Thecover.cn:
In recent years, the facilities and working environment of community medical institutions have greatly improved, but the lack of professionals is still a severe handicap for them. What measures have been taken during the 13th Five-Year Plan period to improve the situation? How effective have the measures been? Thank you.
Yu Xuejun:
Thank you for your question. Qualified medical professionals are the foundation for building a healthy China and an important guarantee for better community services. During the 13th Five-Year Plan period, the NHC took a variety of robust measures to improve the number and competence of medical professionals working at the community level. I would like to inform you of the work done in several areas.
First, we have trained medical professionals for community medical institutions through our medical education system, which is comprised of college education, post-graduation education and continuing education. We have established a unified national system to standardize the training of resident doctors. The purpose is to cultivate qualified clinicians under the same standards, and the system has helped train a large number of medical college graduates who have gone to work at township health centers in central and western China as agreed before. We have also taken a series of measures to guide the flow of medical professionals, including ones to pair up urban and rural medical institutions for the former to support the latter, to encourage college graduates to work at community medical institutions, to require urban doctors to work at community institutions before getting a promotion, and to send 10,000 doctors to support rural health projects. In recent years, the proportion of medical professionals holding intermediate and senior professional titles at community institutions has continued to increase, and the structure has been further optimized.
Second, we have encouraged registered doctors to work for multiple medical institutions so that medical professionals can provide health care services at the community level. During the 13th Five-Year Plan period, we established a regional registration system for doctors. We revised and issued the Administrative Measures for the Registration of Practicing Medical Doctors, which changes "place of practice to "provincial and county-level administrative division of the location of the medical, prevention or health care institution where a medical practitioner practices. After registering, doctors can work for multiple medical institutions within the registered provincial and county-level administrative regions. They only need to register at their main working institution and then file the records if they practice medicine in other places. At present, there are 260,000 doctors practicing in multiple institutions across the country, effectively alleviating the shortage of medical personnel in community-level medical institutions and private hospitals.
Third, we have increased training for doctors to bring professionals to community-level institutions. We have issued guidance to promote the coordinated reform of the national doctor training and incentive mechanism, and conducted research and formulated outlines for the training of general practitioners in job transfers. Beneficial policies were introduced to support doctors to participate in the general practitioner job transfer training program. Trainees from poverty-stricken areas, ethnic minority areas, and old revolutionary base areas will be given priority in hiring under the same conditions. During the training period, the pay package for trainees is guaranteed. After passing the training examination, their scope of practice as a general practitioner will be expanded. At present, 180,000 people have taken part in the general practitioner job transfer training. The number of general practitioners per 10,000 people has increased from 1.38 in 2015 to 2.61 this year.
Fourth, we have improved the competence of community-level professionals through special training. Since 2018, we have implemented competence improvement training projects for physicians, nurses, management staff, and village doctors working in township hospitals and community health service centers to help them hone their skills. As of 2020, the central government has invested a total of 1.02 billion yuan into the training of more than 500,000 health workers at the community level.
At present, the total amount of high-quality medical resources in China is insufficient, and the distribution of medical resources between urban and rural areas is still uneven. In particular, we still face a shortage of professionals. In the future, we must continue to boost the talent pool and enable medical professionals to better provide health care services for people. Thank you.
