Yu Zhengsheng Joins Medical and Health Sector Discussion, Focus on Improving Healthcare Workers' Environment

Huang Jiefu stated in an interview with the media on the 4th, “If doctors are no longer willing to practice, how can healthcare reform proceed?”

According to a People's Daily Online report from Beijing on March 5, Yu Zhengsheng, a member of the Standing Committee of the Political Bureau of the CPC Central Committee and Chairman of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), visited and joined discussions with CPPCC members from the medical and health sectors attending the Fourth Session of the 12th National Committee of the CPPCC on March 4.

Wen Jianmin, a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC) and Director of the Department of Orthopedics at Wangjing Hospital of the Chinese Academy of Medical Sciences, revealed that Chairman Yu Zhengsheng listened to the speeches of 13 CPPCC members during the discussion session.CPPCC Member Wen Jianmin: Reform the Compensation System for Medical PersonnelWen Jianmin, a member of the National Committee of the Chinese People's Political Consultative Conference and Director of the Orthopedics Department at Wangjing Hospital of the China Academy of Chinese Medical Sciences, presented his proposal to Chairman Yu Zhengsheng, suggesting that efforts to mobilize the enthusiasm of medical personnel should begin with reforming the compensation system. For a long time, medical staff in public hospitals have been uniformly managed and compensated under the “cadre” classification, which fails to reflect the unique characteristics of the healthcare industry. As a result, overall income levels are low, and compensation is disproportionate to the workload. There is insufficient linkage between remuneration and performance, and base salaries are extremely low. For example, at Wangjing Hospital, where Dr. Wen works, an attending physician who has worked for eight years after obtaining a master’s degree and is currently pursuing a doctoral degree receives a base salary of only RMB 2,100, with bonuses dependent on the revenue generated by their respective department. Departments such as pediatrics, obstetrics, and pathology, despite involving high work intensity, significant pressure, and elevated risks, generate relatively low revenue streams, resulting in meager bonuses, low incomes, and financial strain for staff. This situation has also fostered unethical practices among some medical professionals, such as accepting kickbacks from pharmaceutical companies.

He argues that if a compensation system tailored to the unique characteristics of the healthcare industry is not established, the motivation of medical personnel will not be enhanced, and the goals of healthcare reform will inevitably fail to be achieved. Therefore, he recommends that fiscal investment in healthcare reform should be strategically redirected toward human resources, with a focus on improving the wages and benefits of medical staff. Measures to reform the compensation of public hospital personnel should be introduced as soon as possible, and the Labor Law must be strictly enforced to ensure overtime pay for work performed beyond the standard eight-hour workday. Furthermore, a special allowance system for specific positions within the healthcare sector should be established to attract highly skilled talent into the industry, thereby addressing dilemmas such as the “shortage of pediatricians.” In addition, a non-monetary compensation system should be implemented, including paid leave, insurance coverage, and flexible retirement options.CPPCC Member Yang Jinsheng: Advancing the Development of Traditional Chinese MedicineAlso speaking at the joint group meeting was Yang Jinsheng, a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), Deputy Director of the Central Committee on Medicine and Health of China Zhi Gong Party, and Director of the Center for Exchange and Cooperation in Traditional Chinese Medicine (TCM) with Taiwan, Hong Kong, and Macao under the National Administration of Traditional Chinese Medicine. In his address, he proposed implementing policies and improving mechanisms to promote the healthy development of TCM. His recommendations specifically covered four areas:

First, further strengthen the organizational framework for traditional Chinese medicine (TCM) work. A senior State Council official shall serve as the convener to regularly convene the Inter-Ministerial Joint Conference on National TCM Work, with the aim of studying specific policy measures for TCM development and addressing major issues. Further clarify the coordinating and planning functions of the national TCM administrative authorities, ensuring alignment with central directives to prevent “high-level paralysis.”

Second, further strengthen the implementation of policies for the development of Traditional Chinese Medicine (TCM). Accelerate the legislative process of the TCM Law, add chapters and projects related to TCM in the National 13th Five-Year Plan, establish a stable fiscal investment policy, and improve incentive policies for TCM services, such as the price formation and compensation mechanisms for TCM services.

Third, further implement the policy of placing equal emphasis on Traditional Chinese Medicine (TCM) and Western medicine. Ensure the equal status of TCM and Western medicine in terms of ideological awareness, legal standing, academic development, and clinical services; respect the TCM talent cultivation models of "apprenticeship under masters" and specialization in unique skills; encourage Western medicine practitioners to leave their posts to study TCM; uphold the mutual learning and complementary advantages of TCM and Western medicine; and appropriately increase the service prices for TCM items that reflect labor-intensive technical services.

Fourth, further promote the comprehensive industrialization of Traditional Chinese Medicine (TCM). Increase investment in scientific research and leverage modern technologies to achieve standardization, informatization, industrialization, and modernization of TCM. Formulate incentive policies for the development of the TCM industry, facilitate the transformation and upgrading of the traditional Chinese pharmaceutical industry, and promote the growth of emerging service sectors such as TCM-based wellness and healthcare, healthy aging care, and health tourism. Expand the international influence of TCM through multiple channels.Committee Member Huang Jiefu: Regulating Medical Resources with Market LeversHuang Jiefu, Vice Chairman of the National Committee of the Chinese People’s Political Consultative Conference’s Special Committee on Education, Science, Culture, Public Health and Sports, and former Vice Minister of Health, discussed healthcare reform from the perspective of a clinician. He stated, “Healthcare reform is not about ‘reforming doctors’ or ‘reforming drugs.’ Rather, it is about reforming, nurturing, and accelerating the development of the pharmaceutical and medical services market, thereby addressing the people’s growing health needs through the advancement of healthcare services.” Furthermore, he argued that ticket scalping for hospital appointments is a manifestation of structural contradictions within the healthcare system.

He proposed that, at the current stage, healthcare reform should leverage market mechanisms, rather than relying solely on the government, to regulate the allocation of medical resources. A critical aspect of healthcare reform is to incentivize healthcare professionals, an area where previous reforms fell short. Furthermore, greater emphasis should be placed on chronic disease management, shifting the focus from treatment to prevention, and engaging the entire population in the construction of a Healthy China.Committee Member Zhang Shu: Doctors Should Also Enjoy Returns from the Commercialization of Scientific and Technological AchievementsZhang Shu, a member of the National Committee of the Chinese People’s Political Consultative Conference and Director of the Internal Medicine Management Committee at Fuwai Hospital, Chinese Academy of Medical Sciences, stated in his address that while the state encourages medical innovation, many physicians are unable to share in the rewards of translating scientific and technological achievements into practical applications, unlike research scientists. Instead, they are treated akin to civil servants, with all returns from scientific and technological innovations accruing to the state, and even facing restrictions on international travel. He argued that clinicians should enjoy the same benefits from the commercialization of scientific and technological achievements as researchers at scientific institutes. In the United States, more than 20% of GDP is generated by medical technologies, and China should also develop in this direction.Committee Member Wang Hongyang: Resolving the Pediatric Care Crisis Requires Improving Compensation and Working Conditions for PediatriciansWang Hongyang, an academician of the Chinese Academy of Engineering and chief physician at the Laboratory of Biological Signal Transduction of the Third Affiliated Hospital of Shanghai Second Military Medical University, has focused on resolving the dilemmas in pediatrics. Wang Hongyang believes that the causes of the prominent contradiction between the supply and demand of pediatric medical services are multifaceted: The inadequate training channels for pediatricians have severed the source of talent development, fundamentally affecting the pediatric workforce; policy restrictions and flaws in the evaluation system have led many general hospitals to either not establish pediatric departments or to provide only perfunctory outpatient services; high job requirements, intense workload, low compensation, and severe doctor-patient tensions have left pediatricians feeling hopeless, prompting them to leave the profession; the exodus of pediatricians has further exacerbated the scarcity of pediatric medical resources, making it even more difficult to cope with the increasingly prevalent overutilization of pediatric healthcare services—for instance, some parents bring their feverish children to the hospital three times in a single night. Wang Hongyang suggests that while restoring undergraduate admissions can indeed help reserve a backup force for pediatrics, the fundamental solution to the shortage of pediatricians lies in establishing a supply-demand balance system for medical talent cultivation oriented toward industry needs, improving the unreasonable compensation and treatment for existing pediatric medical staff, stabilizing the current workforce, and continuously attracting new talent.CPPCC Member Chi Hui: Improving the Working Environment and Compensation for Medical and Nursing StaffChi Hui, Director of the Planning and Development Department at the Chinese Academy of Medical Sciences, has recommended improving the working conditions and compensation for healthcare professionals, and supporting and incentivizing the development of researchers in the field of medical science and technology, particularly young scientists. Drawing on her personal experiences, she expressed uncertainty about the future of the medical profession. She stated that her decision to attend medical school was inspired by reading The Biography of Lin Qiaozhi during her middle school years. After having children, she also supported their choice to pursue medicine. However, subsequent violent incidents against healthcare workers left her feeling disheartened and uncertain. Chi specifically referenced the Harbin incident involving violence against a doctor. She said that upon seeing the news report, her immediate instinct was to call her child to issue a warning and prevent any potential harm. Now, when some young people who take pride in wearing the white coat ask her, “You have always said that the environment for doctors would improve; why has there been no significant progress after all this time?” Chi admits that she is at a loss for words.Committee Member Fang Laiying: Advancing the Basic Healthcare and Health Promotion LawFang Laiying, Director and Party Secretary of the Beijing Municipal Health and Family Planning Commission, has recommended actively advancing the legislative process of the Basic Healthcare and Health Promotion Law to provide legal safeguards for the Healthy China initiative. Fang stated that the formulation of the Basic Healthcare and Health Promotion Law should integrate reform and innovation within its legal framework. This is particularly important given the severe fragmentation of China’s health policies. For instance, medical insurance, the most significant policy tool in healthcare, is administered by the human resources and social security departments; recurring financial investments, which best reflect government responsibility, are managed by the finance departments; the education and training of physicians, the most critical human resource element, fall under the purview of the education departments; major planning and investment projects are determined by the development and reform departments; and key checkpoints for preventing the importation and spread of infectious diseases from abroad are overseen by the quality inspection, quarantine, and customs authorities. Consequently, the health department itself has the narrowest policy space. Furthermore, China boasts a vast territory with uneven socioeconomic development. Under these circumstances, the enactment of the Basic Healthcare and Health Promotion Law must break down interdepartmental barriers, making coordinated planning especially vital and decisive policymaking even more critical.Commissioner Xia Ning: Enhancing the Service Capacity of County-Level Public HospitalsXia Ning, Deputy Director of the Health and Family Planning Commission of Guangxi Zhuang Autonomous Region, suggested enhancing the service capacity of county-level public hospitals to facilitate the establishment of a tiered diagnosis and treatment system. Xia noted that there is an overall shortage of resources in county-level public hospitals. First, there is a insufficient number of hospital beds. Taking Guangxi as an example, in 2015, the number of beds per 1,000 residents in county-level public hospitals across the autonomous region was 1.4, falling short of the national requirement of 1.80. Approximately 17,300 additional beds are needed. Second, the infrastructure of county-level hospitals has not met standardized requirements. Between 2009 and 2015, the central government supported 161 county-level hospital projects in Guangxi; however, 43 county-level maternal and child health hospitals and 22 county-level traditional Chinese medicine hospitals still lacked construction projects. Meanwhile, some newly established or relocated and rebuilt county-level general hospitals also failed to meet standardized requirements. It is recommended to increase investment in county-level hospitals to improve their service capacity.CPPCC Member Lei Jufang: Encouraging Independent Innovation in the Pharmaceutical IndustryLei Jufang, Vice Chair of the Tibet Autonomous Region Federation of Industry and Commerce and Chairman of Tibet Cheezheng Tibetan Medicine Co., Ltd., Analyzes Opportunities and Challenges Facing China’s Indigenous Pharmaceutical IndustryLei Jufang stated that in 2015, China’s pharmaceutical industry achieved sales revenue of RMB 1.3591 trillion, with a growth rate of 9.1%, while the traditional Chinese medicine (TCM) patent medicine sector recorded sales revenue of RMB 345.7 billion, with a growth rate of 5.6%. With a population of 1.3 billion, healthcare reforms aimed at benefiting the general public will inevitably create significant opportunities and room for development for China’s indigenous pharmaceutical industry, although certain challenges remain. For instance, classic TCM formulas originally developed in China face numerous regulatory hurdles and a lengthy, burdensome process for both marketing approval and secondary innovation. Market access policies also fail to adequately support innovation. Lei Jufang recommends relaxing clinical trial exemption requirements for the registration of classic TCM formulations, particularly regarding approval requirements for changes in dosage form or flavor for over-the-counter (OTC) products. She also proposes abolishing secondary price negotiations for innovative drugs still under patent protection, thereby encouraging innovation and the expansion of renowned, high-quality products within China’s indigenous pharmaceutical industry.

 Yu Zhengsheng pointed out: “Health is the foundation of people’s happiness and an important indicator of social progress.”According to Xinhua News Agency, at the joint group meeting of members from the medical and health sectors, Yu Zhengsheng, a member of the Standing Committee of the Political Bureau of the CPC Central Committee and Chairman of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), engaged in in-depth discussions and exchanges with attendees. Yu Zhengsheng fully affirmed the significant contributions made by the vast number of medical and health workers, including CPPCC members from the medical and health sectors. He emphasized that health is the foundation of people’s well-being and an important indicator of social progress. It is essential to consistently adhere to the orientation of serving the people’s health, uphold the principles of prioritizing prevention, focusing on rural areas, and placing equal emphasis on traditional Chinese medicine and Western medicine, so as to provide the public with safe, effective, convenient, and affordable public health services and basic medical care. Efforts should be accelerated to reform the medical and health systems, adhering to the goals of ensuring basic coverage, strengthening grassroots services, and establishing robust mechanisms, while implementing coordinated reforms in medical services, health insurance, and pharmaceuticals to effectively address the difficulties and high costs associated with accessing medical care. The medical and health service system should be improved, the universal health insurance system strengthened, supervision of medical quality enhanced, and medical ethics and professional conduct reinforced to foster harmonious doctor-patient relationships. Medical and health workers should be respected, cherished, cared for, and supported, with their enthusiasm and creativity fully mobilized and protected. Yu Zhengsheng expressed his hope that CPPCC members from the medical and health sectors would give full play to their professional expertise, strengthen research and policy deliberations on key issues in the medical and health fields, and make greater contributions to building a Healthy China.

Source: People's Daily Online; Reporter: Zhao Jinghan.