Policy designed to enhance services, provide better training

China's latest policy measures to bolster its national healthcare service system will facilitate the offering of high-quality healthcare services at the grassroots level, help solve problems troubling the public most in the sector, and make services more equitable and accessible, officials and analysts said.

A policy document jointly released by the general offices of the Communist Party of China Central Committee and the State Council in late March highlighted the need to draw on China's experience in fighting COVID-19 to develop a more systematic, consistent, scientific, balanced and efficient medical system.

Key measures include focusing on rural areas and communities to build teams of healthcare workers, narrowing the talent gap between urban and rural areas and encouraging village doctors to take part in more education programs.

Improvements will also be made in public health, intensive care and geriatrics training, the document said, adding that general practitioners, pediatricians and respiratory physicians will also receive more training.

To strengthen national public healthcare, more work will be done to refine the monitoring and early warning system of diseases to ensure that major epidemics are discovered as early as possible.

An official with the National Health Commission said in a statement after the release of the document that the priorities of the policy measures are to boost healthcare resources by training more talented individuals and enhancing the quality of services at the grassroots level.

They said that bolstering the national healthcare network remains a key task at the rural and community levels, and that the government will devote greater effort to training, as workers are in short supply in these areas.

Bolstering hospitals

The latest policy document also stressed the need to boost the development of county-level hospitals. Steps should be taken to improve their ability to treat and diagnose major diseases, including tumors and cardiovascular and cerebrovascular diseases.

Another key measure is employing multiple ways of encouraging top-tier hospitals to support the development of county-level hospitals by pairing off through assistance programs.

China has a three-tier system for ranking hospitals, with third-tier hospitals, which have the largest number of beds and provide comprehensive medical services, at the top of the system. Most county-level hospitals are second-tier, while most grassroots-level hospitals are first-tier.

Statistics provided by the commission show that there were 977,790 grassroots healthcare institutions and 36,570 hospitals at the end of 2021. According to the commission, 87.7 percent of county hospitals — or a total of 17,924 institutions — were effectively equivalent to second-tier hospitals or higher by the end of 2022.

Wu Yaobao, president of the People's Hospital in Wulian county, Shandong province, said that county-level hospitals are key providers of healthcare services.

"Only with the development of county-level hospitals can we ensure the general public enjoys fair, reasonably priced and quality medical care," he said.

It is important that county-level hospitals give greater priority to improving the quality of healthcare services, and make parallel efforts to boost their level of management and improve their ability to treat tumors and rare diseases, he said.

However, many county-level hospitals face challenges, including hiring workers, he said, adding that the most significant aspect of the new policy document is that it will deliver more realistic benefits to the general public.

The development of departments for emergency rescue, gynecology, intensive care and infectious diseases at county hospitals will enable the early prevention, discovery and treatment of disease. By enabling patients to receive this kind of healthcare at county hospitals, where they are better covered by health insurance, heavy expenditure can be avoided, which is also helpful in preventing the recurrence of poverty, he added.

The rollout of the policy will encourage the more reasonable allocation of medical resources, as well as the modernization of medical services so that county residents will not have to travel elsewhere to access better healthcare, Wu said.

Family doctor focus

Another key focus of the document is to refine the development of the family doctor system, a key focus of healthcare reform over the past decade.

China will rely on grassroots healthcare institutions as the main means of offering consistent family doctor services in public health, basic care and health management and general practitioners at second- and third-tier hospitals will be encouraged to provide family doctor services at grassroots institutions, the document stated.

According to the National Health Commission, China can count on 430,000 teams of family doctors to offer basic healthcare services in communities.

Meng Qingyue, executive director with the China Center for Health Development Studies at Peking University, said that family doctors have prioritized service to patients with chronic diseases, pregnant women, children and seniors.

However, he pointed out that there are still problems such as the lack of general practitioners, the lack of coverage in services and the low level of acceptance by the general public of the family doctor system.

The document stresses the need to encourage general practitioners from second and third-tier hospitals to join the ranks of family doctors, a move that will boost the attractiveness of the system, he said.

Measures that encourage families to pay their fees for family doctors based on the number of patients they have, and that offer families a variety of medical insurance policies, will also serve as a pillar for the development of the family doctor system, he added.

Improving consistency

Meng said another highlight of the policy document lies in the fact that it lays out steps to promote stronger integration between healthcare institutions and public health departments.

"An effective response to health-related issues requires the healthcare system to offer the general public consistent, all-round service that covers both treatment and disease prevention," he explained.

Meng added that the fight against COVID-19 has demonstrated the importance of integration between disease prevention and treatment, and more work must be done to raise the level of awareness among health workers in this regard, and to enable greater collaboration between healthcare institutions and public health agencies.

According to the National Bureau of Statistics, 19.8 percent of the population was 60 or older at the end of last year, and the population fell for the first time in six decades, heralding a period of negative growth.

To cope with China's increasingly aging society, more work must be done to integrate the healthcare system with the elderly care sector to offer all-round service to senior residents, Meng said.

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