House of Representatives focus on public hospital reform Big Hospital out of famous doctors more doctor

-Evening News reporter He Tianbao trainee reporter Zhu Mongxue report to the big hospital, registered pay queue long, visiting time is short, see experts difficult, hospitalization difficult, waiting for long operation time, medical examination appointment time is also long ...　　People complain, society blames, and medical staff are depressed, and the deans of public hospitals in the storm vortex have something to say. Yesterday, sponsored by this newspaper, the third "Shanghai famous Hospital President Forum" held in Shanghai Asian Dragon International Plaza. Shanghai Health Bureau Director Jianguang, Baoshan District Health bureau Secretary Li Shihua, Yangpu District Health Bureau Director Kingelin, Luwan Health Bureau Director Chao Dandan, Yan Chai Hospital Dean Fan Guanlong, Huashan hospital Dean Qiang, Ruijin Hospital deputy Dean Jiang Changbin, Xinhua Hospital Deputy Dean Tangen, the city Centers for Disease Control and Prevention, Secretary Fuschen,　　City Medical Emergency Center director Zhaohuaqiang more than 20 guests gathered, focus on public hospital reform, on how to ease the "difficult to see a doctor" problem. Hospital Deans Sigh: Shanghai's public health service and level has been in the developed countries, the level of the medical technology is basically in line with the developed countries, but the public hospital faced with debt management, lack of development stamina, doctors seriously overloaded work and so on.　　The next reform is very difficult, needs the support of the whole society, but no matter how difficult the reform, public hospitals not only to the famous doctors, but also to the doctor, in the humanities and ethical and moral high demand. Listening to the Dean pour "bitter" medical staff why collective Aphasia public hospital reform is imminent, this is the president of the big hospital unanimous words.　　But the key players and participants in the reform, the medical staff are collectively aphasia. "Peking University Hospital died in Peking University professor", "Nanjing Doctor Internet Delay disease child vitality" ... These extreme cases expose a very small number of health care professionals low professional quality, the status of the loss of professional ethics.　　But at present more daily situation is, the medical staff is "pushed" to the public opinion of the cusp, bear the patient because of medical treatment difficult, expensive to see a doctor of all anger and dissatisfaction. "The problem today is the group aphasia of medical personnel. Luwan District Health Bureau Secretary Chao Dandan said. He suggested that the social environment and policy environment of the hospital should be clearly understood. If the dean of a certain hospital is not good, take the Dean off the line.　　If a single hospital is criticized as a hospital problem, and now the problem is that if most hospitals are accused by the people, is considered "problematic", which means that the overall health care policy design has been a number of problems, need to be adjusted. Chai, 539 days a year. Yan Chai Hospital Dean Fan Guanlong said that the current disorder of medical order in Shanghai, the disorder of patients to visit the medical resources are busy and leisure. People of all sizes to the big hospital, three hospitals and some of the medical staff of the two hospitals have been overworked. According to the Shanghai Health Economics Association Statistics, last year, the medical staff of Yan Chai Hospital overtime, a year's workload has reached 539 days. More "Amazing" is that, in the busy to the extreme, the first half of this year, the workload of health care workers is still increasing. According to statistic data of Shanghai Kang Hospital Management Center, Shanghai cityHospital outpatient volume has already exceed more than 100 million people, this January-September, the city-level hospital outpatient volume continued to increase 16.86%, the number of surgical patients increased by 18.53%.　　Such "soaring" "in short supply" situation if the continuation of the quality of medical services can not really be guaranteed. About 30% of the public hospitals operating in debt Fan Guanlong also revealed that at least 30% of the public hospitals are operating in debt. This statement by the Shanghai Municipal Health Bureau director Jianguang approval. Jianguang said, now many public hospitals are operating at a loss, 2007-year loss of 200 million yuan, 2008-year loss of 350 million yuan. There is a price system distortion problem, "to the hospital massage a course of 5 times only more than 10 yuan, now is to squeeze a foot outside to 60 yuan Ah!"　　A dean, who declined to be named, regrets. Fan Guanlong that, at present, open a heart surgery needs 10 people for one person service, only 3000 yuan operation fee is unreasonable. And the increase in the drug rate is also determined by the Government, the abolition of the current government to make up the funds are not in place. If the government does not make up, public hospitals can only operate in debt. Since 07, hospital drug prices have been reduced, so far the Yan-Chai Hospital has lost 17% of the increase rate, a year at least 80 million loss.　　At present, this account is paid by the hospital, more than 30% of the public hospitals in Shanghai are now facing a loss of operation, if this situation continues to develop, how can the hospital better serve the people? Reform goes into the throes why do people have complaints? Jianguang said that in retrospect, China's health care development is very fast, and Shanghai's public health is no less than the United States. Shanghai's "three major health indicators" (per capita life expectancy, maternal mortality, infant mortality) are now in the world developed countries and regions of the middle level. The cost of generating these benefits is different, and the U.S. investment in health care accounts for about 14% of GDP, compared with less than 3% in Shanghai.　　Taking into account the vast population of Shanghai, our public health management level has actually surpassed many developed countries in the world. Public health is doing so well, why do people still grumble? Jianguang Analysis Way, this is because the common people and the public medical system most direct contact in the doctor process, its most direct feeling is "I see a doctor is not convenient."　　Today's "difficult to see a doctor" problem has undermined the patient's immediate feelings, resulting in a lot of discontent is inevitable. Medical is a world problem. "Medical care is a worldwide problem," the president said. "If you go to some countries to see a disease in public hospitals, you can feel it." A dean revealed that his best friend had appendicitis in a foreign country, waiting in line for surgery until it was perforated. Another director revealed that one of his friends in the United States brain has a glioma, diameter 3 cm, should be immediately removed surgery, but foreign doctors said it takes 2 months to turn to surgery. Foreign doctors recommended him to go home to Shanghai Huashan Hospital. After two weeks, the man returned to the United States, and the foreign doctors were surprised by the "the knife is so good", a total of only 50,000 yuan of surgery costsAnd the total cost of the special ward, also surprised foreign doctors.　　In the United States, it takes at least 80,000 dollars to move one of these operations. The public should have an objective evaluation of health industry, especially in Shanghai. "There are problems, there are achievements, there are problems, which are the problems of our medical staff, and some of them are policy issues."　　"The Dean said, should not be sweeping, when it comes to the domestic public hospital shook his head, as soon as foreign countries, the advantages of each country together into a set of perfect medical system." "We should look at the problem according to the law of scientific hygiene, and don't take tomorrow's reform goal as today's request." "Chao Dandan said. He cautioned that the institutional barriers or policy barriers created by the institutional and fragmented management system would make reform difficult. "But I believe that public hospital reform will certainly change well."　　"Huashan Hospital Dean Qiang that no matter how difficult the reform, public hospitals not only to the famous doctors, but also to doctor, in the humanities and ethical and moral high demand."　　The government has increased its investment in "rice-pot" rather than "black hole", Jianguang points out, the general idea of this round of public hospital reform is to promote the comprehensive reform of Shanghai public hospitals, focusing on the four core of "reforming the system mechanism, adjusting service system, strengthening internal management and playing basic foundation". Among them, the first task is to reform the institutional mechanism.　　The two mechanisms are most critical: first, a reasonable input compensation mechanism to ensure the normal operation of public hospitals, so that public hospitals "have rice pot" to eliminate the motivation of profit; the second is to effectively operate a regulatory mechanism to standardize the behaviour of public hospitals so that public hospitals do not become "input black holes" and ensure quality and safety.　　On the compensation mechanism, there are three measures: first, to increase the government's investment in health care, and to increase the proportion of public hospital income (ie, "investment Party"). Second, to straighten out the price system, the inspection and inspection items easy to induce consumption to reduce the standard of fees, the service services to significantly improve the fee standards for different levels of medical institutions to open a wide range of fees, reflecting the value of technology and labor. Through "The government input and the service price increases one point, the medicine price drops one cent", the reform "takes the Physic medicine" the unreasonable compensatory mechanism.　　After deducting the financial subsidy, the medical service price is approved on the basis of cost accounting, and is adjusted with the social price level and the development of medical technology. Third, reform the payment mechanism and explore the implementation of the total medical insurance prepaid system. With regard to regulatory mechanisms, one must establish an efficient and effective regulatory mechanism for medical institutions, specific measures include: first, the establishment of a public welfare as the core, patient-centric, medical quality and safety as the premise of the comprehensive evaluation system, not only to call on the government to increase investment, but also to ensure that all its income should be used for commonweal purposes. The second is to launch trade associations, social independent third parties, the media, the public and many other forces, comprehensive use of legal, administrative, economic, public opinion of a variety of means to participate in the supervision of public hospitals, and constantly encourage and restrain publicHospitals turn external pressure into development power. The third is to strengthen the industry law enforcement supervision, improve the medical institutions and medical personnel "one family, one file" and "one person one file" practice record.　　In addition, information sharing is used to reduce the wastage of medical resources. "Doctors ' income should not be lower than that of teachers" Chao Dandan, Director of Health Bureau, said that the income of medical staff should have a reasonable definition. Chao Dandan said, there are two ways to send money: one is no matter whether the hospital has money, first spent to say; there is a hospital even if the money, I do not spend, in short, medical staff pay full view of the Dean's philosophy. "Doctors pay less than teachers around the world," he said. Chao Dandan said that the reason is that the degree of risk, doctors than teachers, on labor intensity, doctors than teachers. He added that in industries such as doctors and lawyers, which require a long period of professional study and a short time to produce effective work, the world's practice is to pay a high salary at work to compensate for learning.