Departmental quality and safety control of medical activities (hereinafter – departmental control) remains one of the least studied forms of Russian medical control from scientific, organizational and legal points of view. The hypothesis has been put forward that a holistic departmental control system has not been formed on the territory of the Russian regions, which requires additional scientific assessment. The aim of the study was to determine the problematic moments of the departmental control system formation in  a  Russian Federation subject and to  give scientifically justified proposals for its organizational improvement. Materials and methods were based on a content analysis of regulatory legal acts and open source data, as well as a comparative analysis of  federal and regional executive bodies’ performance indicators. The features of  the distribution and implementation of departmental control powers in the Chelyabinsk region have been determined. According to the methodology for assessing the criteria for the severity of potential negative consequences of possible non-compliance by medical organizations with mandatory requirements, developed by Federal Service on Surveillance in Healthcare, the degree of need for departmental control for all federal and regional executive body’s of the Chelyabinsk region was determined. It has been established that a holistic system of departmental quality control has not yet been formed in the Russian regions – departmental control in subordinate organizations is not carried out or is carried out with insufficient efficiency. To complete the formation of the departmental control system, it is necessary to reorient it from external influences (appeals, complaints, instructions and requests) to the internal needs of executive authorities, to develop common targets for the activities of subordinate medical organizations, to adequately calculate the burden on officials during departmental control, to redistribute regional medical organizations by subordination and, in a number of entities, to transfer municipal health institutions to state subordination.