Chairman Yu Zhengsheng attended the discussion with members from the medical and health sector—what did the delegates say?

Release time:

2016-03-05 09:59

　　On March 4, Yu Zhengsheng, member of the Standing Committee of the Political Bureau of the CPC Central Committee and Chairman of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), visited the CPPCC members from the medical and health sector who were attending the Fourth Session of the 12th National CPPCC and participated in the discussion.

　　Wen Jianmin, a member of the National Committee of the Chinese People's Political Consultative Conference and director of the Department of Orthopedics at Wangjing Hospital of the Chinese Academy of Medical Sciences, told reporters that during the discussion meeting, Chairman Yu Zhengsheng listened to remarks from a total of 13 CPPCC members. Reporters from People's Daily Online have compiled and summarized some of these remarks.

　　Committee Member Wen Jianmin: Reform the Remuneration System for Medical Personnel

　　Wen Jianmin, a member of the National Committee of the Chinese People's Political Consultative Conference and Director of the Department of Orthopedics at Wangjing Hospital of the China Academy of Traditional Chinese Medicine, briefed Chairman Yu Zhengsheng on his proposal that "to boost the enthusiasm of medical personnel, we should start with reforming the salary system." For a long time, medical personnel in public hospitals have been uniformly managed and paid under the status of "cadres," which fails to reflect the unique characteristics of the medical profession. As a result, their overall income has remained relatively low, and there is a significant disconnect between their earnings and the effort they put in. Moreover, the link between medical personnel’s salaries and their performance is insufficient, and their base salaries are extremely low. For example, at Wangjing Hospital, where Wen Jianmin works, a attending physician who holds a master’s degree and has been working for eight years—while currently pursuing a doctoral degree—earns only 2,100 yuan per month in base salary, with bonuses largely dependent on the “revenue” generated by their respective departments. Departments such as pediatrics, obstetrics, and pathology, which generate relatively little recurring revenue, face high work intensity, great pressure, and high risks—but receive meager bonuses and low incomes, leaving these medical staff struggling to make ends meet. This situation has also given rise to some unhealthy practices among medical personnel, such as accepting “kickbacks” from pharmaceutical companies.

　　He believes that if a compensation system tailored to the unique characteristics of the healthcare industry cannot be established, the motivation of medical personnel will remain low, and the goals of healthcare reform will inevitably fail to be achieved. Therefore, he recommends that financial investments in healthcare reform should be redirected primarily toward human resource development—raising the salaries and benefits of medical personnel, promptly introducing measures to reform the salary and benefit systems for medical staff in public hospitals, and strictly enforcing labor laws by providing overtime pay for work beyond the standard 8-hour day. Additionally, a special allowance system for specialized positions in the healthcare sector should be established to attract highly skilled and specialized talents into the medical field, thereby breaking through challenges such as the shortage of pediatricians. Furthermore, a non-monetary compensation system should also be introduced, encompassing paid leave, insurance coverage, and flexible retirement options.

　　Committee Member Yang Jinsheng: Promote the Development of Traditional Chinese Medicine.

　　Also speaking at the joint meeting was Yang Jinsheng, a member of the National Committee of the Chinese People's Political Consultative Conference, Deputy Chairperson of the Medical and Health Committee of the Central Committee of the China Zhi Gong Party, and Director of the Center for Cross-Strait and Hong Kong-Macao-Taiwan TCM Exchange and Cooperation under the State Administration of Traditional Chinese Medicine. In his speech, he suggested that we should implement policies, improve mechanisms, and promote the healthy development of the TCM cause. Specifically, he put forward four recommendations:

　　First, we will further strengthen the organizational framework for TCM work. Leading officials from the State Council will serve as conveners and hold regular inter-ministerial joint meetings on TCM affairs to deliberate specific policy measures for TCM development and address major issues. We will also clarify the overall planning functions of the national TCM administration authorities, ensuring alignment with central directives and preventing “paralysis at the higher levels.”

　　Second, further strengthen the implementation of policies for the development of traditional Chinese medicine. Accelerate the legislative process of the “Law on Traditional Chinese Medicine,” add chapters and projects on TCM to the 13th Five-Year Plan of the nation, establish a stable fiscal investment policy, and refine incentive policies for TCM services—such as mechanisms for setting and compensating TCM service prices.

　　Third, we must further ensure that the principle of giving equal weight to both traditional Chinese medicine (TCM) and Western medicine is put into practice. This involves establishing the equal status of TCM and Western medicine in terms of ideological awareness, legal standing, academic development, and clinical services. We should respect TCM’s “master-apprentice” model and its approach to cultivating specialized talents through unique skills. We should encourage Western medical practitioners who leave their posts to study TCM, and uphold the principle of mutual learning and complementary strengths between TCM and Western medicine. Additionally, we should appropriately raise the service prices for TCM-related labor-intensive and skill-based medical procedures.

　　Fourth, further promote the comprehensive industrial development of traditional Chinese medicine. Increase investment in scientific research and leverage modern technologies to achieve standardization, informatization, industrialization, and modernization of TCM. Formulate incentive policies to encourage the development of the TCM industry, facilitate the transformation and upgrading of the Chinese medicinal material industry, and advance the development of emerging service industries such as TCM-based health and wellness, healthy aging, and health tourism. Expand the international influence of TCM through multiple channels.

　　Committee Member Huang Jiefu: Using Market Leverage to Regulate Medical Resources

　　Huang Jiefu, Deputy Director of the Education, Science, Culture, Health, and Sports Committee of the National Committee of the Chinese People's Political Consultative Conference and former Deputy Minister of Health, spoke from the perspective of a clinician on healthcare reform. He said, “Healthcare reform is neither ‘reforming medicine’ nor ‘reforming drugs.’ Rather, it’s about reforming the pharmaceutical market—cultivating the pharmaceutical market, accelerating its rapid development, and using the advancement of public health to address the growing health needs of the people.” In addition, he believes that scalpers are a manifestation of structural contradictions in the healthcare system.

　　Shao Yiming, a member of the National Committee of the Chinese People's Political Consultative Conference and director of the Virus and Immunity Laboratory at the Center for Sexually Transmitted Diseases and AIDS Prevention and Control of the Chinese Center for Disease Control and Prevention, told reporters that during the morning session, participants put forward many constructive suggestions on healthcare reform. He was particularly impressed by the remarks made by委员 Huang Jiefu. “Comrade Huang Jiefu previously served as Deputy Minister of Health and has an excellent understanding of the medical and health sector. He pointed out that, at this stage, healthcare reform should not rely on the government alone but rather leverage the market to regulate the allocation of medical resources. A key aspect of healthcare reform is to motivate healthcare workers—something that previous reforms have failed to achieve. In addition, we need to strengthen the management of chronic diseases—not just through treatment, but through prevention—and ensure that all citizens actively participate in building a Healthy China,” said Shao Yiming.

　　Committee Member Zhang Shu: Doctors Should Also Benefit from the Rewards of Scientific and Technological Achievements Transformation.

　　According to Shao Yiming’s recollection, Zhang Shu, a member of the National Committee of the Chinese People's Political Consultative Conference and Director of the Internal Medicine Management Committee at Fuwai Cardiovascular Hospital of the Chinese Academy of Medical Sciences, pointed out in his speech that while the state encourages medical innovation, many doctors are unable to share in the rewards derived from the commercialization of scientific and technological achievements—just as civil servants do. Instead, all such rewards go to the state, and even traveling abroad is subject to restrictions. He argued that doctors working in medical institutions should, like scientists in research institutes, also be able to reap the benefits of the commercialization of scientific and technological innovations. In the United States, over 20% of GDP is generated by medical technology; our country should also move in this direction.

　　Committee Member Wang Hongyang: To break the predicament in pediatrics, we still need to improve pediatricians’ working conditions and benefits.

　　Wang Hongyang, chief physician of the Laboratory for Bio-Signal Transduction at the Third Affiliated Hospital of Shanghai Second Military Medical University and an academician of the Chinese Academy of Engineering, is focusing on finding solutions to the challenges facing pediatrics. Wang Hongyang believes that the root causes behind the growing imbalance between supply and demand in pediatric medical services are multifaceted: First, the channels for training pediatricians are not smooth, and the break in talent cultivation at the source fundamentally affects the pool of pediatric medical professionals. Second, due to policy restrictions and flaws in the evaluation system, many general hospitals either do not have pediatric departments at all or merely offer minimal outpatient services. Third, the demanding nature of pediatricians’ work—high intensity, low pay, and strained doctor-patient relationships—leaves them feeling hopeless and prompts them to leave the profession. Finally, the exodus of pediatricians further exacerbates the shortage of pediatric medical resources, making it increasingly difficult to cope with the growing trend of overutilization of pediatric care—for instance, some parents carry their feverish children to the hospital three times in a single night. Wang Hongyang suggests that resuming undergraduate enrollment can indeed help build a reserve of future pediatricians. However, the fundamental solution to the pediatrician shortage lies in establishing a medical talent development system that is oriented toward industry needs and balances supply and demand. It is also crucial to improve the currently unreasonable compensation and working conditions for pediatric healthcare workers, stabilize the existing workforce, and continuously attract new talent to join the field.

　　Committee Member Chi Hui: Improve the working environment and compensation for medical staff.

　　Chi Hui, Director of the Planning and Development Office at the Chinese Academy of Medical Sciences, suggests improving working conditions and compensation for medical staff, as well as providing support and incentives for researchers in the field of medical science and technology—especially young researchers. Drawing on her own experiences, she expressed uncertainty about the future of the medical profession. She said that her decision to enter medical school was inspired by reading “The Biography of Lin Qiaozhi” during middle school. After having children herself, she also encouraged them to pursue careers in medicine. However, several violent incidents involving attacks on doctors left her feeling deeply confused. Chi Hui specifically mentioned the Harbin incident involving an attack on a doctor. She said that when she first saw the news report, her immediate thought was to call her child and warn him to be careful and avoid any accidents. Now, whenever children who take pride in wearing white coats ask her, “You’ve always said the medical environment would improve—why hasn’t it gotten better after all this time?” Chi Hui admits that she’s at a loss for words.

　　Committee Member Fang Laiying: Promote the "Basic Medical and Health Law"

　　Fang Laiying, Director of the Beijing Municipal Health and Family Planning Commission and Party Secretary, suggested actively advancing the process of drafting the Basic Medical and Health Law to provide legal safeguards for a Healthy China. Fang Laiying stated that in formulating the Basic Medical and Health Law, it is essential to promote reform and innovation within a legally sound framework. Particularly given the highly fragmented nature of China’s health policies—where, for instance, the most important health policy instrument, medical insurance, is managed by the Ministry of Human Resources and Social Security; regular financial appropriations, which best reflect government responsibilities, are handled by the finance department; the education and training of doctors—the most critical human resource—are overseen by the education authorities; major planning and investment projects are determined by the development and reform authorities; and the crucial checkpoints for preventing the importation and spread of foreign infectious diseases fall under the purview of the quality inspection and quarantine authorities—the space for policy maneuverability available to health authorities is actually the narrowest. Meanwhile, China is vast and its socio-economic development is unevenly distributed. Under these circumstances, drafting the Basic Medical and Health Law requires breaking down departmental barriers, emphasizing integrated coordination, and placing particular emphasis on sound decision-making.

　　Committee Member Xia Ning: Enhancing the Service Capacity of County-Level Public Hospitals

　　Xia Ning, Deputy Director of the Health and Family Planning Commission of the Guangxi Zhuang Autonomous Region, suggested enhancing the service capacity of county-level public hospitals to support the advancement of the tiered medical care system. Xia Ning pointed out that county-level public hospitals currently face an overall shortage of resources. First, these hospitals have insufficient bed capacity. Taking Guangxi as an example, in 2015, the number of beds per 1,000 permanent residents in county-level public hospitals across the entire autonomous region was 1.4, below the national standard of 1.80 beds, meaning about 17,300 additional beds are needed. Second, the basic infrastructure of county-level hospitals has yet to meet standardized requirements. From 2009 to 2015, the central government provided support for 161 projects in Guangxi’s county-level hospitals; however, 43 county-level maternal and child health hospitals and 22 county-level traditional Chinese medicine hospitals still lack construction funding. Meanwhile, some newly established or relocated and rebuilt county-level general hospitals also fail to meet the required standards. Therefore, it is recommended to increase investment in county-level hospitals to enhance their service capabilities.

　　Committee Member Lei Jufang: Encourage Innovation in the Independent Pharmaceutical Industry

　　Lei Jufang, Vice Chairperson of the Federation of Industry and Commerce of the Tibet Autonomous Region and Chairman of Tibet Qizheng Tibetan Medicine Co., Ltd., analyzed the opportunities and challenges facing China's independent pharmaceutical industry. Lei Jufang said that in 2015, China's pharmaceutical industry achieved sales revenue of 1,359.1 billion yuan, with a growth rate of 9.1%, while the sales revenue of traditional Chinese medicine reached 345.7 billion yuan, with a growth rate of 5.6%. With a population of 1.3 billion, the healthcare reform aimed at benefiting the general public will undoubtedly bring tremendous development opportunities and room for growth to China's independent pharmaceutical industry—but it also faces certain difficulties. For instance, with regard to China's original classic prescriptions, whether it’s the approval process or secondary innovation, there are numerous hurdles and a long, arduous road ahead, making it simply too burdensome to bear. Moreover, market access does not adequately support innovation. Lei Jufang suggested relaxing the clinical trial exemption requirements for classic prescriptions, especially for OTC products undergoing formulation changes or flavor modifications; and abolishing the requirement for secondary price negotiations on innovative drugs still under patent protection, thereby encouraging innovation and expansion of high-quality, well-known products in the independent pharmaceutical industry.