Rural doctor " People walk in the net and break " Its anxiety: From whose guarantee are villagers healthy from?

Rural doctor " People walk in the net and break " Its anxiety: From whose guarantee are villagers healthy from?
"Medicine of old village has been returned, medicine of young village can not be supplemented in, the rural doctor's team leaves no successor, rural tertiary hygiene serve the intersection of network and threat that bottom face of network. A few years later, why did the people at these seventy years of age carry on the work, the guarantee that who villagers are healthy? " Will it be will it be 3 o'clock afternoon May 6, Li link record, welcome the same day second patient. The patient has bought a box of medicines, costs 3.8 yuan. 69 -year-old Wei Li whether the intersection of Shandong and the intersection of Tai'an and the intersection of city and the intersection of Dongping and the intersection of county and Shahe stand the intersection of town and the the intersection of every village and medicine in record. The reporter sees, his clinic is that a area is only cabin of 30 square meters, the sick bed is two wooden beds which is spreading the straw mat, the desk has accompanied he " old fogey " in decades ,The medical apparatus is clinical thermometer, blood pressure table, stethoscope this " Third one " . Li link record, say because medical the intersection of condition and simple and crude, the intersection of apparatus and the intersection of person who lack and reason, his clinic is poor-performed, monthly income is only 200 many yuan. Under the great background that the government increases the input into clinic hardware facility in the village in recent years, the similar such village clinic is now actually rare. But the fourth hygiene of country serves the census data to reveal, the main source of clinic income in the village is the development of the operational activity, it is very low to subsidize the income proportion, only accounts for 1.5%, 9.6% of the village clinics are accepted and does not support propping up. "Take a long view, at village level clinic poor-performed, go bankrupt even, threaten rural public health, serve directly. " 11 deputy to the National People's Congress, the intersection of Henan Province and the intersection of Kaifeng and the intersection of city and the intersection of Tongxu and the intersection of county and large the intersection of hillock and the intersection of township and doctor of village village WenFang Ma Liu Su Li say frankly to the reporter. And take an overall view of the new medical reform scheme that will be issued in 2009, requirement of three respects of building and managing construction etc. that it has put forward organizational construction, personnel in improving the networking of rural tertiary hygiene, but the recent focal point of work mainly places two aspects of the hospital and health clinics in towns and townships on the county. In other words, the important component, having " bottom of networks " of the service system of the rural hygiene Title at village level for hygiene service organization,consider policy which obtain enough yet. Which kind of influence will this bring to new medical reform? Chen Zhu " Unsatisfied " Compared with Li Wei clinic of one, Ma Wen sweet-smelling clinic can be rated as " luxuriously " . Reporter see various flowers and plants are being planted in little instituting in front of the building in the getting white two light building, present vitality, the first floor is the physical examination room, have been filled with brand-new medical apparatuses such as electrocardiograph, Ultrasonography B machine,etc. inside, second floor spacious neat office, cover with the intersection of Ma Wen and sweet-smelling and state leader, the intersection of Ministry of Public Health and officer, the intersection of Henan and group photo of provincial leader,etc. at the wall. It is reported, this small building is built at the cost of local government, the medical apparatus is the donations of some enterprises. Ma Wen sweet-smelling clinic " Luxurious " ,Overlay because its special identity - -He is the only deputy to the National People's Congress in 900,000 rural doctors at present in China. Require all parts should build standardized clinic while being relevant according to rural the intersection of hygiene and integrated management, allocate the basic medical apparatus, in order to satisfy " the small disease does not go out of the village " Requirement. The reporter surveys and studies and finds, because construction of the clinic and the acquiring and is basically cured oneself to bear by the township of the apparatus, medicine of township often lacks enthusiasm to this. House where some unable medicine of township of building new clinic have to choose to rent villagers, then carry on the simple transformation, some township medicine retires simply, meanwhile, the medical apparatus wears out seriously, what most township medicine used is still the equipment of last century. Its background is a weak old problem of rural hygiene resource. " the statistical communique data of the hygiene will be understood in 2009 " that Ministry of Public Health releases will be pointed out: "The foundation of development of hygiene industry is weak, the total amount of resource distribution of the hygiene does not meet the health care service demand that urban and rural residents increase day by day, especially rural hygiene development owes account too much. The rural per-capita hygiene expenses are fewer than 1/4 of the urbanite (1862 yuan of per person of urbanite in 2008, rural per-capita 455 yuan) . " Chen Zhu, minister of Ministry of Public Health, also claims when national two Conferences gives an interview this spring, " it is still many that I think to owe a debt, especially in the countryside, in the basic unit " ,This makes, he " Unsatisfied " . The government has already made certain efforts to the rural hygiene in recent years. " rural hygiene construction and development plan of service system " that were implemented in 2003 propose building governmental input to the outlying village clinic for the first time, every province has carried on certain construction to the village clinic through self-raised fund of finance at all levels such as the province, city, county. After the implementing scheme of the medical reform will be issued in 2009, the central space is according to the standard (10000 yuan of apparatus among them) of 50,000 yuan for every village clinic ,It is remote to invest 1,250 million yuan again to the Midwest, nationality, border, poor great infectious disease and endemic disease prevail 25000 the intersection of village and clinic of area build apparatus of the house. Among them, it invests 1 billion yuan to all use for building construction the central authorities, the local government forms a complete set 250 million yuan is used for construction of apparatus. Serve the long-term scarce contradiction to the rural basic public health, the country determines to start the service item of 6 items of great public health since 2009, including rural women " Second cancer " (breast cancer, cervical cancer) Checking the project, countryside changes water and changes the project of the lavatory etc.. This year, the country determines to serve the funds standard of people's average annual basic public health from improvement of 15 yuan to 25 yuan. This is a government, to narrowing the disparity between area and crowd in urban and rural areas progressively, promote urban and rural residents to enjoy another important arrangement of equal basic public health service of melting progressively. Another secret worry of the rural hygiene of the gap between generations is that the township cures the team wears out, reserve talents are deficient. Horse heroes have been following father Ma WenFang and practising medicine all the time. He tells reporters, he has already thought of changing one's profession now. Horse heroes say 35 -year-old he marry several years already, but there is not a one's own house so far. "The residence base has all criticized for many years, but there is no money to cover. " So, he and wife has been living in the clinic all the time, has not wanted even child. Horse heroes said, he originally studied the computer, and then in Ma WenFang's " encouraged " Leave and change one's profession and study medicine, and become a helper for father in the clinic. But yuan of incomes let him to be difficult to have savings every month, especially Ma Wen sweet-smelling to elect as behind the deputy to the National People's Congress, because frequently participate in the meeting, survey and study, the business of the clinic declines to an enormous extent, there are less incomes. Horse heroes' brother-in-law has already followed Ma Wen sweet-smellingly and practised medicine for 20 the coming years, but left the clinic two years ago. In the view of horse heroes, the reason is, there are too few incomes, can not " really stand " . Now, the brother-in-law of the hall has incomes of thousands of yuan per month to serve the meal, nearly quite the annual income when it takes up a job as a doctor. Dongping county of Shandong connects medicine of every village of Zhang city of mountain area and meets autumn to tell our publication slowly Reporter, he can have incomes of about 1200 yuan each month, but his monthly income of the wife that the clothing factory works in the village is 1500 yuan, he of the regret of self inductance is always rushing to do house work at home. Slowly? Is �� mended with cramps finely? 6 years old, graduate from the health school of Zibo of Shandong. It has three reasons while taking up a job as a doctor that he says he goes back to the township: Oneself or natives, guard the township and defend the territory of one's country; Second, medicine of township is still respected in the locality; Third, cost more than 30,000 yuan to study medicine, felt and has not done this job waste by oneself. But he says, more than 50 classmates in the class originally, there are few ones that nowadays really went back to the township to practise medicine, selling the health product or entering the crude drugs company in majority. The reporter interviews to find, mostly took over form former generation and began to practise medicine in the 1990s of last century in about 40 years old of medicine of township that nowadays obtained employment, but at present, the future generation of people already fewer person would like to carry on. Ma WenFang is weighed down with anxieties for this. It is to Henan, Shandong, three research which save 100 clinics at village level and 100 rural doctors of Hunan according to him in 2010, the mean age of medicine of township has been already over 63 years old. Henan Province Tongxu county which Ma WenFang belongs to, there are 687 rural doctors in all, have accounted for 87.7% of the total number over 51 among them person, persons under the age of 40 only accounts for 12.3%. Obviously, the contradiction that the township cured the gap between generations of the team has been already prominent. As to this, Deputy Bureau Director of county hospital of Shandong Dongping Ju QingYuan expresses when being interviewed by reporter, for supplementary fresh strength, issue relevant regulation while being local, encourage the intersection of township and offspring of medicine carry on, the responsible institution can give priority to and employ them to be clinic doctors in the village. But take a broad view of the whole country, though the rural doctor is bearing increasingly many basic medical treatment and public health service task, but lack the governmental input for a long time, it is unable to obtain policies such as proper treatment and social security,etc. at the same time, have influenced the enthusiasm of the rural doctor's work and stability of team seriously. The new medical reform " Assault " The more severe one is, defend the healthy rural doctors of hundreds of millions of peasants, is impacted by some new medical reform policies. New rural cooperation medical treatment system (call in the following text and shut newly and agriculturally) that had started, already basically covered the whole country now since 2003 ,Its purport is to relieve peasants " The difficulty and high cost of getting medical treatment " ,Have already reaped certain effect in practice, but cause certain pressure to clinic at village level originally poor-performed. Because rely mainly on comprehensive arrangement for serious disease newly and agriculturally jointly, much areas of the whole country have not included the service that the rural doctor has offered in him and compensated the category. In other words, the new agricultural compensation that offers jointly is directed primarily to the hospitalization cost that the above medical organization at village level happens. So, in order to wipe out the hospitalization cost, peasants often choose to go to the hospital of health clinics in towns and townships, county to seek medical advice. Interview medicine of township and say, new and agricultural after implementing jointly, their income state is surely affected more or less. Even if the clinics at village level of some areas are included in the new agricultural compensation range shut, but submit an expense account the proportion is well below the health clinics in towns and townships, still face patient's running off. In addition, a difference rate policy of medicines that the burden tries hard to recommend that the country diagnoses the illness in order to lighten peasants, also aggravating the management predicament of the village clinic. In that the price markup from medicines of the main income of the village clinic is sold, under lacking the situation that the government compensates, if require that carries out a difference rate of medicines unilaterally in the village clinic, the village clinic loses the living space. However, if the method that the village clinic continues extending medicines and raising the price and selling, then, its price of medicines will be higher than already the health clinics in towns and townships that led carrying out a difference of medicines, this will further cause the cause of disease to flow into the more high-level health organ. Under the background of fact that it is failed to follow up in time, in full amount that much local government finance are subsidized, the clinic at village level has already fallen into a dilemma. The reporter surveys and studies and finds, the village the more convenient to the administrative centers of villages and towns or the closer, traffic of county town, the worse the management state of its clinic of village is. The reason just lies in the patient inclines to choose the health clinics in towns and townships or larger hospital even more, in order to submit an expense account more medical fee. This kind of situation has already caused the concern in the educational circles. " history of rural doctor of China is reviewed " one of the seminar chief leading cadres, Dalian medical university slip by the professor writes articles to point out " with the research of current situation, some areas are after implementing newly and agriculturally jointly, the function of health clinics in towns and townships and county medical organization is strengthened and enlarged; By contrast, the function is weakened in the village clinic, function shrinks. Ma WenFang says, there are less charging items in the village clinic, the expenses standard is very low, the medicines profit is meagre, lead to the fact it is difficult for some village clinics to operate, even already " blank village " of medicine of village has appeared in some villages . He warn this will increase villager, diagnose the illness difficult problem not merely, from observe while being long-term, will also threaten the security of the service network bottom of the rural hygiene. "The guarantee that who villagers are healthy? " In Ma Wen is sweet-smelling seems, he himself is that villagers " live " Health file. This is medicine of township and important reason with value of village clinic in his mind too. Ma WenFang says, the township cures the stable future related to rural hygiene of the team, also very important to peasants' health. He explains, as the basic unit of the tertiary medical site in the countryside, the village clinic can not have replacably function. "Without clinics, a disease go to the home town, go to the county, does this accord with logic? So, the bottom of the network can't be broken. " In February of this year, Chen Zhu, minister of Ministry of Public Health, says when being interviewed by media: "By the look of national conditions in the present stage of our country, the rural doctor's team will serve peasantry for a long time. It is due to them to deepen five key jobs of medical reform, peasantry are due to them. " But the question confronted is, some area financial subsidy funds number is relatively low. Ma WenFang proposes in national two Conferences of this spring the proposal points out, do not generally really conform with the devotion of the rural doctor in public service funds of 60- 120 yuan. WenFang Ma think township medicine future weight should to finish rural public health, serve, prevention and the making a diagnosis and giving treatment of common disease of laying particular emphasis on various diseases, reduce the rural morbidity on one hand, relieve the pressure of the large hospital, save medical resources, on the other hand, the country will put a part in the funds into the public health and serve to compensate to the rural doctor, in order to solve its problem of income. Ma WenFang wrote in his proposal in this spring: "Medicine of old village has been returned, medicine of young village can not be supplemented in, the rural doctor's team leaves no successor, rural tertiary hygiene serve the intersection of network and threat that bottom face of network. A few years later, why did the people at these seventy years of age carry on the work, the guarantee that who villagers are healthy? " Li links one and worries too - -On May 6, Li linked one until came off duty, did not have etc. Come the third patient, he 10.3 in turnover for. Li ShaoFei

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