Li Bin: Deepening the Reform of the Medical and Health Care System

(en.nhfpc.gov.cn)

Updated: 2014-08-24

2. Deeping the Comprehensive Reform of Medical and Health Care Institutions at the Community Level

Firstly, efforts will be made to: solidify and improve the national essential drug system, stabilize the centralized mechanism of purchasing essential drugs, push forward the gradual extension of the essential drug system to village clinics and non-governmental-sponsored medical and health care institutions at the community level, improve the stable and long-term effective compensation mechanism of medical and health care institutions at the community level, deepen the reform of manpower planning, personnel management and salary structures in institutions at the community level, and solidify the achievements of the health care reform at the community level. Secondly, efforts will be continued to strengthen the building of the medical and health care service network at the community level and improve the rural medical and health care service network led by county-level hospitals and based on township health centers and village clinics. In the urban areas, efforts will be made to accelerate the building of a new type of urban medical and health care service system based on community health care services. Thirdly, efforts will be made to implement the Project of Upgrading the Service Capacity of Chinese Medicine at the Community Level. Fourthly, efforts will be made to: change the patterns of health care provisions, establish a graded diagnosis and treatment and two-way referral system, actively push forward the model of getting health care services from contracted family doctors, and establish the agreement-based relationship between general practitioners and residents. Fifthly, efforts will be made to: steadily improve the level of equalization of basic public health care and further increase the per capita outlay standard for public health care; do a good job providing basic public health care items and some major public health care items such as vaccination planning, women and children health care; improve the management of people suffering serious mental illness; and increase health education. The integration of regional public health care resources will be strengthened. Sixthly, efforts will be made to further implement the compensation and pension policies for doctors in the countryside, strengthen the cultivation and trainings of doctors in the countryside, upgrade the capabilities of doctors in the countryside to deliver better services, and constantly lay a solid foundation for the rural health care network.

3. Accelerating the Public Hospital Reform

As the most important players in the medical service provision system in China, public hospitals have been serving as pillars guaranteeing basic medical and health care. Firstly, governments at all levels should take the responsibilities to run hospitals in a practical and earnest way; determine reasonable functions, numbers, sizes, structures and distributions of public hospitals; and maintain the status of publically funded medical institutions in providing basic medical and health care for urban and rural residents. Secondly, efforts will be made, by removing the notion of “feeding hospitals by selling drugs”, to push forward the reform in such areas as management, pricing schemes and supply of medicines, strengthen the prices of medicines, and establish a scientific compensation mechanism. Thirdly, efforts will be made to push forward the establishment of an inner governance structure of public hospitals, deepen the comprehensive reform of such mechanisms as personnel management and income distribution, establish new personnel and salary systems in line with characteristics of the sector, attach more importance to performance-based assessment, establish a scientific evaluation mechanism based on results and achievements of providing medical services, and establish and improve the modern system of hospital management. With a service population of 900 million, county-level public hospitals serve as a connection between big hospitals and medical and health care institutions at the community level. Moreover, county-level public hospitals are crucial to addressing the problem of “seeking medical care is difficult and expensive.” At present, the reform of county-level hospitals should be highlighted and the pace of reform should be accelerated. Efforts will be made to fully complete the reform of county-level public hospitals within three years, thus enabling each county-level hospital to serve as the leading hospital in the whole county. At the same time, efforts will be made to deepen and expand the piloting of comprehensive reform in urban hospitals, do a better job in top-level design, overall planning, unified guidance, comprehensive advancement, and pilot systematic reforms so as to see the duplicate effect of the reforms.