Tuesday 7 April 2009

Service, cost-cutting key to health reform


Funding boost, hospital charges phase-out, staff motivation are plan’s 3 main planks

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Guanyu said...

Service, cost-cutting key to health reform

Funding boost, hospital charges phase-out, staff motivation are plan’s 3 main planks

Zhuang Pinghui and Josephine Ma
7 April 2009

Providing high-quality service in hospitals and bringing down health care costs were the keys to measure the success of the mainland’s new medical reform, according to a reform plan announced yesterday.

The central government planned to increase funding for hospitals, phase out a medical surcharge to ease patients’ financial burdens and provide more incentives to motivate medical workers, the much-anticipated plan said.

Health care should be treated as a public service, not a business, it said. The government would increase direct funding to hospitals to prevent them from becoming overly commercialised. The increase would be incremental and selective, since authorities want every penny to be spent wisely.

Money had been earmarked to fund infrastructure, upgrade equipment and provide pensions for retired medical staff, the plan said. The central government would “strictly” control the size, debts and building plans of public hospitals to ensure cost-effectiveness, the document said.

Hospitals specialising in mental health, infectious diseases, occupational conditions, and maternal and children’s health would have priority under the new system.

Funding for public health care, such as the prevention of infectious disease epidemics, would also be improved, with government-financed increases in pay for personnel in public health institutes, and higher funding for the establishment and development of such institutes.

Medical experts last night welcomed the reform, saying its general direction was sound. But they said the announced plan was too vague and it was unclear whether it could live up to its promises.

“It’s easy to come up with a plausible policy and win all the praise. The real hard part is to put it into practice,” said Wen Jianmin, director of the orthopaedics department of Wangjing Hospital under the China Academy of Chinese Medical Science.

“Until [we read] the supporting documents on the public hospital reform [which will provide the details], I will have reservations about it.”

Mr. Wen said it remained unclear how long it would take for the authorities to process a hospital’s application for extra funding, how the applications would be assessed and how the money flow would be supervised.

Although the guidelines were vague and unclear, hospital staff members were glad they did not immediately scrap the 15 per cent surcharge that hospitals charge on the medicines they dispense. The surcharge was introduced during the previous health care reforms, in the 1990s, as a way of helping hospitals generate some of their own income.

Some had called for an immediate elimination of the surcharge. But yesterday’s guidelines promised only that the surcharge would be gradually replaced with a fixed fee for writing prescriptions.

While yesterday’s guidelines reconfirmed the dominant role of non-profit hospitals and medical institutes in medical services, it also left a door open for private hospitals. Some public hospitals, especially those run by state-owned companies, were encouraged to restructure themselves through influxes of private capital.

Staff at grass-roots-level hospitals would also receive more opportunities for promotions, training and better pay. The guidelines promised the salaries of low-level hospital staff would be kept in line with the average salary of local public servants.