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The main attention of health service in Russia is …………….
We believe that one of the main available methods of ……….
Ambulant patients are seen …………………………………...
The ambulances are equipped by ……………………………..
The main task of this centre is ………………………………..

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· Hospitals and clinics exist in all major towns and cities of Russia. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. The quality of hospital rooms varies according to the quality of a person’s health insurance scheme.

· Emergency treatment is provided at the emergency room of all hospitals. Emergency departments are open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available. Emergency care is available free for everyone, however, once your condition is stabilized you will need to show proof of your insurance status. You will also have to pay a fee directly to all of the doctors who have treated you.

· There are private practices in Russia. The premises, equipment and personnel are funded by private insurance contributions, but it is used only by a small minority of people, often as a top up to the basic state healthcare and to cover them for the services deemed non-essential.

· Dental care in Russia is expensive, and most citizens cannot afford the treatment. Citizens must pay themselves for dental treatments including routine checkups.

· Dispensing chemists sell medicines in Russia. A prescription is known as a retsept can only be prescribed by doctors and consultants; however basic medical advice can be given from the pharmacist. Prescription medicine is only available from a qualified and registered chemist or from a hospital pharmacy. In rural areas, the supply of medicine is particularly dire; usually there is only one pharmacy in each large village and villagers often queue for their medicine all day without knowing if the pharmacy has the required medicine in stock.

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The Tyumen center was the first of the neurosurgery and the seventh of the general ticket of the federal centers. The so-called «medical camp», near the village of Patrusheva was picked out for the building site. There was also the surgical campus of the Tyumen regional hospital and the medical unit «Neftyanik». In addition, in 2012 there was built the Radiological center of the Tyumen regional oncological clinic. Also it is planned to construct new academic building of the Tyumen State medical academy, the anatomical center and also the main campus of the regional oncological clinic.The construction of the Tyumen center started in 2008.^[8] The first surgery was held at the April 25, 2011. In 2011 the clinic was allocated with 330 surgery quotas within the government procurement, in 2012 – 3,000 quotas.
The hospital consists of five specialized units: for adults (neurovascular, vertebrological, the neuro-oncology unit, functional neurosurgery), with 20 beds per each unit and for children, with 15 beds. Besides, there is the admission office counted for 80 visits per turn. The subsidiary units: the medical ultrasonography department, the operating suite, the department of perioperative medicine and life support.
The medical care for the citizens of the Russian Federation is provided within the government procurement, for free, regardless of the region of residence. The patients may get the medical care via the appointments of the regional medical departmentsand also via the own admission office of the center. The clinic provides treatment of such diseases as:

· arterial aneurysms · arteriovenous malformations · Parkinson's disease · hemifacial spasm · hydrocephalus (adults and children) · cerebral palsy · spina bifida · craniosynostosis · spinal disc herniation · neuralgia of occipital nerves · neuropathic pain

· choroid plexus papilloma · CNS tumours · degenerative spine disease · newborns’ perinatal pathologies · spinal fracture and after-effects · posttraumatic, postapoplectic spastic and pain syndromes · Dandy–Walker syndrome · stenosis of different genesis · torsion dystonia · epilepsy · essential tremor

Statistically, 80% of the patients make complete recovery, 15% keep curing with medicaments. Due to the minimally invasive surgery methods, the tissues intrusion is minimal. It helps to discharge the majority of the patients from a hospital already through 3–5 days after surgery. The center provides a number of advanced technologies. The vertebrological department provides the endoscopic elimination of intervertebral disk hernia. The oncology department explores the Norwegian system of dynamic 3D neuronavigation SonoWand. The intraoperative neuromonitor applied in the functional neurosurgery department helps to conduct the chips-stimulators implantations which are used for the vagus nerve stimulation. The patients can turn off the painful sensation at any point using remote control.

The minimally invasive surgery is provided due to the mobile tomographic microscope O-arm ® Surgical Imaging System of the American company Medtronic. It is necessary to notice that the surgery is equipped by a telemedicine system which allows the surgeons to get the consultations in real time mode from any specialists all over the world.

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Mrs Osman,

Your operation is on Monday 14th January. Please go to B Ward at 12.3 pm.
Your consultant is Mr Hamilton.

You can have a light breakfast at 7.3 am and have water up to 10.15 am. Please do not wear

jewellery or make-up. You will need to bring your slippers and a dressing gown.

Please contact the above number to confirm your bed for this date as soon as possible.

Yours sincerely,

J Manning

Jane Manning

Secretary

1. The letter tells Mrs Osman where to go for her operation.

2. Mrs Osman can find information in the letter about what to take to hospital.