Wednesday, 27 February 2013

Retired doctors urged to work in rural areas

by Laurie Burkitt
China is encouraging doctors to come out of retirement and work in rural areas as part of an effort to tackle a health-care disparity between wealthy cities and the much poorer countryside.
The move is one of a number of initiatives outlined by China's health minister to revamp a health-care system that reinforces the social inequalities now threatening the country's economic growth and stability. China offers progressive medical facilities in large cities such as Beijing and Shanghai, for those who can afford it, but still struggles to provide basic care to large portions of the rural population.
Many medical professionals prefer living in cities, fueling the disparity. On Tuesday, Health Minister Chen Zhu said the ministry is boosting incentives, such as free education, to entice physicians to work in less developed regions.
The ministry is also rolling out a new examination system that will lower the standards required for doctors who aim to work in villages, Dr. Chen said at a briefing with representatives of the World Health Organization on China's health-care reform. Retired doctors from large public hospitals will be invited to return to work in primary-care facilities around the nation, he said. He didn't outline specific details for the new examination system or the programs for retired physicians.
Doctors working in public hospitals follow the national retirement regulations, with men retiring at 60 and women at 55. Private hospitals can hire or retain doctors beyond those age limits.
Health officials will also increase efforts to create more county hospitals and primary health facilities in the countryside to take the strain off large urban hospitals, Dr. Chen said. "This is a critical year" for health reform, he said, adding that there is now more expectation among the general public for better health care.
The world's most populous country is in the midst of one of the largest health-care overhauls the world has ever seen. China has spent $125 billion in recent years to extend public health-insurance coverage to 95% of the population.
The yawning gap between the country's rich and the poor, most obviously between its city and rural dwellers, is an issue facing China's new government that takes power in March at a meeting of the National People's Congress. The median household income of city residents was 28,000 yuan, or roughly $4,500, in 2010, nearly triple that of rural counterparts, according to China's Southwestern University of Finance and Economics.
The rift threatens to unhinge the country's growth and ignite social unrest. And it is widely playing out in the country's health system.
Health officials announced years ago plans to expand hospital networks across China, but village and rural dwellers are still traveling often thousands of miles across the country to city hospitals where they seek treatment when treatment back home either isn't available or isn't up to par with city standards
The result has been overcrowded city hospitals, where the sick spend days, even weeks, waiting for appointments in overflowing waiting rooms.
China's central and western regions remain the country's largest weak spots, said Wang Jin, a partner in consultant firm McKinsey's health-care group in China. "There has been recent investment in those areas and other rural areas, but historically there has been such a deep gap there that the government is still catching up," Ms. Wang said.
While much of the emphasis has been on improving the quantity of hospitals and doctors in rural areas, future leaders will be tasked with a need to improve the quality of care, Ms. Wang said, noting that many rural doctors' skill sets limit their ability to operate on patients and treat certain diseases.
Health officials are also aiming to improve the reimbursement rate for rural families dealing with critical and catastrophic illnesses, Dr. Chen said, adding that the country's national insurance has reimbursement rates of around 70% for rural citizens, but the other 30% is often a huge burden.
Dr. Chen also said that it is expanding sales within counties of pharmaceuticals on China's essential drug list, a list of Western and traditional drugs that cover diseases such as cancer and that are subsidized by provincial governments.
Source: WSJ

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