Behind the commune hospitals at the basic level of nearly 300 million buy-back of Yuhang

Behind the commune hospitals at the basic level of nearly 300 million buy-back of Yuhang
Auction from property right to made a public possession again, retract from what has been sold to a huge sum of money, the commune hospital of Yuhang reformed system to get back to the origin. The industry personage thinks, such a change no doubt reveals the attitude toward public health of the government, happen from " Get rid of the burden " Get and " buy and serve " Transition,sell but, getting more meaningful behind one that buy one. As everyone knows, September 30, Yuhang district of Hangzhou of Zhejiang Province announces, 29 original private shareholding system commune hospitals of this district, except that a transition is a private medical organization, other 28 commune hospitals are all furnished funds for retracting by the government finance. And 7 years ago, 29 individuals and his the shareholder, through striking unexpectedly, sold the ownership of breaking these 29 commune hospitals with the total price of 75 million yuans of Yuhang district. This buy-back, the district government of Yuhang furnishes funds of nearly 300 million yuan. "Attitude is good, it is very reasonable to charge too, or let people rest assured in the hospital where the public run. " On October 30, in Yuhang foot-path mountain community health Center in the district, the Shen 's of villager accompanying the wife to see the doctor defends and tells reporters. The newly-built foot-path mountain town community health Center, cover an area of 0.8 hectares, floor area is more than 6660 square meters, free from worry and bright visit hall, good hardware, can match in excellence or beauty with the hospital of ordinary county absolutely. Several months ago, it is still a private hospital. It is a director of this community health Center that 41 -year-old Chu Hong connects with. Before the shareholding system reform in 2002, it was a president of the mountain commune hospital of the foot-path that Chu Hong connected with, reform system, he control interest 51%, become the Chairman of hospital. Chu Hong tells reporters in succession, in middle and later periods of the 1990s of last century, appropriations that the government gave to the township hospital were fewer and fewer, township hospitals are generally poor-performed, some are even debt-ridden. In 2003, under the push of the district government of Yuhang, the mountain commune hospital of the foot-path carried on the shareholding system reform, "the intersection of hospital and the intersection of debt and 960,000 at that time, oneself toughen one's scalp competitive bidding. " Finally, he and 7 shareholders invest 3 million yuan altogether, has bought the foot-path mountain commune hospital at that time. Implement for a few years of shareholding system, the health clinics in towns and townships have not got better development In 2003, 29 health clinics in towns and townships of Yuhang including mountain commune hospital of the foot-path all carried on the transformation of the shareholding system. Through auctioning, the price of 72 million yuan is transferred to individual at total price in 29 health clinics in towns and townships. "The government put into insufficiently at that time, commune hospitals at the basic level generally suffered the loss, it was even to survive a problem. " Chief of Yuhang Municipal Health Bureau GuoLin Huang say at that time, Yuhang all income of commune hospital have only several ten million yuan to add up, at least 70% of the commune hospitals face loss, the great majority lose amount above 30%. "Want to lighten the burden on one hand, on the other hand even want to vitalize resources. " Huang GuoLin says, like a lot of places in the whole country, Yuhang determines to introduce the market-based mechanism, implement shareholding system transformation to the commune hospital. According to the file at that time of Yuhang, after the shareholding system reform of commune hospital, the undertaking properties of its organization did not change, the funds are subsidized and only limited to the public health project to subsidize, implement it with the town township in the district (street) Condominium, management system relying mainly on district, government's leading public health on the macroscopic, in microcosmic the shareholder participates in inside to manage. The intersection of country and forest Huang think method this, in have his rationality at that time. It is reported, after reforming system, Yuhang about 1/3 of the commune hospitals has realized surpluses, 1/3 are fair, but there is the lying in the commune hospital of the lower area as to remote, economic development level and still suffering the loss of 1/3. "After reforming system, because the foundation of the hospital is better, there are certain position advantages, probably there are clinic incomes of 2 million yuan every year. " Hong Chu claim, reform system, stand up your enthusiasm transfer really, " because want the profit in succession, attitude is not certainly bad. " "After running for a few years, reform system while bringing a gleam of for the existence of the commune hospitals at the basic level of villages and towns and transforming, also exposed a lot of questions gradually. " Huang GuoLin says. It is reported, in order to lower costs, the shareholders are generally can't be more unwilling. Put into insufficient, many commune hospital facility outmoded and medical equipment lag behind and medical house nervous going to a doctor environment to be relatively poor. An investigation of the health bureau of Yuhang district reveals: Before the new round of reform, 80% of the houses of community health station of the whole district have not reached relevant stipulating the standard. In the gentle longan of moustache, among a few years after the shareholding system reform, the health clinics in towns and townships have not got better development, some even shrink, and peasants choose to go to the county to the hospital or go to the hospital of Hangzhou urban area to see the doctor directly more. Hu WenLong was one hundred Zhangs of second big shareholder of commune hospital, backbone of the blood screening test lab in town originally. He tells reporters, while implementing the shareholding system, the shareholders invest more than 400,000 yuan altogether. Because the hospital puts into limitedly, the apparatus is outmoded, can only do the simplest laboratory test project, peasants are unwilling to come again too. Among them, liver function is tested for one month, just made one, blood routine is done one in two days. "At that time, I had even thought the blood screening test lab can be closed. " Hu WenLong says. Attract talent into another difficult problem which these private commune hospitals led. It is reported, among 7 years implementing shareholding system, commune hospital of one hundred Zhangs employed two people altogether, a doctor, a nurse; The yellow lake commune hospital has only employed a person. The other commune hospitals are similar on the whole too. Return to public service this time, there are more than 50 staff to collude in the commune hospital in the village, but engaged a casual labour outsiding nearly takes half. "In order to absorb talents, the hospital has made hard too. " A person in charge of hospital says, but the salary can not be born for the high hospital, there is no people to come few to give, the worker feels too that lacks guarantee. Each local villager tell by China Youth News reporter,with before a lot of for inspection and minor operation which health clinics in towns and townships can make, do not do now. The traffic is convenient nowadays, the large hospital going to the town is very convenient too, the inferior position of the commune hospital at the basic level is more and more prominent. The intersection of medicines and expensive, the intersection of clinic and times of the intersection of expenses and question such as being on the high side, follow it. The relevant person of health bureau in Yuhang says, puts the private hospital in the relatively rigid state-run hospital of system, hoping to play a role in activating the medical market with the flexible mechanism, expect how long get off, the great environment has changed. There were doctors at that time" See the doctor " Called " do business " After the shareholding system reform of commune hospital, not financial input, can only go on " raise the institute with medicine " in an all-round way Route. Meanwhile, take business income as the core to confirm the distribution mechanism of doctor's remuneration, also force the doctor to regard medical treatment as main service content. Participate in the shareholders of the yellow lake town commune hospital Zhu ShengZhen by shares and say, after the shareholding system, the profit overwhelming majority of the commune hospital comes from the income of medicines. It is reported, every commune hospital sold the medicine income at that time, accounted for 80%~90% of all business incomes. A doctor says, it was called doing business that they would see the doctor at that time, it was that the business had come that the patient had come, "the salary should be earned by oneself, frankly speaking, but depend on ' medicine '. At that time, the government was considering the expensive problem of seeing the doctor how to solve, but our doctor was considering how to have a meal. " A copy of materials from " medical and health of Yuhang " reveals, after reforming system, I? ? The clinic persons of 9 commune hospitals rise to 1,298,000 people in 2004 from 1,152,000 people in 2000, increase by 12.17%; And the business income rises to 101,020,000 yuan in 2004 from 65,410,000 yuan in 2000, has increased by 54.45%. "Person has only increased the clinic by 12.17%, and the business income has increased by 54.45%. " This doctor replies: It means any? Prove the money that the patient diagnosed the illness and spent is increasing. 30 Ye Fei of a little over years old is the doctor of the mountain town community health Center of the foot-path, entered the commune hospital of town centre of mountain of the foot-path, transformation two times among 7 years after graduation from university in 2003, he has gone through. "The hospital should survive, should certainly make money. " Ye Fei says, in his past experience of taking up a job as a doctor, it is " skill " of prescribing that drill repeatedly . Make each prescription, besides wanting to have an optimistic view of the disease for patients, how much should care for the hospital and make more or less, how much one's own task amount can increase. "This brings enormous presure to one's own work. " Ye Fei says. It is not merely Ye Fei. In order to raise managing incomes, most doctors are arranged to diagnose. The income returns in the own mechanism controlling by oneself, has encouraged trending towards the profit of the hospital. In order to raise incomes, hospital and doctor incline to make the large prescription, use high price medicine for the patient, do more inspections. According to the materials, after the shareholding system, 29 commune hospitals are by the loss in 2000, the balance was up to 8,213,500 yuan by 2004, have increased by 303.27% compared with 2000. The worker of a commune hospital tells China Youth News reporter, a lot of patients think the private hospital make profit as one's only aim, even if is the normal checking and using medicine, ordinary people will think that excessively check, the large prescription starts, earn the evil mind money, vicious circle, worsen relationship between doctors and patients, cause at the basic level commune hospital break one's promise, let gradually in this way, some commune hospital the intersection of doctors and patients and dispute take place frequently too, person satisfaction drop. In fact, are regarded as the pivot of constructing the rural tertiary medical prevention and health care network, the centre that the health clinics in towns and townships are controlled by rural disease too, are offering basic medical treatment service for local peasant outside, still bear the propaganda of epidemic prevention, health care and birth control knowledge, and more public health functions, for example carry on the administration of hygiene to the medical organization of the home town, carry on the professional guidance etc. to the medical worker. "But the commune hospital of the shareholding system is unwilling to spend greatly energy launches other services. " Huang GuoLin says, the government can only implement functions such as the public health,etc. by way of buying and is served. And the commune hospital taking as, obviously can't bear the duty of management of public health. 19 files jocularescort the Emperor " The new medical reform " The difficulty and high cost of getting medical treatment has the people's livelihood topic which the various circles of society condemn in recent years all the time. " old complaint " Where on earth? The intersection of country and forest Huang think origin put into as to insufficient medical the intersection of resource and maldistribution government and hospital trend towards profit, medical insurance ensure competence to be low, and the medicines price is empty and high. In the view of leader of Yuhang district, solve the people's livelihood difficult problem of the difficulty and high cost of getting medical treatment, the medical reform is an only way. Medical marketization can yet be regarded as a kind of beneficial exploration, but the market-based prerequisite of medical treatment too, it should be that the public medical health organ can bear people's basic health care guarantee. Will it be March 2009, receiving much concern " the the intersection of Central Committee of the Communist Party of China and the intersection of the State Council and suggetion on deepening the system reform of the medical and health " and the State Council about <>Announce, regard this as the sign, has pulled open the curtain of the new round of medical reform in succession. And before this, Yuhang prefecture committee, district government have already smelt the direction of the medical reform sharply. In September of 2008, started the new round of medical reform in Yuhang. It is reported, it is this medical reform, prefecture committee of Yuhang, district government and relevant functional department successively issued " about deepening the implementation suggestion of the comprehensive reform of the health care system in Yuhang district ", " several opinions on advancing construction of strong district of the hygiene ", " notice on accelerating community's hygiene service operating mechanism and reforming implementation suggestion ", " notice on printing and distributing the township commune hospital assets of district Town of Yuhang and purchasing the method ", " notice on printing and distributing community's hygiene service organization structuring planning in urban and rural areas of Yuhang district of Hangzhou ", 19 policy files such as " several opinions on encouraging defending skill talents and working for every town community health Center ". On December 31, 2008, the district government of Yuhang purchases the commune hospital of the first shareholding system. In 2009, purchasing the scheme confirms " compensates and compensates with the interest certain investment according to investment amount " formally Purchase principle,last west 4 town the purchases of commune hospital,etc.. By September 30 this year, last two commune hospitals purchase and finish in the district. It is purchased that this time wholly-owned, Yuhang has realized each town township (street) There is goal of a commune hospital which governments holds. The intersection of country and forest Huang tell reporters, while purchasing the commune hospital of the shareholding system and making the transition as the hygiene service organization of the community in the government, define the community health Center as the public beneficial public institution which the government held, still allocate 13~15, every berth and increase standards such as 0.7 establishment,etc. according to every Wan's service population, have checked and ratified to staff members. From December of 2008, Yuhang district also started the new reconstructives of 13 community health Centers according to planning. Two grades of finance provide funds from district Town, have allocated the full-automatic biochemical appearance in unison for the community health Center, six major possessions of medical apparatuses such as 500mAX line machine, colored Ultrasonography B, three categorised blood count appearance, urine analysis instrument, electrocardiograph. It is introduced, only this several items, invest nearly 400 million yuan in finance of Yuhang. While the hardware is put into, Yuhang district issues the reward policy again, encourages the professional technician of the hygiene to go to the remote community health Center of town township in the west to work, the district finance in examining and allocating the foundation of personnel's funds according to the regulation, and then increase the funds of personnel of 6000 yuan of annual per person; To the specialized personnel of undergraduate course and the above education, work in our unit for full 5 years and the above and check and rate the good one synthetically, serve and subsidize 30,000 yuan for my disposable basic unit. After 4 districts belong to the hospital and send 11 medical workers to help the 4 towns of community health Centers in the west to work, the local medical level is obviously promoted. The intersection of country and forest Huang think no doubt, medical reform want, take real way of Huimin, must consider, relieve masses, diagnose the illness expensive seeing the doctor difficult problemming conscientiously, only devote more efforts to investing in the government, it is public beneficial to stand fast at, could keep common people's trust to the medical organization. The doctor can't be the job of making profit As to Yuhang This time the new round of for medical reform,summarize forest Huang: Change the system, build the mechanism, build the house, guide the ability and intelligence. First pilot unit of this reform in Yuhang district - -The yellow lake town community health Center, have started " two lines of revenue and expenditure " at first With the assigned management system of the performance. " two lines of revenue and expenditure " ,Namely refer to income and expenditure of the community health Center " Walk on two legs " ,The income enters the financial account of town township directly, the expenditure is squeezed into the centre from another account by the finance of town township. " accept " , " prop up " ? Throw octogenarian ���� competent thumb young to wish Jian of river �� the intersection of �� and the intersection of Chinese scholartree and the intersection of Su and the intersection of fan and the intersection of �� and Sui fit �� Sui barium �� arc? And " the performance is distributed " ,Divide salary into two pieces of salary of basic wage and performance, efficiency, service quality, resident's satisfaction, per person that salary of performance and community's hygiene serve make a diagnosis the control of the expenses is linked directly. As to this, the intersection of country and forest Huang think advantage of this measure to can cut off, sell medicine, turn on single deducting a percentage lucrative demanding fundamentally, change the medical worker and make great prescription, situation checked repeatedly in order to ensure by oneself, tie medical personnel's income to implementation of service of the public health at the same time, arouse staff member's enthusiasm. "Should let medical treatment return to public service, provided that that lets this job of the doctor of public service hospital turn into a public service job rather than job gained. " GuoLin Huang say, implement two lines of revenue and expenditure and performance assign, manage, can also promote equality that public health serve take. He thinks, ordinary people complain that it is expensive to see the doctor, to a great extent, because the hospital " works eating by oneself " Income structure,last medicines, check mechanism that be tied to doctor's income at income, the rising of the expenses plays a very big role. The result that can see is: Implement " two lines of revenue and expenditure " And then yellow the intersection of lake and the intersection of town and clinic of community health Center prescription value once drops from 111.64 yuan in 2008 to 83.85 yuan in 2009; But clinic person has risen to 41,400 persons last year from 30,100 persons. Expenses once are realized at price of medicines and clinic " Pair drops " While,last " the pairs of growth " clinic person and masses satisfaction . In January - September of this year, per person wrote out a prescription the fee dropped to 62.5 yuan especially. The burden that the masses see the doctor is obviously lightened. This Zhu ShengZhen, director of centre, says, the commune hospital would develop in the past, the worker wanted to issue the bonus, the president has to consider the profit question. Getting different in now, needn't consider question that make money, how improve medical engineering level, let patient to be satisfied to become most serious thing. She thinks, the reform has changed the examination mechanism taking medical business income as the centre in the past, make the centre come back completely public beneficially, has solved the problem of the difficulty and high cost of getting medical treatment of ordinary people from source too. Reporter know change of working way, whom new medical reform this bring to doctor most loud to change. A doctor tells reporters, it is doctor's most basic function of community's responsibility to see the doctor now, more time and energy of the doctor is transferred to the hygiene service organization of the community " The six in one " (prevent, medical treatment, keep healthy, health education, recovering, birth control technological guidance) Functionally. " new building, new apparatus, new personnel " ,On August 2 this year, community health Center in town of one hundred Zhangs is with the brand-new image, meet the new round ofly and join and shut resident's health physical examination. Newly-built community health Center of more than 16 million yuan at the cost of government after this medical reform, take up an area of 0.667, 4300 more than of floor area, the intersection of centre and medical district, the intersection of prevention and health care and district, the intersection of health and physical examination area, the intersection of woman and the intersection of health care and district, clear function of recovering etc.. Belong to conditions such as hospital expert's technology,etc. in the district, resident's number of people of physical examination for the first time in the area under one's jurisdiction rises to nearly 4000 from more than 2000 original. "The patient's trust has increased, combine with the new apparatus, liver function tests the project can do two or three in one day now, checking the project expands much too. " Feel for a time that can cancel Hu WenLong in the blood screening test lab and say. Compete for the centre director who takes up an official post and tell reporters bigly and refinedly in vain after this reform, with before one hundred Zhang unwilling not to come in a lot of university student for community health Center, put out 4 posts to compete for this year, 28 people registered. The intersection of government and leading role should weaken house, live one hundred aunt Liu of community, think condition, wish to go to the county hospital by car for half an hour in the past. The ability to move around has been inconvenient recently, have to go to the community health Center of the home gate. "I had never expected, see the doctor without registering directly here, doctor's attitude is good too, the level is good, really very convenient. " A few words of aunt Liu, that was said is that medical organizations at the basic level such as the community health Center,etc. are relieving the masses of our country and seeing the doctor on the important function that the difficult respect is being produced. Bai HongBin says, the medical organization at the basic level is generally set up in the urban and rural residents life range, quantity is numerous, is widespread, community's doctor should be residents' neighbours, friends, improving the convenience, accessibility of medical care and controlling the medical cost, improving the relationship between doctors and patients, there is advantage which large hospitals can't compare. Meanwhile, medical health organs in the basic unit generally use basic medicines, suitable technology, develop the activity of health education, prevention and health care,etc. extensively, start with putting prevention first, improving resident's health level, difficult to relieve and see the doctor by letting residents fall ill few. "Promote the development of medical organization at the basic level in urban and rural areas, let it accept the choosing first of the service conveniently and seek medical advice as the masses, can lighten the pressure of the large hospital effectively, difficult to relieve and see the doctor conscientiously. " The intersection of country and forest Huang think hygiene medical treatment need, construct one in urban and rural areas the intersection of basic unit and medical health organ and large the intersection of hospital and division of labor and coordination of work, support with each other, orderly operation mechanism, form the large hospital and the pattern of seeking medical advice hierarchically of cooperation that the health organ at the basic level divides the work, offer safe, effective, convenience, cheap medical care to common people. "It can not eaten in the large hospital at present that change, the current situation that can not be had enough in small hospital, must place public financial investment on the countryside, community especially. " Though this reform, let the mountain community health Center director Chu Hong of the foot-path include and reduce much in succession, but this former boss, applaud for the new round of medical reform. He thinks, the medical health organ of the foundation should be public service properties. The commune hospital reforms system and gets back to the starting point again since the terminal, fully prove too, medical input, the leading role of the government can't be weakened. Chu Hong says in succession, the tranquil mood of the general public of service centre of mountain hygiene of the foot-path, has regained patient's trust too after reforming system. "Not staying in the past, talents' commune hospital at the basic level became the target that employment of large quantities of graduates of medical college was chosen. " Huang GuoLin says, newly recruited 100 graduates last year alone, entrusted and trained 35 people. News from Hangzhou on November 3

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