Thursday, 9 April 2015

Military hospitals in China: unaccountable and a law to themselves

by Michael Woodhead
It comes as a surprise to many visitors to China to discover that the swish medical facility in the middle of town is called something like the People's Liberation Army 301 Hospital. 

Military hospitals are a major feature of China's healthcare system - most cities have a major hospital run by the military, whether it be the army, navy or airforce. But don't expect to see them staffed by China's answer to Hawkeye or Major Burns. They are, for all intents and purposes, little different to other hospitals in appearance. No uniforms in evidence, they seem to be just state-owned profit-driven operations, like any other Chinese hospital.

However, according to an article by Zhao Han in Caixin this week, the military hospitals are a law unto themselves. The reporter relates the case of a bogus doctor working in Beijing who stole the identity of a real Shanghai doctor. When the Shanghai doctor discovered this, she demanded that the fake doctor return her identity documents and records. However, when reporters made further inquiries, they hit a brick wall of military secrecy because the fake doctor had been working at a clinic affiliated with the military PLA 466 Hospital.

When the matter was taken up with the authorities, they also got short shrift from the army hospital:

"The health bureau that oversees medical facilities in Haidian District, where Beijing No. 466 Hospital is located, said it does not have the authority to supervise military-affiliated hospitals.
Calls to the health division of the People's Liberation Army's General Logistics Department were not answered," Caixin reports.

This case illustrates a common observation about military hospitals in China - they are effectively beyond the control of the health department. What this means for China's health reforms - and the supposed development of private hospitals in the country - remains to be seen.How will the military react to the unpopular proposals to deregulate hospitals and reduce  profit-linked overservicing practices? Will they also support the move to primary care by allowing doctors to work in the community and accepting new referral networks (and thus losing revenue?) I doubt it.

And as we have recently seen with illegal organ transplantation, the military hospitals network is also protected from action against unethical practices. How the military hospitals are treated will be a true test of whether Xi Jinping is serious about health reforms and rule of law in China.

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