by Michael Woodhead
Doctor's income must not be linked to sales of drugs or other profit-linked activities such as the numbers of tests done or patients seen, the National Health and Family Planning Commission has decreed.
Under the new health reforms for county-level hospitals, any bonus schemes for doctors must be 'scientific' and related to appropriate performance measures such as efficiency and patient satisfaction, the NHFPC has decreed.
It is forbidden for hospitals to set up schemes in which doctors are given quotas or rewards for use of drugs, tests or patients treated, and appraisal must be based on public good and work efficiency.
The rules apply to country-level hospitals, and are an extension of the reforms that were initiated in a trial basis in a 311 hospitals, now extended to more than 1000 hospitals. From now on, county hospitals that serve populations of more than 30,000 people will be graded as second level hospitals.
The new proclamation "Concerning the reform of County Level Hospitals" is made on behalf of the NHFPC in conjunction with the Ministry of Finance, Ministry of Social Security and the State Council.
The aim of the new rules is to break the dependence of hospitals on income from drug sales, the so-called "drug dependence" system. The aim is to establish a new and sustainable model of hospital funding.
The new 'white paper' also contains new guidelines for hospital drug purchasing mechanisms: country level hospitals will now be expected to rely on the provincial level purchasing systems for the drug supplies. Quality will take precedence over price in purchasing, but prices are still expected to be reasonable and fair, based on tendering systems. Suppliers will be expected to guarantee drug supply and will manage logistics, to cut out the 'middleman' wholesalers role in drug delivery to hospitals.