Health Dispute Ignites Talk of Cabinet Shuffle

A bizarre conflict between a renowned pediatrician and the Health and Social Development Ministry has stirred talk about an imminent Cabinet reshuffle and even evoked memories of Stalin's infamous Doctors' Plot.

Analysts said Friday that the dispute with pediatrician Leonid Roshal could signal that Health and Social Development Minister Tatyana Golikova might be on her way out.

The conflict started on April 13 when Roshal lambasted conditions in the country's health sector at a medical conference attended by both Golikova and Prime Minister Vladimir Putin.

In his speech, which only became public when it was published by Novaya Gazeta last week, he argued that the widespread underpayment of medical staff contributes to rampant corruption in the sector.

Roshal, who has received numerous awards for his disaster relief work around the world, draws attention when he speaks. By far the country's best-known pediatrician, he acted as a mediator during hostage-takings at Moscow's Dubrovka Theater in 2002 and the Beslan school in 2004 and heads a children's hospital in Moscow. He even has a star named after him in the Taurus constellation.

But all the recognition did not save Roshal, who will turn 78 on Wednesday, from being denounced in an open letter by health ministry staff who accused him of having a "negative professional past" and of sabotaging the ministry's work.

The letter, signed by "the ministry team," was posted on the ministry's web site on April 18, the same day that Novaya Gazeta published Roshal's speech.

It was also posted as an addendum to the conference's transcript on Putin's web site. That transcript, however, does not contain Roshal's speech. Rather, it ends with a scathing attack against Roshal signed by a certain Andrei Petrovich, who describes himself as a "simple gastroenterologist."

But Putin's site does contain a post-speech discussion between the prime minister and Roshal in which Putin says he prefers Roshal's criticism to those people who "calmly and phlegmatically keep picking away at problems."

It also seems that Roshal has the support of an overwhelming majority of doctors online, as evidenced by the hundreds of comments in his defense published underneath the ministry's complaint letter on its own web site.

Thickening the plot was a mysterious incident last Thursday when a group of young people delivered a seemingly ill friend to Roshal's hospital, saying the young woman had probably suffered a stroke.

But after emergency preparations were completed, the would-be patient told baffled hospital staff that she was all right. "She said the whole thing had been an 'inspection' and that she was an actor," said Razmik Keshishyan, a doctor at the clinic, according to the RBC.ru news web site.

Roshal said in interviews Friday that he was unsure about the incident's meaning. "If it was a joke, we're not offended. If it was a provocation, it's bad," he told Vesti FM radio.

The incident also recalled the murky death of Maxim Goloviznin, a regional leader of the Just Russia party who died outside a Moscow hospital on April 15 after staff refused to admit him.

The uproar left experts scratching their heads, with some speculating that Roshal was being used in a government intrigue against Golikova. "I think he unwillingly became an instrument in a political game," said Kirill Danishevsky, a health expert who heads the Society for Evidence-Based Medicine.

Danishevsky said the invitation for Roshal to speak at the congress had made the conflict inevitable because nothing else could have been expected from him. "He just said what he has been saying for four years," he said.

In another twist, political analyst Stanislav Belkovsky published an article in Moskovsky Komsomolets on Friday that defended Roshal and called for the arrest of Golikova and her husband, Industry and Trade Minister Viktor Khristenko, on charges of corruption. He also accused the health ministry of pilfering funds for tomographic scanners and recalled that Golikova had promoted a drug called Arbidol that is produced by Pharmstandard, a company believed to have close links to her family.

Similar accusations were voiced earlier this month by Moscow Times columnist Yulia Latynina. They also appear on opposition activist Maria Litvinovich's new web site, Election2012.ru.

"If an investigation confirms the worst fears, [Golikova] would get 10 to 15 years," Belkovsky wrote.

He also alleged that Khristenko controls shares worth some $3 billion in two factories in the Chelyabinsk region.

Spokespeople for both ministries denied the accusations Friday. A spokesman for Golikova said by telephone that he would not comment on "slanderous allegations." He refused to give his name.

Alexei Mukhin, head of the Center for Political Information, a think tank, suggested that Putin had asked Roshal to speak to lay the basis for a Cabinet shakeup in the run-up to the December State Duma elections.

Mukhin recalled that before the 2007 Duma elections, then-President Putin fired health minister Mikhail Zurabov, widely regarded at the time as the least popular Cabinet member.

"This could be positive for United Russia," Mukhin said.

Not all analysts agreed, however. Vladimir Pribylovsky, head of the Panorama think tank, argued that Golikova would remain in her post while Putin and Roshal were probably not part of any intrigue against her. "She has many enemies," he said.

That notwithstanding, United Russia acknowledged the debate's salience Friday by dubbing it the "Doctors' Plot" in a feature on its web site. That name refers to an anti-Semitic witch hunt toward the end of Stalin's life when the Soviet dictator accused a group of mainly Jewish doctors of conspiring against his leadership.