMH OHI1
cTonKH)'nI1Cb, npH nOJIY'leHHI1 nepBHl.JHOH Me./lHKO-CaHlITapHOH nOMOllll1 B 2007 fO~, O,llHaKO,
npl1 :nOM,   ,llon»   fOPO,llCKHX ,llOMOX03»HCTB (15%) Cpe,llH HHX 6bUIa HeMHOfO Bblwe, 1.JeM ,llonjl
cenbCK11X       ,llOMOX03j1HCTB      (7 -12%).       OCHoBHble           np06neMbl,         OTMel.JeHHble          fOPO,llCKHMI1
,llOMOx03»HCTBaMH:      (i)   npOC11JI11 ormaTbl 3a yC.fI)'fl1, (ii) 6bUII1 BblH)')K,lleHbl ,llOnfO )f(Jl.aTb npl1eMa
pa60THI1KaMI1 3,llpaBOOXpaHeHH» I1JII1 3anHCI1 Ha npHeM, (iii) HeXBaTKa ,lleHef Ha nel.JeHl1e, 11 (iv)
OTCYTCTBHe      CKOPOH     Me,llmutHcKoH        nOMOllll1.       B     1.Jl1cno   OCHOBHblX np06neM,            OTMel.JeHHbIX.
CeJJbCKHMH ,llOMOX03j1HCTBaMI1, BOWnl1:            (i)   ,llaJIeKOe pacnonQ)KeHl1e      CBll,        (ii) ,llOnfOe O)f(H,l:{aHHe
npl1eMa pa60THHKaMI1 3,llpaBOoXpaHeHH» I1JII1 3anHCI1 Ha npl1eM, (iii) HeKOMneTeHTHOCTb Bpal.Ja
I1JIH OTCYTCTBHe onblTa, (iv) npOC11JI11 ormaTbl 3a ycnyfl1, (v) OTCYTCTBl1e ,lleHef Ha nel.JeHl1e, H
(vi) OTCYTCTBl1e I1JIH YCTapeBwee 060pY,llOBaHl1e B yqpe)f(Jl.eHI1I1.


6.30     HeCMOTPjI Ha TO, 'ITO onpoweHHoe HaceneHHe BblCKaJaJIO B u:enOM y,llOBJIeTBOpeHHOCTb
ycnyraMH nepBl1l.JHOH Me,llHKO-CaHIITapHOH nOMOllll1, 60nbllll1HCTBO BHeen" PM npe,llJIO)KeHI1H
,llJIjI nOBbIWeHH» Kal.JeCTBa 11 paCWl1peHH» ,llocryna K ycnyraM. KaK BI1,llHO 113 Ta6nl1l.(b1 6.2,
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(53%);   (ii)    cOBepllleHcTBoBaHHe         nO,llfOTOBKH       BpaqeH       (49%);    11    (iii)    BBe,lleHHe     npaKTI1KH
KpyrnocYT01.JHOfO (24-qaCOBofo) 06c.fI)')KHBaHH» (38%).




                                                              84 

                                             TsCiJ1HQS 6.2 

       Mepbl no nOSblweHHIO K'S'JeCTSS H JlOC"ryI1HOCTH nepBH'JHoR MeJlHK'G-esHHTspHOR nOMOIQH 

                       (npOQeHT JlOMOX03RACTB B K'3)KJloR OCiJ13CTH H B QeJ10M) 



                                                                        r.CSMSp-      r. Map-                                         Deero
                           nPEMO'lKEHWI                                  K'aHJl        rHJ1aH            oCiJ1,             ODJ1.

   nOBbimcHHc JlOCryoHoCTH H KaqCCTBa MC,!lHKaMcmOB                        59             68                44                   56       53
   YJIY'Imcmlc OO,!lrOTOBKH Bpa'icA                                        64             53                34                   58       49
   BHCJl.PCHHC opaKTHKH Kpymocyro'lHofo                                     17            42                37                   43       38
   (24 'IaCoBoro) 06CJI)'IKHBaHIDI
   COKpamcHHe BPCMCHH OIKHJl.aHHli cKopoA nOMOlllH                         24             42                25               26           27
   Y JIY'ImcHHc OOJl.fOTOBKH Mc.ncccrep                                    27             20                17               34           25
   I1HtiJOPMHpOBaHlIC HaccnCHHlI 0 nnaTHhrx H                               IO            12                  9                  19       14
  6ccnnaTHhrx MCJl.HQHHCkHX ycnyrax
   06nCf'lCHHC opOQc.nyPJ:.J HaopaBncHHlI K cnCQHaJIHCTaM                   16            15                  9                  14       12
   H B .lI.Pymc yqpCIKJl.CHHlI



IfCmO'lHUK: BccMHpHhrA 6aHK, o6CnCJl.OBaHllC OKaJ3HIDI Ka'lCCTBCHHhIX yCJI)'f,                   £''''1'M''01;'" ...   2007 f.




6.31      .D:aHHbIe 06CneJi.OBaHHlI Ji.OMOX0311HCTB rOBopwr 0 TOM, tITO pec:popMhf 3Ji.paBOOXpaHCHHlI
MO:>KHO paCCMaT(JHSaTb B Ka'leCTBe Mep, HMeBWHX nOnOiKHTeJ1bHOe B03Ji.eHCTBHe Ha HaceneHHC.
Donce nonOBHHbI pecn0H,llCHTOB                 (66%)        B XOJi.e 06cneJi.OBaHHlI Ji.OMOX0311HCTB OTMeTHJ1H, tITO
KaqCCTBO YCIIYr nepBH'JHOrO JBCHa 3Ji.paBOOXpaHcHHlI nOBblCHlIOCb 3a nocneJi.HHe T(JH rOJi.a,
npH'IeM     HaH60nblllM          'IaCT!:.    :ITHX       pCCnOHJi.eHTOB     npHXOJi.lITClI      Ha    cenbCKYJO             MeCTHOCTb.
HeKOTopble YJIY'lweHHlI, OTMeqeHHble yqaCTHHKaMH <PoK)'c~rpynn 06CY:>KJI.eHHH, 6bmH CBlI3aHbi C
pacnOnO:>KeHHeM yqpe)KJI.eHHll, 060PYJi.OBaHHeM, a TaK:>Ke Ji.OC1)'TIHOCTblO ycnyr:



          CBn HMelOT HOBbIe HHCTPYMeHTbI H 060PYJi.OBaHHe.                                       HaM He HY:>KHO e3Ji.lITb B
          ropoJi. -       06cYJICoeHue 8 rjJ01cyc-zpynne, CMeWa1lHOe, 50+, CaMapKaHO
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          CaMapKaHO
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DOJIbWCe qHCnO :>KHTenCH B ropOJi.ax H                                  MecTHOCTH <i>epraHcKoH 06nacTH perynSlpHo
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06CncJi.OBaHHlI H BaKQHHaQHH, qCM :>I<HTeJIH CaMapKaHJI.CKOH 06naCTH (CM. npHllO:>I<CHHC C-2).
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                                                                .85 

6blJla H3 CenbCKOH MeCTHOCTH <l>epraHcKOH 06naCTH, TOr,na KaK CaMaJI HH3KaJI - H3 CenbCKOH
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6.33    XOTJI OTBeTbI, KacaJOlI(HeCJI B03,neHCTBHJI pe<p0pM Ha KaqeCTBO nepBHqHOH Me,nHKO­
CaHHTapHOH      nOMOlI(H,    6bIDH     B   uenOM   nOnO>KHTenbHbI,        MHome     onpollleHHble      BblPaJHJIH
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3THM 6bIDH 06ecnoKoeHbI B <l>epraHcKoH 06naCTH. HanpHMep,                   74%   pecnoH,lleHTOB COmaCHJIHCb
C TeM, qTO OHH He 3HaJOT, KaKHe Me,nHUHHCKHe ycnyrH JlBnJlIOTCJI O<pHQHaJIbHO nnaTHbIMH, a
TaKHe ,non>KHbI npe,nOCTaBJIJlTbCJI 6ecnnaTHO. TeM He MeHee, 60nblllHHCTBO pecnoH,lleHTOB                  (74%)
COrnaCHJIHCb C TeM, qTO Bce )l(HTenH HX HaceneHHoro nyHKTa HMelOT ,nocTYfl K 6eCnnaTHOH
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HeXBaTKa BpaqeH HJIH cneQHanHCTOB B COOTBeTCTByIOlI(HX yqpe)l(,lleHHJIX


6.34    TaKHM 06paJoM, OTBeTbI peCnOH,lleHTOB JlBJIJlIOTCJI nOKaJaTeneM HeKoro npOTHBOpeqHJI,
COnyTCTByIOlI(ero H3MeHeHHJlM B CHCTeMe 061I(ecTBeHHOrO 3,npaBooxpaHeHHJI. C O,nHOH CTOPOHbI,
ynyqlllHJIOCb    KaqeCTBO     ycnyr 3,npaBooXpaHeHHJI         H     HX ,nocrynHoCTb.     C   ,npyroH    CTOPOHbI,
npaBHJIa, perynHpyIOlI(He nnary 3a 3TH ycnyrH, OCTalOTCJI HeJlCHbIMH, a TalOKe HMeeT MeCTO
HeXBaTKa BpaqeH H ,npyrHX CneUHaJIHCTOB.               KpOMe Toro, >KHTenH cenbCKOH MeCTHOCTH              60nee
,nOBonbHbI CHCTeMOH nepBHqHOrO 3BeHa 3,npaBooxpaHeHHJI, qeM )l(HTenH ropo,nCKOH MeCTHOCTH.




                     B. n03UI(lUI nocTABlllUKOB no KA'IECTBY YCJlYr lIMen

6.35    fny6HHHble HHTepBblO, npoBe,neHHble C npe,nCTaBHTenJlMH nOCTaBlI(HKOB nepBHqHOH
Me,nHKo-CaHHTapHOH nOMOlI(H, 6bIDH Hcnonb30BaHbI JlJUI H3yqeHHJI HX nOHHMaHHJI H MHeHHH,
KaCaJOlI(HXCJI pJl,na BonpOCOB no ynpaBJIeHHIO 3,npaBooxpaHeHHeM, B qHCnO onpOllleHHbIX BOlllJIH
PYKOBo,nHTenH CBIl, 3aBeJl)'lOInHe paHoHHbIMH nOnHKJlHHHKaMH, BpaqH, aKYlllepbI, Me,nceCTPbI H
npOqHH Me,nHQHHCKHH nepcoHan H3 CBIl, naQHeHThI pa3JIHqHOrO B03paCTa, nona H ceMeHHoro
nonO)l(eHHJI,    npeno,naBarenH         Me,nHQHHCKHX        KOnne,WKeH,      npe,nce,naTenH       MaxannHHcKHX
KOMHTeTOB,      TPa,llHl..{HOHHble   uenHTenH,     npe,nCTaBHTenH        XOKHMHJlTa,     PYKOBo;:urreJlH   HHO,
HMelOlI(HX OTHOllleHHe K 3,npaBooxpaHeHHIO.


BuoeHue nOCma6~UKQ.MU 603oeiicm6UR pefjJopM

6.36    B   MaprHJIaHe, r,ne pe<poPMbI HaxO.llJlTCJI Ha 60nee npo,nBHHYTOH CTa,llHH, qeM B                     r.
CaMapKaH,lle, nOCTaBlI(HKH nepBHqHOH             Me,nHKo-CaHHTapHOH nOMOInH OTMeqanH                   paJnHqHble
n03HTHBHble       H3MeHeHHJI,        npoH30llle,nume     Bcne,nCTBHe        Pe<POPMbI     nepBHqHOrO       3BeHa
3,npaBOOXpaHeHHJI.      CHaqana      HaceneHHe,    TaIOKe     KaK    H   nOCTIlBlI(HKH   ycnyr,    OTHecnHCb    K
H3MeHeHHJlM C He,noBepHeM, HO BCKope npHHJlJIH HOBOBBe,neHHJI H npH3HaJIH HX nOnO)l(HTenbHOe
B03,neHcTBHe.


        BHaqane HeKOTopble BpaqH He XOTenH pa60TIlTb B KaqeCTBe BOil. HeKoTopble
        ysonHJIHCb, HO 3aTeM BepHYnHcb, TaK KaK ycnoBHJI TPy,na 6i,IDH nyqllle. OHH HMelOT
       . CBOH Ka6HHeT, a TaIOKe He06xo,nHMoe 060py,nOBaHHe H pacxo,nHble MaTepHanbI. BpaqH B
        ,npyrnx nOnHKJIHHHKaX MOryr HMeTb TonbKO o,nHY Me,ncecrpy, TOr,na KaK HawH BOil
        HMelOT OT ,nByx ,no TPex. -        3a8eO)'lOU/uu CeMeUHOU nOfluKlluHUKOU, Map2WlaH




                                                       86 

           HamHM naUHeHTaM HpaBHTC.II TO, 'ITO Y HHX OJl.HH Bpa'l Ha BCIO ceMbIO.                                 HM
           npHXO}l.HJlOCb XOJl.HTb B Jl.eTCK)'lOnOIlHKJlHHHKY, B3pOCJI)1O nOIlHKJlHHHKY H Ha )KeHCK)'lO
           KOHCYIIbTaUHIO. -       Tila66pfJIl   arE, Map2UJlaH
6.37       nOCTaBIUHKH ycnyr KaK B r. CaMapKaH}l.e, TaK H MaprHIlaHe, OTMe'laIlH nOIlO)KHreIlbHblH
3q,q,eKT     npoeKTa      «3Jl.OpOBbe-2»,      KOTOPblH         nOJl.Jl.ep)KHBaeT    peq,opMbl,       OCHalUaeT             H
nOIlHKJlHHHKH          HOBblM      o6oPYJl.OBaHHeM,             BHeJl.pHII     B    HeKoTopoH          creneHH        npj.JMoe
q,HHaHcHpoBaHHe CBn H nOIlHKJlHHHK, npeJl.OCTaBHII HeKOTOpYlO creneHb He3aBHCHMOCTH B
ynpaBJIeHHH cpeJl.CTBaMH H 3aKYnKaMH H ynyqIllHII nOJl.roTOBKY KMpoB.



           B npOIllIlOM roJlY BceMHpHbIH 6aHK 06ecne'lHII Hac                   3Kr annapaTaMH         H HHCTPYMeHTaMH
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           HHCTPYMCHTaMH, POCTOMcpaMH H BccaMH. -                          3aeeoylOUfuu ceMeUHOU nOllUKJlUHUKOU,
           CcwapKaHO

           CBn OCHalUCHbl nyqIlle, 'IeM HaIlla         60IlbHHua.-llpeoceOameJlb nporjJco103a arE,
                      MapZUJlaH

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           I1IOJl..IIM 3TH q,HIlbMbl. Mbl CMorIlH COKpaTHTb YPOBCHb HHq,eKUHOHHbIX 3a60IleBaHHH.­
           3aeeoylOUfuu CeMeUHOU nOllUKJlUHUKOU, MapZUJlaH

6.38                                     nOIlHKIlHHHK CaMapKaH}l.a BHJl..IIT nOIlb3Y OT C03Jl.aHH.II <l>OH}l.OB
pa3BHTHH B Ka)KJl.OH nOIlHKJlHHHKC (HCKOTOPblC Ha3bIBaIOT ero «q,OH}l.OM rnaBBpaqa»).


           jf KynHII KOMnbIOTcp H BceB03MO)KHOO HeJl.OpOroe 060PYJl.OBaHHe. B 2006 roAY MbI
           npH06peIlH                'IeM 3a npeJl.blJl.YlUHe TPH roJl.a. -         3a6eOYlOUfUU ceMeUHOU
           nOllUKJlUHUKO~       CCWapKaHO

           npHKaJ N!!276 n03BOIllIeT MHe BblJl.aBaTb npeMHH pa6OTHHKaM, npH6aBJIj.JTb                       15% K HX
           OKIl3Jl.Y TPH-'IeThlpe paJa B roJl.. Y MeHlI 60Ilbwe HeT np06I1eM C npH06pereHHeM
           MeJl.HKaMeHTOB. BCIIH AeHer rocYAapCTBeHHoro 6IOJl)KeTa HeAOCTaTOLlHO, TO .II MOry
           CHlITh HeKOTOpYlO CyMMY C Hawero CneUHaIlbHOrO CLleTa H KynHTb I1eKapCTBeHHble
           cpe.nCTBa. -     3aeeOJ'lOUfUU ceMeUHOU nOllUKJlUHUlWU, CcwapKaHO

6.39       YqaCTKOBble Bpa<m: H naTPoHIDKHhle MeAcecTPbI OTMeLlaIlH MHO)KeCTBO nOIlO)l(HTeIlbHbIX
HlMeHeHHM        B    nOIlb3Y    CBOHX      naUHeHTOB       B    pe3YIlbTare       peq,OPM,   npoBoAHMbIX         B    cq,epe
3ApaBOOXpaHeHH.II. B HX qHCIIO BOWIlH:               (i)   OT nauueHTOB 60Ilbwe He TPe6yeTC.II nOCTOlIHHoe
npO)KHBaHHe B paMOHe 06CJI)')KHBaHHj[ Bbl6paHHoro HMH I1eqe6HOrO yqpe)KJl.eHH.II Jl.II.II nonyqeHH.II
MeAHUHHCKOH nOMOIUH;              (ii)                     Bpa'iH H naTPOH3)KHble MeAceCTPbl nOIlHKJlHHHK,
nocelUaIOlUHe         AOMOX031IHCTBa,       06HapY:»\HBaIOT 60IlbHbIX              naUHeHTOB      H   COO6IUaIOT      0   HHX
nOIlHKJlHHHKe, K        KOTOPOH OHH npHKpenneHbl;                  (iii)   pa60THHKH Me.n.HQHHCKHX yqpe)KJl.eHHH
OCBe.n.OMIIeHbl 0       npHKaJe 425, npeAYcMaTPHBaIOlUeM Mepbl no                                           6e30nacHoro
MarepHHCTsa.


           Tenepb y Hac eCTh CKpHHHHr ueHTPbI, rAe )KeHIUHH MOryT 06cIIeAOBaTb Ha HaIlH'lHe
           TaKHX npH3HaKOB naTOIlOrH'lecKoM 6epeMeHHOCTH, KaK yrp03a npe)KJl.espeMeHHbIX
           PO.n.OB,                           MOA H BH1I-HHq,eKUIDI.                           rOAa HaJM y Hac He
           6blIl0 TaKOrO CKpHHHHr ueHTPa. -           AKyUtep, nOllUKJlUHUKa arE, Map2UJlaH


                                                             87 

        B   1996-1998 rr. pe3KO B03pocno qHCnO                       TY6CpK)'ne30M. O,nHaKo B
        nocne.nyIOIltHe ro,nM qaCTOTa 3a60neBaHH.II PC3KO COKpaTHnaCb. PaHbWC Mbl HanpaBJ1JIJ1H
        17-18 nal1.HCHTOB B npOTHBOTY6cpK)'ne3HblH ,nHcnaHccp e:>KCro,nHO, a Tenepb MI.l
        HanpaBJ1)leM TonbKO 3 HJ1H 4. -nYJlbMOHOJlOZ, £(rE, MapzWlaH

6.40     COTpy,nHHKH CBn <l>cpraHcKoH 06nacTH OTMeTHJ1H, 'tIT0 B pe3ynbTare pe<jJopM B c<jJepe
3JJ:paBooXpaHeHH.II npOH30wen p.llJJ:         CB.II3aHHblX C no,nroToBKoH BpaqeH H 60nee
WHPOKHM JJ:OCTYnOM K 06pa30BarenbHOMY MarepHaJIY. K npHMcpy, PaH3JJ:paBM (PaHoHHbIC
OTJJ:enCHH.II 3JJ:paBooxpaHeHH5I) H 06J13JJ:paBbl (06nacTHbIe ynpaBJIeHH.II 3,npaBooxpaHeHH.II)
opraHH3)'IDT 06yqalOIltHC K)'pCbl H ceMHHapbl .1lIDI BpaqeH, aKywepoB H MCJJ:CCCTep C ucnblO
OKa3aHH.II co,neHCTBHJI B nOBbIWeHH.II HX                 OJJ:HH H3 CBn <l>cpraHcKoH 06nacTH
HaqM ny6m.fKaumo C06CTBeHHbiX PYKOBOJJ:CTB H CnpaBO'lHHKOB no nCqeHHIO naI1.HCHTOB.

        HeJJ:aBHO JI 06HapY:>KHJ1 y OJJ:Horo pe6eHKa 3XHHOKOKK03 H caM nOCTaB·HJ1 JJ:HarH03, 6C3
        ynbYpa3BYKOBoro                       - BOn       , </Jepzana

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        no OMOH TeMaTHKe H Mbl npHMeH.IIeM HX. PaHbWe no O,nHOH reMaTHKC 6blJ1H KHHrH
        TonbKO OJJ:Horo aBTOpa. CeH'IaC MbI MO:>KeM npHMeH.llTb pa3nHqHble MeTO,nb1 neqeHH.II.
        Tenepb Mbl pacnonaraeM                                   nCqeHHIO aHeMHH, rHnepToHHH. O,nHH
        H3 yqe6HHKoB 6blJ1 HanHCaH B TaWJ1aKe, ero aBTopbl - Ca60xaTXOH MHp3aeBa H Hawa
        CTaPWaJI MeJJ:ceCYpa XMHMHXOH.                      yqe6HHKH HaM nOCTaBJIJlnH H3                      a
        renepb MbI caMH H3,naCM HX. -         3a6eoylOU/UU CBll, </JepzaHa

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        HaweH 6ece,noH. MHC 6blJ10 oqeHb npH.IITHo. - Meocecmpa CBn, </JepzaHa

6.41     TaK:>KC BOn      renepb         MOryT       npHHHMaTb         caMOCTO.llTenbHble        peWeHH.II   npH
).lHarHocTHpoBaHHH nal1.HeHTOB.

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       o,nHoro rOJJ:a, a Tenepb JI caM MOry pewaTh, KOro neqHTh JJ:OMa, a Koro Heo6xo)lHMO
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       06.113arenbHO. Tenepb JI caM MOry npHHHMaTh peWeHH.II. PaHbWe .II Mor npHHHMaTh
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       3aBHCHMOCTH OT HX nona HJ1H B03paCTa. BOn CBn, CaMapKaHO

6.42     Tenepb, KorJJ:a B yqpe:>K).leHH.IIX HMeeTC.II HOBoe MeJJ:HUHHCKoe H na60paTopHoe
060pYJJ:OBaHHe pa60TaTb C naUHeHTaMH CTMO ner'le, oco6eHHO B <l>epraHcKOH 06nacTH •

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         xHpyprWlecKHe Onep8l1.HH, TaK KaK M.II 3TOro y Hac CCTb Bce He06xo).lHMbIe
         HHCTPYMeHThI. -       Bon CBn, CaMapKaHO


                                                       88
         MbI npOnHCbIBaJIH HHbeKll;HH )l0 10                                   JlJUl JJe'leHHJI Toro HJJH
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         COKpaTHJJOCb qHCJJO HHq,eKll;HOHHbIX 3a60JIeBaHHH. B HameM CBn TaJOKe HMeeTCR
         TaKOe COBpeMeHHoe ooOPY)lOBaHHe, KaK        3Kr annapaT H 060pY)lOBaHHe .llJ1jI
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         YJI)"lWHJJHCb. -   3a6eoy1OUfuu CBll, (/)epzana

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         Y)l06Hbl B npHMeHeH.nt. PaHbllJe aKYlliep - rHHeKOJIOnt npOBepJUlH cep)llte6HeHHe
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         3aeeOylOUfuu CBll, (/)epzana


6.43                 Ha                    CB1f3aHHbIe    c· peq,opMaMH,       npOBO)lHMbIMH           B   cq,epe
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           Tpe6yeMoro       MR    3anOJIHeHIDI   Pa3JJHqHbIX     q,OPM,    a     TaJOKe                          B
KOHCYJIbTaLtHH C BbImeCTOHIUHMH HHCTaHltIDIMH H opraHH3altHRMH.                  OHH nOJIarWOT, 'ITO 3T0
OTpIDKaeTCH He TOJIbKO Ha KaqeCTBe H nO)lp06HOCTH )laHHblx, 3aHOCHMbIX B q,OPMbl, HO H Ha
Ka'feCTBe ycnyr, npe)lOCTaBJI1feMbIX naLtHeHTaM.


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        HCTOPHIO 60JIe3HH 60JIbHOro, a TaJOKe CTaTHCTH"IeCKHe q,0PMbI.           Y   KpynHblx
        OpraHH3altHH M.II noro eCTh cneltHaJIbHO OTBe)leHHbIH qeJJOBeK, KOTOPblH 3aHHMaeTCH
        3THMH )leJIaMH C yTpa )l0 Beqepa, HO Mbl HBJIJleMC1f He60JIbWHM yqpe:lK)leHHeM. ­
        3aeeOY1OUfUU CBll, CaMapKanO

        TOJJbKO no Ka:lK)lOMY H3 HanpaBJIeHHH (Kap)lHOJJOrIDI, nyJIbMOHOJIOrHR, ypOJJOntJl H
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        PaHbwe y Hac 6blJIH npOBepKH TOJIbKO O)lHH pa3 B rO)l, CeHqaC :lKe no     3-4 pa3a B rO)l.          3T0
        KOJIOCCaJIbHaJI TpaTa BpeMeHH, CHJJ H Hamero 3)lOPOBbJl.          3aeeoy1OUfuu CBfl,
        CaMapKanO

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6.44   BceM pa60THHKaM npHXO./lHTCJI pa60TaTb npaKTH"IecKH B )lBa pa3a 60JJbWe nOJJO:lKeHHOrO
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ycyry6JJReTCJI eme H naltHeHTaMH:




                                                  89 

          .llruKe eCJIH OHH 3HafOT, 'ITO 60JIbHOro He06xoJlHMO Be3TH B 60JIbHHQ)', OHH 3BOHJIT H
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          MHHYI'bl cnOKOHHoro BpeMeHH -                 3a6eiJylOlquu CBll, CClMapKaHiJ

Cnpoc na yC/lyzu nep6U1IHOU Me()UKo-canumapnou nOMoU{u

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y~3BHMbIX CJIOeB HaCeJIeHHJI, KOTopble He B COCTO~HHH HJIH He MOryT n03BOJIHTb ce6e e3JlHTb B
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6.46      Y cnyrH     CBn         (nOJIHbIH       H   npeJlBapHTeJIbHblH    JlHam03,    Ha:ma'leHHe      JIe'leHHJI,   H
HeCJIO)f(Hble npoueJlYPbl JIe'leHHJI) }')Ke 60JIee pa3Hoo6pa3Hbl, 60JIee BblCOKoro Ka'leCTBa H OHH
HaxO~JI 6JIIDKe K JloMY. B 'IaCTHOCTH, CBn MOryT npOBOJlHTb aHaJIH3 KpOBH, MO'IH H KaJIa,
He06xoJlHMbIH AJ1~          onpeJleJIeHHJI JlHarH03a,         a TalOKe     AJ1~   npocToro   06CJIeJlOBaHH~      nepeJl
BblXOJlOM    Ha pa60ry HJIH OTbe3JlOM                  Ha yqe6y. .lln~     60JIee CJIO)f(HbIX aHaJIH30B, KOTopble
HeB03MO)f(H0 npoBeCTH B CBn, 06pa3UbI ,ll,JlJl aHaJIH30B 6epyrc~ B CBn, npOBep~fOTCJI B uPE H 0
pe3YJIbTaTaX coo6mafOT B CBn Ha CJIeJlY10mHH JleHb. XOTR cHTYaUHJI eme He HJleaJIbHa, cnpoc
Ha YCJIYrH CBn, TalOKe KaK H YJlOBJIeTBOpeHHOCTb HMH, paCTeT no CJIeJlY10mHM JlBYM npH'IHHaM:
(i)   Y'Ipe)f(JleHH~ CBn CnpOeKTHpOBaHbl H CKOHCTPy"pOBaHbl Jl]lJl YJl06CTBa, KaK nepCOHaJIa, TaK
H naIJ,HeHTOB.      OHH     HaxOJl.llTCJI B pllJlHYce       4-5   KM HJIH 'Iaca XOJlb6bl OT JlOMa. PaHbwe caMoe
6JIH3JIe)f(amee     yqpe)f(JleHHe,          B    KOTopoe    npHXOJlHJIOCb    XO,nHTb    JIlOWlM,     HaxO.ll,HJ1OCb    Ha
pacCTo~HHH         30-50    KM;      (ii)       Pa60THHKH    3JlpaBOOXPaHeHH~        nOJIyqHJIH     Me,nHUHHCKoe       H
JIa60paTopHoe 060PYJlOBaHHe, MeJlHUHHCKHe H xHpyprH'leCKHe HHCTPYMembl, a TaIOKe CYMKH
AJ1~ MeJlCeCTep. 31'0 n03BOJIHJIO MeCTHblM MeJlpa60THHKaM OKa3bIBaTb nepBH'IH)'IO MeJlHKO­
CaHHTapH)'lO nOMomb.


6.47      TaK KaK YJlOBJIeTBOpeHHOCTb nQTPe6HTeJIeH BbIPOCJIa, 'IHCJIO BH3HTOB naUHemOB B CBn
BblPOCJIO JlO TOH TO'lKH, KOrJla CBn He MO)f(eT YJlOBJIeTB0PHTb cnpoc.


          Tenepb JIJOJlH npHe3)f(afQT K HaM C JlPymx paHOHOB. B paHOHe Hawero CBn npO)K}fBaeT
          60JIee   15 914   'IeJIOBeK, H 3'{0 O'leHb MHOro. Pa60TaTb C TaKHM 60JIbWHM KOJIH'IecTBOM
          JIfOJleH CJIO)f(HO. -     3aBeJlYfOmHH CBn, <l>epraHa


          PaHbwe Mbl HanpaBJIJlJIH nauHemOB C npocryJlOH B 60JIbHHQ)'. CeWiac Mbl cnpaBJIJleMCJI
          co BceM caMH.- 3aBeJlYfOmHH CBn, CaMapKaHJl


6.48      qHCJIO naUHemOB H3 ceMeH                    co   CpeJlHHM    ypoBHeM     JlOXOJla H MaJIoo6ecne'leHHbiX
B03POCJIO B pe3yJIbTaTe OTTOKa ropoJlCKorO HaCeJIeHHJI H3 ropoJlOB H HannblBa MHrpaHTOB H3
CeJIbCKOH MeCTHOCTH B ropoJla . .llaHH~ JlHHaMHKa He TOJIbKO yseJIH'IHJIa cnpoc Ha YCJIYrH, HO H
CMeCTHJIa HX B CTOpOHy npo<pHJIaKTH'IeCKHX MeponpHJITHH.


                                                             90 

        Tenepb Y HaC                 nau.HeHTOB H3 MMo06ecneqeHHhIX ceMeH, a TaIOKe O,!UtHOKHX
        npeCTapeJlbIX                TaK KaK OHH                  BOCnpHHMqHBbl K 60JIe3HBM B cu.rry
        He,o:OCTaTOqHOrO nHTaHWI H OTCYTCTBWI Ha.LUIe:lKam.HX CaHHTapHbIX YCJIOBHH. nOqeMY Y
        Hac GOJIbWe naQHeHTOB? nOTOMY 'ITO HaWH YCJJyrH GeCl1J1aTHbl.-                    3a6eoy1OUluu
        CeMelmOU nOIlUKJlUHUKOU, MapZWlaH

        Cpe,o:H HaWHX naQHeHTOB Tenepb MHOro neHCHOHepOB, HHBMH,UOB H O,o:HHOKHX JDO,o:eH.
        no:rroMY Mbl npe,o:OCTaBJIBeM MHO:lKeCTBO JIbroT MB ,o:aHHOH rpynnM nau.HeHTOB. OHH
        MOryr npOHTH GeCl1J1aTHoe 06CJIe,o:OBaHHe H nOJIY'fHTh 6eCl1J1aTHOe JIeqeHHe. ECJIH BM
        oGpaTHJlH BHHMaHHe Ha BbIBecKY                  Bxo,o:e B         nOJIHKJlHHHKY, TO Ha HeH
        rOBopHTCB, qTO Bce «6eCl1J1aTHO» -            3a6eoY1OUlUU 63POCIIOU nOIlUKllUHUKOU, CaMapKaHO

        Enaro,o:apB pa60Te HawHX M8XaJJJ1HHCKHX KOMHTeTOB H Me,o:pa6OTHHKOB, B HaCTmnu.ee
        BpeMB K BpaqaM oopam.alOTCB Bce 60JIbmee KOJIHtIeCTBO mo,o:eH. Me,o:ceCTpbl nOCelQalOT
        Ka:lK,UOe ,o:OMOX03)lHCTBO H ,o:enaIOT nOMeTKH 0 COCTOBHHH 3,o:OPOBbB ero qneHOB B
        :lKYpHMe                                  KTD-HH6y,o:b 3a60JIeJI, Me}lcccTPa OTBO,o:HT HX B
        nOmIKJIHHHKY.            OHH He B COCTOBHHH caMH npHHTH, TO K HHM npHXo,o:HT Bpaq H
        OCMaTPHBaeT HX }lOMa.               GOJIbHOMY Hy)KHa CneQHMH3HpOBaHHa.ll nOMOlQb, Tor,o:a
        yqaCTKoBblH Bpaq npHBO}lHT cneu.mUIHCTa M.II OCMQTPa.- 3a6eoY1OUluu CeMeUHOU
        nOIlUKJlUHUKO~ CaMapKaHO



6.49    nOCTaBlQHKH       YCJJyr,     oco6eHHo      ropo,o:cKHX      GOJIbHHU.,   OTMeqMH       cna.u.   KOJIHqeCTBa
06palQeHHH        onpe,o:eJIeHHblX     rpynn       HaCeJIeHH.II      B   yqpe)f(Jl.eHWI       nepBHqHOrO       3BeHa
3}lpaBoOxpaHeHH.II no CJIeJlYlOlQHM npH'IHHaM:


           MY:lK'IHH CeH'IaC Y:lKe MeHbwe, TaK KaK MHOrHe H3 HHX B B03paCTe OT 16,0:0 50 JIeT
           yexMH B POCCHlO B nOHCK8X pa60Th1.               Bpa'l 63POCIIOU nOIlUKJlUHUKU, CaMapKaHO

           Y   MY:lK'IHH HeT BpeMeHH Ha TO, 'iToobl 6oJIeTh.         A eCJIH OHH 60JIelOT, TO JIe'laT ce6)l
           Cpe}lCTBaMH HapO}lHOH Me,!UtQHHbI.- Flla66pa'l             £(FE, MapzWlaH

           B HaCTOBlQee BpeM)l K HaM 06pam.aeTC)l Bee MeHbwe naQHeHTOB H3 CeJIbCKOH
           MeCTHOCTH. 3a }leHb Mbi OCMaTPHBaeM OT                 }l0 40 naQHeHTOB H3 Hawero                   H
           TOJIbKO npHMepHo     5 H3 HHX H3 CeJIbCKOH MeCTHOCTH.            q..CJIO naUHeHTOB H3 CeJlLCKOH
           MeCTHOCTH COKpaTHJlOCb, nOToMY 'iTO HX CBn pa60Tal0T ny<Jwe. Teneph OHH 3HaIOT
           CBOHX yqacTKoBblX                H 8KYIDePOK.- AK)lUU!p        nOIlUKJlUHUKU             MapzwzaH


,l(oxoo nocmatJU(UI\06

6.50    Bce nOCTaBlQHKH yc.rryr OTMeTHJlH, qTQ HX 3apa60THM nnaTa HH3Ka, H nOKpblBaeT
TonbKO }l0 30-40% OT pacxo}loB Ha npo)KHBaHHe. }.lIDKe C }lOnOJIHHTeJIbHhIMH npeMHMbHbIMH,
KOTopble    MOryr    COCTaBJIBTh      }l0   15%    HX    3apa60THOH       l1J1aTM,   Bpa'iH    He    3apa6aTblBalOT
}lOCTaTO'lHO, '!TOGbI nnaTHTb 3a nHTaHHe ceMbH.


        nOCMOTPHTe Ha MOH TYIPJIH - OHH CTOJIT 65 000 c)'M.                Hx MHe nO}lapHJlH MOH 6paTb.ll.
        OHH CHOCHJlHCb, nOTOMY qTQ.II MHoro xo»<y.              JI   spaq C GonbwHM CTIDKeM pa60Th1,
        3aBeJlYlOlUM nOJIHKJlHHHKOH, HO .II He MOry n03BOJIHTh ce6e KYnHTh HOBbie TYIPJIH, He
        rOBopB Y:lKe 0 MaIDHHe. qTO 11 MOry KYTIHTb Ha CBOH 110 000 c)'M? KaJKJl.h1H MeCJ1Q )l


                                                         91 

         .It)'MalO 0 TOM, 'ITO iKe K)'IUITb - e.IQI HJlH oneiK.IQI?             S yiUly Ha neHCHIO, H 'ITO )l<e y
         MeHS eCTh?          3aeeOylOlqUU YlipeJICOeHUeM, MapZWlaH

         3apa6OTHOH IIDaTbl nOJDKHO XBaTaTb Ha nOK)'nKY npO.IQlKTOB nHTaHIDI H OIIDaTy
         o6yqeHIDI nereH, a TaIOKe Ha neTCKHH can. MbI nOJl>KHbI 6bITb B COCTOl1HHH n03BOJlHTb
                K)'nHTb XOJlOJlHJlbHHK HJlH TeJleBH30p. Pa3Mep HaweH 3apa6oTHOH IIDaThI He
         H3MeHHJICll co BpeMeH COBeTCKOrO COI03a. Torna Bpall Mor KYnHTh                    I   Kf Ml1Ca B neHb Ha
         CBOIO 3apIIDaTy, H CeHqaC cHTyaUIDI TaK311 iKe.             fleouamp oemCKOU nOllUIUlUHUKU,
         CaMapKaHO

         Ceiiqac 11 nOIl)"{alO       000 CyM,       11 3Toro HenOCTaTOllHO. -    flampOHaJICHaR MeiJcecmpa
         ceMeUHOU nOllUIUlUHUKU, Map2WlaH

         K8K 06CY>K)laJIOCb B npenblnyw,HX rJlaB8X 113-3a HH3KOH O$HUHaJIbHOH 3apa6OTHOH
IIDaThI nOCTaBw,HKH ycnyr qaCTO nOnOJlHl1lOT CBO" noxon 3apa6OTKaMH H3 TPex HCTOqHHKOB:
HeMenHUHHCKall npennpHHHMaTeJlbCK311 nellTeJlbHOCTb, BTOP311 pa60Ta B npyroM yqpejKJleHHH
(BKJllOq311 'faCTHbIe yqpejKJleHIDI), H IIDaTa OT CBOHX naUHeHTOB.                    Pa3Mepbl TaKoro noxona
38BHCllT OT Toro, me pa60TaeT nocTaBw,HK ycnyr. B 60JlbHHU8X OCHOBHbIM nOXOnOM, nOMHMO
3apa6OTHOH IIDaTbI, l1BJIl1lOTCl1 IIDaTa OT naUHeHTOB, B TO BpeMS KaK B nOJlHKJlHHHK8X OCHOBHOH
nOXon    HCXOnHT 3a         CqeT COnepiKaHHl1         Mara3HHa, ameKH        HJlH   Ka$e,       a   TaJOKe   o6yqeHHl1
WKOJlbHHKOB       HJIH    pa60ThI   B KaqeCTBe        peMeCJleHHHKa.       ,ll.oxonbl B $opMe         nOnapKOB    HJlH
npO,IQ'KTOB nHTaHIDI pacnpOCTPaHeHbI B co06w,eCTBe, CB1l3aHHOM TeCHblMH Y3aMH, Torna KaK
npennO'ITeHHe neHbraM OTnaeTCJI B MeHee CIIDOqeHHOH roponcKoii cpene. TaKHM 06Pa30M,
peMeCJleHHHqeCTBO B KalleCTBe nOnOJlHHTeJlbHOrO nOXona 60nee                                                 B ropone
MaprHJIaHe,     B   TO     BpeMll   KaK    IIDaTa    HaJIH'fHblMH neHbraMH 60nee           pacnpoCTPaHeHa B r.
CaMapKaHne.


        3neCb He npHHSTO npOCHTb y naUHema lIero-nH60, H 3TO                           HeB03MOiKHO. To, "ITO
        naeTCJI KaK BbIpIDKeHHe npH:JHaTeJlbHOCTH - 3TO npOCTO MeJlOllb, KOTOP311 llBJll1eTCl1
        npocTO 3HaKOM YBIDKeHIDI H 6J1arOnapHOCTH, HHlIero 6oJlee. HawH YCnyrH                                     H
        3TO MaJIeHbKHH ropon. -           3a6eO)11OlqUU ceMeUHOU nOllUIUlUHUKOU, Map2WlaH

        Mbi neqeM 6YJlOqKH B Haweii ceMbe H npOnaeM HX1Ha                                   OT 3TOro COCTaBJIl1eT
        OT   50 000 no 100 000 CyM        B MeC.lfU. B COBeTCKOe BpeMl1 Bpaq pa60TaJI TOJlbKO B Ka'feCTBe
        Bpa'fa, yqHTeJlb -TOJlbKO yqHTeneM ••. A ceHtJac Bce no-npyroMY.               -AKYUJep
        nOllUIUlUHUK~      MapZWlaH

        Bpall CBn, )l<HBYW,HH B CeJlbCKOH MeCTHOCTH, MO)l<eT nep)l<aTh nOMawHHii CKOT, can H
        oropon.          B ropone, Hama pa60Ta l1BJll1eTC.If enHHCTBeHHbIM HCTOqHHKOM nOXona.
        n03TOMY BpallH 6epYT HO'fHble neiKYPcTBa. ,ll.oxon OT HOllHblX neiKYPCTB MO)l<eT
        COCTaBJIllTb no    3040% 3apa60THoH IIDaThI. - rllaeepa'l ceMeUHOU nOllUIUlUHUKU,
        MapZWlaH

6.52     no MHeHHl(} nOCTaBW,HKOB yCJlyr cHTyaUHl1 B CaMapKaHne HeMHoro OTJlHlIaeTCl1 OT
nOJlO)l<eHIDI B MaprHJIaHe.


       Hf"UnTn'nLllf'   naUHeHTbI               Koq,e, WOKOJIan H BHHOrpan.            KTO HMelOT CBOH
       oropo)lbl, npHHOCl1T eBOH OBOW,H H q,PYKThI. Te, y Koro eCTb neHbrH, 6J1aronapl1T Hac
       neHbraMH. ECJlH II BIDKY, 'ITO naUHeHT                      l1 He        neHer. -    Bpa'l63pOCllOU
       nOllUIUlUHUKU, CaMapKaHO


                                                          92 

       OHH MOryr npHHeCTH BaM 06e,n. nOT.feM)' 6bI HeT?! Ecm1, CKIDKeM, naUHeHTa npHXo,nHJlH
       npOBe,naTb nRTh po,nCTBeHHHKOB, H KIDKJlblH npHHec 06e,n, TO nOT.feM)' 6b1 He ,naTb
       H3JlHWHIOIO e,!:{}' Me,nceCTpaM, BMeCTO Toro 'lT06bI BbIKH,!lbiBaTb ee? -             llpO¢C0103l(rE,
       Ccw.apKaHO

       BpaT.fH He no.rryqaIOT HHT.fero 60Jlee CBoeH 3apa60THoH JIJIaTbl no            Mecry   pa60Tbl.   11 nocJle
       pa60TbI, MHOrHe H3 HHX H.rt)'T                     B T.faCTHbie KJlHHHKH M}J ,nonOJlHHTeJlbHOH
       pa60ThI.      llpo¢c0103l.(rE, Ccw.apKaHo

6.53    Bce nOCTaBmHKH            ycnyr CqHTaIOT, 'ITO He06xo,nHMOCTb nOHCKa ,nonOJlHHTeJlbHOrO
HCTOT.fHHKa    ,noxo,na        cymeCTBeHHO        orpaHHqHBaeT            HX       B03MO)l(HOCTb    nOBbIWeHH}!
npocpeccHOHaJlbHOH          KBaJlHcpHKaUHH,    'ITO   B     pe3YJlbTaTe    npHBo,nHT     K   HH3KOM)'    KaT.feCTBY
npe,noCTaBJJ.lIeMbIX HMH ycnyr.


        Bo-nepBbIX, qenOBeK YCTaeT, BO-BTOPbIX, OH MO)l(eT on03,naTh Ha pa60ry Ha cJle,nyIOmee
        yTpO, H, B-TpeTbHX, Y Hero He OCTaeTC}J BpeMeHH Ha CaMOpa3BHTHe. BMeCTO TOro 'lT06b1
        BepHYThCJI ,nOMOH, r,ne OH CMO)l(eT nO'IHTaTb HOByIO JlHTeparypy no CBoeH 06J1aCTH, Bpa'I
        pa60TaeT Ha CBoeM oropo,ne H                       rJla66palf        Map2WlaH

        Ham ypoJlor pa60TaeT B nOJlHKJlHHHKe H B 'IaCTHOH KJlHHHKe. B                         HaCTORmee BpeM}J
        Ka)I(JlblH TpeTHH pa60THHK HMeeT BHewHHH HCTO'IHHK ,noxo,na. Me,ncecTpbl pa6OTaIOT B
        KaT.feCTBe    pa6OTHHKoB         COUHaJlbHOH       ccpepbl,     npHHOCJI    ,nOMOX03RHcTBaM       e,ny.
        3aeeoylOUluu e3pOCJlOU nOJlUKllUHU1WU, Ccw.apKaHo

        HamH      BpaT.fH    pa60TaIOT    no   HOT.faM     Ha CTaHUHJIX CKOPOH         Me,nHUHHCKOH       nOMOmH.
        fHHeKOJlOrH 6epYT HO'IHble ,neiK)'pCTBa B po,nHJIbHbiX ,nOMax.                  3a6eoylOUluu CeMeUHOU
        nOJlUKllUHUKO~       MapZUJlaH




6.54    XOTH B ueJlOM OTHoweHHe rocy,napcTBeHHbIX nOCTaBmHKOB ycnyr K 'IaCTHOH npaKTHKe
nOJlO)l(HTeJlbHOe, HeMHorHe 3aHHTepeCOBaHbi B pa60Te B 'IaCTHOM Me,nHUHHCKOM yqpeJK,lleHHH


       1.IacTHaH npaKTHKa H opraHH3aUHH, HaxO)l}Jm;HeCJI Ha rocy,napcTBeHHoM 6IOJl)I(eTe, KaK
        KOHKYpHPyIOT, TaK H ,nonOJlH}JIOT                                               nOBbIweHHIO Ka'IeCTBa
       ycnyr. 1.IaCTHyIO npaKTHKY, KaK npaBHJlo, Ha'IHHaeT OnblTHblH CneUHaJlHCT' ,lJ;pyrne
        60HTCSl Ha'IHHaTh T.facTHyIO Me,nHUHHcKyIO npaKTHKY. OnaCaHCb 6aHKpoTCTBa. ­
       rJla66palf WE, Map2WlaH

       Kor,na MbI He MO)l(eM OICa3aTb yrny6J1eHHOO Me,nHUHHCKoe 06cJle,noBaHHe C
       npHMeHeHHeM CneUHaJlbHoro 060py,nOBaHH}!, Mbl cOBeryeM HallIHM nauueHTaM
       06paTHTbCSl B qacTHylO KJlHHHKY MjI 06CJle,nOBaHH}!, a 3aTeM BePHYTbC}J K HaM C
       pe3YJlbTaTBMH.        3aeeoylOUluu ceMeUHOU nOJlUKllUHUKOU, Ccw.apKaHO

       1.IaCTHbie yqpeJK,lleHH}! MOryr 06JlerT.fHTb OCHOBHble CHMmOMbI OCTporo 3a6oJleBaHIDl,
        npHMeH~Ui CHJlbHo,neHCTByIOm;He npenapan,l, H naUHeHT Ha'IHHaeT ,nyMaTb, 'ITO OH
       Bbl3,nopOBeJi. HO'Iepe3       10 ,nHeH 60Jle3Hb      nOBTOpSleTCSl B 60Jlee TSl)I(eJlOH cpopMe. B
       HaCTOHm;HH MOMeHT nauueHTbI 06pamaIOTC}J B rocy,napCTBeHHble yqpeJK,lleHH}!. ­
       3a6eoylOUluu CeMeUHOU nOJlUKllUHUKOU, Map2WlaH




                                                          93 

O'4€H«O «Oy,€CmBO po6onu.1 nOCmtlBUI,U«OB          CBn

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BHYTpeHHHMH          opraHaMH.    BHellIHgR     ou;eHKa    npOBo,uHTCR   CnelUfaJIHCTaMH     Paih,upaBa    H
06Jl3Jl.paB8, a TalOKe COBMeCTHbIMH KOMHCC~MH H npOBepKaMH. TalOKe eCJlH COTpy,uHHK CBn
CTaJIKHBaeTCR C npo6JleMOH B cBoeH KJIHHH'IecKOH npaKTHKe, oH/oHa MOryT nOnpOCHTh COBe-ra
CneU;HaJIHCTOB Paii3Jl.paBa H 06m,upaBa.           .llIDKe ecJlH He                HHKaKOH KOHCYJlbTall;HH,
CneU;HaJIHCTbI PaJh,upaBa H 06Jl3,upaBa npOBOMT 06yqeHHe no onpe,ueJleHHblM cq,epaM B xo,ue
CBOHX e)l(eMeCgqHbIX HJlH e)l(eKsapTaJIbHblX BH3HTOB B CBn.


         K HaM npHe3)1(aJOT mo,uH H3 npoeKTa «3,uopOBbe» Jl.JlR                     H aHaJIH3a
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         (fJepcaHa

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6.56     BHYTpeHHRR ou;eHKa Ka'lecTBa pa60ThI CBn OCHOBaHa Ha CHCTeMe 6aJIbHOH ou;eHKH, 

KOTOpWl pa3pa60T8Ha CneUHaJIbHO Jl.Jlg                  H 0,u06peHa MHHHCTepCTBOM 

(npHKa3   N2276). 


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                                                        94 

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                                                             95 

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                                                             96 

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                                                           97 

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            MeCTa B ,D,pyroe. -      06cY:JICoeHue 6 q;OKYc-zpynne, My.JIC'IUHbl ZOPOOCKOU MecmHocmu
            24-49, CaMapKaHO

                   Bbl )K:a.rIyeTeCh, TO HHIcrO He 6y,D,eT OTHOCHTbC.II K 8aM XOPOllIO 8 cne.uyrolUHj:f paJ.
            BaM npH,D,eTcjI 06paTHTbClI K TOMY )Ke Bpaqy HJIH Me,D,CCcTPe, a BbI y HHX BCer,D,a 6Y,D,eTe
            accoUHHpoBaTbCjl CO CK3H,D,anOM.    06Cy.:HCOeHUe                         6    q;OKYc-zpynne,       :JICeHUlUHbl
            ZOP0OcKOU MecmHocmu 24-49. CaMapKaHO




                                                                98 

6.69     OqnuUiaJIbHO, He cymeCTBYeT HHcnnyra ofieCneqHBalOmero yqacTHe HaCeJIeHRII B
npouecce      COBepweHCTBOBaHRII          ycnyr" CBn.       Y'IaCTHe       npeJ].CTaBHTeJIeH     coofimecTB      HJlH
opraHH3aUHH lKeHmHH He BcerJ].a npH3HaeTClI, J].alKe KorJ].a OHH lIBJHllOTClI qneHaMH COBeTIl CBn
(KaK H B OJ].HOM H3 CBn <l>epraHcKOH OfiJIaCTH):


         B CBn HMeeTClI KeHraw [COBeT], COCTOllmHH H3 npeJ].CTaBHTeJIeH npo4>c01030B,
         lKeHcKoro COBeTIl H MaXaJ1JlHHcKOro KOMHTeTIl. Mbl ofiCYlKJl.aeM OCHOBHble BonpOCbl (He
         MeJ].HUHHCKHe) Ha 3aceJ].aHRIIX J].aHHoro KeHrama.                 3aBe.nyIOmHH CBn, <l>epraHa


6.70     HeCMOTpll Ha TO, 'ITO PYKOBOJ].HTeJIH H pafiOTHHKH COB npH3HalOT HeofixoJ].HMOCTb
HeKOTopOH CTeneHH yqaCTRII HaCeJIeHRII B ofieCne'leHHH Ka'leCTBa ycnyr CBn H J].alKe B
paCXOJl,ax, OHH He XOTjlT, '1Tofibl :no nOJl,p83YMeBaJlO BHeJl,peHHe eme O)l,Horo YPOBIDI KOHTpOJI.II B
cymecTByromyro ueno'lKY npOBepOK H KOMHCCHH. Bo H3fielKalIHe :noro, COTpyJl,HHKH CBn
npe,WlararoT BKJIlOqHTb      npeJl,CTaBHTeJleH HaCeJIeHH.II B cymeCTByromHe                COBeTbl      H   rpynnbl
3Jl,0POBbll, KOTopble <PYHKUHOHHpyroT Ha ceroJl,IDiWHHH J].eHb B HeKOTOpblX CBn. OHH TaKlKe
OTMeTHJlH, 'ITO ,Wl.ll TOro, '1TOfibl HaCeJIeHMe Momo npHHHMaTh yqaCTHe, ero HeofixoJl,HMO
ofiyqHTb He TOJlbKO MeTOJl,aM KOHTpOJl.ll, HO H MeTOJl,aM OK83aHRII nO.1l.Jl.eplKKH CBn.


         npeJl,CTaBHTeJlH HaCeJleHRII Jl,OJllKHbI BOHTH B COCTaB KOMHCCHH, KOHTpOJlHpyromHX
         Jl,ejlTeJlbHOCTb HawHX CBn - Jl,onyCTHM, qneHbl MaxaJ1JlHHCKHX KOMHTeTOB. HnH lKe
         JIIOJl,eH MOlKHO                 3anOJlHHTb BonpOCHHKH Jl.JI.II Bbl.llCHeHI-Ui Toro, ({TO HM
         HpaBHTCW He HpaBHTCjI B Jl,e.IITeJlbHOCTH HX CBn. -               3a6ei'JYKJUlUU CBll. <Pepzana

         Y	         ecTh npaBa, KOTopbIe rocYJl,apCTBeHHble opraHbl 3.npaBooxpaHeHHlI Jl,OJllKHbl
         )'BalKan. 11H0rJl,a cnyqaeTc.II TaK, 'ITO Bpa'l On83Jl,bIBaeT Ha pafiOTY, B TO BpeMR KaK ero
         Jl,O)KHJlaeTC.II ueJIaJI OqepeJl,b JlIOJl,eH. B HaweM yqpe)KJl.eHHH eCTb KHHra lKaJlofi, OJl,HaKO, B
         OCHOBHOM, B HeH COJl,eplKaTC.II CJlOBa fiJlaroJl,apHOCTH. -          3aeei'JyKJUlUU CBll. <PepzaHa

6.71     Pe3YJIbTaTbi OfiCy)KJl.eHI-IH B <P0KYc-rpynnax roBOP.llT 0 TOM, 'ITO B ueJlOM, MaxaJ1JlHHCKHe
KOMHTeThl     MOryT      yJl,OBJIeTBOP.IITb    nOTpefiHOCTH          qneHOB     CoofimeCTBa      B     CaHHTapHOM
npOCBemeHHH, HaUeJIeHHoro Ha onpeJl,eJleHHbIe rpynnbI (HanpHMep, fiepeMeHHble lKeHmHHbI,
npeCTapeJIble), a TaKlKe B Jl,OHeCeHHH .nO CBn fiecnOKOHCTB qneHa coofimeCTBa, B cnyqae KorJl,a
oH/oHa CTOJlKHYJlC.II(aCb) C KOHKpeTHOH npOfiJIeMOH HJlH HMeeT lKaJl06y. OJl,HaKO OHH MeHee
3<p<peKTHBHbI B cnocofiCTBOBaHHH fioJIee WHpoKOro yqaCTRII rpa)KJl.aH B ofieCneqeHHH                        ",h"..,•.,,,

KaqeCTBa ycnyr, OK83b1BaeMbiX CBn.



               D. 	 BblBO,IO:.1 H PEKOMEH.lI.AUHH no nOBblWEHHIO KAl.JECTBA YCJlyr
                            nEPBIf'IHOA ME,llHKo-CAHHTAPHOA nOMOmH

6.72    rJlaBHLle BbIBO)lL1 UV'Wl\_A~"><.,n."", OKllY 3aKJIIO'IaroTClI B TOM, ({TO B ueJIOM nOTpefiHTeJIH
yJl,OBJleTBOpeHbl   KaqeCTBOM        ycnyr    nepBHqHOrO       3BeHa       3Jl,pasooxpaHeHHlI,    He    'l)'BCTBYIOT
HHKaKoro Jl,aBJIeHRII C UeJIblO nonyqeHHjI Heo<pHUHaJlbHOH OnJIaThI 3a                               nOMOUU> H He
CqHTaIOT, 'ITO onpeJl,eJIeHHble CJIOH HaCeJleHRII HecnpaBe,WlHBO nonyqalOT npHBHJIerHpoBaHHoe
JIeqeHHe. OHM BHJl.lIT, ({TO B03Jl,eHCTBHe pe<pOPM 3Jl,paBOOxpaHeHHR, XOT.II Ha                        MOMeHT Bce
ellle p83BOpa'lHBalOmHXCR,       B ueJIOM n03HTHBHO B nJIaHe nOBbIweHHlI Jl,OCTY"HOCTH nepBH'lHOH
MeJl,HKo-caHHTapHOH nOMOlllH H                             fioJIee WHpOKoro cneKTpa ycnyr. O)l,HaKO J].alKe
B   <l>epraHcKOH    OfiJIaCTH,   rJl,e   pe<pOPMbl   HaxO)l,.llTCR    Ha   fioJlee   PaJBHTOH    CTaAHH,     '1eM     B
CaMapKaH)l,CKOH, nOTpefiHTeJlH ofipamalOT oc06oe BHHMaHHe Ha nOTpefiHOCTh B fiOJlbWeM
KOJlH'leCTBe H fioJIee KBaJlH<pHUHpOBaHHbIX Bpa'lax, fioJIee fiblCTpopearHpyrollleH                         CKOPOH
MeJl,HUHHCKOH nOMolUH, COKpameHHR BpeMeHH O)KHJlaHHR npHeMa KBaJIH<pHUHposaHHoro spaqa.


                                                       99 

C    n03HUUH       nOCTRBIUHKOB      yCJIyr,    perpOpMbI           CHCTCMbI          3,nPRBOOXPRHCHIDI       npHHeCJIH
npeHMYmeCTB, BKJIIO'I!UI BHe,npCHHe npHHuuna cnpaseMHBorO pacnpC,nCJIeHIDI 61O)l)KeTa Ha
OCHOBaHHH         nO..nyIUeBoro    rpHHaHCHpOBaHHl1,           paCIUHpCHHe             ,nocryna    HaCCJIeHIDI         K    ycnyraM
yqpC:iK,lleHHH nepBH'IHOrO 3BeHR 3,npaBOOXpaHeHIDI, YJIyqweHHc 06ecnc'IeHIDI MC,nHUHHCKHM
JIa60paTOpHblM o60py,nOBaHHeM CeJIbCKHe CBn H npe,nOCTaBJIeHHe CeJIbCKHM nOTPe6HTeJIl1M
OrpHUUaJIbHOrO npaBR Bbl60pa nOCTaBmHKa ycnyr.                           HecMoTPl1 Ha 3TH n03HTHBHbIC TCH,lleHUHH,
nOCTaBmHKH ycnyr iKaJIOBaJIHCb Ha HH3KHH YPOBCHb 3RPR6oTHOH nJIaThI, KOTOPbIH He nOKpblBaeT
pacxo,nbl Ha npOiKHBRHHe H He KOMneHCHpYeT cymecTBcHHoe 6peMH, KOTOpoe HaJIOiKHJlH
HOBOBBe,neHHble          a,nMHHHCTPaTHBHbIe           TPc60BaHHI                 Ha     HX    BpeMl1.       HIDKeCJIe..nyIOIUHe
peKOMCH,llaUHH OCHOBaHbI Ha ,naHHblX HCCJIe,nOBaHHI H npo'lHX ,naHHbIX, npe,nOCTaBJIeHHbIX co
CTOPOHbI nOTPe6HTeJIeH H nOCT3SIUHKOB YCnyf.                            OHH MOryT cnoc06CTBOBaTb YKPCnJICHHIO
npouecca BblpaJKeHHl1 MHeHHH H OTBeTCTBeHHOCTH B ceKTope fIMCn, 3a HCKJIIO'IeHHeM Tex
BonpOCOB,                Y/KC paCCMaTPHBaJIHCb B npe,nbl..nyIUHX fJIaBax.


6.73       MbI    npe,ncTaBJIl1eM   HIDKeCJIc,nyJOIUHe           PCKOMCH,llRUHH, OCHOBRHHblC                 Ha pe3YJIbTaTax
06CJIe,noBaHIDI H npo'lHX ,naHHbIX, npe,nOCTaBJIeHHbIX co CTOPOHbl nOTPe6HTeJIeH H nOCTaBIUHKOB
ycnyr, C ueJIblO ycoBepweHCTBOBaHHl1 no,nOT'leTHOCTH B nepBH'IHOM 3BeHe 3,npaBOOXpaHCHIDI H
o6eCne'leHIDI Toro, 'ITO MHeHHH nOTpe6HTeJIeH 6blJlH YCJIblWaHbI.


6.74       flpocBemaTb 06meCTBeHHOCTh no nOBo,ny perpopM. Pe3YJIbTaThI 06CJIe,noBRHIDI OKTIY
y6eJlHTeJIbHO rOBopHT 0 TOM, 'ITO 06meCTBcHHOCTh HyiK,llaeTcl B 60JIee HCHOH HHrpopMal{HH 0
nOCJIe,nCTBHHX perpopMHpoBaHHH CHCTeMbI 3,npaBooxpaHeHIDI H 0 TOM, KaK o6ecne'lHTb 60JIee
Ka'lCCTBeHHblC        ycnyrH    nCpBH'lHOrO      3BeHa         3,npaBOOXpaHCHIDI.             Cpe,nH      npo'lHX          BonpOCOB,
nOTpe6HTeJIHM         He06xo,nHMa    lilHrpopMaUIDl:       (i)      0     rpaKTH'IecKHX       H3MeHeHHJJX         B    yCJIyrRx     H
npouc.nypax, OKa3bIBReMblX HX yqpC:iK,lleHHeM, B pe3YJIbTaTe perpopM;                             (ii)   0 TOM, KaKHC YCJIYTH
,nOJIiKHbl npe,noCTaBJIl1ThCH 6eCnJIaTHO, a              KaKHe nJIaTHO, H CKOJIbKO OHM CTOHT B Ka:IK,llOM
yqpe:iK,lleHHH nepBHqHOrO 3BeHa 3,npaBooxpaHeHHH,                       (iii)   KaK Bbl3BaTb 3KCTPeHH)'IO Me,nHUHHCKyJO
nOMOmb (HanpHMep, HOMepa TeJIerpOHOB Ml1 BbI30Ba MaIUHHbI CKOPOH nOMomH),(iv) rparpHK,
YKa3blBaIOIUHH, Kor,na Bpa'lH H Me,nceCTPbl MOryT npHHHMaTh nauueHTOB, (v) 0 TOM, KaK no,naTh
OrpHUHaJIbH)'lO iKaJI06y 0 Hey,nOBJIeTBOpHTeJIbHOM Ka'leCTBe ycnyr.                             Y'Ipe:iK,lleHHe nepBH'IHOrO
3BeHa 3,npaBooxpaHeHIDI ,nOJIiKHO B3l1Tb Ha ce611 Be..nymyIO pOJIb B npe,noCTaBJIeHHH ,naHHoH
HHrpopMaUHH nmpe6HTeJUIM nocpe,ncTBOM pa3MeIUeHIDI nJIaKaTOB HJIH                                        pa3)la'DI 6powwp,          a
TaKiKe     qepe3    pa3MeIUeHHe      3aMeTOK      B      ueHTPe          Maxa.IUlHHCKOro          KOMHTeTa.       KpoMe        TOro,
MHHHCTePCTBO 3,npaBooxpaHeHIDI MOrJIO 6bl rpHHaHCHpOBaTb npoBe,neHHe HHrpopMaUHOHHbIX
KaMnaHHH no BceH CTPaHe Ml1 TOro, 'lT06bl nOTPe6HTeJIH 3HaJIH 0 nOCJIe,nCTBIDIX perpopMbI
ceKTOpa 3.npaBooxpaHeHIDI H 0 TOM, KaKHe MepbI OHH MOryT npe,nnpHHllTh, MH OKa3aHIDI
BJIIDIHHH    HR    Ka'leCTBO    ycnyr,    npe,nOCTaBJIHeMblX B                  HX    yqpe:iK,lleHHH     nepBH'IHOH         Me,nHKO­
CaHHTapHOH nOMOmH.


6.75       C03,naTb                      COSeT HJlH KOMHTeT B                                  3,npaBooxpaHeHHl1 C ueJIblO
YKpenJIeHIDI HX OTBeTCTBeHHOCTH nepe,n 06IUeCTBoM. npaBoBoH rpyH,llaMeHT Ml1 C03,naHIDI
,naHHblX    COBeTOB      Y/Ke     cymeCTBYeT     B       KaqeCTBe          OCHOBbl        ,neueHTpaJIH3al.{HH
COl{HaJIbHbIMH YCnyraMH B COOTBeTCTBHH C nOJIHTHKOH rocy,napCTBa. B COCTaB ,naHHoro opraHa
MOryT BOHTH npe,ncTaBHTemf           [(PI>,   opraHoB caMoynpaBJIeHIDI rpa:lK,llaH, KOMHTeTa iKeHUUlH, H
MaxaJIJIHHCKHX KOMHTeTOB. POJIb TaKoro COBeTa HJlH KOMHTeTa MOiKeT 3aKJllO'IaTbCH B:                                       (i) HaHMe
Cmpy,nHHKOB         Ha   KOHKypCHOH        OCHOBe;       Oi)       YTBep:iK,lleHHH        nepeqHR        ycnyr,       3a    KOTopble
yqpe:iK,lleHHe MOiKeT B3HMaTh onJIary;           (iii)   pa3pa6OTKe H YTBep:iK,lleHHH np03pal.IHOH CHCTeMbI
OnJIaTbI MH OrpOPMJICHHH nJIaTeiKeH 3a Me,nHUUHCKHe npoue.nypbl; (iv) nOHCKe HCTO'IHHKa
rpHHaHcHpOBaHHl1 B ueJIl1X pa3BHTIDI yqpe:iK,lleHIDI; (v) C03,naHHH CHCTeMbl MH npe,noCTaBJIeHIDI
rpa:lK,llaHRM     B03MOiKHOCTH      no,naQH    iKaJI06b1       0    Hey,nOBJIeTB0PHTeJIbHOM               Ka'leCTBe         ycnyr   H
nonyqeHIDI y,nOBJIeTBOpHIOIUero OTBeTa, npe,nOCTaBJIeHIDI OT3bIBOB 0 Ka'leCTBe 06cJIYiKHBaHIDI H


                                                           100 

npe)])1o)KeHHH no COBepmeHCTBOBaHHlO Me.ruru:HHCKOH nOMOmH B yqpe:lK,ll.eHHH;                                      (vi)    pa3}la'le H
         KapTO"feK      6aJIJlhHOH        oueHKH    rpIDKJlaH     }lBIDKJlhl    B    rO}l     )])1S1    nOJJyqeHIDI           OT3hIBOB
nOTpe6HTeJleH, npmKHBalOlIUfX B 30He OXBaTa yqpe:lK,ll.eHHSI


6.76     MHHHcrepcTBY 3}lpaBOOXpaHeHIDI He06xo}lHMO 6Y}leT pa3pa60TaTh npoeKT HopMaTHBHo­
npaBoBbIX                      )])lSI }laHHbIX COBeTOB rulH KOMHTeTOB H                                              cpe}lCTBa )])1S1
06yqeHHSI    'IJIeHOB COBeTa HJJH KOMHTeTa pa60Te C 06meCTBeHHOCThIO HJlH nOTpe6HTeJlSlMH,
OTHomeHIDIM C nOTpe6HTeJlSlMH H npO'lHM HaBbiKaM.                                        COBeTa, ero $YHKl.{HH, pOJlb H
MexaHH3Mhi OT"feTHOCTH 6yJlYr 06CyiK,ll.eHbI H corJlaCOBaHbI Cpe}lH MecTHoro co06meCTBa.                                              B
npouecce     pa3pa60TKe            3THX    MexaHH3MOB         co06meCTBa            }lOJDKHhI          yqHTbIBaTh             eCTh   JlH
He06xo}lHMOCTb BKJIIO'IaTb B COCTaB 1JJ1eHa, Ha KOToporo                                 B03JJO)KeHa pOJlb OTCTaHBaHHSI
HHTepeCOB     no    OT}leJJhHOMY                           HJJH     rpynne          3a60JleBaHHH          (HanpHMep,             BIf4,
TY6epKYJle3).                        TaK)Ke }lOJJ)KHO peWHTh, KaK COBeT 6y}leT B3aHMO}leHCTBOBaTb C
COOTBeTCTBywmHM M8XaJJJJHHCKHM KOMHTeTOM, KOTOPblH                                    nO}l'lHIDITbC.II                    no CBoeMY
COOTBeTCTBywmeMY              OKPYry        H      npo}lOJJ)KaTh      pa60TaTb            C      CBn         B        npOBe}leHHH
CneUHaJIH3HpOBaHHbIX          CaHHTapHO-npOCBeTHTeJlbCKHX               MeponpIDITHH              (TaKHX       KaK,        06yqeHHe
KOpMJleHHIO 6YJlYlUHX MaM).


6.77     I1HCTHTYThI        rpIDKJlaHCKOro         06mecTBa        MOryT       6h1Tb       06yqeHbi         )])111     nOJlJlep)KKH
M8XaJIJlHHCKHX KOMHTeTOB, MeCTHblX opraHoB ynpaBJJeHIDI                             H ueHTpaJIbHoro ynpaBJJeHH.II B
Be}leHHH MOHHTOpHHra CHCTeMhl 06meCTBeHHOrO 3}lpaBooxpaHeHIDI. ,llaHHble HHCTHT)'Thi 6yJlYr
pa60TaTh )])1.11 }laJIbHeHwero cOBepweHcTBOBaHHlI 3$$eKTHBHOCTH ynpaBJleHHlI H nOBblweHHSI
Ka'leCTBa   ycnyr       H     Me}lHKaMeHTOB,          npe}lOCTaBJlSleMbIX           yqpe:lK,ll.eHIDIMH         o6meCTBeHHoro
3}lpasooxpaHeHHSI,      06eCne"feHIDI        C06J1IO}leHIDI     3aKOHOB,       HMelOmHX OTHoweHHe                      K      Me}lHKO­
                   pa60THHKaMH,            }lonycKalOmHM           oWH6KH,           a      TaIOKe        )])111       nOBhlweHHSI
OCBe}lOMneHHOCTH 06mecTBa 0 nOTpe6HOcT1IX OT}lenhHhIX Y.ll3BHMbIX cnoeB HaCeneHH.II B oxpaHe
CBoero 3}lOPOBbll,                                         Me}lHUHHCKHX o6CJle}lOBaHHH H HCnOJlb30BaHHH
KOHTponll Ha}l p0:lK,ll.aeMocTblO.


6.78    COKpameHHe 6IOpoKpaTHH. nOCTaBmHKH ycnyr npH3HaIOT Heo6xo}lHMOCTh TOro, "ITO
yqpe:lK,ll.eHIDI }lOJJ)KHbl nOJ{BepraTbClI peryJl.llpHblM npoBepKaM. TeM He MeHee, 60JlbWHHCTBO
cornaCHbi    C   TeM,       "ITO    "fpe3MepHble      Tpe60BaHIDI       K      OT"feTHOCTH,            npOBepKH           H    npO'lHe
a}lMHHHCTpaTHBHble           3a}la'lH      (HanpHMep,      )])1HTeJJbHble           co6paHIDI,          6YM8)KHM               pa60Ta,
3aHHMalOmM MHoro apeMeHH) CHH)K8IOT 3$$eKTHBHOCTb HX }le.llTeJJbHOCTH H MewalOT HM
JJe'lHTh naUHeHTOa.




                                                          101 

                               VII.             OSOSmEHHE BblBO,l(OB H PEKOMEH.l(AUHH

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 nepBHl.JHoro 3BeHa 3}l.paBOOXpaHeHIDI B COl.JeraHHH C pe!jlopMaMH KaJHal.JeHCTBa, 3anyIlJ,eHHb1MH
 Ha nHJ10THOH OCHOBe, cnOC06CTBOBMH nOBbIllieHHIO 3!jl!jleKTHBHOCTH nOCTaBIlJ,HKOB nepBHl.JHOH
 MeJl.HKO-CaHHTapHoH nOMOIlJ,H B                                      O}l.HaKO BBHJl.Y nonanHoH peMH3all.HH pe!jlopM,
 HX B03}l.eHCTBHe Ha CHCTeMY rocY}l.apCTBeHHOrO ynpaBJ1eHHH H Me}l.Hll.HHCKOro 06cn)nKHBaHIDI
 6blJ10 HeO}l.H03Hal.JHbIM B paJpe3e PaJJ1Hl.JHbIX acneKTOB ynpaBJ1eHHH, perHoHoB H nO}l.CeKTOpoB.



                                        A. KAqECTBO CHCTEMLI YIIPABJlEHWI

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TeXHHl.JeCKOH             6aJbI,     peMOHTa         H       TeXHHl.JeCKoro         06CJJY:lKHBaHHH,          H       MaTepHMbHOro
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<ITO, B CBOIO Ol.Jepe}l.b, nOBbICHJ10 npOHlBo}l.HTeJ1bHOCTb Ypy}l.a. BHe}l.peHHe MexaHHlMa Oll.eHKH
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BHHMaHIDI            Ha    COCTOJlHHH       3)lOPOBbH         CBOHX        nauHeHTOB.
onpomeHHbIX B CaMapKaH}l.CKOH H <l>epraHcKoH 06J1aCTlIX, C006IlJ,HJ1H, <ITO OHH peryJ1l1pHO
o6pam.aIOTcH B yqpe)KJ(eHHlI nepBHl.JHOro 3BeHa }l.J1J1 nonyqeHIDI 6ecnnaTHoH nepBHtIHOH Me}l.HKo­
CaHHTapHOH nOMOIlJ,H B c!jlepe }l.HarHOCTHKH H J1el.JeHHJI, 3KCTpeHHoH nOMOIlJ,H H BaKll.HHall.HH.
O}l.HO H3 rJ1aBHbIX 3aKnIO'1eHHH, KOTopoe 6blJ10 nonyqeHo npH onpoce, KllK }l.OMOX03HHCTB, TaK H
onpocoB nall.HeHTOB Ha BbIXO}l.e H3 MeJlYl.Jpe)KJ(eHIDI, 3llKJ1IOl.JanHCb B TOM, <ITO HaCeJ1eHHe 6bmo B
ll.eJ10M y}l.OMerBOpeHO Kal.JeCTBOM nepBHl.JHOH Me}l.HKo-CaHHTapHOH nOMOIlJ,H. OHH Hl'MIMJlIOT
:lKeJ1aHHe       BHOBb      06paTHTbCJI         B   }l.aHHoe     MeJlY<Ipe)KJ(eHHe        B    6YJJ.YIlJ,eM       H    npe}l.nOl.JHTaIOT
rOCY}l.apCTBeHHble MeJJ.yqpe)KJ(eHHJI l.JaCTHbIM Bpal.JaM, BBHJl.Y KsanH!jlHll.HpOSaHHOCTH                                              B
CBn / nOJ1HKnHHHKe s CBoeM paHOfte H ,D.oporOBH3HbI ycnyr Bpal.JeH, 3aHHMaIOIlJ,HXCJI '1acruoH
npaKTHKoii.


7.3         O)lHaKO He}l.OCTarol.JHOe !jlHHaHcHpoBaHHe nepSHtIHoro 3BeHa 3}l.paBOOXpaHeHIDI HaHeCJ10
YPOH ero 3!jl!jleKTHBHocTH. HecMoYpJl Ha TO, <ITO pe!jlOPMbI paCmHpHnH }l.OCTYfl HaCeJ1eHIDI K
nepBHl.JHOH Me}l.HKO-CaHHTapHOH                     nOMOIlJ,H, eIlJ,e cym.eCTsyer PM npernrrCTsHH.                         HanpHMep,
ropo)lCKHe :lKHTeJ1H rOBOpHnH 0 TaKHX np06J1eM3X, KllK Tpe60saHHe Heo!jlHll.HMbHOH nnaTbI 3a
J1el.JeHHe CO CroPOHbl nOCTasIlJ,HKos ycnyT HnH .D.J]HTeJ1bHOe O:lKH}l.aHHe npHeMa, a Ha ceJ1e
nOYpe6HTeJ1H CCbmMHCb Ha TaKHe npo6J1eMbI, KaK OT}l.MeHHOCTb CBn, He3annaHHpoBaHHoe
lY'N'VT'I'.'T'lHAP   Bpal.JeH HnH Me}l.CeCTep, a TaK:lKe OTCyYCTBHe 3J1eMeHTapHb1X y}l.06CTB (HanpHMep,
OTonneHIDI). COfJ1aCHO                                    }l.OJ1e onpomeHHblx, HeCOOTBerCTBYIOIlJ,WI Ype60BaHIDIM
cn)nK6a CKOPOH Me}l.Hll.HHCKOH nOMOIlJ,H B lHa'lHTeJ1bHOH CTeneHH COKpaIlJ,aer }l.oCTYfl nall.HeHTOB
K 3KCYpeHHOH Me}l.Hll.HHcKOH nOMOIlJ,H B                                                 TaKHe Ypy}l.HOCTH B HeKOTopOH
CTeneHH         OYpa:lKaIOT        nOCJ1e}l.CTBIDI       He}l.OCTaTO'lHOrO        !jlHHaHcHpOBaHIDI           nepBHl.JHOrO       3BeHa
3}l.paBOOXpaHeHIDl, B l.JaCTHOCTH BbITeKaIOIlJ,aJI OTCIO}l.a HH3KaJI 3apa60THaJI nnaTa H OKna)lbI
Bpa'leH H Me}l.CeCTep, HeXBaTKa cpe}l.cTB Ha                    onepall.HOHHbIe pacxoJl.b1 H TeX06CJJY:lKHBaHHe.


7.4         He3!jl!jleKTHBHOe HCn0J1b30BaHHe Cpe)lCTB, BbI3BaHHoe 3a}l.epJKKaMH $HHaHcHpOBaHHJI H
He}l.o6pocOBeCTHoH             KOHKypeHll.HeH            B    c$epe          focY}l.apCTBeHHbIX        3aKYlloK,         npO}l.OJ1)KaIOT
npeflJlTCTBOBaTb           pe3YJ1bTaTHBHOCTH             Mep,    npe}l.npHHHMaeMblx            rocY}l.apCTBOM.           3a}l.ep:lKKH   B

                                                                     102 

BbI,neJleHJfH Cpe,nCTB, nO-BH)UIMOMY, npOHCXO,nHJlH HaH60Jlee 3aMeTHO B 06J1aCTRX, r,ne eme He
ocymecTBJlRJlHCb peq,opMbI Ka3Ha'IeHCKOH CHCTeMbI, 'ITO ,naeT HMe~ Ha TO, 'ITO peq,opMbI
Ka3HaLfeHCTBa        CMJlrLfaIOT ,naHHble       np06J1eMbI.      ,l.l;aHHbIe   3a,nep)f(KH     nperulTCTByIOT         HaH60Jlee
paQHOHaJIbHOMY HCnOJlHeHlfJO 6IO)].)KeTa CO CTOPOHbI CBn H npHlI)')K.naIOT HX HMeTb ,neJlo C
nOCTaBlI.{HKOM, KOTOPbIH rOTOB ~aTb OIUIaTbI ,nOJlbllIe, HO MO)l(eT 3anpOCHTb 60JlbllIe, H MOryT
BbI3BaTb CMeIUeHHe pacxo,nOBaHHR B croPOHY TeX CTaTeH 6IO)].)KeTa, cpe,nCTBa no KOTOPbIM
HMeIOTCR       B   HaJIH'IHH,    HO He TPe6yIOTCR            B ,naHHoe      BpeMR       MR CBn. He,n06poCOBeCTHaR
KOHKYpeHQHR B rocy,napCTBeHHbIX 3aKYnKax npHBO.nHT K 3aBbIlIIeHHIO QeHbI Me,nHKaMeHTOB H
060py,noBaHHR. Bce 3TH q,aKTOpbl Be,nyT K TOMY, 'ITO paCXO,nbI Ha 3,npaBooxpaHeHHe MOryT 6bITb
'Ipe3MepHO 3aBbIlIIeHbI.


7.5       DOJlbllIaR      np03paLfHOCTb         6bIJIa       ,nOCTHr~          B       rocy,napcTBeHHOM          q,HHaHcoBoM
ynpaBJIeHHH. Peq,opMHpoBaHHe Ka3Ha'IeHCKOH CHCTeMbI n03BOJlHJlH MHHHCTepCTBY q,HHaHcoB
no,nrOTaBJIHBaTb ,nOCTOBepHble, CBoeBpeMeHHble H HC'IepnbIBaIOIUHe OT'IeTbI J1I06bIX BH,nOB H
mo60ro         YPOBIDI       no,np06HocTH        MR          npHIDITHJI     ynpaBJleH'IeCKHX             pellIeHHH.      nocJle
nOJlHOMaClIITa6HOH peaJIH3aQHH peq,opM O)I(}I,QaeTCR nOBblllIeHHe 3q,q,eKTHBHOCTH 6IO)].)KeTa
3,npaBOOXpaHeHHJI. no,n60p KMPOB H npo,nBH)I(eHHe Me,nnepCOHaJIa no CJIY)I(6e OCHOBbIBaIOTCR
Ha 'IeTKHX P)'KOBO,nCTBax H npHHQHnax; o,nHaKO MbI 6bIJIH BbIHY~eHbI OCHOBbIBaTb ,naHHoe
3aKJIIOLfeHHe Ha He60JlbllIOH BbI60pKe H3-3a HH3KOH TeKY'IeCTH KMpOB. np03pa'IHOCTb 3aKYnOK
OCTaeTCR aKTYaJJbHbIM BonpOCOM, BbI3bIBaIOIUHM 60JlbllIOe 6ecnOKOHCTBO H3-3a pa3p03HeHHOCTH
3aKoHo,naTeJlbHOH H HHcnrryQHOHaJIbHOH 6a3bI H OTCyrCTBHJI P)'KOBO,nCTB no npOQe.nypllM
3aKYnOK, Ha'IHHlUI C 3Tana TeH,nepa H ,no peruCTPaQHH KOHTPaKTa. np06J1eMa np03paLfHOCTH
yCyry6J1ReTCR orpaHHLfeHHOCTbIO pacnpOCTPaHeHHJI HHq,opMaQHH 06 onepaQHRX no 3aKYnKaM
(B03MO)l(HOCTb       yqaCTHJI      B   KOHKypCHbIX        roprax,     npHIDITHH         pellIeHHJI   0   KOHTPaKTe       Hero
npHc~eHHH), 'IaCTbIM HCnOJlb30BaHHeM Me,nHQHHCKHMH yqpe~eHHJlMH npRMbIX ,norOBopOB H
OTCYTCTBHeM CHCTeMbI no paCCMOTpeHHIO )f(aJJ06.


7.6       nO,nOT'IeTHOCTb CTPMaeT OT cymecTByIOIUHX MexaHH3MOB H npaKTHK, ,neHCTByIOmHX B
ceKTope    3,npaBOOXpaHeHHJI,          a   TaK)l(e   OT He,nOCTaTKa nOTeHQHaJIa. ,[{BOHHlUI cy60p,nHHaQHR
C03,naeT He'IeTKHe J1HHHH no,nOT'IeTHOCTH 3a BbInOJIHeHHe pa60TbI, no,nrOTOBKY H                                 HCnOJlHeHHe
6IO)].)KeTa,   q,HHaHcHpoBaHHe Me,nHQHHCKHX yqpe~eHHH.                             CymeCTByIOT Pa3JlH'IHble            MeTO,nbI
OT'IeTHOCTH no ynpaBJIeHHIO H q,HHaHcHpoBaHHIO, Tal< KaK Me.nyqpe~eHHe no,nOT'IeTHO 3a CBOIO
,neRTeJIbHOCTb       ,nByM      OT,neJIbHbIM    opraHH3aQHJlM.         OrpaHH'IeHHOe           yqaCTHe       MHH3,npaBa      H
Me,nHQHHCKHX yqpe~eHHH (3a HCKJlIO'IeHHeM CBn H                                peq,opMHpOBaHHbJX nOJlHKJlHHHK) B
nJIaHHpOBaHHH 6IO)].)KeTa HeraTHBHO BJlHJleT Ha no,nOT'IeTHOCTb 3a pe3YJlbTaTbI ,neRTeJIbHOCTH
BBHJl}' Toro, lffO 6IO)].)KeT onpe,neJlReTCH 3a npeAenaMH HX BJlHJIHHJI . Cna6blH Ha.ll30p co CTOPOHbI
Ka3Ha'IeHCTBa       3a   paCXonaMH         <I>OH,nOB     pa3BHTHH     H    CJla6bIH       nOTeHIUiaJI     .nnR   npOBeneHHJI
BHYTPeHHero ay,nwra TO)l(e He Cnoc06CTBYJOT nOnOT'IeTHOCTH MenHQHHCKHX yqpe~eHHH                                            no
pacXOnOBaHluo cBoero 6IO)].)KeTa. B cnyqae 38KY"0K, HenOCTaTOK nOTeHIUiaJIa MHHHCTepCTBa
3npaBOOXpaHeHHR orpaHH'IHBaeT H3 B03MO)l(HOCTH                        KOHTPOJIR H npOBepOK, C03naBlUI                 lIIHpOKHe
B03MO)l(HOCTH        MR      3J1oynoTPe6JIeHHH           H     KOppynQHH.          B     3aKJlIOLfeHHH,      nOnOT'IeTHOCTb
yqpe~eHHH nepe,n nOTpe6HTeJlRMH nOnpblBaeTCR TPMHQHOHHbIMH HopMaMH, TaKHMH KaK
CHMnaTHR H YB8)I(eHHe no OTHOllIeHHIO K Menpa60THHKY H He)l(eJlaHHe BblPa)l(8Tb c06cTBeHHoe
MHeHHe, a TIlIOKe He,noBepHJI K cymeCTByIOmeH CHCTeMe nOnOT'IeTHOCTH.


7.7      KOMaH,nHo-MMHHHCTPaTHBHbIH                      06pa3     MbluiJIeHHJI         orpaHH'IHBaeT        He3aBHCHMOCTb
nOCTaBIUHKOB ycnyr H npHBo,nHT K He3q,q,eKTHBHOMY HCnOJlb30BaHHIO pecypCOB. HanpHMep,
HCnOJlHeHHe 6IO)].)KeTa CBn nOMe)l(HT )l(eCTKOMY KOHTPOJlIO co CTOPOHbI Ka3Ha'IeHCTBa BnJIOTb
no nOnCTaTeH KaTerOpHH pacXOnoB, 'ITO He n03BOJlReT CBn nepepacnpeneJlHTb CBOH paCXO,nbI C
yqeroM     MeIDIlOllUfXcR         nwpe6HOCTeH.            )l{eCTKoe       CJIenOBaHHe        06R3aTeJlbHoMY           nepe'IHIO
He06xonHMbIX JIeKapCTBeHHbJX CpenCTB, YTBep~eHHoMY MHH3npaBoM, J1HlIIHJlO CBn rH6KOCTH


                                                              103 

B COCTaBJleHHH C06CTBeHHbIX nepe'lHeH npenapaTOB, KOTOpble· 60JlbllIe OTBe'lalOT MeCTHbIM
YCJlOBHJlM. B pe3yJIbTaTe, yqpe>K.ll.eHHJI BbIH}'>K.lI.eHbI paCXO,nOBaTb OrpaHH'IeHHble pecypcbI Ha
JIeKapcTBa, KOTOpble         He H)')KHbI. CrporHH             Ha)l30P H )l{eCTKHH           MOHHTopHHr Me,nHUHHcKOro
nepcOHaJIa cnOC06CTBOBaJIH nOBbIllIeHHIO npOH3Bo,nKfeJIbHOCTH Tpy,na. O,nHaKO BBIm)' TOro, 'ITO
oueHKa ,neJlTeJIbHOCTH nepCOHaJIa BKJIIO'IaeT TaK)l{e Q>aKTOpbI, BbIXOJlJlmHe 3a paMKH KOHTpOJIJI
COTpy,nHHKOB, HX CTpax nepe,n HaKa3aHHeM 3a He3Q>Q>eKTHBH)'IO pa60ry C03,naeT HenpaBHJlbHble
CTHMYJIbI, JlJIJI 3aHH)I{eHHJI .lI.aHHbIX HJIH Q>aJIbCHQ>HKaI.{HH Me.ll.HUHHCKOH CTaTHCTHKH.


7.8      OrpaHH'-IeHHaJI        np03palJ.HOCTb         H     nO.ll.OT'IeTHOCTh   OTKPbIBaJOT           B03MO)l{HOCTH      .nJJJI
HeueJIeBOrO HCnOJlb30BaHIDI cpe,ncTB, TeM caMbIM nOBbIllIaJl Q>Im)'I.{HapHble pHCKH. ,llaHHble,
nOJIY'leHHble B pe3YJIbTaTe npOBe.ll.eHHOrO HaMH 0630pa npaKTHKH ynpaBJleHHJI Q>HHaHcaMH H
3aKYnKaMH B Y36eKHcTaHe, YXa3bIBaJOT Ha TO, 'ITO pacxo,nOBaHHe cpe,nCTB <I>oH)la pa3BHTH~,
KOHQ>JIHKT HHTepeCOB H orpaHH'IeHHaJI KOHKypeHI.{HJI npH ocymeCTBJIeHHH rocy,napCTBeHHblX
3aKynoK, nOBbIllIaJOT Q>H.lJ.YllHapHble PHCKH B HCnOJIb30BaHHH pecypCOB 3,npaBOOXpaHeHHJI . nOKa
3TH    BonpOCbI       He     6y.lJ.YT     pellIeHbI,       paUHOHaJIbHOe       HCnOJIb30BaHHe            peCypCOB      6Y.ll.eT
KOMnpOMeTHpOBaTbCJI, a no CK3)I{eTCJI Ha KOHe'lHbIX pe3YJIbTaTax ,neJlTeJIbHOCTH B ceKTope
3,npaBOOXpaHeHHJI.


7.9      ,lLnJl cpaBHeHHJI CTOHT OTMeTHTb, 'ITO MbI TaK)l{e 06HapYJKH.llH H3p~,nHoe KOJIHlJ.eCTBO
npHMepoB Ha.nne)l{ameH npaKTHKH ynpaBJIeHHJI, .lI.OCTOHHbIX nOXBaJIbI, B <I>epraHcKoH 06JIacTH. B
Ka'leCTBe nHoHepa peQ>0pM <I>epraHCKaJI 06JIaCTb nOJlYlf.HJIa 60JIee cymeCTBeHHOe YBeJIHlJ.eHHe
06"beMa 61OJl)KeTa 3,npaBooxpaHeHHJI JlJIJI npoBe.ll.eHHJI OCHOBHbIX pa60T no peKoHcTpYKUHH
3,naHHH H nOCTaBKe 060py,noBaHHJI, '1eM CaMapKaH)lCKaJI 06JIaCTh. KpoMe TOro, no cpaBHeHHIO C
CaMapKaH)lCKOH 06JIaCTblO <I>epraHCKaJI 06JIacTb nOJlYlf.HJIa 60JIbllIe TeXHH'-IeCKOrO co,neHCTBHJI
co CTOPOHbI ,nOHOPOB, 06yqeHHJI no BHe,npeHHIO HOBOH no.uyweBoH CHCTeMbI Q>HHaHcHpOBaHHJI,
Q>HHaHcoBOMY ynpaBJIeHHIO,               a   TaK)l{e   no     Me,nHI.{HHCKHM     MeTo,naM       H   npaKTHKH.      TaK    KaK
Pa3JIH'-IHble    KOMnOHeHTbI        peQ>opM       BHe.ll.pJIJIHCb     nonanHO       B       Te'leHHe    HeCKOJIbKHX      JIeT,
<I>epraHCKaJI 06JIaCTb TaK)I{e H3BJIeKJIa nOJIb3Y H3 OnbITa, HaKOIDIeHHoro B nHJIOTHbIX paHoHax,
ror,na KaK B CaMapKaH,nCKOH 06JIaCTH Bce KOMnOHeHTbI peQ>0pM Ha'laJIH BHe.npJlTbCJI Cpa3Y B
60JIee C)I{3Tble CpOKH.


7.10     no nOH npH'-lHHe <I>epraHCKaJI 06JIacTh OKa3aJIaCb B 60JIee BbIHrphlllIHOM nOJIO)l(eHHH,
'1eM CaMapKaH.llCKaJI C TO'lKH 3peHHJI OKa3aHHJI nepBH'-IHOH Me.l\HKo-CaHHTapHOH nOMOI..QH Ha
ceJIe. <I>HHaHcoBbie MeHe,ll)KepbI H Me,nnepCOHaJI B <I>epraHcKoH 06JIaCTH HMelOT 60JIbllIHH
nOTeHI.{HaJI H OnbIT B ynpaBJIeHHH 61OJl)KeTaMH CBOHX yqpe>K.ll.eHHH. BBIm)' TOro, 'ITO Tenepb OHH
06JIa)laJOT     60JlbllIeH   Q>HHaHCOBOH         He3aBHCHMOCTbIO,         CBn       Ha)leJIeHbI        nOJIHOMO'lHJIMH        no
npHHJITHIO      pellIeHHH    06    HCnOJIb30BaHHH             CBOHX   6IOJl)KeTOB       H    B3J1THIO    Ha    ce6J1   HOBbIX
06J13aHHOCTeH no 3aKYDKaM, Tor,na KaK CBn CaMapKaH)lCKOH 06JIaCTH JIHIDb He,naBHO nOJlYlf.HJIH
He3aBHCHMOCTb B ynpaBJIeHHH CBOHMH Q>HHaHcaMH. npOl.(e,nypbI · KOH~HbIX 3aKYnoK 6bmH
HCnOJIb30BaHbI no 60JIee llIHPOKOMY cneKTpy KareropHH pacxo,noB B <I>epraHe no cpaBHeHHIO C
CaMapKaH)lOM. KpoMe TOro, 60JlbllIee '1HCJIO nOTpe6HTeJIeH B <I>epraHcKoH 06JIacTH 6bmH B
3Ha'lHTeJIbHOH      CTeneHH     y,noBJIeTBOpeHbl            Ka'leCTBOM   Me.ll.HI.{HHCKOrO 06C.1I)')I{HBaHHJI,         '1eM    B
CaMapKaH)lCKOH 06JIacTH, TaK)l{e KaK H ,nocTYD K 3KCTpeHHOH nOMOmH B <I>epraHe 6blJl HaMHoro
JIY'lllIe 6JIaro,napJl 60JIee KOPOTKOMY BpeMeHH O)KHJlaHIDI npH6b1THJI CJl)')K6bl CKOPOH nOMOmH.


7.11     O.ll.HaKO C TO'IKH 3peHHJI HeKoTopblX aCneKTOB Q>HHaHCOBOrO ynpaBJIeHHJI <l>epraHCKaJI
06J1aCTb npoHrpblBaeT CaMapKaH)lCKOH, TaK KaK peQ>0pMbl Ka3Ha'leikrna B <I>epraHcKoH 06JIaCTH
6blJlH HaqaThI n03)1{e. npOCpOlJ.KH B BblIDIare 3apa60THoH IDIaThI H OIDIaTe 3a Me,nHI.{HHCKHe
npHHa.nne)I{HOCTH 6blJlH ,nOJIbllIe B <I>epraHe. CHcreMa Ka3HaQeHCTBa TaM MeHbllIe co,neHCTBOBaJIa
CBn    npH      ocymeCTBJIeHHH          KOHTJ)OJIJI    3a    HCnOJIHeHHeM ,norOBopoB, Tor,na               B   CaMapKaH)le
OKa3blBaJIaCb nOMep)l{Ka CBn B BHJle npe,nOCTaBJIeHHJI Q>OPM THnOBoro KOHTJ)aKTa.


                                                              104 

7.12    OqeBH)lHO, 'ITO nepBHtfHaJI MeJUfKo-camrrapHaJI nOMOlU,b, B TOM q,opMe, B KOTOPOM OHa
OK83bIB8eTC.II   CBn,                             y.rryqmeHHit,   tfeM   B   roPO)lCKOH   MeCTHOCTH,      r)le
nepBHtfHa.II Me,nHKo-C8HHTaPHaJI nOMOlU,b npe,noCTaBJI.lleTC.II nOnHKJlHHHK8MH. JJ:on.ll cenbCKHX
nOTPe6HTeneit, KOTopble )loBonbHbl KatfecTBoM ycnyr, npe)lOCT8imReMblX            CBn,    Bblme, tfeM )lOJI.l!.
ropo,ncKHX       nOTPe6HTeneit,    y,nOBneTBOpeHHbIX       ycnyraMH,     0K83bIB8eMblMH        ropO,nCKHMH
nOnHKJlHHHKaMH. bOJ1l:'lllee tfHCnO CeJ1bCKHX, tfeM rOpO)lCKHX )KHTeneH C006lU,MO 0 TOM, 'ITO Y
HHX eCTb )locryn K 6eCnnaTHbIM YCnyr8M nepBHtfHoit Me)lHKO-CaHHTapHOH nOMOlU,H.



                                      B. TIJIAHbI HA IiY.1{YlUEE

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npe.lV1ar8IOTC.II Cpe)lHeCpOtfHble H ,nonrocpO'lHble Mepbl no ,ll,MbHeitllleMY cOBepmeHCTBoB8HHIO
nepBHtfHOrO        3BeHa    3)lpaBOOXpaHeHH.II.                      npe.lV10)KeHHbIX       peKOMeH)laQHH
HCtfepm>IBaIOlU,HH,   0,nH8KO,    np8BHTenbcTBY     cne.nyeT   P8CCT8BHTb      npHOPHTeTbI,     HCXO,nH     H3
c06cTBeHHoM 38HHTepecoBaHHocTH H nOTeHQHMa no K8)K)lOH peKoMeH)laQHH.                      B   Ta6nHQe     7.1
npHBO)lHTCR 0606lU,eHHe 3a.D,aQ B 06naCTH rocynp8BneHH.II, KOTOpble 6bmH 06c~eHbI B )l8HHOM
OT'leTe, HeKOTopbIe npe.lV10)KeHH}] no H3 )lOCTH)KeHHIO H H8H60nee no,nXOAAlU,He Be)lOMCTBa no
HX BbmOJ1HeHHIO H8 MeCTHOM H QelITpMbHoM ypoBHe.




                                                   105 

                                          TaoJluQa 7.1 

         PeKOMellll8QUU no ycoeepweHCTBoBaHulO CHCTeMbl 311paBooxpBHeuHH B Y30eKuCTBue 




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                                           KpamKOCpO'lHble lOOO'lU
nOBblCHTb           YnpaSJleHHe           L     HCKIlW'IHTh 4laKTOpbl 3a paMKaMH KOHTPOJlll              MHH311pasl
34141eKTHBHOCTL     KMpaMH                      MellHUHHCKHX pa6OTHHKoB H3 OueHI\H                       06J1311paB
rocynpaBJIeHHlI                                 Ka'lecTBa HX
rryrCM                                    2.    YnyIfWHTh CHCTCMY noompcHHA H3 c!>oHlla                  MHH41HH H
YBeJlHIfeHHJI                                   palBHTHIi nocpellCTBoM BHe.npeHIDI '1eTKHX               MHH3.npaB
CTHMYJlOS H                                     KpHTepHCa OUCHKH, n0CTpocHHblX Ha TaKHX
yny'lweHHJI                                     npHHUHnax l\aK OKa3aHHC KaIfeCTlleHHoit
MOpaJILHOrO llYxa                               nOMomH, OPHCHTHPOBftHHOCTb Ha KJlHeHTa,
MellHUHHcKOro                                   co6mo.ncHHc npHHQHnOa .n06pocolleCTHoA
nCpCOHaJIft.                                    npaKTHKH H IILmOJlHCHHe 1l0IDKHOCTHLIX
                                                06J13ftTeJlLCTII.


                                           CpeOHeCp0'lHble 3000'lU
nOBLICHTh           OKalaHHC ycnyr no
.neitCTlleHHoCTL    ncpBHIfHon MC.nHKo-   3.    COKpaTHTh 6lOPOKpftl1flO, YCTpaHHB                       MHH41HW
CBn B OKa3aHHH      CaHHTapHOn nOMomH           '1pe3MCpHLIC TPe60BaHHlI OTIfeTHOCTH,                    MHHlllpaBl
ycnyr                                           nposcpKH, .!lJIHTeJlbHble coaemaHIDI H                06J13.npaa   I   U,PIi
                                                6YMIDKH)'10 pa601)', OTHHMatOmylO MHOro
                                                apeMeHH


                    c!>HHaHcoBoe          4.    YaCJlH'IHTh He3asHcHMOCTL CBn II                          MHH41HH.
                    ynpallJlCHHC                HCnOJlHeHHH 61OmKeTa, nOHHlHS .neTaJtLHOCTH             IilOlllKeTHLln
                                                KOHTpOJlIl MHH41HHa 3a pacxo.naMH C ypOIIHII               OT.lleJI
                                                no.nCTaTen .no ypoBHlI CTaTen pacXO.nOB.
                                          5.    OCTIIBHTh B CKJIe npaso CBn H nOJUfKJIHHHK
                                                OCTaBJllITb y ce611 HeH3paCXO,llOBaHHbIC Ha
                                                KOHCU rO,lla cpe,llCTBa c!>oHlla palBHTHIi nyTeM         MHH41HH H
                                                aBTOMaTH'ICCKOrO nepCBO,lla                              MHHl.apaB
                                                HCH3paCXO,llOaaHJ:lblX OCTaTKOB Ha Ha'laJIO
                                                cne,nylOmcro 4lHHaHcoBoro rO,lla 6el
                                                cOKpameHHJI e>KerollHblX aCCHrHOBaHHR.
nOBblCHTh                                 6.    npe,llOCTaBJleHHe CBn H .llpymM
~41CKTHBHOCTb                                   npeo6palOBaHHblM MC,IlY'lpe)K.lleHIDIM npaso
pa60Tht OprauOB                                 nepeCMBTPHBaTh l1JlftHbl no paCXO,llOBaHHIO
BJlaCTH nyTeM                                   cpe,llCTII c!>OHll PalBHTHJI B Te'leHHe rO.l1ft 6el
60Jlee                                          >KeCTKOro KOHTPOJlll co CTOpoHbl MHH41HHa.            MHH3,1lPas H     Wli
PauHOHaJIbHOro
HCnOJlb30llaHHJI    3aKYmm                7.    OprauH30BaTb ueUTpaJIbHOe 3aKYnO'IHOe                    MHH3.llPas
pecypcoB.                                       ynpasneHHe B CHCTeMe l.llpasooXpaHeHIDI
                    YnpaBJIeHHe           8.    nOBblCHTb nOJlHOMOIfIDI P)'KoBoJlHTeneR                 MHH3.apas H
                    KMpaMH                      Me.lIY'lpe)K.lleHHR B HaRMe nepCOHaJIa                    MHH41HH
                                                (KOJlHt{eCTBO H .l10JI>KHOCTH, HaHfiollee
                                                Heo6xoJlHMLle.!lJlJl MeCTHblX ycnoBHn), a
                                                TaK>Ke onpe.l1eJ1eHHH palMepa            '"
                                                                                     ~Y"~~    ,nv,
                                                MaThl.!lJlJl peWeHHJI np06neM C HeXllaTKoR
                                                KBaJIH4IHQH20BaHHblX KaJIPOB
                                          9.    YCOllepweHCTBOBaTh nOJlHTHKY H npaKTHKY                  MHH3.apaB
                                                nOJl60panepCOHan~qTQ6LlOTKpbITb
                                                B03MO>KHOCTH Jl]llI KapbepHOro pOCTa.
                                          10.   nepeCMOTPeTh .... ,,)'''":.)' .y ol1JlaThI!pY.ll:~       MHH3JlpaB


                                                    106 

laoa,,"
ynpa6JIeHUJl
                            Opep",
                         npUMeHeHUJl
                                                                     HoopofiHoe onucauue Mep                          I
                                                                                                                      I
                                                                                                                           BeOOMcmea no
                                                                                                                            eIJmOJlUeHUNJ
                                                                                                                                laOa'l
                                                       '1To6b1 YMeHLWHTL JHa'UlMOCTL BLlcnyrH JleT
                                                       H nOBblCHTb 3Ha'lHMOcn. HaBblKOB H
                                                       KBaJlHIjlHKaUHH.


                     3axynKH H8                II. 	C03,tl8TL OT,tleJl          no nOnHTHKe 38KYnOK,                         MHH3,tlP8B
                     ueHTpaJlLHOM                      KOTOPLI:It B03LMeT Ha ce611 BHe,tlpeHHe
                     ypOBHe                            Ha,!l1Ie'lKamHX MeTO,tlOB OCYlUeCTBJleHHlI
                                                       38KYnOK B cIjlepe 3,tlpasooxpaHeHHlI                                  MHHIjlHH      I
                                               12. 	 Y CKOPHTL paJpa60TKY PYKOBO,tlCTB8 no                                   MHH3,tlpaB
                                                       3aKYI1KaM Jl,IUI 3,tlpaBOOXpaHeHHlI
                                               13. 	 n                 " " ,tloeryl1 '1aCTHoro ceKTopa K                  MHH3,tlpaB H P<l>O
YBemf'lHTb                                             HHljlopMal.\lUI 0 I1POBO,tlHMblX 3aKYnKax H HX
np03p8'1HOCTb H                                        pe3yJIbTaTax Ha BCCX ypOBHlIX. CHH3HTb
31jlljleKTHBHOCTb                                      CTOHMOCTI> TeH,!lepHol{ ,tloK}'MeHTaUHH.
nyTeM YCMeHH$!                                         Y CTpaHHTb KOHljlnHKT HHTepecOB B cny"lae
KOHKYpeHUHH B                                          .ll.OpH .ll.apMoH H Y3MemexHHKoH.
rocy,tlapCTBeHHblx                             14. 	   YCHJlHTI> KOHKYPeHUHIO, YCTp8HHB                                      MB3CI1T
3aKYnKax Jl,IUI                                        npe,tlS8pwrenbHYIO perHCTpaQHlO npo,ll)'KTa H
,tlOCTH'lKeHHlI                                        I1paKTHKY BblBepKH ero ueHbl.
60m,wef.i «OT,naQH                             15.     P8Cl1pOCTpaHllTI> cpe,tlH wHPOKO:lt
Ha KIDK.!lbIH                                          06IUeCTBeHHoCTH ,tleTaJJH YTsep'll(,!leHHOrO                           MHHIjlHH
,tloJUlap».                                            61O,!l'lI(eTa 3,tlPaBOOXpaHeHHlI.


                     YnpaMeHHe                 16. 	 PaJpa60TaTb TeXHH'lecKHe cneUHIjlHK8UHH                     no          MHH3,tlP8B
                     38KYnlC8MH H8                     H8H6onee "I8CTO 38KYn8eMbiM TOB8PaM o6IUeH
                     ypoBHe MeCTHblX                   CTOHMOCTblO MeHee            100000 ,tlOJUlapOB ClllA      H
                     yqpe'll(,!leHHH                   yKpel1HTb 11000HUHaJl nepCOHaJl8
                                                            .i:::.
                                                       I'"VV •       _"w."" v C JaKYnKaMH.
                     <l>HH8HCOBaIJ             17. 	 npHMeHllTh Te 'lKe           MeXaHH3Mbl                                  MHHIjlHH
                     nO,tlOT"leTHOCTb no               npe,tlBapwrenbHoro KOHTpOJlll no OTHoweHHIO
                     61O,!l'lI(eTY H                   K p8CXO,tlaM <l>oH,!la PaJBHTH$!, Koropble
                     3aKynKaM                          I1pHMeHlllOTCli Mll 06bNHoro 61O,!l'lI(eTa.
                                               18. 	 YKpenHTb nOTeHUHaJl MHHJ,tlpaSa Mll
                                                       I1pOBe,tleHHlI BHYTPeHHero ay,!lHTa                                    MHHljltlH1
                                                       (KOHTpOJlbHaIJ HHcneKUHlI) H nOTeHUHaJla                               MHH3,tlpaB
                                                       MHHIjlHHa (KPY).
                                               19. 	 nocreneHHo BHellplITb llJIlI 61O,!l'lI(eTa
                                                       CTpYKTYPY nO}lOT'feTHOCTH,                                            MHH3.llPas H
                                                       OpHeHTHpOBaHHYIO Ha pe3ynbTaT.                                         06n3.llpaB
                                                                                                                      I      ,,6.   ,.1.
YCMemfe              nO,tlOT"leTHOCTb          20. 	 <l>OPMaJlH30SaTb npouecc            oueHKH p860Tbi                             'Y     H
nO}lOT"leTHOCTH      npOH3BO}lHTeJJbHOCT               nepCOHaJla nOCpe,tlCTBOM paJpa60TKH                                    MHH3,tlpas
                     HTpY.lla                          PYKOBO}lCTB, 3aKJJlUl.LIBaIOlUHX npHHUHnbl H
                                                       npOUe.llYPbl 06'beKTHBHoti If np03pa'lHo:lt
                                                       oueHKH C 06113aTeJlbHblM
                                                       ,tlOK}'MeHTHpOBaHHeM Bcex nony"leHHblX
                                                       peJynbTaTOB, B uenllx 6ollbwe:lt
                                                       06'beKTHBHOCTH H pacnpOCTpaHeHHlI CpeJlH                               MHH3}lpaB
                                                       COTpY.llHHKOB.
                                               21. 	 nO:3TWlHO BHe,tlpHTh nOJlOT"leTHOcn.,
                                                       OpHeHTHpoBaHHYJO Ha pe3YllbTaT,.llJllI
                                                       ynpasneHHlI Ka}lPaMH.
                     nO,tlOT"leTHOcn.          22. 	 I1HljlopMHPOBaTL HaceneHHe 0              peljlOPMax,                  Yqpe'll(,!leHHlI
                     yqp_e'll(,!leHHH nepeJl           11               LIlli         lIt.nn "v'I'...~n,w"'..,                 OMcn



                                                                107 

                                                                                           BeOOMcm6a no
                           CtPepfl'
3aoa'lu                                              nOOpo6Hoe onucaHue Mep                 6f1mOJlHeHUIO
                        npUMeHeHUR
ynpa6JleHUR                                                                                     laOa'l
                     HaceneHHeM              nOCpe.llCTBOM paJMellleHIDI nnaKaTOB,
                                             06'bIiBneHHA H11H paJ.llaqH 6poullop B
                                             Me.ll}"lpelK,lleHIDI x.
                                       23.   I1HCTH1)'UHOHanH3HpoBaTh COBeT
                                             noneqwreneA Ha ypOBHe CBn H                      06m.llpaB
                                             nOnHKJIHHHK.
                                       24.   06yqHTh HHCTH1)'Thl rpll)l(JlaHcKoro
                                             o6111eCTBa «JlOnOnHIITh» Maxa.TlJlHHCKHe          ,llOHOPhl
                                             KOMHTeThI, MeCTHhie H ueHTPanhHhle opraHhl
                                             ynpasneHHII B MOHHTOpHHre CHCTeMhl
                                             3JlPasooXpaHeHHJI.
                                         POJlZOCpO'lHfI,e laOa'IU
nOBhlCHTh            HaUHoHanhHaJI     25.   PaJpa60TaTh H npHHJlTh HOBoe                     MHH3.llPas,
np03paqHOCTh,        CHCTeMa 3aKynOK         3aKOHO.llaTenhCTBO no 3aKynKaM B                MB3Cl1HT,
nOJlO~eTHOC1b   B                            COOTBeTCTBHH C MelK,llyHapOJlHhlMH            MHHHCTepCTBo
rocY.llapCTBeHHhlx                           CTaHJlapTaMH                                   3KOHOMHKH H
3aKynKax                                                                                  rocY.llapCTBeHHhlH
                                                                                              KOMHTeT
                                                                                           apXHTeKTyphl H
                                                                                           CTpOHTeJIhCTBa




                                                 108 

                                                    llPHJlOiKEHHE !

                1. MEXAHH1Mbi ClJHHAHCHPOBAHIDI ME)(HUHHCKHX yqPEiKj(EHHR


1.          <I>HHaHcHpoBaHHe CBn H npeo6pa30BaHHbIx ceMeMHbIx nOJ1HKJlHHHK, OCHOBaHO Ha
$opM)'J1ax no.nyweBoro $HHaHcHpoBaHIDI (BCTaBKa                       1).    <I>OpM)'J1bl o6ecneQHBalOT TO, <iTO
6a30Bb1M ypOBeHb $HHaHCHpOBaHIDI He HIDKe ypOBHJf npe,nbI,l{)'mero ro,na, a no.nyweBoM 61OJl)KeT
OTpaJKaeT xapaKTepHCTHKH 06CJIYlKHBaeMOro HaCeJ1eHIDl.




                                                     Rcr8BK8 I 

                                   Q)0PMYJI8 nO.llymeooro lfliiH8HCiiPOB8HiiS CRn 


     1. IiSlOBSS crSBKS rlO.lIymcooro lfliiHSHCiiPOBSHiiH .lIJIH CRn
           BCR(t) [RHB(/) '" SRPHC(/)] I PRPHC(/),
 zoe:
 BCR(t)           6aJOBaH CTaBKa no.nywcBoro qnfHaHCHpoBaHH5I CBn B o6nacnl B t ro.ny
 RHB(t)         = o6u.udl 61O,IllKeT 3.npaBooxpaHcHIDI o6nacTH B t roJlY (3a HCKlJlQ'ICHHCM accHnmBaHHil: Ha
 CaHHTapHO-3nH.lIeMHOnOrH'lecKj'iO     e.ny)l(6y,     KanHTanbHble     BnO)l(eHIDI     H     CneUHaJlbHble
 ueHYpaJIH30BaHHbIe MeponpIDITH5I)
 SRPHC(t) = cpe,nID!JI ,nOAA (%) CBn B 61O,n)l(eTe o6nacnl B I roJlY (3Ta ,nOAA He ,non)l(Ha 6bITb MeHbme
 QlaKTH'leCKHX pacxo,nOB CBn B npellhlJlYlIleM ro.ny)
 PRPHC(t) = 061I1aH 'IHCneHHOCTb HaccneHIDI, npHKpelIJIeHHOrO KCBn B t ro.ny

 2. Ezcro,nuble 8CCHnlOB8HHH us ,nymy HSCeJICUHH lIS OT.lIeJILHOe CRn
         YCB(k,t)   =:   BCR(t) '" P(k,t) '" SAc(k,t) '" OC (k,t),
 zoe:
 YCB (k,t)     e)l(erOl1Hble no.nymeBlde 61O,IllKeTHble aCCHrHOBaHH5I Ha CBn k B t roJlY
 BCR (t)       =: 6aJOBM CTaBKa nOJlYmeBoro QlHHaHCHpOBaHH5I Ha Bce CBn B t ro.ny B o6nacTH, r.lle

 pacnOnO)l(eH CBn k
 P (k,I)    = 'IHCneHHOCTb HaceneHHH, npHKpelIJIeHHOrO KCBn k B t ro,ny
 SACkJ        COCTaBHoA nonoBo3paCTHoA nonpaBO'lHLlA K03Q1Q1HUHeHT l1JlH HaceneHIDI, npH.KpenneHHoro
 KCBn k B t roJlY
 OC (k,/)      = ,npyroil: nonpaBO'lHblif K03Q1Q1HUHeHT l1Jl5I CBn k B t ro.ny (HanpHMep, nonpaBKa Ha
 IIJIOTHOCTb npH.KpelIJIeHHoro Hace.neHIDI, BCTaBK8 5.3)

 HCmO'IHUK:      nOCTaHOBJICHHC KM N!!217 (28 cCHu6pH 2005 r.) H npHKaJ M3 N2484 (4 OKTH6pH 2005
 r ..



2.         no     BceM       CTp8He       npHMeHJflOTCJI     O.llHHaKOBble     nonpaBO'-lHbIe   n0J10B03paCTHble
K03$$HltHeHTbl (BCTaBKa             2).   )laHHble K03$$HltHeHTbI, OCHOBaHHble Ha HCCJ1e,nOBaHHH YPOBHJI
HCn0J1b30BaHHJl ycnyr rIMCn Pa3J1HQHbIMH n0J10B03P8CTHbIMH rpynnaMH, 6billH YTBep)KJleHbl
M3.     TeM He MeHee, B npHKa3e co,nep)KHTCJI nOJ1o)KeHHe                     ,luUI.M3   K8CaTeJ1bHO nepeCMOTpa
K03$$HltHeHTOB c yqeTOM JlOnOJ1HHTeJ1bHOrO                 omITa H HH$OPMaI.tHH.




                                                           109 

                                                                    BCTaBKS   2

                                       nOl1pSBO"lHbJe nOJlOBOlpSCTHbJe K03~4nnUleHTbl 



                                                                                                       nOnpSBO"lHble
                   nOJlOBOOpSCTHble rpynnbl
                                                                                                      K03~~HUHeHTbJ


                   MnaueHUhI My)KcKoro H JlCeHcKoro nona)10 12 MeClIueB                                       2,6

                   Mami'lHKH H )1eBO'IKH OT 13 MeCHues )10 14 neT                                             0,8

                   )l{eHmHHbIOT 15 )1049 JleT                                                                 1,9

                   Bce OCT3JThHOe B3pocnoe HaceneHHe > 15 JleT                                                0,5

                     I1cmO'IHUK:       nOCTaHOSneHHe KM JII'!!217 (28 CeHTR6pJl 2005                       H npHKaJ M3 JII'!1484 (4
    OKTH6p1l 2005 r.).



                                BCTaBKS      3
                                3.        K03cPtlmUHeHTbi                    rmOTHOCTH
      cJ)eprSHCK8H oon8CTb: K03~~HUHeHTbl nJlOTnOCTH 
                         HaCeJlemm            (KJ1H)     He            5IBJlj"UOTC5I
                           IlllcenenHS!,    2007 r.   
                        06J1JaTeJlbHbIMH        H     npHMeHJlIOTCJI              Ha
                                                                               ypOBHe           06naCTH                no           Mepe
             HsceneHHe, npHKpenneHHoe                                          He06xo,UHMOCTH.          OHH        BBO,URTC5I         W151
                             KCBn                         KnH                 ,UononHeHw 61O,UJlCeTHblX accHrHoBaHHH
             HaceneHHe < 3.000                                                 Ha    CBn       co    CpaBHHTenbHO           MeHbmHM
             HaceneHHe >3.000 < 5.000                        1,2               06CJl)'JKHsaeMblM        HaceneHHeM              H     TeM

             HaceneHHe >5.000                                1,0               caMblM nOJSOn5l1OT HM KOMneHcHposSTb
                                                                               OTHOCHTenbHO                BblCOK}1Q                ,UonlO
     MemO'll/UK:   M3.
                                                                               nOCTOllHHblX 3aTpsT B CBOux. 61O,UJlCeTax.
                                                                                           KSK                                      CBn
sKKYM)'nHpYJOTClI            HS   ypoBHe          o6nscTH,      H    06nacmoe       ynpaBJIeHHe       J,UPSBooxpsHeHIDI,              KSK
"noKynSTenb" ycnyr                          BbInOJlHlieT cPYUKUHH                       YTBep:lK}:(aJOlilero
HMeHHO HS 06nsCTHoM ypoBHe onpe,UemleTCH Heo6xo,UHMOCTb H ueneco06pa3HocTb npHMeHeHIDI
KIIH. Ecnu 06n8CTIlOe             ynpaBJIeHHe 3)l.paBOOXpaHeHw npHHHMaeT pemeHHe 06 HCnOJlb30BaHliH
           OHH MOryT 6b1Tb                                 KO       BceM CBn 06nacTH. 3HalJeHIDI K03cPcPHuueHTOB
ruIOTHOCTH         HSCeneHHlI        onpe,UeJllllOTClI       Ha     ypoBHe    06J1SCTH     H    ynep:lK}:(aJOTCJI          06nacTHbiM
ynpaBneHHeM 3,UpsBooxpaHeHIDI H 06J1aCTHb1M cPHHaHcOBblM ynpasneHHeM.                                                       npoue.uypa
lIBJ1HeTCJI qaCTblO eiKerO,UHoro npouecca no,UrOTOBKH 61O)l.)KeTa. Bo BCTaBKe                                  3    npe,UCTaBJIeHbI
K03cPcPHuueHTbl,                              B <i>epraHcKoH 06nsCTH.


4.          2007     r.           nepBbIM         rO,UOM     oCYlIleCTBJleHIDI       pecPoPM        cPHHaHcHpoBamm             CBn        B
CSMapKSH,UCKOH o6J1sCTH; TeM He MeHee, 06naCTHOO ynpSBJleHHe 3,UPSBooxpaHeHIDI npe,Uno'lJlo
He Hcnonb30BaTb                    B 3TOM cPHHaHCOBOM ro.uy. OHO TalOKe                                 npHMeHHTb npHHuun
no.uymeBoro aCCHfHOBaHIDI TonbKO K CTaTbHM paCXO,UOB Ha KMPhl, paCCMOTpeHHbIM B rJlaBe                                                   IV
(K     TeKYIIlHM         pacxo,UaM     Ha     3aprmaTY        H     pacxo,UaM       nOMHMO      3aprmaTbI).        C       2008     r.    B
CaMapKaH,UCKOH o6nacTH no.uymeBoe cPHHaHcHpoBmme 6YJleT npHMeHliTbCR B nOJlHOM 061>eMe
-     C nOnpaBKaMH Ha rmOTHOCTb HaCeJleHIDI                        Hi   HJlH JlpyrnMH Heo6xoJlHMbIMH nonpaBKaMH                          KO
BceM CBn o6naCTH.


5.          PaHoHHbIe H ropo,UcKHe cPHHaHCOBbIe OT,UenhI rOTOBSIT CBOH 61O,QJKeTHhIe npe.unOiKeHHR
HCXOM        H3     npe,UnonOiKemm            0    cPHHaHCOBOH           caMOOKynseMOCTH.           PaHOHHbIH          H    ropO,UCKOH
               cPOPMHPyJOTCH 3a ClJeT MeCTHbIX HaJIorOBbIX nOCyYWleHHH H 3apsHee YCTaHOBJleHHOH



                                                                     110 

)].OIlH        pecny6IlHKaHCKHX           HaJlOroBblX         ' C60pOB.      Bce      Me)].HLUfHCKHe              yqpe)f(Jl.eHIDI,        3a
Q>HHaHCHpOBaHHe KOTOPblX OTBe"laJOT paHOHHbie H rOpO)].CKHe ynpaBIleHIDI 311081BOC)XI)8ffefIIDI
                                          MHUHOHHOrO 6fO)l.)KeTHOrO n ouecca.

              Bcr8BK'8   4: 3K'CnepHMeHTaJlLHble K'OJ«I>«I>HLuleHTLI 

                         nOltyweBoro «I>HHSHCHPOBSHHH: 
                                6.           IloJluKlluHuKu. PeQ>opMbl
          ll,eHTpllJlbHble PSRoHHblelropOltCK'He nOJlHK1lHHHK'H 
                       CeKTOp8 3)].p8BooxpaHeHIDI 6bl1lH
                                                                                        p8cnpoCTp8HeHbi H8 ropO)].CKHe
     3KcnCpHMClITaJli>HOC nO)lYUlcaoc cjlHHaHCHpOBaHHe ocymCCTI!J1JIeTClI               nOIlHKIlHHHKH                                      B
     no TeM >Ke cjlopMynaM, KOTOpi>le npHMeIDIlOTcli K CBil,
                                                                                        3KcnepHMeHTaJlbHOM                   nop~)].Ke     B
     CKOppeKTHpoBaHHi>1M C )"IeTOM ycnoBHH roPO)lCKHX nOJIHKJlHHHK. B
     CaMapKaH)lCKO~ 06JIaCTH npHMeHlIJIHCb CJIeJl)'!OmHe nOnpaBO'lHble
                                                                                        2006        r. OHH OCYlUeCTBJUlfOTC)'I
     K03cjlcjlHUHeHTl>I nJIOTHOCTH HaceneHIDI B 2007 r.:                                BO MHorHX ropo)].ax HeCKOIlbKHX
                                                                                        06IlaCTeH,                               BKIlfO"IM
     ilOJlHKJIHHHKH, 06cnY>KHB. HaceneHHe     < 27.000                    1,42          C8M8pKaH)l.CKYtO H <l>epr8HCKYtO
     ilOJIHKJIHHHKH, 06c1lY>KHB, HaCeJleHHe >27,000,      < 35,000        1,06
                                                                                        06Il8CTH                  (BcT8BKa               4).
     ilOJIHKJlHHHKH, 06cJlY>KHII, HaCeJleHHe>   35,000                    1,00
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Hcnonb30BaBUIHeCJI B 3KcnepHMeHTaJlbHbiX nOIlHKJIHHHKax CaMapKaH)l.CKOH                                                      OTp8)KafOT
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COCTaBIleHIDO 6fO)l.)KeTa Ha OCHOBe 3MeHCTBOBaHHbiX pecYPCOB (HopMaTHBOB).                                                   B    )].aHHOM
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                                                                                               43
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41 T.e. Bee, KpOMe CBn H 3KCnepHMeHTa.llI:.HbIX nonHKllHHHK
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ceMHHapy no «I>HHaHCHpOBaHIDO CTallHOHapoB.                   USAID, OlITH6ph 2005 r.

                                                                 111 

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<l>epraHcKoH 06JIacTH B          2005   r.




                                                         BCTaBK85 

                    PaUHOH8J1H3aUHH CTaUHoHapHLlx y'lpe*JleHHA B «I>epraHcKoA 06JIaCTH 



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                                                            112 

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BHe6JOJt)KeTHblX cpe.nCTB.




                                                             113 

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                                                    114 

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TeH}:{epHblH KOMHTeT.


3.           ,nJHI KOHTpaKTOB Ha CYMMY MeHee             1 MnH.   AOJ1J1. ClllA M3 <P0PMHPYeT nOCTOHHHble HnH
CneUHaJIbHble TeH}:{epHble KOMHTeThI H pa60"lHe rpynnbl. BeJIH 3aMaHHpOBaHHaH cYMMa TeH}:{epa
npeBblrnaeT           1   MnH. AOJIJI. CIlIA,    KM     C03AaeT TeH}:{epHble KOMHTeTbl H COOTBeTCTBYIOllufe
pa60"lHe rpynnbI. COCTas HX yqaCTHHKos SKJIIO"IaeT npeACTaBHTeJIeH TeH}:{epHblX KOMHTeTOS H3
        MHHHCTepcTBa BHernHe3lKOHOMH"IeCKHX CBR3e", HHBeCTHUHH H TOprOBJIH                                (MB3CHT) H M3
(KOJIH"IecTSO npeACTaBHTeJIeH He AOJI)f(HO npeBbIrnan                         30%    OT 06mero "IHCJIa yqaCTHHKos).
BbIrneYKa3aHHble npHHUHnbI npHMeHHMbl KO sceM TeH}:{epaM BHe 3aBHCHMOCTH OT HCTO"lHHKa
<pHHaHCHPOBaHHH.


4.                                         BHernHe3KOHOMH"IeCKOe                  npeAnpHHTHe            ("Y3MeA3KCnOPT"),
nOApa3AeJIeHHe              M3,   OTBe"laeT     3a      3axynKH        JIeKapCTBeHHblX          CpeACTB,     MeAHUHHcKOro
060pYAOSaHHH,               H   MaTepHaJIOB     MR       MeAHUHHCKHX                                <pHHaHCHpyeMble          H3
rocYAapCTBeHHOrO 61OJ])KeTa,                a TaK)f(e    H3   cpeACTB 3aHMoB           H    KpeAHTOB       Me)f(J{yHapoAHblX
opraHH3au:uH. "Y3MeA3IKCnOPT" MO)f(eT                           ynOJIHOMO"leH M3 MJI BbInOJIHeHHH <PYHKUHH
pa60"leH rpynnbl H areHTa no 38K)'nKaM, B 3asHcHMoCTH OT KOHKpeTHOH CuryaItHH. ITPH


4S    E.lUIHCTseHHble KOHTPaKThl Ha npOBe)leHHe CTpowreJlbHI>IX pa6oT, 3aKJlIO'IaeMbie Ha pecny6J1HII:aHCII:OM ypoBHe,
OTHOClITCl'I II: "MMHHHCTpaTHBHbIM 3axynKaM" T.e. peMOIIT II MO)lepHH3/llUU1 3JlaHidt MHHHCTepCTBa, CPIIHaHCHpyeMble
1-13 filO.IDI<eTa   M3.
46   B COOTBeTCTBHH C nOCTaHOBJIeHHeM KM Ng456 (21        HOl'l6pJl   2000 r.).

                                                              115
BblflOJlHeHHH ct>YHKUHH areHTa no 3aKynKaM, 06J13aHHOCTH pa60qeH rpynnbI paCWHpJlIOTCJI H
BKJIIOqaJOT .nonOJlHHTeJlbHble 3a;:J.aHIDI, TaKHe KaK no.nnHcaHHe KOHTpaKTOB, KOHTpOJlb 3a HX
HCnOJlHeHHeM           H    TaMO)f(eHHOe         o<}lopMJIeHHe.          "Y3Me.n3KCnOPT"              BKJIIOqaeT     TpH     OT.neJla,
CneUHaJIH3HPYlOIIJ.HXCJI Ha 3aKY"Ke Me.nHQHHCKOrO 060py.nOBaHHH, JleKapcTBeHHbIX cpe.nCTB H
KOHTpaKTaX "no.n KJIIOq" COOTBeTCTBeHHO.


5.         llocma6U/uKu.           AKQHOHepHWI aCCOQHaQIDI (")J;0pH-)J;apMoH") CneUHaJIH3HPYeTCJI Ha
nOCTaBKax H pacnpe.neJleHHH JleKapCTBeHHblX Cpe.nCTB cpe.nH Me.nHUHHCKHX yqpe)f(JleHHH Bcex
ypoBHeH. ")J;0pH-)J;apMoH" JlBJlJleTCJI KOMMepqeCKOH opraHH3aUHeH C orpaHIReHHblM                                                (25%)
rocy.napCTBeHHbIM             KOHTpOJleM.          AccoQHaQIDl,                 BKJIIOqWl        .nOqepHHe       npe.nnpHJlTHJI        H
no.npa3.neJleHIDI, JlBJlJleTCJI KpynHeHwHM nOCTaBIIJ.HKOM H .nHCTpH6bIOTOPOM <}lapMaUeBTHqeCKOH
npo.nyKQHH        B    Y36eKHCTaHe.        no      oueHKaM           ~eHTpa        JleKapCTBeHHOH          nOJlHTHKH,      Ha    .nomo
accOUHaUHH            ")J;opH-)J;apMoH"      npHXo.nHTCJI             80%         pbIHKa    JleKapcTBeHHblX          cpe.ncTB      .llJIJI
yqpe)f(JleHHH IlMCn, no cpaBHeHHlO C                        ee n03HQHeH MOHonOJlHCTa BO BpeMeHa COBeTCKOrO
COI03a.     Y     KOMnaHHH         HaJIIDKeHbI          OTHOllleHHJI        C    Me.nyqpe)f(JleHHJlMH,          HMeeTCJI    ToproBo­
pacnpe.neJlHTeJlbHWI CeTb no BceH cTpaHe, BKJllOqWl XOJlo.noBYlO uenb )lJIJI BaKQHH, Ha;:J.e)f(HWI
CHCTeMa        KOHTpOJlJl       KaqeCTBa     H     MOHOnOJlHJI           Ha       npo.n~          HapKQTHqeCKHX         cpe.ncTB       H
nCHXOTp0nHbIx npenapaToB. DOJlee Toro, aCCOUHaUHJI nO-npe)f(HeMy JlBJlJleTCJI e.nHHCTBeHHbIM
rapaHTHpOBaHHhIM KaHaJIOM nOCTaBKH H pacnpe.neJleHHJI <}lapMaueBTHqeCKHX npenapaToB )lJIJI
y.naJIeHHblX Me.nyqpe)f(JleHHH no BceH CTpaHe -                         no PbIHOK, B KOTOPOM He 3aHHTepeCOBaHbI
qaCTHble nOCTaBIIJ.HKH <}lapMaue~eCKOH npo.nyKUHH.


6.        KOHmpOJlb Ka'leCm6a.                   rJlaBHOe       ynpaBJleHHe KOHTpOJlJl KaqecTBa JleKapCTBeHHblx
                                                                       47
cpe.ncTB    H     H3.neJlHH     Me.nHQHHCKOH TeXHHKH                M3    (YnpaBJleHHe no KOHTpOJlIO KaqeCTBa)
oCYIIJ.ecTBJIJleT e.nHHYJO rocy.napcTBeHHYIO nOJlHTHI<)' B c<}lepe pacnpe.neJleHIDI JleKapcTBeHHbIx
cpe.ncTB H Me.nHQHHCKHX MaTepHaJIOB, pa3pa6aTblBaeT CTaH)laPTbI KaqeCTBa )lJIJI 3THX TOBapoB H
06eCneqHBaeT HX C06J1IO.neHHe. Ero OCHOBHWI .neJlTeJlbHOCTb BKJIlOqaeT KOHTpOJlb KaqeCTBa,
perHCTpaQHIO           H    CePTH<}lHKaUHlO             Me.nHQHHCKHX             TOBapoB         (BKJllOqWl      HMnoPTHpyeMbIe).
YnpaBJleHHe no KOHTpOJlIO KaqeCTBa BbInOJlHJIeT 3TH npoue.nypbI )lJIJI Bcex KOHTpaKTOB Ha
nOCTaBI<)' JleKapcTB BHe 3aBHCHMOCTH OT HCTO'fHHKa <}lHHaHCHpoBaHHJI H npoue.nyp 3aI<)'nOK
<}lHHaHCHpYlOIIJ.eH opraHH3aQHH. TeM He MeHee, Ha)lJIe)f(aI.UWI npoH3Bo.nCTBeHHWI npaKTHKa
(GMP)      -      cePTH<}lHKaUHJI       npoH3Bo.nHTeJleH              JleKapCTBeHHblX             Cpe,lJ.CTB,    peKOMeH,lJ.OBaHHaJI
BceMHpHOH opraHH3aUHeH 3.npaBooxpaHeHHJI                              (B03), -        He BXO.nHT B qHCJlO npHMeHJIeMbIX
CTaH)laPTOB KaqeCTBa.


7.        BHympeHHuu            KOHmpOJlb.          KOHTpOJlbHWI                HHcneK.UHJI       6bUla   C03.naHa     B    KaqeCTBe
no.npa3.neJleHHJI BHYTPeHHero ay.nHTa B cTpyKTYpe M3 nOCTaHOBJIeHHeM                                       KM .N'!! 18 (14      JlHBapJl
1999       r.).       KOHTpOJlbHWI         HHCneKUHJI                no.nqHHJleTCJI         Henocpe.nCTBeHHO               MHHHCTpy
3.npaBooxpaHeHIDI, KOTOPbIH TaK)f(e Ha3HaqaeT ee HaqaJIbHHKa. B ee COCTaB BXO.nHT ueHTpaJIbHbIH
oq>HC B TawKeHTe H TePPHTOPHaJIbHble no.npa3.neJleHHJI BO Bcex 06J1acTJlx C 06IIJ.HM lllTaTOM B                                      43
COTpy.nHHKa.          ~eJlblO     KOHTpOJlbHOH             HHcneKQHH              JlBJlJleTCJI     06eCneqeHHe        C06J1IO.neHHJI
Me.nHQHHCKHMH yqpe)f(JleHHJlMH HOpMaTHBHbIX aKTOB B c<}lepe 3.npaBooXpaHeHHJI. Ee OCHOBHbIe
06J13aHHOCTH          BKJllOqaIOT      KOHTpOJlb           H8.ll     npoBe.neHHeM           3aKY"oK,          pacnpe.neJleHHeM         H
paQHOHaJIbHbIM          HCnOJlb30BaHHeM           JleKapCTBeHHblX                cpe.ncTB    H     Me.nHQHHCKHX       MaTepHaJIOB,
KOTopbIe        OT.neJlbHble     Jleqe6Ho-npo<}lHJIaKTH'IeCKHe                    yqpe)f(JleHHJI       npH06peTalOT         3a    CqeT
rocy.napCTBeHHblX cpe.ncTB H .nOXO.nOB OT OKa3aHHJI nnaTHblX Me.llHQHHCKHX ycnyr. KOHTpOJlbHWI
HHCneKQIDI TaK)f(e npHHHMaeT MepbI no npeceqeHHIO KoppynQHH H paccMaTpHBaeT )f(alI06bI




47 eM. nOCTaHOBJIeHHe         KM .N'!! 181, 25   MaJI   1995   r.


                                                                    116 

yqacTHHKOB TeH.ll.epOB H nOCTaBIIJ.HKOB Ha He3aKOHHhle   Me.ll.HUHHCKHX
yqpe:JK.lleHHH.




                                           117 

                                                      llPHJIO')l(EHJlE 2

       1.     CJlCTEMA 3APAliOTHOH nJlATbl B CEKTOPE 3WABOOXPAHEHIDI: HEKOTOPblE
                                                TEXHJlqECKJlE~TARJI




1.          OCHOBHbIMH HopMaTHBHbIMH rucraMH, onpeJl.eJHIIOlllHMH cHcreM)' 3apa6oTHoH nnaThI;
SlBJHIIOTCSI: nOCTaHOBJleHHe npe3HJJ.eHTa                  N!!229        (1 Jl.eKa6pSI 2005      r.)   "0 cOBepweHCTBOBaHHH
CHCTeMbI onnaTbI TpYJl.a MeJl.HUHHCKHX pa6OTHHKoB"; nOCTaHOBJleHHe                                      KM N!!276     (21 Jl.eKa6pSl
2005    r.)   "06 YTBep)f(J\eHHH ycoBepweHCTBOBaHHOH CHCTeMbI OnnaThI TpYJl.a MeJl.HUHHCKHX
pa60THHKOB"; H COBMeCTHble nOCTaHOBJleHHJI M<I>, M3 H MHHHCrepCTBa TpYJl.a N!!N!!1536, 1537,
H    1538 COOTBeTCTBeHHO (14 SlHBapSi 2005 r.) 0 $oHJJ.e MaTepHaJIbHOrO CTHM)'JlHpoBaHHJI H
PaJBHTHJI MeJl.HlUfHCKHX opraHH3a1UfH H onnare TpYJl.a PYKOBO,lVIllJ,HX pa6OTHHKoB. KpoMe Toro,
BO BcnOMOrareJlbHhIX Jl.OK)'MeHTax COJl.ep)f(8TCSI paJbSlcHeHHJI no HOBOH CHCTeMe, H ny6JlHKYIOTCSI
nepHOJl.HqeCKH         06HOBJlSleMble         Jl.aHHble        0       TapH<I>HbIX      K03<1><I>H1UfelITax      H    nOBbIWeHHJlX
MHHHMaJIbHOH 3apa6OTHoH nnaTb!.


2.          Cepmu¢uKalfWl:            CYllleCTBYeT 4 ypOBIDI CepTH<I>HKaUHH: oTCYTCTBHe KaTeropHH (JJ.JlSl
BblnyCKHHKOB yqe6Hblx 3aBeJl.eHHH), BTOPaJI KarerOpHJI (MSI COTpYJl.HHKOB C 5-JleTHHM onblTOM
pa6OTbI), nepBaJI KareropHJI (7 JleT), H BbICWaJI KarerOpHSI (10 JleT). Ceprn<l>HKa1UflO Heo6xo.lJ.}lMO
nOBTOpHo         npoxo.lJ.}lTh    qepe3    onpeJl.eJleHHbIH              nepHOJl.      BpeMeHH,        HJlH   KBaJIH<I>HKalUfOHHaJI
KarerOpHJI CTaHeT HeJl.eHCTBHreJlbHoH.


3.          Pa6o'laJl HazpY3Ka ("cma6Ka'):                nepBaJI nOJlHaJI CTaBKa 06blqHO H3MepSleTCSI B qacax,
3TO CTaHJJ.apTHbIH pa60qIDi Jl.eHb. Pa60qaJI HarpY3Ka CBbllUe OMOH CTaBKH onpeJl.eJlSleTCSI Ha
OCHOBaHHH Jl.OnOJlHHTeJlbHbIX cny)l(e6HbIX o6S13aHHoCTeH, KOTopble MOryT BbInOJlIDITbCSI, B TOM
qHCJle qaCTj.fqHO, OJl.HOBpeMeHHO C pa60TOH Ha nOJlH}'lO CTaBK)'. H8JJ.6aBKa K 3apnnare 3a
BbICnyry JleT MO)l(eT BblnnaqHBaTbCSI, ecJlH B lUTaTHOM pacnHcaHHH YKaJaHO,                                          ~o   COTpYJl.HHK
pa60TaJI "HenOJlHbIH pa60qHH Jl.eHb" (B OTJlj.fqHe OT Jl.onOJlHHTeJlbHOH pa60qeH HarpY3KH Ha
COTpYJl.HHKa, 3aHSIToro nOJlHbIH pa60qj.fH Jl.eHb).


4.          Hao6a6Ku:      COTpYJl.HHKH CBn, BbInOJlIDIIOIllHe ynpaBJleHqeCKHe <l>YHKllHH (HanpHMep,
3aBenyIOlllHe, CTapWHe MeJl.CeCTpbI), nOJIyqaIOT H8JJ.6aBK)' B paJMepe 25% OT MHHHMaJIbHOH
e)l(~MeCSlqHOH 3apnnaThI (He OT TapH<I>HoH CTaBKH), HJlH 6oJlee, eCJlH OHH 06cny)l(HBaIOT
MHOrOqHCJleHHoe          HaCeJleHHe        H,    CJleJl.OBaTeJlbHO,             PYKOBO,lVlT     60JlbWHM        qHCJlOM          BpaqeH.
PyKOBO.lJ.}lTeJlH     MeJl.HlUfHCKHX       yqpe)f(J\eHHH               BHe    CHCTeMbI    fIMCn         paHOHHoro         HJlH    60Jlee
BbICOKOro ypOBIDI HMeIOT npaBO Ha nOJIyqeHHe H8JJ.6aBKH Jl.O 70%.                                         B   npHJlO)l(eHHH 2          K
nOCTaHOBJleHHIO        N!!276,    nepeqHCJleHhl Jl.OJl)l(HOCTH, npeJJ.YcMaTpHBaIOlllHe npaBo Ha nOJIyqeHHe
Jl.OnnaT B CBSl3H C onaCHbIMH JJ.JlSl 3J1.0POBMI HJlH oco60 TSI)I(eJlbIMH YCJlOBHJlMH TpYJl.a.


5.          COTpYMHKH 06blqHO Haqj.fHaIOT nOJIyqaTh Ha,n6aBKH 3a HenpepbIBHbIH TpYJl.OBOH                                          CTa)I(

qepe3 5 JleT, XOTSI pa60THHKH onpeJl.eJleHHblX MeJl.HlUfHCKHX yqpe)f(J\eHHH, BKJlIO'IaJI CBn,
HaqHHaIOT        nonyqaTb        HX   Qepe3     3    rOJl.a,       H    HX     pa3Mep    6blCTpO       B03paCTaeT.        HanpHMep,
nOCTaHOBJleHHe         KM N!!276        (Pa3J1.eJl   VI,       naparpa<l> 24) YCTaHaBJlHBaeT paJMep Ha,n6aBoK B
npouemax OT TaPH<I>HOH CTaBKH Ha OCHOBHOH Jl.OJl)l(HOCTH, OT 10% Jl.O MaKCHMaJIbHOrO 3HaQeHHJI
B 50% Qepe3 11 JleT. KaK H Jl.pyrHe H8JJ.6aBKH B CHCTeMe 3apa6OTHoH nnaThI, OHH MOryT 6blTh
CKoppeKTHpoBaHhI: nOCTaHOBJleHHeM npe3HJJ.eHTa                               N!!524   OT 2006   r.   6bIDH nOBbllUeHbl Jl.OnnaThI
3a BbICnyry JleT MeJl.CecTpaM, HMeIOlllHM BblClUee 06paJoBaHHe H 3aHHMaIOlllHM onpeJl.eJleHHble
Jl.OJDKHOCTH .




                                                                   118
6.         I10PJl)lOK HClfHCJIeHH.sI HenpephIBHoro CTIDKa pa60ThI YKa3aH B I1oCTaHOBJIeHHH                          KM
.M!276 (I1pHJIOJKeHHe B).


7.         Ha.n6aBKH MOryI' HrpaTh 60JIhnryJO POJIh SHe nepSH'lHoro 3seHa 3)lpaBOOXpaHeHH.sI, HO
nO)106HhIH aHaJIH3 BhIXO)l1IT 3a paMKH )laHHOrO HCCJIe)lOBaHH.sI.


8.         (/)0110   MamepUaJlbHOZO        cmUMYllup08aHllJl        U p(138UmWl.      MeOU'IUHCKUX       opZaHWa'lUU:
I1CTOqHHKH        $opMHpoBaHHJI        <l>OH)la:   )lO    5%   OT                  06'heMa                    cpe)lCTB,
BbI)lemleMhlX )lJIJI Me)lHUHHCKOro yqpeJK)leHH.sI; Cpe)lCTBa, nocrynalOlJ.U{e OT qaCTHblX JIHU H
npOqHX         cnoHcopoB,    a    TalOKe     OT    Bcex   rmaTHblX       YCJIYr,    OKa3bIBaeMhIX        Me)lHUHHCKHM
yqpeJK)leHHeM; H C3KOHOMJIeHHLIe 61O)lJKeTHhle Cpe)lCTBa. qacTh Cpe)lCTB $oH)la pacxo.uyeTCJI Ha
BbInJIaThI      COTPY)lHHKaM;      OCTaBWaJlC.sI     qaCTh     HanpaBJIJleTCI        Ha   pa3BIITHe      MaTepHaJIhHO­
TeXHHqeCKOH 6a3bI HJIH onepaUHoHHble paCXO)lhI. I10JIHKJIHHHKH H CBI1 MOryI' H3paCXO)lOBaTh
25% Cpe)lCTB <l>oH)la Ha MarepHaJIhHOe CTHMYJIHpOBaHHe COTPY)lHHKOB; ueHTPaJIbHhle paHoHHbIe
H rOpO)lCKHe 60JIhHHUbI           35%.


9.         B    I1oCTaHOBJIeHHH     I1pe3HJlerrra .Ma29           BBO)lIITC.sI   nOHJITHe    "$OH)l     MaTepHaJIbHOrO
CTHMYJIHpOBaHH.sI H Pa3BIITHJI", B TO BpeMJI KaK KpHTepHH, npOUembI H )leTaJIH CHCTeMhI
paCqeTOB pa3pa60TaHhl B COBMeCTHhlX I1oCTaHOBJIeHHlIX MHHHCTepCTBa 3)lpaBOOXpaHeHHJI,
MHHHCTepCTBa TPY)la H MHHHCTepCTBa $HHaHCOB .N!~N!!1536 H 1537                            (14   JlHBapSI 2006 r.). 100­
6aJIJIOBaJI     CHcreMa     paCqeTOB     C   nO)lp06HbIMH         KPHTepH.sIMH      npHBe)leHa      B   nOCJIe)lylOllleM
COBMeCTHOM nOCTaHOBJIeHHH OT 2006 r.


10.        B COOTBeTCTBHH C COBMeCTHhlM I1oCTaHOBJIeHHeM                    N21        B nOJIHKJIHHHKax H CBn (H
HX nO)lpa3)leJIeHHlIX), a TaIOKe B ueHTPaJIhHhlX paHoHHhlx H rOpO)lCKHX 60JIhHHUax eJKeMeCJlqHhle
npeMHaJIbHbIe Ha.n6aBKH MOryI' COCTaBJIJlTh OT 5% )l0 15% OT TapH$HoH CTIlBKH )lJIJI MJIa.nwero
Me)lnepcOHaJIa H OT 10%)l0 15%)lJIjJ Cpe)lHero Me)lnepCOHaJIa (rnasHhlM 06Pa30M, Me)lCeCTep) H
BpalfeH.        Ha.n6aBKH     B    CneUHaJIH3HpOBaHHhlx           Me)lHUHHCKHX        yqpeJK)leHHllX,      OT)leJIeHH.sIX·
3KcTPeHHOH nOMOIllH H ueHTPax nepBoH Me)lHUHHCKOH nOMom.H MOryI' 6hlTh HeMHoro Bhlwe.




                                                          119 

                               2.   PAIiO'IAR HArpY3KA H TPY.lI.OBOR CTAJK

l.           B Ta6J1Hue   1 HIDKe   npe,nCTaBJleHbl pa60'lJaJj Harp}'3Ka (cTaBKH) H Ha1.fHCJleHHbIH CTIDK no
BceM KaTeropIDIM ,nOJDKHOCTeH B            6   CBn H   3   nOJlHKJlHHHKax, ,naHHble 0 KOTOPblX HMeJlHCb B
HaJIH1.fHH.       no    npH1.fHHe    HeKoTopblX     He,nOCTaIOll.{HX   H     HeT01.fHbIX   HCXO,nHbIX     ,naHHblX,
HH)f(enpHBe,neHHble UH<PPbl cJle.nyeT paCCMaTPHBaTb KaK npH6J1H3HTeJlbHble paC1.feTbl, a He KaK
T01.fH)'lO    CTarnCTH1.fecK}'lO    HH<popMaUHlQ.      31'0     oc06eHHO    OTHOCIITCII    K   CBn,     r,ne        H3-3a
He60JlbllIOrO 1.fHCJla COTPy,nHHKOB cpe,nHHe BeJlH1.fHHbl MOryr 6bITb paCC1.fHTaHbl HCXO.lUl H3 Bcero
.nsyx HJIH TPex 3Ha1.feHHH.

                                       TafiJlHQa 1
        PafiO'lHC Ba~pKH H CTmK 2afioTbi B CBn H DOJlHKJlHBHK8X (I lIHBaElI                         2007 q
                                                        Ha'lHCJleHHblA CTa",
       .lI.OJllKHOCTH          MeJlyqp~eHHe            CpeJlHHH             CpeJlHee 3HaqeHHe         MeJlHaHHOe
                                                    pa3Mep CTaBKH                                      3HaqeHHe
             BpaqH"
                                      CBn 1                   1,3                    19                    20
                                      CBn2                    1,0                    19                    19
                                      CBn3                    1,3                    16                      17
                                      CBn4                    1,4                    I                          I
                                      CBns                    I,S                    16                        I3
                                      CBn6                    I,S          )].aHHhle OTCyrcTBYIOT
                                nOJlHKJlHHHKa A               1,0                     21                       19
                                nOJlHKJlHHHKa B               1,1                     12                       13
                                nOJlHKJlHHHKa C               1,3                    10                        9
cJ)HHaHcoBbIH MeHeJljKep
                                      CBn I                   1,0                    0
                                      CBn2                    1,0                    0
                                      CBn3                    1,0                    0
                                      CBn4                    1,0                    0
                                      CBn s                   1,0                    0
                                      CBn6                    1,0                    0
CpellHHA MeJlnepCOH8JI"
                                      CBn I                   0,9                    14                        17
                                      CBn2                    0,9                    7                       6
                                      CBrr 3                  0,6                    12                      I3
                                      CBn4                    1,0                    II                      20
                                      CBns                    0,7                    13                      16
                                      CBn6                    0,6                    17                      19
                               nOJIHKJlHHHKa A                1,0                    10                      10
                                nOJlHKJlHHHKa B               1,1                    10                        8
                                nOJlHKJlHHHKa C               1,0                    S                         9
                           r
MnuwHA MeJlnepCOH8Jl
                                      CBn I                   1,0          )].aHHhle OTCyrCTBYIOT
                                     CBn2                     O,S          )].aHHbJe OTCyrCTByxir
                                     CBn3                     0,6                     7                        7
                                     CBn4                     1,0          )].aHHbJe OTCyrCTBYIOT
                                     cans                     0,7                     4                        2
                                     CBn6                     0,4          )].aHHbJe OTCyrCTByJOT



                                                        120 

                             nOJIliKllHHHKa   B         1,0                     9                         17
                                                                                                          8
                              )fln:ar-rltflf' ynpaSJleHHe 3JlPaBOOXpaHeHHH It OT)leJlbHble Me)lHUHHCKHe
yqpe)l(JleHIDI, )laHHhIe 0 3apa6oTHoii nnaTe Me)lnepCOHaJIa.


llpUMe'lGHue: .1laHHhle   npe,nCTaWleHbI no BblweYKa3aHHbiM CBn, nOJlHKJIHHHKaM              N!!3   H   N!!8 r.
CaMapKaH)l. H nOJlHKJIHHHKe     N21 r.   MapnrnaH B cI>epraHCKOH OfiJlaCTH.
a. B paCqCTax He yqreHbl CTOMaTOJlOrH (KOTOpble Oq,Hl(HaJIbHO Ofi'he,nHHeHbl C ,npyrHMH
BpaqaMH), H BKJIlOqeHbI BpaqH 06meHnpaKTHKH, a TalOKe BpaqH-CneQHaJIHCTbI nOJlHKJIHHHK .
   .1laHHble no q,HHaHCOBbIM MeHeJl)KepaM CKopee q,aKTH'leCKHe, qeM ycpe}lHeHHble, TaK KaK B
CBn npe.nyCMOTpeHa MaKcHMyM           1 ,nOJliKHOCTb q,HHaHCOBOrO MeHeJl)Kepa. 3Ta ,nOJliKHOCTb
YHHKaJIbHa ,nmI          TaK KaK B nOJlHKJIHHHKaX HMeeTCl1                nepcOHaJIa WBI peWeHHl1
80npOC08, C8113aHHbIX C q,HHaHCaMH, Ka.npaMH H 3aKYnKaMH. nOKa3aTeJlb HaqHCJleHHOrO
CTIDKa, paBHhlH HYJlIO, 80 scex CJIY'iaSIX MmKCT                TOT q,aKT, 'iTO B CaMapKaH)l.CKOH
ofiJlacTH ,nOJIiKHOCTb q,HHaHcoBoro MeHeJl)Kepa fibUla 8Be,neHa JlHlUb B       2007 r.,   H, TaKHM
OfiPa30M, B ,noKYMeHTbI MOrJIH He BOHrn OfiHOBJleHHble ,naHHble 0 COTpy,nHHKax, HawrTblX Ha
:rry ,nOJIiKHOCTb.
B. Cpe,nHHH Me,nHQHHCKHH nepCOHaJI BKJIIO'IaCT ,nHIIJIOMHpOBaHHhIX Me,nHl(HHCKHX cecrep.
r. Mna.nWHH Me,nHl(HHCKHH nepcOHaJI BKJIlOqaCT MJla,nwHX Me,nHQHHCKHX                        H B HeKOTopblX
CJIY'iaSIX MOiKCT TaKiKe 8KJIK>qan. CaHHTapOK.




                                                    121 

                                           nPHJIO)KEHHE 3


     1. ):(OMOX03HHCTBA, OI>PAll\AIOll\HECH 3A YCJIyrAMII nMcn II OCHOBHhlE nPH'lJIIHhI
                                    OI>PAll\EHHH 3A nOMOll\hlO

1.        B 2007 r.      B ropo)].ax HaMHoro 60nbUIe )].oMox03J1ilcTB 06panmocb 3a nepBHtlHoH
Me)].HKo-CaHHTapHOH nOMomblO, qeM B CeJIhCKOH MeCTHOCTH (PHC.                1) - 40-48%   no cpaBHeHlUO C
25-31 %.    HaHMeHbUIHH       npoueHT   qneHOB    )].OMOX03J1HCTB,   06paTHBUIHXcJI      3a   Me)].HUHHcKOH
nOMomblO, 6bIn OTMeqeH B cenbCKHX paHoHax <l>epraHcKoH 06nacTH.

           PHC.   1. 06paIQeHHe qJleHOB )].OMOX03HHCTB 3a yc.rryraMH lIMen B 2007 r.
          (%   OT o6IQero qRCJla qJleHOB )].OMOX03HHCTB B KalK)lOM HaCeJIeHHOM nyHKTe)




                      iii 06pa~amtCb 3a nOMO~blO     • He o6pa~amtCb 3a nOMO~blO
                                                                                              75




          r. CaMapKaHA           r. MaprnnaH           CenbClG1e paliloHbl      CenbCK~e paliloHbl
                                                        CaMapKaHAcKoliI        <PepraHCKoliI o6naCT~
                                                           06naC"H1



2.        OCHOBHOH npHqHHOH 06pameHIDI 3a yc.nyraMH fIMCn -                     KaK B ropo)].ax, TaK H B
cenbCKHX paHoHax -        6bIna )].HarnOCTHKa HllH JIeqeHHe      (45-49%     Bcex lJJIeHOB )].OMOX0311HCTB
06paTMHcb 3a :nOH ycnyroH CM. HIDKe). 3a HeOTnO)lmOH nOMomblO qame 06pamanHCb B
ropo)].ax, qeM B cenbCKOH MeCTHOCTH        (17-19%      no cpaBHeHHlO C        6-12%).   npH6nH3HTenbHO
O)].HHaKOBOMY     npoueHT)'    naUHeHTOB   B     ropo)].ax   H   CeJIbCKHX    PaHOHax    6bIn      He06xo)].HM
Me)].HUHHcKHH OCMOTp rum npoBeJl.eHHe aHanH30B          (21-28%). B   BaKUHHaQHH HY)i(Jl.anHCb nHUIb        6­
13%    naUHeHTOB.




                                                    122 

Puc. 2.0CHOBHble npH'IHHbl 06pallleHHH rOp0,UCKHX ,UOMOX03HHCTB 3a YCJlyraMH                                                     IIMCII
 (%    OT o6mero lfHCJ1a lfJIeHOB ,UOMOX03j1HCTB, 06paTHBllJJfXCjI 3a Me.u.Hl.{HHCKOH nOMOmblO)




 EilAMarHOCTMKa/ne'leHMe          • HeOTnOlKHaJi nOMOIIU>          [J BaK4MHa4MJI        [J 6epeMeHHOCTb                .OCMOTpJaHanM3bl




        48                                                                    47




                        r. CaMapKaHA                                                             r. MapllIIlaH




Puc.   3.   OCuoBHble npU'IUHbl o6pameHHH CeJlbCKHX ,UOMOX03HHCTB 3a YCJIyraMH                                                  llMCII
             (%   OT lfHCJ1a lfJIeHOB AOMOX03j1HCTB, o6paTHBllJJfXCjI 3a MeAHl.{HHCKOH nOMomblO)



                  III AMarnOCTMKa/ne'leHMe             • HeornOlKHaJi nOMOIIU>

                  [J 6epeMeHHocTb                      .OcMOTp/aHanM3bl



                                                                         49




              CenbuMe paiOHbI eaWapJUlHACKOM o6naCTM                               CerlbCIM8 paMOHbI CllepraHCKOM ol5naCll4




                                                                 123 

PHC.   4. )1;oMox03HiicTBa, 06paTHBIDHecH 3a YCJlyraMH lIMcn B 2007                      r., DO HaJlH'IHIO llenii 

                                          llO 16 JleT 

                            (% OT o6mero      'IHCJ1a 'IJ1eHOB JJ.OMOX03HHCTB) 





                         mCeMbM ClleTbMM 1I016neT          -CeMbM 6eJJleTeiiJlO 16 neT

                   53




          r. CaMapKaHA             r. Mapr~naH             CenbCK~e pa~OHbl             CenbCK~epa~OHbl
                                                            CaMapKaHACKO~           <l>epraHcKO~   o6naC1l1
                                                                06naCT~




 PHC.    5. CpellHee KOJlH'IeCTBO    nocem:eHHii Y'lpelK,lleuHii         IIMcn      B   2007   r., DO HaJlH'IHIO


                           mCeMbll C JleTbMIl 11016 neT      - CeMbM 6eJ .QeTeii JIO 16 neT

            4.2




            r. CaMapKaHA             r. Mapr~naH              CenbCK~epa~OHbl             CenbCK~epa~OHbl
                                                           CaMapKaHACKO~ o611aCT~        Cl>epraHcKo~ o6naCT~




                                             lleTeii llO   16 JleT




                                                     124 

                              2.   "llACTOTA nocElUEHIDI Yl.fPEJlC)(EHHflIlMCn

I.      "lfaCToTa nOCemeHHJI Me.nyqpe)!(){eHHH ,l(J1J1 npoxo)!(){emUl perynJlpHOrO Me,l(HUHHCKoro
oCMo-rpa HJIH BaKUHHaUHI1 6hIJIa HIDKe B r . CaMapKaH,l(, 4eM B r. MaprHnaH (CM. HIDKe). 82%
,l(OMOX03J1HCTB B r. MapnrnaH nocemaJIl1 Me.nyqpe)!(){eHIDI C :noH uenblO KaK MHHHM)'M pa3 B
ro,l(, TOf,l(a KaK B r. CaMapKaH,l( TaKHX ,l(OMOX03J1HCTB 6blJIO Bcero   58%. 27% ,l(OMOX03J1HCTB B r.
CaMapKaH,l( H       11 % B r. Maprl1naH HHKOr,l(a He nocemalOT Me.nyqpe)!(){eHHJI C :nOH uenhlO.

     PHC.   1. 1.JacToT3    nocemeHHSI Me~Y'lpe)K,[{eHHii 'IJIeHaMH ropO~CKHX ~OMOX03S1iicTB ~JISI 

                        npOXO)K,[{eHHSI peryJISlpUoro     Me~OCMOTpa      UJIH BaKUHHaUHH 

                             (% OT o6mero 4Hcna ,l(OMOX03J1HCTB B K8)I(JlOM ropo,l(e) 



                I!iI HecKol1bKO pa3 B rOA                        .KaKMMHMMYMpa3 B rOA
                DnpM611M3MTel1bHO pa3 B     2-3 rOAa             D He 6ol1ee   1-2 pa3 B lKM3H M
                • HMKorAa, MI1M 3aTPYAHRIlMCb OTBeTMTb


                                                                 58




                         r. CaMapKaHA                                           r. MaprL>1JlaH




2.          B   cenbCKHX paHoHax <I>epraHcKoH o6nacTH 4JIeHbl ,l(OMOX03J1HCTB Y,l(enJlIOT 60nhwe
BHI1MaHHJI perynJlPHoM)' Me,l(OcMOTJlY H BaKUHHaUHH, 4eM B cenhCKHX paHoHax CaMapKaH,l(CKOH
o6nacTH (CM. HIDKe). 76% .n:oMoxo3J1ilcTB B <I>epraHcKoH o6nacTH H 56% B CaMapKaancKoH
o6nacTI1 o6pamalOTcJI 3a 3THMI1 Bl1.D:aMH yCJ1)'r KaK MI1HHM)'M pa3 B ro.n:, B TO BpeMJI KaK 23%
.n:OMOX03J1HCTB B CaMapKaH,l(CKOH o6nacTI1 11 9% ,l(OMOX03HHCTB B <I>epraHcKoH o6naCTH HHKor.n:a
3Toro He .n:enaJIl1. TaKI1M 06Pa30M, o6maJI cl1ryaUIDI C nocemeHHeM Me.n:yqpe)!(){eHHH ,l(J1J1
npOXO)!(){eHIDI perynJlpHOrO Me,l(OCMoTPa 11 BaKQI1HaQl1H B <I>epraHcKoH o6naCTH 3Ha4HTenhHO
.IT)'4we, 4eM B CaMapKaH,l(CKOH o6nacTH.




                                                         125 

PHC.    2.   qacToTa "OCe~eHHH Me.llHUHHCKHX Y'lpe~eHHH 'IJleHaMH CeJlLCKHX .llOMOX03HHCTB
           .llJlH "pOXO~eHHH peryJlHpHoro Me.llOcMOTpa HJlH BaKUHHaUHH                        (%    B o6JIacno()

                Ill! HeCKonbKO pa3 B ro,Q                         • KaK MMHMMyM pa3 B ro,Q

                o npM6nM3MTenbHo pa3 B 2-3 rO,Qa                    o He 60nee   1·2 pa3 B lKM3HM
                • HMKor,Qa MnM 3aTpY,QHHIlMCb OTBeTMTb


                                                                    46




              CenbCKV1e   pa~OHbl CaMapKaHACKO~ 
               CenbCKV1e   pa~OHbl Cl>epraHcKO~            ofinacrn
                              OfinaCTV1 



3.           Me.llffilHHCKHe pa60THHKH B r. MaprHJIaH HaMHoro lJ~e nocemaJOT .llOMOX03gHCTBa.llJIg
npOBe.lleHHjJ peryJIgpHOrO Me.llOCMoTpa H BaKIUiHaUHH, lJeM B r. CaMapKaH.l\. Me.llHUHHCKHe
pa60THHKH .lleJIaJOT 3TO KaK MHHHM)'M paJ B MeCgu B               55% .llOMOX03gHCTB         B r. MaprHlIaH, H JIHlUh
B    35%   .llOMOX03gHCTB B r. CaMapKaH.l\: HeCKOJIhKO paJ B ro.ll H MeHee Me.llHUHHCKHe pa60THHKH
nOCelI.(aJOT     35-37%      .llOMOX03gHCTB        B   060HX    ropo.llax   H    HHKOr.lla    He     nocemaJOT         24%
.llOMOX03gHCTB B r. CaMapKaH.ll H           10%   B r. MaprHlIaH.


 PHC.   3. qacToTa "OCe~eHHH              rOp0.llCKHX .llOMOX03HHCTB Me.llHUHHCKHMH pa60THHKaMH .llJlH
           "pOBe.lleHHH peryJlHpHOrO Me.llOCMOTpa HJlH BaKUHHaUHH                     (% OT o6lI.(ero    lJHCJIa



                       \II HeCKonbKO pa3 B HeAenlO         • HeCKonbKO pa3 B MeCHL\

                       c HeCKonbKO pa3 B ro,Q M MeHee      [] HMKor,Qa



                                                                            49

                                     37                                                  35

                                                  24

                                                                                                       10




                       r. CaMapKaHA                                         r. Mapn1IlaH

                                          .llOMOX03gHCTB B KIDK.llOM rop0.lle)




                                                          126
PHC.   4. 1.JacToTa nocemeUHH            CeJlbCKHX ~OMOX03HHCTB Me~HQHHCKHMH pa60THHKaMH ~JIH
 npoBe~eHHH peryJIHpHOrO Me~ocMoTp8 HJIB B8KQHHaQHH                                    (%    OT qHCna ~OMOX03H:HCTB B
                                                         KIDI<.L{OH o6nacTH)


                     flI HeCKonbKO pa3 B HeAemo                         • HeCKonbKO paJ B MeCHl!

                     o HeCKonbKO paJ B rOA M MeHee                      OHMKOrAa


                         53




                                                                                                           l5




              Gem.clMe PIMOHbI CaMaplt8HAeKO" oC:naCTM                           Cem.ClM8 paMOHbI ¢epraHCICOM oCSnacTYI




                                                                127 

 3.    MHEHHE HOTPEJiHTEJlER                0 CHCTEME HEPBWlHOR ME,nHKO-CAHHTAPHOR HOMOm:H
                              (% )lOMOX0311HCTB, COrJIaCHbIX C yrnep:lK.D:eHHeM)

                                                                                CAMAPKAHJt I)EPfAHCKMI BCEro
                         YTBEI'lJC.nEHHJf                                       OIiJlACTh  OIiJIACTh



BCE lK1ffElIH HAIllEfO HAC. llYHKTA HMEIOT .nOCTYTI K
IiECIDIATHhIM YCllYrAM nMCn                                          58   67         78        76       74
Mhl HE 3HAEM, KAKHE MEJlHUHHCKHE YCllYrH ()¢>lfUHAllbHO
mlmuoTC.SI IDIATHbIMJl, A KAKHE JiEC!1JlATHhIMH                      70   73         80        70       74
KA'lECTBO MEtlHUHHCKHX YClIYr YlIY'lIllHJlOCb 3A
nOCJIEJlHHE 3 roM.                                                   50   45         72        69       66
B HAllIHX MEJlY'lPE>K./lE:IilfiiX HE XBATAET BPA'lEA/CnEUHA1IHCTOB   50   52         49        55       52

Mhl HE3HAEM, KYM nOJlATh )I(A)101iY, ECJIH Mbl HE IlOllY'lAEM
KA'lECTBEHHbIE MEJl. ycnYn1I1J1H HAM OTKAlblBAlOT B
IlPEJlOCTABJIEHHl1 MEJlHUI1HCKOA nOMOI.lU1.                          60   63         47        48       50
JIIo,1\H 3,llECb MOrYT IlOJlY'lHTh KA'lECTBEIDMO MEJlHUHHCKYlO
nOMOllth TOJlbKO nPH IlOMOI.lU1 B3.lITKH HJJH CBR3Efl.               53   49         35        47       43
MEcTHhIE BJlACTi1 IlOMorAlOT MA}]OHMYl.lU1M CEMbRM nOJlY'lHTh
HEOIiXOJlHMYlO MEJlHUHHCKYlO nOMOllth.                               36   27         40        51       43
Mhllibl XOTEJlH !10Jlb30BAThC>I YcnYrAMH'lACTHhIX             HO
3,llECb HX HET HJJH HEJlOCTATO'lHO                                   33   32         37        48       40
PAJiOTH!iKH ME,1IY'lPE)!(JlEHl-IA CnPAIllHBAlOT HACEJlEHHE,
JlOBOJlbHbI OHM PAJiOToA 3THX MEJlY'/PElKJlEHHA,
I1JIH HET.                                                           36   27         42        44       40


MECTHhIE BJlACTi1 CIlPAIllJi!BAlOT HACEJlEHHE, JlOBOJlbHbi JIM OHM
PAJiOToA                     I1JIH HET.                              32   21         28        40       32
 r1nATA 3A MEAHUHHCKHE YCJJYrH CYUlECTBEHHO CHH3l1J1ACb 3A
nOCJIEJlHHE 3 roM.                                                   18    15        23        19       20
Y MEJlCECTEP HH3KHE 3APWlAThI, BOT nO'IEMY Mbl OM !1JlATUM.          45   21         17        15        19




                                                          128 

                                                        nPHJIOJICEHHE 4



            1. 06CJIEJI,OBAHHE KAlIECTBA nPEJI,OCTABJIEHIDI YCJIyr - METOJl,OJIOBur

I.   BIDKHOH 3a.ua'leH AaHHoro HccneJ{osaHIDI 1IBJUIJI8Cb oueHKa CHCTeMbI nepSH'lliOH MeAHKO­
CamITapHOH nOMolUH                   (fIMCn)     B Y36eKHcTaHe C TO'IKH 3peHIDI nOTPe6HTeneH H nOCTaBmHKOB
ycnyr       fIMCn.      B    3TOM       OTHomeHHH, B paMKax AaHHoro HccneJ{osaHIDI                        6bIno
06cneAosaHHe Ka'leCTSa npeAoCTaMeHIDI ycnyr                           (OKIIY)        JJ.JJ1I H3yqeHIDI MHeHIDI rpaJK,JJ.aH H
nOCTaBmHKOB MeAHUHHCKHX ycnyr 0 AOCTYilHOCTH, Ka'leCTBe H pacueHKax Ha MeAHUHHCKHe
ycnyrH,         a   TalOKe       0    HaJJH'IHH    H    34>4>eKTHSHOCTH         MexaHH3MOS,         nocpeACTBoM            KOTOPbIX
nQTPe6HTeJ1H           MOryT           nOJ{aTb     >KaJJo6y      Ha      Ka'leCTSO     ycnyr        fIMCn         H
YAOMeTSOpHTeJ1bHOe                   pemeHHe      csoux     npo6neM       S   c4>epe   3ApasooxpaueHIDI.               B    paMKax
                              nposeAeH p1lJ{ KOHcYJ1bTaUHH, a TalOKe KOJ1H'leCTSeHHble H Ka'leCTSeHHble
HCCJ1eAOBaHH1I AJ111 nyqmero nOHHMaHH1I CJ1eJJ.Y1OlUux BonpOCOB:


     a) 	 ]1ocryn K          fIMCn. B XOAe o6cneAoBaHIDI 6blJIH H3yqeHbi                          MHeHH1I nOTPe6HTeJ1eH           °
            AocrynHocTH         fIMCn B OTHOmeHHH MecTOHaxO>KJJ.eHIDI                                                  pacxoAoB H
            npo'lux 4>aKTOpoB.


     6) 	 Ka'leCTBo          fIMCn.         B XOAe      06CJ1eAOSaHIDI         6blJIH H3yqeHbI MHeHIDI rpaJK,JJ.aH HJ1H
            nQTPe6HTeJ1eH ycnyr            fIMCn 0         Ka'-leCTBe 3THX ycnyr, H ux TO'-lKH 3peHIDI 0 TOM, KaKHe
            aCneKTbI        cymecmyIOmeH            CHCTeMbI      MIDIIOT       Ha   Ka'-leCTBO     H   AOCT)'TIHOCTb        ycnyr
            (HanpHMep,           MOXO 06yqeHHble Bpa'-lH,             HeAOCTaTOK MeAHKaMeHTOB, OTCYTCTBHe Ha
            pa60'leM MeCTe, HopMaTHBHbie HJ1H HHCTHTYUHOHaJJbHble H3MeHeHH1I) H .!IM1IIOTC.!I
            oc06eHHO np06J1eMaTH'-lHbIMH.


     B)                      B   paMKax 06cneJJ,oBaHIDI paCCMaTPHBaJJOCb, CKOJ1bKO nwpe6HTeJ1H nnaTliT 3a
            ycnyrH    fIMCn           B OTHOmemfH MeAHUHHCKOH nOMOmH H neKapCTB, a TaIOKe npoC.lIT J1H
            naUHeHTOB npOH3BeCTH Heo4>HUHaJJbHble nnaTe)I(H nOCTaBlUHKaM MeAHQHHCKUX ycnyr.


     r) .                                   3a.ua'leH       o6cneAoBaHIDI         6blJIO                 noH.llTh        xapaKTep
            B3aHMOOTHomeHHH Me)KJJ.y HaceJ1eHHeM H nOCTaBlUHKaMH ycnyr                                    fIMCn         H Me>KJJ.Y
            Hace.neHHeM H MeCTHJ>IMH HHCTHTYUHOHaJJbHblMH CTPYKTYPaMH, a TaIOKe KaKHM 06pa30M
            3TH BJaHMOOTHOmeHIDI                  H cymeCTByIOlUHe            MeXaHH3MbI        nOAOT'IeTHOCTH         OKa3blsalOT
            BJ1H.!IHMe Ha Ka'-leCTBO H AOCT)'IlHOCTb ycnyr nepsH'lHoro 3BeHa 3ApaBooxpaHeHH1I.                                    B
            paMKax      06CJ1eAOBaHIDI            TalOKe     6blJIH   onpeAeJ1eHbI         AonycTHMble      JJ.JJ.lI   BHeApeHIDI
            MeXaHH3Mbl,              KOTopble      MOryT       npeJ{OCTaBHTb         B03MO>KHOCTb         HaceJ1eHHIO,           KaK
            nOTPe6HTeJ1IO, YCHJ1HTb CBOH r0J10C H BJ1ID1HMe JJ.JJ.lI 06eCne'leHIDI 60J1ee Ka'-leCTBeHHbIX
            ycnyr nepBH'IHOrO JBeHa 3ApaBooxpaHeHIDI.


     A)                                                                                    B    xOAe 06CJ1eAOBaHIDI         OKIIY
            TalOKe nnaHHpOB8JIOCb Y3HaTb                    MHeHHe    nOCTaBmHKOB              MeJJ,HUHHCKUX ycnyr          06   ux
            YCJ10BIDIX TPYAa, H OnpeAeJ1HTb OCHOBHble npQ6neMbl, C KOTOPblMH OHM CTaJJKHBalOTC1I
            npH npeAOCTaBJ1eHHH Ka'-leCTBeHHbIX ycnyr                         fIMCn        (HanpHMep,     HH3Ka.l1      3apnnaTa,
            OTCYTCTBHe AOCTaTO'lHOH nOArOTOBKH, nnoxoe ynpaMeHHe Me.n:yqpe>KJJ.eHHeM).


2.          B   PaMKax       OKnY        6blJIH HCn0J1b30SaHbI KaK KOJ1Jf'feCTBeHHble, TaR H Ka'-leCTBeHHble
MeTOAbl c60pa H aHaJJH3a AaHHbIX.                               MeTOAbI SKpaTue npeJ{CTaMeHbl HH>Ke H 60J1ee



                                                                 129 

nO)lp06HO OnHCaHbI B )lpyrHX npHJIO:>KeHHJlX K )laHHOM)' OT'Iery . OHH n03BOnHJIH rpynne
HCCne)lOBaTeneH nyqllIe nOIDlTb BOnpOCbI, CBSl3aHHble C ynpasneHHeM CHCTeMOH IlMCn C TO'lKH
3peHHJI Pa3nH'IHbIX ee yqaCTHHKOB.


    a) 	 0630P HMelOmeHCSI nHTeparypbI, BKJlIO'IaSI aHMH3 )lOKYMeHTOB npoeKTa, OT'IeTOB 0
          COQHMbHbIX HCCne)lOBaHHJlX, )lHCK}'CCHJlX B Q>OKyc-rpynnax, H MOHHTopHHre npoeKTa, a
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          npOBe)leHHbIX          )lpyrHMH        opraHH3aUHJIMH               (HanpHMep,         )lOK}'MeHTa          IOHI1CE<I>      ­
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          nOCTaBll!HKOB Me)lHQHHCKHX ycnyr B npe)lOCTaBJIeHHH IlMCn H npo'lHX BonpocoB,
          CBSl3aHHbIX C HCCne)lOBaHHeM ynpaBneHHJI B cQ>epe 3)lpaBOOXpaHeHHSI.


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          ynpaBJIeHHSI B CHCTeMe IlMCn.                     Y    yqaCTHHKoB CnpOCHJIH HX MHeHHe 06 OCHOBHblX
          np06neMax B CHCTeMe IlMCn Y36eKHCTaHa, ponH MaxannHHcKHX KOMHTeTOB H npo'lHX
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          npO)lOJDKHTCSI B paMKax          60nee MaCllITa6HOrO HCCne.llOBaHHSI.

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          3.llpaBOOXpaHeHHJI.         B 'IHCne pecnOH)leHTOB 6bInH 3aBe.ll)'lOlUHe                           CBn;    rnaBHble Bpa'lH
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          naQHeHTbI        paJnH'lHOrO       B03pacTa,          nona     H    ceMeHHoro         nOnO:>KeHHJI;        npenO.llaBaTenH
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          Hcnonb3yJOlllHe MeTO.llbl TPa.l{HQHOHHOH Me.llHQHHbI;                             npe.llCTaBHTenH XOKHMHJlTOB H
          PYKOBO.llHTenH ImO, HMelOmHX OTHOllIeHHe K 3.llpaBOOXpaHeHHlO.


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                                                                 130 

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         ).lJ1JI nO.ll}"leHHSI nepBH'IHOH                                            nOMOlUH.



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npOaHaJlH3HpoBaTL            Pa3J1H'IIDI    B        Ka'leCTBe           ycnyr             rIMCn,        pacueHKax        H    CTeneHH
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pecpopMaTopoM" H CaMapKaH)J.CKOH o6nacTLIO, "Ha'lHHaIOIUHM pecpopMaTopoM". 06Cne,1.l0BaHHe
6blJ10 npOBe,1.leHO B   3   paHoHax -      1 ropo,1.le    H   2   cenbCKHX paHoHax: r. MaprIDlaH, Ji3bnsaHcKoM H
TawnaKcKoM cenbCKHX paHoHax <l>epraHcKoH 06nacTH H r. CaMapKaH)J., ,llJKaM6aHcKoM H
TaiinaKcKoM cenLCKHX paHoHax CaMapKaH,1.lCKOH 06nacm.


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snaCTnM, OCYIUeCTBJ1nIOIUHM pecpopMY ceKTopa 3,1.lpaBOOXpaHeHHSI.


2. 	 PEcnOH,nEHTbl YrJIY6JIEHHbIX HHTEPBblO C nOCTABmHKAMH ME,lUUJ.HHCKHX YCJIyr

1.      HHJKe npe,1.lCTaBneHbI xapaKTepHcTHKH pecnOH,1.leHTOB H Me.uyqpeJK)J.eHHH. no sceM HHM
KOHcynbTaHTbl      CCPOPMHpOBaJlH           sepoJiTHOCTHYIO                  BLI60pKY,        3a    HCKJ1IO'IeHHeM        HeCKonbKHX
pecnOH,1.leHTOB H Me.uyqpe)l{,J.leHHH B CaMapKaH,1.lCKOH 06nacm.                                             CneUHaJlH3HpOBaHHble
Me.uyqpe)l{,J.leHHSI 6b1nH HCKJ1IOt{eHblH3 Bb160pKH.




                                                                  131
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                                                                                  132 

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    CTOJlIiQAM                                                                                                   I

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     <I>epraHcKM                                                           rJIaBHLJii
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     <I>epraHcKM                                                           naTPOH~HruVyqaCTKoBM
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     <I>epraHcKM                                                           rJIaBHLJii
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     <I>epraHcKM                                                           n pe)lCe)laTenh
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     <I>epraHcKM                                                           rnaBHbJii
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     <I>epraHcKM                                                           Bpaq-CneUHaJIHCT
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     <I>epraHcKM                                                           Bpaq-CnelUfaJIHCT
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     <I>epraHcKM                                                           naTPOH~HruVyqacTKoBM
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    <I>epraHcKM                                                            Bpaq-CnelUfaJIHCT
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 13 o6nacTh          paiioH         (UPE)                                  o61Ileii~aKTHKH)
    <I>epraHCKaR     TamnaKcKHii    l..{eHTpaJIbHM paiiOHHaR 60JIbHHua     npe)lCe)laTenh
 14 06JIaCTb        paiioH          JuP~                                   !Il'Q«!JcolO3a
    <I>epraHcKM      TamnaKcKHii                                           rnaBHblil
 15 o6nacTb        -.EaAoH          nOnHKJIHHHKa uPE                       Bpa'lhaBeJJYlOIIlHil
    <I>epraHcKM      TamnaKCKHii
16 o6nacTb          paiioH          nOJIHKJIHHHKa uPE                      BOn
    <I>epraHcKM     TamnaKcKHii                                            Bpaq-CnelUfaJIHCT
17 o6JIacTh         paiioH          nOnHXJJHHHKa uPE                       (HapKOJIor)
    <I>epraHcKM     TamnaKcKHii
18 o6nacTh         _p_aiioH         nOJIHKJIHHHKa uPE                      CTl!PWM Me)lCeCTPa
    <I>epraHcKM     TamnaKCKHH                                             naTPOH~HruVyqacTKOBaR
19 o6nacTb          paiioH          nOJIHKJIHHHKa uPE                      Me)lCec!pa
    <I>epraHcKM     TamnaKcKHii
20 06naCTh          paiioH          nOnHKJIHHHKa uPE                       AK)'WepKa
    <I>epraHcKM     TaIDJIaKCKHii                                          rnaBHLJii
21 o6naCTh         -'p aiioH        CBn                                    Bpaq/3aBeJJYlOlI.Ulii
    <I>epraHcKM     T amnaKcKHii                                           rJIaBHLJii
22 06JIaCTb        paiioH           CBn                                    Ipa'lIJaBeJJYlOUlHii
    <I>epraHcKM     TamnaKcKHii
23 o6naCTh          paRoH           CBn                                    Bon
    <I>epraHCKaR    TamnaKcKHii
24 06JIaCTh         paRoH           CBn                                    Bon
25   <I>epraHcKM   TamnaKcKHii      CBn                                    CTaPIDM Me)lCecTPa


                                            134 

         06naCTb           I paAOH
       cI>epraHCKaJI         TaumaKcKH~                                                               naTpOHamHaJliyqacTKosaJI
26     ofinscTb             paMoH                 CBn                                                 Me,!!ceCTpS
     · cI>epraHCKaJI        TaumsKcKHM                                                                naTpOHaJKHaJliyqacTKosaJI
27     ofinacTb             paMoH                 CBn                                                 Me,!!cec1J)s
       cI>epraHCKaJI        TsumaKcKHif
28     o6nacTb              paMOH                 CBn                                                 AKYlIlepKS
       cI>epraHCKaJI        R3'b.llSaHCKHA        [(eHTpaJIbHaJI paMOHHa.ll fionbHHua                 3aMeCTHTenb maSHoro
29     o6nacTh              paMoH                 (uPS)                                               SpaQa/3ase",.•~~
                                                                                                      BpaQ-CneUHaJIHCT
         cI>epraHCKaJI      Rl'b.llSaHCKHM        [(eHTpaJIbHaJI paAoHHaJI 60nbHHUs                   (BMecTo Bon no
30 06nSCTb                  ~ailOH                _(uPSl                                              BbIGopKe)
       """plan.... ,        RTh.IIBaHCKHA         [(elf:     n
                                                                 palloHHaJI 60nbHHua                  BpsQ-CneUHaJIHCT
31     o6nscTb              paiiOH                (uPS}                                               (xHPYPr)
       cI>epraHCKaJI        Rl'b.llSaHCKHA        [(eHTpaJIbHaJI paAoHHaJI fiOJlbHHQa                 n pe,!!ce]laTeJlb
32     ofinacTb             p_aAoH                (uPS)                                               npoQ>colO3a
       cI>epraHCKaJI        RTh.llBaHCKHii        [(eHTpaJIbHaJI paiioHHaJI fionbHHua
33     o6naCTh              ~alloH                CuPS)                                             CTapUlaJI Me,!!ceCTpa
       cI>epraHCKaJI        RThllSaHCKHii         [(eHTpaJIbHaJI paAoHHaJI 60nbHHua                 OnepaUHOHHaJI
34     oGnsCTb             J)aiiOH                (uPS)                                             Me,!!cec1]!a
       cI>epraHCKaJI        Rl'b.llSSHCKHA                                                          rJlaBHbIH
35     ofinscTb             paiioH                nOnHKnHHHKa uPS                                 • spaq/laBe.!l)'lOIUHH
       (J>epraHCKaH         RTh.llSSHCKHii        CBn (sMecTo nOnHKnHHHKH uPS C
36     06naCTh              paMoH                 BOn)                                                Bon
       (J>epraHCKaJI        RThJlSSHCKHA                                                              Bpaq-CneUUaJIHCT
37   · ofinacTb             paROH                 nOITUK1UIH1.fl(a uPS                                (XHpypr)
       (J>epraHCKaH         Rl'b.IIBaHcKHII
38     o6nacTb              panOH                 nOnHKnHHHKS uPS                                     Al<)'lIlepKa
       cI>epraHCKaH         R3'b.IIBaHcKHII                                                           rnasHbIii
39   i o6naCTb              paAoH                 CBn                                                 spaq/laBe.!!YlOIIlHA
     I (J>epraucKaH         RThllSaHCKHH                                                              rnRsHbdi
40     ofinacTh             palioH                CBn                                                 Bpaq/3aBe,!l}'lOIIlHH
       (J>eprSHCKaJI        Rl'b.IIBaHCKHA
41     ofinacTh             paiiOH            . CBn                                               i   CTapmaH Me,!!cecTpa
       (J>epraHCKaJI        RTh.IIBaHCKHH                                                             naTpOHRmHaJliyqsCTKOSaJI
42     ofinacTb             paROH                 CBn                                                 Me]lCeCTpa
       (J>epraHCKaH         RThliSSHCKHR
43 • OfiJlSCTb             JlaRoH                 CBn                                                 Al0'lIl~Ka
         CaMSPKRH.!!CKaH                                                                              rJlSBHbIA
44       06JIaCTb          I r. CaMapKSH.!!       ro               ....   HI   nOJIl                  Bpsq/3aBem'IOIIlHA      "~


                                                                                                      Bpaq-CneUUaJIHCT
         CaMapKaH.!!CKaH                                                                              (SMeCTO Bon no
45       o6naCTb            r. CaMSpKaH.!!    I rOpO'!!CKali ceMef.iHaH nOnHKJIHHHKa                  Bbl60pKe)
         CaMapKSH.!!CKaH                      I
46       o6nscTh            r. CaMa~KSH.!!    I rOpO,!!CKaH ceMeliHaH nOlIHKJIHHHKa                   CTaj)lIlaH Me,!!ce(;1]Ja
         CaMSpKaH.!!CKaH
47       ofinacTh           r. CaMa~KaH.!!        rO-,,-O]lCKali CeMe~HaJI nOnHKnHHHKS              Me,!!cecTpa
         CaMapKSH.!!CKaH                                                                            rJlaBHbIA
48       o6nacTh            r. CaMSpKaH.!!        lleH1])aJIbHaJI ropo,!!cKaH      hnn<   ""lIa   I J>pa'tlJaSe.!!YlOIIlHA
         CaMapKaH.!!CKaH                                                                          I npe,        1.,;1.,

49       06JIaCTb           r. CaMapKSH.!!        [(eHTpaJIbHaH ropo,!(CKali hnm,HUlla            i                              .-
         CaMapKaH.!!CKaH                                                                          I rnaBHbIA
50       ofinacn.           r. CaMapKaH.!!        nOJIHKJ1HHHKS JJ)'UI B3pOCJThIX                 I Bpaq!3aBe.!lYiOIUHA
51       CaMSpKaH.!!CKaH    r. CaMapKaH.!!        [(eHTpaJIbHaH roPO'!(CKaH                           CTapmaH MeJlCeCTpa


                                                           135 

     oonaCTh                                        nOnHKllHHHKa
     CaMapKaH)lCKM                                                                       Bpaq-CneUHaTlHcT
52 oonacTi.                     r, CaMapKaH)l       .l{eTCKM 110:                        (ne,llHaTp)
   rl          rrll'.1tJ1lIl'

53 o6nacn.                      r, CaMapKaH)l       .l{eTCKM nonHKllHHHKa                CraplllM Me,llCeCTpa
     r·                  I'll                                                            Bpaq-CneUHaTlHCT (Bpaq
54   o6nacTh                    r. CaMapK!lH)l      IlonHKllHHHKa JLJUI BlPOCJlblX       o6IUeH l1paKTHKH)
     CaMapKaH)lCKM                                                                       Bpaq-CneUHaTlHcT (Bpaq
55   o6nacTb                      r. CaMapKaH,Il    IlonHKllHHHKa ,/lJIJI B3POClIbIX     OOlUeHl1paKTHKH)
     CaMapKaH)lCKM               ,L(>KaM6ailcKHH    UempaTIbHM f' .K          60nbHHua   rnaBHbdt
56   06nacTb                     panOH              (uPE)                                BpaQ/3aBeJlYlOIUHi1
     CaMapKaH)lCKM               ,L(>KaM6aAcKHH     UeHTpaTIbHM paAoHHM 60nbHHua         Bpaq-CneUHaTlHCT (Bpaq
57   oonacTb                      paHoR             (UPE)                                o6lUei\ npaKTHKH)
     CaMapKaH)lCKM               ,L(>KaM6aAcKHH     UeHTpaTIbHM paAOHHM 60nbHHua         IlpeJlce,llaTeJIl,
58   o611acTI,                   patioH             (uPE)                                npo$colO3a
     CaMapK!lH)lCKM              ,L(>KaM6ailcKHA                                         3aMeCTHTeJIl, rnaBHoro
59   o6nacn.                     pailoH             IlonHKllHHHKa uPE                    Bpaqa/3aBeJlYlOlUerO
     r:            ,,,...,.      ,L(>KaM6aticKHi1
60   06JIaCTb                    paiioH             CeMei1HaJI nonHKllHHHKa uPE          BOil
     CaMapKaH)lCKM               ,L(>KaM6aticKldt                                        Bpaq-CneUHaTlHcT
61   o6JIacTh                    pruiOH             IlonHKllHHHKa uPE                    (peHTreHOJIOr)
     CaMapKaH)lCKaJI             ,L(>KaM6ruicKHti
62   o6nacTh                     pai1:oH            IloJIHKllHHHKa uPE                   C'raplllaJI Me,llCecTpa
     CaMapKaH)lCKM               ,L(>KaM6aHcKHit                                         IlaTpoHIDKHaslyqacTKoBM
63   o6nacn.                     paAOH              IloJUfKllHHHKa uPE                   MeJlCeCTpa
     CaMapKaH)lCKM               ,L(>KaM6aitcKHil
64   o6JIacn.                    paAOH              IlonHKllHHHK8 uPE                    AKymepKa
     CaMapKaH)lCKM              ,L(>KaM6aitcKHit                                         3aMeCTHTenb
65   o6JIacn.                   paitoH              IloJIHKllHHHK8 uPE                   3aBe,llyIOlUero CBIl
     CaM8pKaH)lCKM              ,L(>K8M68HC KHit                                         rn8sHbIit
66   06JI8cn.                   paHoH               CBIl                                 BpaQi3aBeJlYlOIUHH
     C8MapKaH)lCKM              ,L(>KaM6aAcKHIt
67   o6JIacn.                   paAoH               CBIl                                 BOil
     CaMapKaH)lCKM              ,L(>KaM6aHCKHil
68   06JIaCTb                   patioH              CBIl                                 BOil
     CaMapKaH)lCKM              ,L(>KaM6aitcKHn
69   o6nacn.                    paAoH               CBIl                                 BOil
     CaMapKaH)lCKM              ,L(>KaM6aitcKHit
70   06JIaCTb                   paHoH               CBIl                                 CraplllaJI MeJlCeCTpa
     CaMapKaH)lCKM              ,L(>KaM6ancKHi1:                                         IlaTpoHIDKHaslyqaCTKoBM
71   o6n8CTb                    panOH               CBIl                                 Me,llCeCTpa
     CaMapKaH)lCKM              ,L(>KaM6aHCKHH
72   06JIaCTb                   paAoH               CBIl                                 AK}'lllepKa
     CaM8PK8H)lCKM              TruiJl8KCKHi1       UempaTILHM paAoHHaJI 60JIbHHua       3aMeCTHTeJIb rnasHoro
73   o6naCTb                    paAOH               (uPE2                                SpaQa/3aBeJlYlOlUerO
                                                                                         Bpaq-CneUHaTlHcT
     CaMapKaH)lCKM              TaAnaKcKHi1         UempaTILHM paHoHHM 60JIbHHua         (sMecTO BOil no
                                                                                 ..
74   o6nacn.                    pai1:oH             (uPE)                                Bhl6opKe)
     CaMapKaH)lCKaJI            TaAnaKcKHn          UempaTIbHaJI panOHHaJI 60JlbHHua     Bpaq-CneUHaTlHCT
75   o6nacTh                    paAOH               (uPE)                                (peaHHMaTOnor)
     CaMapKaH)lCKaJI            TaAnaKcKHi1         UempaTILHaJI paAOHHaJI 60nLHHua      IlpeJlceJlaTenb
76   o6naCTb                    paAOH               (UPE)                                npo$COlO3a
     CaMapKaH)lCKM              TaAnaKcKHi1         UempanLHaJI paAOHHaJ! 60JlLHHua
77   o6J1acTh                   paAOH               (UPE)                                CrapmM MeJlCeCTpa


                                                             136 

     CaMapKalUlCKrui   TafuIaKCKIlli                               naTpoHIDKHalll)"lacTKoBrui
78   oGJIaCTh          paRoH           CBn (3aMemeHHe KBOThI WE)   Me}lCecTpa
     CaMapKalUlCKrui   TafuIaKcKHA
79   o6JIacTh          paAoH           CBn (3aMemeHHe KBOThI WE)   BOn
     CaMapKaIUlCKrui   TafuIaKCKHA                                 Bpaq-CneUUaJIHCT
80   oGJIaCTL          paAoH           nOJIHKJlHHHKa uPE           (ncHXHa1'Ql
     CaMapKaH}lCKrui   TafuIaKcKHA
81   oGJIacTh          paAoH           nOJIHKJlHHHKa uPE           AK)'wepKa
     CaMapKalUlcKrui   TafuIaKcKHA                                 Bpaq-CneUUaJIHCT
82   o6JIacTh          paAoH           nOJIHKJlHHHKa WE            (peBMaTOJlOr)
     CaMapKalUlcKrui   TaHJIaKCKHA                                 rJIasHhIA
83   oGJIaCTh          paHoH           CBn                         Bpaq!Jase.ll)'lO IllHA
     CaMapKalUlCKrui   TafuIaKCKHH                                 rJIasHhlA
84   oGJIaCTh          paHoH           CBn                         Bpa'li3aBe.ll)'lOlIlHH
     CaMapKalUlCKrui   TafuIaKcKHA
85   o6JIacTh          paHoH           CBn                         Cral'mrul Me}lCeC~a
     CaMapKalUlcKrui   TaHJIaKCKHH                                 naTpoHIDKHalII)"laCTKOBajJ
86   oGJIacTh          paHoH           CBn                         Me}lCec1J>a
     CaMapKalUlcKrui   TafuIaKcKHA
87   oGJIaCTh          paHoH           CBn                         AK)'WeI'Ka




                                              137 

               6. HH4>OPMAU,IDI 0 PECIIOH,llEHTAX 06CJIE)J,OBAHIDI )J,OMOXOlgA:CTB

1.                          B   JlOMOXOlSlHCTBax       6blJIH   npOBeJleHbI    C    HCnOJIblOBaHHeM     aHKeTbI   C
BonpocaMH JlJIJI       KIDK}lOrO       'UleHa JlOMOXOlJlHCTBa.       rpynna        CneUHaJIHCTOB,   npoBoJlHBWHX
o6CJIeJloBaHHe, onpawHBaJIa TOJIbKO TeX '1JIeHOB JlOMOXOlJlHCTB, KOTopble OTBe'laJIH la npHlvfme
peweHHH, CBJllaHHbIX C nonyqeHHeM rIMCn H 06paI1{eHHeM B yqpe~eHHJI rIMCn.                                        B
JlOMOXOlJlHCTBe OHH HMeJIH CJIeJlYIOI1{HH "T'~""'"


           •   rJIaBa JlOMOXOlJlHCTBa        (38,2%)
           •   Cynpyra rJIaBbI JlOMOXOlJlHCTBa   (45,6%)
           •   CbItUJlO'lb rJIaBbI JlOMOX03J1HCTBa (6,4%)
           •   MaTb/oTeU rJIaBbI JlOMOXOlJlHCTBa (O,'}I%)
           •   3J1Tb/HeBeCTKa rJIaBbI JlOMOX03.sliicTBa (8,1 %)
           •   ,llpyrHe pOJlCTBeHHHKH (0,6%)
           •   OrKalaJIHCb OTBe'laTb Ha Bonpoc 0                    B JlOMOXOlJlHCTBe    (0,2%)

C014UOllbHQ-3«OHOMUflec«ue xapa«.mepucmu«u OOMOX03RiicmB

2.                              COOTHoweHHe       )KeHI1{HH     H   ~'1HH               'UleHOB
onpoweHHblX B paMKax 06cJIeJlOBaHHJI, 6blJIO rrpH6JIHlHTeJIbHO O}lHHaKOBbIM. 3a HCKJIIO'IeHHeM
JleTeH B              JlO   1 rOJla,             B03pacT 'lJIeHOB JlOMOX03J1HCTB 6bIJI 27~30 JIeT.


3.                  BbICOKHH ypOBeHb 06palOBaHHJI CpeJlH 'UleHOB JlOMOX03J1HCTB cTapwe                      16   neT
6bIJI OTMe'leH B r. CaMapKaHJl; B OCTaJIbHblX paHoHax 06CJIeJlOB8HHJI ypoBeHb 06palOBaHHJI
'lJIeHOB JlOMOX03J1HCTB 6bIJI           npH6nH3HTeJIbHO OJlHH8KOBblM.   B ueJIOM, 23~30% npOueHTOB
'lJIeHOB JlOMOX03J1HCTB cTapwe         16 JIeT 6blJIH TPYJloYCTpoeHbl, 10-15% 6blJIH H8 neHCHH, 7~ 10%
6blJIH   6e3p86OTHblMH,          11-13% 6blJIH JlOMOXOl,dfK8MH, 1-2% - HHBaJIH}l8MH, H 1-7%


4.         Cpe}lH JlOMOX03J1HCTB, yqaCTBoBaBwHX B 06cneJlOBaHHH H He HMeBWHX BOJlOnpOBOJla,
12%   6blJIH B r. MaprHJIaH,           52%   B CeJIbCKHX paHoHax <l>epraHcKoH 06nacTH, H          71%   B cenbCKHX
paifiOJiax CaMapKaH}lCKOH 06JIaCTH.             nepe60H B nOJla'le BOJlOnpOBO]l.HOH SOJlbI 6bIBaIOT qaCTO H
npOHCXOJVIT BO Bcex perHoHax.


5.      .bOJIbWOH npoueHT JlOMOX03J1HCTB OueHHJI KaqeCTBO BOJlOnpOBOJlHOH BOJlbI KaK xopowee
(90% H Bblwe B palHbIX perHoHax CqHTaIOT, 'iTO HX nHTbeBaJI BOJla xopowero KaqeCTBa). KpoMe
Toro, 94% JlOMOX03J1HCTB B cenbcKoH           MeCTHOCTH     nOTPe6mlIOT CBOIO
CeJIbCKOX03J1HCTBeHHYIO rrpOJlYKUHIO, B TO BpeMJI KaK S roPOJlax T8KHX JlOMOX03J1HCTB scero 28­
33%.

6.         KOMM)'HaJIbHbIe ycnynf npe]l.OCTaBJUIIOTCJI JlOMOX03J1HCTBaM HepaBHoMepHo. HanpHMep,
H3 Bcex BHJlOB ycnyr TOJIbKO                                    eCTb BO Bcex                        TeM He MeHee,
3Ta ycnyra npe]l.OCTaBmleTCJI C qaCTbIMH nepe60JlMH.


7.         nOlITH Bce   (93%)      ]l.OMOX03J1HCTBa B r. MaprHJIaH H       69% B r. CaMapKaH}l He HMeIOT
UeHTPaJIbHOro OTOnneHHJI. ijpHPOJlHblH ral He nOJlaeTCJI B               30% JlOMOX03S1HCTB B r. MaprHJIaH,
16%                      B r. CaMapKaH}l, 34% JlOMOX03J1HCTB B CeJIbCKHX paHoHax <l>epraHcKoH
06nacTH H      39% ]l.OMOX03J1HCTS'S CeJIbCKHX paHoHax CaMapKaH}lCKOH 06naCTH. Bo Bcex pernoHax
TaJOKe npOHCXOJlJlT qaCTble H npO]l.OJl)KHTeJIbHble nepe60H B ra::JOC:HaO)R:eHHH.
  8.       GIpYK1Ypa e:IKeMeCJI'IHhIX pacxo,noB ,nOMOX03J1HCTB npH6JlH3HTeJlhHO O,nHHaKOBa ,nJlJl
  Bcex perHOHoB:    61-66% -      pacxo,nhl Ha nHTaHHe H o,ne:IKAY,    5-7%     Ha KOMMYHaJIhHhle pacxo,nhl, H
  4-8%     Ha MemnumCKHe YCJIYTH.           B   ropo,nax Ha Me,nHUHHCKHe ycnyrH npHXo,nHTCJI                  6-8%
  e:IKeMeCJI'IHOrO 6IOJl)f(eTa, TOr,na KaK no CTpaHe 3TOT nOKa3aTeJIh COCTaBJIJleT            4%.

  9.       83-90% ,nOMOX03J1HCTB                      OCHOBHhle npo.nyKThl nHTaHHJI, TaKHe KaK MJlCO H
  MOJlOKO;  11-13 % ,nOMOX03Jd:fCTB     He n01pe6mlIOT MJlCO H MJlCHble npo.nyKThI, HJlH nOTpe6mllOT HX
  o'lem.   peAKo.    Cpe,nHee      ,nHeBHoe                     MHca   H   MHCHhIX        npo.nyKTOB     Ha   qneHa
 ,nOMOX03J1HCTBa    (BKJlIO'Iag    ,neTeH ,no   1   ro,na)   COCTaBJIHeT   OT    24   r   B   CeJlhCKHX    paHoHax
.. 	CaMapKaH,nCKOH 06JlaCTH ,no      44   r B r. CaMapKaH,n.      HaH60JlhWHM pa3JlH'lHeM B cTpYKTYPe
 nHTaHHJI )l{HTeneH ropO,nCKHX          H CeJlhCKHX paHoHoB HBJIHeTCH KOJlHqeCTBO                   nOTpe6JlJleMOrO
 MJlCalMJlCHbIX npo.nyKTOB H MOJlOKalMOJlO'lHbIX npo.nyKToB (3a HCKJlIOqeHHeM cblpa, KaHMaKa H
 CMeTaHbl).     PeCnOH,neHTbl       B   ropOl.tax              nOTpe6mlIOT       nepBble      H3    nepe'lHCJleHHbIX
 npo.nyKTOB, Tor,na KaK CeJIhCKHe )KHTeJIH 60JlbWe nOTpOOJlJlIOT BTOpble.




                                                       139 

             7. <l»OPMHPOBAHHE BhI60PKH,lI,JlH OIiCJIE,nOBAHIUI,nOMOX01BHCTB

 I.      06CJIe.nyeMoe         H8ceneHHe        BKJUOqaJIO    npe.n:CTaBHTeJIeH         Bcex     B03PacTHbiX       rpYIUJ,
npOJKHB81OlUHX B .n:Byx 06JIaCTSX (CaM8pKan.n:cKOH H <l>epraHcKoH), B                                 H3 KOTOPbIX 6bUIH
OT06paHbI O.n:HH ropo.n: H .n:B8 CeJIbCKHX p8HOH8.                Bbl60pKa HaCqHTbISaJIa       1.000    .n:OMOX03gHCTS.
HaceneHHe <l>epraHcKoH 06JIaCTH COCTaSJISeT                2.729.800      qeJIOSeK, a HaceJIeHHe CaMapKaHJJ:CKOH
            - 2.749.800 qeJIOBeK. B <l>epraHCKOH 06JIacTH HaCeJIeHHe Ji3bJlBaHCKOrO paHoHa
COCTaBJIJleT   60.500 qeJIOBeK, H HaCeJIeHHe TalWIaKcKoro paHoHa - 118.600 qeJIOSeK. nal..>I;;JII;;It1'nl;;
r. MaprHJIaH - 153.800 '{eJIOSeK. B CaMapKan.n:cKOH 06JIacTH HaCeJIeHHe )J)KaM6aHcKoro paHOHa
COCTaBJIJleT 98.600 qeJIOSeK, H TaHJIaKCKOro paHoHa - 124.500 qeJIOSeK. Ha MOMeHT npoBe.n:eHHS
06cm~.n:()Ba:HHlJ[ HaCeJIeHHe r. CaMapKan.n: COCTaBJISJIO 362.100 qeJIOSeK.

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                    Bcero 
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60%
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50%
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                                                              HRH HHBaJlHll
20%

                                                      •       CryneHT llHeBHoro
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                                                      IIIBpeMeHHo 6eJpa6oTHblH
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      fopo.n/eeJIO,                   CeJIO, Beero            no   Pll.D.Y npH'IHH,
         Beero                                             HUleT     pa60ry




                                      143 

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80%
70%
60%
50%                                                              mM)')K'lHHbl

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30%
20%
10%
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                                    144 

                                     JIHTEPATYPA 


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                                           146