Wednesday, 13 February 2013

Petitioning still plays a role in hospital complaints in China

by Zhang Qian,  School of Public Health, Fudan University, Shanghai
The Letters and Visit (petition) system is a channel for people to express grievances and seek justice, which also applies to hospital complaints.
There is a department for Letters and Visits (LV) in any government at or above the county level, and an Letters and Visits office in any relevant department of the government. Individuals and organizations make comments or lodge complaints to departments and offices of LV at all levels.
The idea of Letters and Visits comes from Mao’s Mass Line directly, but it also root-ed in the tradition “Gao Yuzhuang (to accuse someone before the emperor)” with a history of more than 2,000 years.
People use the Letters and Visits System  driven by the simple trust in governments, especially governments at higher levels, with the hope that leaders will re-turn justice to the people once they learned about their suffering, or simply because there is nowhere else to accept their complaints.
The government values Letters and Visits system more by new regulations and lifting the position of Letters and Visits office. But it’s not the only grievance redressal channel established formally in hospital complaints. There are at least other two out of the hospitals to deal with hospital complaints, which are held by People's Mediation Committee or the legal court. But the Letters and Visits system is still important to people: In Shanghai, about 70% of cases accepted by Letters and Visits in health administration department are related to hospital complaints. We conducted research to find out how Letters and Visits system works in hospital complaints, its advantages and limits, and to explore whether it fits users’ expectation.
We found there were 9,000 complaints at the Letters and Visits office at one city hospital every year. Generally all complaints are accepted. No matter governments of which level the complainant presents to, the case is transmitted to the Letters and Visits office of the government at the corresponding level.
Type I complaints were cases expressing patients’ grievances are transferred to hospital owners. Type II cases were reporting hospitals’ illegal activities are transferred to other departments of BoH according to their statutory functions and duties.
Type I cases were transferred to hospital owners, Type II cases were referred to other departments of the hospital according to their statutory functions and duties.
Investigation were made into important complaints (300-400 per year in Shanghai), which are typical or transmitted from higher level governments.  There is no mechanism for Letters and Visits office to track most case after they are transferred. A report to Letters and Visits office is only necessary for important complaints. The Letters and Visits office can urge a better solution, but it rarely happens. Occasionally the departments or institutions to which complaint cases are referred to do not perform their duties, The Letters and Visits office is meant to report this to the leader of BoH if it occurs.
The Letters and Visits office’s initial response when the case is transferred, is usually within 3-5 days after acceptance.
The report about the results by who handles the case, is generally with 30-60 days.
We conclude that the Letters and Visits system can work as a fallback channel in hospital complaints. It receives complaints through multiple con-tact methods, and transfers to appropriate departments or institutions and plays a coordinating role .
But the Letters and Visits system may not ensure the justice people expected: It works within health system, depends on other channels in handling, and is non-procedural.

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