One Country, Two Health Systems: or how Hong Kong has a socialist health system while China has a capitalist one

by Michael Woodhead
It is seldom remarked, but capitalist Hong Kong has a socialist health system while 'communist' China has a capitalist one. 
Hong Kong has a British NHS-inspired publicly-funded health service that remains efficient, good value for money and corruption free. China, on the other hand, has ditched its Soviet-era state-run 'health for the masses' system and replaced it with a state-owned user-pays system that is run on private lines. Don't take my word for it - there is an excellent article illustrating this in the obscure medical journal the International Journal of Radiation Oncology. It makes an interesting comparison of the Hong Kong and Chinese health systems through the eyes of oncologists who work in a cross-border co-operation clinic in Shenzhen.

Health systems
The oncologists note that Hong Kong's health system is based on heavily-subsidised public hospitals that provide treatment at no cost or only minor cost to all Hong Kong residents. It is an efficient system that accounts for only a modest 5.2% of GDP (compared to around 9% for many western  countries and 17% for the US). The Hong Kong public health system is perhaps a little too successful for some interest groups, as it means there is a very low uptake (27%) of private health insurance.
In contrast, China has a capitalist health system (where “money follows the patient') that is struggling to meet the needs of many citizens. Although China has a high rate of health insurance (often funded by employers), this does not cover expensive drugs or medical treatments. There is no safety net system provided by the state, and medical bills are a major burden, especially for low-income families. Initial consultation charges are a modest $2-3, but all Chinese hospitals have to be financial sustainable and thus doctors are encouraged to prescribe expensive drugs, order tests and even promote nutritional products, none of which may be justified by the patient's condition. As the oncologists say with some understatement: "there are serious concerns about the cost effectiveness and quality of services." 

Disease trends
In terms of cancer, Hong Kong and China are also poles apart. Due to preventive health and better treatment programs, cancer rates have decreased by 22% in Hong Kong in the last 25 years and cancer death rates have decreased by 29%. In China, however, rates of cancer have increased dramatically in the last decade as Chinese people have become wealthier and adopted unhealthy lifestyles and persist in smoking. In Shenzhen, cancer rates increased  from 37 per 100,000 people to 100 per 100,000 in the last 10 years. Many of the common cancers could have been prevented through screening and early detection- such as cervical cancer in women, rates of which have been decreasing in Hong Kong. Hepatitis B vaccination is another intervention that should reduce liver cancer rates. 

Doctor training
For oncologist training, Hong Kong follows the UK system of requiring several years postgraduate training regulated by peer group 'colleges' during which clinicians must demonstrate practical expertise in medical oncology, radiation oncology and palliative care, rather than being single branch specialists. Thus patients are treated by a team of oncologists in a 'one stop shop' model. In China there is no formal training program for oncologists, most specialise in one branch of oncology by doing written exams and there is no palliative care training. In China the work of oncologists is governed by 'standard operating procedures' in which the emphasis is on compliance rather than quality or outcomes. 

Access to treatment
When it comes to treatment, cancer patients in Hong Kong have access via public hospitals to the latest technology such as linear accelerators, at modest cost (US10 per attendance). Access is based on clinical need, not financial status or connections. Thus a full course of radiotherapy would be about $400 for a public patient, whereas it would cost $36,000 for a private patient. Across the border in Shenzhen, access to the latest radiotherapy equipment is - in the words of the authors - "appalling". There are only a handful of poor-quality liner accelerators and they are scattered across various hospitals - most patients and doctors do not know how to access them, and even those who do are often reluctant to use them because of fears about toxicity, not to mention the high cost. Shenzhen needs at least 16 such machines (Hong Kong has 37) but hospitals find it extremely difficult to buy such major items because of red tape from the Ministry of Health and the inflated costs of middlemen and the 'commissions' needed to import high-tech equipment into China. 

Drugs - if you can afford them
Access to chemotherapy drugs also differs markedly between Hong Kong and China. In Hong Kong, drugs are approved for use if they can be shown to be cost effective. Regulators model their the drug approval processes on those of western countries.
Patients pay US $13 per oncologist consultation and US $1.30 per drug prescribed. Some high cost drugs are not publicly funded but some costs may be covered by the public safety net or by charities.
In China, many chemotherapy drugs are not available or are long delayed in gaining approval from the China FDA. Drugs that are approved are available on a user-pays basis and can be very expensive. Pemetrexed, for example, costs US $1155 for the genuine drug in Shenzhen although a Chinese generic version is available for US $353. However, the quality of generic drugs is often poor. There are no programs for low income patients. 

Opium wars left their mark?
For palliative care, Hong Kong has developed an integrated  multidisciplinary system based in public hospitals and with hospices. In China, palliative care services are limited or non-existent. There are no palliative care specialists, and so treatment is provided - if at all - by anaesthetists. Pain relief is hampered by draconian regulations over the use of opioids. Most doctors are not allowed to prescribe them, and those who are authorised can only provide a week's supply. Many terminally-ill cancer patients are too weak to return to the hospital every week. This means that cancer pain is under-treated in China.

Looking to the future, on the positive side, health services in China are now evolving rapidly and there is a huge demand for good-quality clinical services. The authors say their Hong Kong-Shenzhen hospital has been operating for only a year but is already providing valuable lessons and experience. It has established a strict 'no-bribery' rule and has also become the first hospital in China to gain international certification for quality of management.

[Editor's note: This story is based on an article by Drs Anne Lee, Henry Sze, Lam Ka-On and Chen Xian of the Clinical Oncology Center, University of Hong Kong – Shenzhen Hospital.]

What's in the budget for health? Highlights from China's NPC budget announcements

by Michael Woodhead
Unlike political parties in the west, China's ruling Communist Party does not have to publish an election manifesto with budget commitments or account for where it has allocated its budget spending. However, following the recent National People's Congress meeting in Beijing, the Party has released some 'budget statements'. They're pretty vague and there isn't anyone or any agency to check on the figures, but this is what they had to say about health:

The background:

1. Spending on medical and health care last year amounted to 259 billion yuan, 99.4% of the budgeted figure and a 26.4% increase.

2. We raised government subsidies for the new rural cooperative medical care system and basic medical insurance for nonworking urban residents to 280 yuan per person per year.

3. Most provincial-level administrative areas unveiled plans to introduce serious illness insurance for their rural and nonworking urban residents.

4. We increased the standard of funding for basic public health services to 30 yuan per person per year, and continued to support major public health service projects.

5. We made steady progress in the pilot reform of county-level public hospitals and the comprehensive reform of community medical and health care centers, and launched a pilot program for posting general practitioners in such institutions.

6. We moved ahead with developing a system for providing assistance in dealing with medical emergencies.

What's next?

- First, we must facilitate the reform of the medical and health care systems. In line with the requirements for each year's work set forth in the plan for deepening the reform of the medical and health care systems during the Twelfth Five-Year Plan period, we will increase government subsidies for the new rural cooperative medical care system and basic medical insurance for nonworking urban residents from 280 yuan to 320 yuan per person per year and accordingly increase the annual individual contribution from 70 to 90 yuan per person.

- We will more quickly push ahead the work of insuring rural and nonworking urban residents against serious illnesses to further reduce their burden of medical expenses.

- We will increase input in medical assistance in urban and rural areas, expand access to such assistance, and provide assistance to those suffering from serious mental illness.

- We will increase financial input in public health, continue to implement basic and major public health services projects, and raise annual per capita spending on basic public health services to 35 yuan.

- We will continue with the trials on comprehensive reform in county-level public hospitals, and develop better policies of subsidizing community medical and health care centers to motivate them and their staff to enhance their services in terms of both quantity and quality.

But wait, there's more:

* We will abolish the practice of compensating for low medical service charges with high drug prices, adjust the prices of medical care and drugs, and create a mechanism for running hospitals by nongovernmental capital.

* We will consolidate and improve the system of using basic medicines and the new mechanisms for operating community-level clinics.

* We will improve the system of tiered medical services, strengthen training of general practitioners, and allow doctors to work in more than one medical institution so that people have easy access to quality medical services.

* We will build harmonious relations between doctors and patients.

* We will improve our capacity to prevent and treat major communicable and chronic diseases and occupational and endemic diseases. The government subsidy for basic public health services will be increased to 35 yuan per person.

* We will support the development of traditional Chinese medicine and the traditional medicine of ethnic minorities.

* We will unwaveringly adhere to the basic state policy of family planning and will implement the policy that allows married couples to have two children if one parent is a single child.

* We must resolutely press ahead with medical reform and work out a Chinese solution to this global problem so that the Chinese people can enjoy a happier and healthier life.

So there you have it ....

Today's China medical news headlines

More than half a billion Chinese have health cards. At the end of 2013, 540 million Chinese people, or roughly 40% of the population, had social security cards, which are mainly used to pay for medical expenses.It is hoped to expand numbers to 800 million cards by 2015, according to the Shanghai Daily.

Doctors in Beijing will be allowed to work in private hospitals as well as public ones under new regulations being drawn up by the National Health and Family Planning Commission.
At present doctors are restricted to working in only three local hospitals, according to China Daily. The city's health bureau says lifting the restrictions is aimed at encouraging doctors from top public hospitals to work in private medical institutions, attracting more patients to these institutions and thus alleviating the workload on large hospitals.

China may see human-to-human transmission of the H7N9 bird flu virus on a limited scale the WHO representative to the country has said. But there is no evidence that the virus will become sustained or widespread among humans, Bernhard Schwartlander said, according to the Beijing Daily.

"Since October, only one cluster was detected where human-to-human transmission might have occurred. We continue to expect only sporadic human cases," Mr Schwartlander said.


A Shanghai hospital has donated 'free' plastic surgery to a poor 16-year-old girl who survived the devastating Wenchuan earthquake of 2008. According to Shanghai Daily, the Shanghai Huamei Plastic Surgery Hospital gave Li Wenqian a free operation to separate her ring finger and little finger on her right hand, which had grown together after injuries she received when she was buried under debris for nearly 10 hours after the earthquake.

China is setting up a national health data network advisory group to make better use of population and public health information, CRI reports. A team of 28 experts from fields including medicine, demography, engineering, mathematics and law will provide suggestions for strategy, policy and planning based on population and public health data, according to the National Health and Family Planning Commission.



The New England Journal of Medicine is to expand its presence in China through the Wolters Kluwer publishing group and Ovid, according to a press release.

Today's China medical links

An inside look at a Guizhou hospital 
What's it really like getting treatment at a Chinese hospital? How much does it cost, how do patients pay and what happens when you run out of money? Ashish Jha, an associate professor of health policy and management, Harvard School of Public Health, has a great blog post at KevinMD on the nitty gritty of patient care. How do pateints get seen? How doctors manage patients (much more conservatively and slowly) - all based on a visit to the Huaxi District People’s Hospital in Guiyang.

Blood supplies drying up
In the China Daily, blood donations in Beijing have been falling slightly for three consecutive years, and legislation is needed to ensure supplies, according to Ge Hongwei, director of the testing department of the Beijing Red Cross Blood Center. She says the amount of blood used has been increasing by about 15 percent annually in China, widening the gap between supply and demand.

Get me out of here!
A British traveller, Sammy Corfield, blogs about his nightmare experience with various hospitals and doctors  in Zhejiang, when he went seeking treatment for chronic diarrhoea.

Urgent cure needed for China's ailing health system

In Prospect magazine, Beijing-based journalist Yuan Ren offers some thoughts on why China's medical system is in urgent need of reform. She points out that the healthcare system is having to deal with a huge increase in demand (because of increased but inadequate insurance cover) and higher expectations while at the same time grappling with lack of trust from patients. The health system is struggling with corruption, in part because incomes are linked to sales of drugs to patients. She says a "modern, efficient and sustainable model" is needed - but who is to say what that is?

Journalists investigate Beijing hospitals new appointment system - and find it will never work well

translation by Michael Woodhead

Journalists from China's "Health News" have investigated Beijing hospitals' new appointment system introduced four months ago - and found that patients still face long and variable waits to be seen and probably always will unless a gatekeeper system is introduced.

Reporter Liu Zhenni and colleagues evaluated the new appointment system that has replaced the notorious "take a number" system that often meant patients and their families had to queue up for long periods in the early morning to get a registration number and then face additional waits until their number came up.
Under the new system patients can call a 114 number and get a registration number and 'appointment time' over the phone instead of having to queue up in person. However, when the reporters investigated the actual working of the system, they found that patients faced long delays despite arriving at the hospital at the nominated 'appointment' time. In one instance a woman who was given an appointment time of 8am at the Beijing Maternity Hospital outpatients clinic was not actually seen until 9.40am. Under the new system, patient are given an SMS reminder for the time to arrive at the hospital, but these did not reflect the time the patient would actually seen.
On speaking to hospital staff, the reporters found that waiting time varied considerably depending on the daily situation in the clinic, with factors such as patient numbers and illness type affecting waiting times for other patients.
Altogether, six hospitals have adopted the new system, and some had better performance times than others. At the Beijing Third Hospital the SMS reminder gave an 'estimated' appointment time of  1-2pm. The actual time seen was 2.30pm. At a gynecology clinic the suggested time was 2.45pm to 4pm, and the patient was actually seen at 3.15pm.

However, the appointment system is still better than the old 'take a number and wait' system. At the Dongzhimen Hospital which still uses the old system, the journalist arrived at 8am to queue for a number, and was not able to get one until 11am. He eventually was able to see a doctor at 11.30am -  a total wait of  3.5 hours.
At the Meitan Hospital, Dr Zheng Shanhai told reporters it would be very difficult to achieve an accurate appointment time service under the current Chinese system of seeing patients directly in hospital regardless of grading of disease severity. Dr Zheng said some other countries had a 'gatekeeper' healthcare system in which patients were first seen in community clinics and only referred to higher grade hospitals or specialist centres if they could not be treated locally. This allowed health services to predict patient numbers  and also to plan for demand and thus give accurate times for appointments. However, in the Chinese health system, doctors working in the hospital system had to be prepared to see large numbers of undifferentiated patients, said Dr Zheng. This meant that much of their time was taken up with treating minor illness, forcing patients with more serious illness to endure long waits. He likened it to catching a public bus at rush hour and having to wait in a traffic jam - under such a system it was difficult if not impossible to give an accurate estimation of the arrival time.

In the article, journalists said patients deserved to be given some idea of how long they might need to wait under the new system rather than being kept 'in the dark', but hospitals offered no information or suggestions of possible delay times. A staff member of the new 114 phone appointment system said appointment time-slots were generated by an automated system and the actual waiting time and consultation time-slot would be decided by staff in the clinics, according to 'on the ground' realities.
The journalists asked why hospitals could not provide estimated waiting times to patients, based on past experience and patient numbers. For example, if consultation times averaged 10 minutes and there were 100 patients, then it should be possible to give patients an estimated consultation timeslot according to their place in the sequence.
However, a Dr Xu at Tongren Hospital said there was no such thing as 'average' consultation time because times varied according to the patient's condition and staff availability. Hospitals were faced with an unequal and unpredictable 'supply and demand' situation, he said. It would only be possible to give an accurate appointment time if consultation times and patient numbers were strictly  controlled - and this was not the case under China's current healthcare system. With rising demand for health services it would mean patients being asked to wait weeks or even months for an appointment.
A spokeswoman for the Beijing Health Department said the new system had only been operating for four months and it was still in the initial stages of implementation. Although it had aimed to give patients a consultation time-slot within half an hour of the suggested appointment time, it was not possible for hospitals to achieve such precise waiting and treatment times in the early stages, she said.
Source: Health News

China's medical system in need of radical surgery - SCMP editorial

When medical schools no longer attract the brightest minds, when doctors become the target of attacks, and when weapons of self-defence become necessary in hospitals, something is clearly amiss.
Worryingly, the symptoms are spreading on the mainland, so much so that they are further jeopardising the already ailing health care system in the world's most populous nation. The need for major surgery is evident.

One in four Chinese households face 'catastrophic' medical bills

by Michael Woodhead
Up to one in four households in some parts of China  experience catastrophic medical expenses, a study from Shanghai has found.
Dr Li Xiaohong and co-researchers from the School of Public Health, Fudan University analysed data from a survey of 11,577 households conducted in eastern China in 2008.
They found the incidence of household catastrophic medical expenses ranged from 9% to 25%. Households were more likely to experience catastrophic medical expenses if they were in rural areas, had a family member with chronic diseases, had a child younger than five years old, had a person at home who was at least 65 years old, and had a household member who was hospitalised.

Integration of private hospitals faces problems with insurance and working hours

The Party's decision to increase support for private hospitals presents an opportunity but with challenges, experts say, starting with access to insurance money and limits on doctors' working hours.
The broad policy approved by the Third Plenary Session of the Communist Party of China's 18th Central Committee, which ended on Nov 12, states the government should encourage the growth of medical institutions run by private companies or other NGOs.
Private hospitals are thought to be capable of competing with government-funded hospitals by providing more choices to patients. They can also help relieve pressure on an overburdened government system.
Since 2009, when national health reforms began, the central government and authorities in cities such as Guangzhou and Beijing have called for equal treatment for private hospitals — and even favorable policies that will stimulate their growth.
"The latest decision reiterates and emphasizes this," said Zhu Hengpeng, a researcher with the Chinese Academy of Social Sciences' Institute of Economics.
He said the Party's decision shows the willingness to conduct market-oriented reform in a health sector dominated by government-funded hospitals.
The Party also said private hospitals should get a slice of public healthcare insurance money, just as government-funded hospitals do.
But a majority of private hospitals operate outside the insurance program, which means their service costs are higher than their government-funded counterparts, Zhu said.

FT article on the perils of China healthcare

With annual sales growth estimated to exceed 20 per cent, many global drug companies regard China as a “must-win” market.

But problems from basic delivery of services across the vast country to rampant corruption, beset the sector. GlaxoSmithKline’s bribery charges brought international attention to the problems. Measured by availability, price and quality, China has a long way to go.

One big challenge for the government is the high cost of so-called generic drugs that have provided an easy way for big multinationals to make profits. In China, the price of branded generic drugs remains high, as hospitals and companies impose a premium for what they claim are higher quality products compared with lower-cost equivalents made by rivals.

“It is a bit of a strange thing to see old drugs priced far higher than you would see anywhere else in the industrialised world,” says Dr Carl Firth, the chief executive officer and founder of ASLAN Pharmaceuticals, an Asia-focused pharmaceutical company.

“The government has been reducing prices on older drugs but the pricing pressure is not as strong as you would see in the west.”

Another issue is a lack of quality healthcare outside the hospital system. Clinics and community physician practices are beset by in­consistent quality and mistrust, so 90 per cent of inpatient and outpatient services are delivered via hospitals, an expensive platform.

For hospitals and healthcare organisations to make money, they must charge higher prices for pharmaceuticals and other, unregulated, services such as X-rays or scans or prescribe unnecessary drugs, diagnostic or surgical procedures.  

According to Public Finance in China, published by the World Bank, China has two-and-a-half times as many MRI scanners per capita than would be predicted by its GDP.

This led to the conclusion that profit incentives and not patient outcomes may be driving this proliferation of technology. Ironically, this incentive increases the perception that those who can afford scans are receiving better care. Ancillary costs in China’s healthcare system can be very high.

Pharmaceutical prices are controlled by The National Formulary list of medicines. But inclusion in the formulary ensures sales volume. But for lower volume products, avoiding the formulary allows them to be priced higher.

The government introduced an Essential Drug List in 2009, which capped the price of as many as 500 items. According to Barclays, the dream of increasing the availability of essential drugs to primary healthcare facilities has turned into a nightmare, as implementation has focused on price reduction instead of volume, which is not to the benefit of hospitals.

The temptation to game the system has proved too much for even supposedly ethical western drug companies to ignore. Nor is corruption limited to pharmaceutical companies, with the broader healthcare market also under suspicion. 

Read full article at: FT

China healthcare: huge market, huge risks for western multinationals

by Barry S. Cohen
It's little wonder that multinational health care companies (MNCs) may be salivating at the opportunities in China:

1) By 2016 China is expected to be the second-largest drug market, forecast to reach nearly $165 billion that year

2) During the next several years the Chinese drug market is supposed to grow at a rate of 15% to 18% a year compared to little or no gains for the Western countries

3) Growing affluence is permitting many Chinese to pay out of pocket or pay high insurance deductibles to gain access to innovative Western medicine

4) China needs new drugs to treat higher than average incidences of hepatitis B and neck and head cancers. China also has growth potential for drugs to treat arthritis, diabetes, osteoporosis, high blood pressure, high cholesterol, depression HIV/AIDS.

However, all that glitters may not be gold. The chance of a recession as well as internal politics could make it difficult for the multinational pharmaceutical companies to make strong headway into the Chinese market. Nowhere in the world are the pressures greater to expand access to better health care while at the same time controlling costs.

Examples abound. One policy decision eliminated differential pricing on approximately 100 drugs MNCs sold into China. For nearly two decades, these drugs had benefited from special pricing as part of an agreement between the Chinese government and the pharmaceutical industry. Furthermore, a blind bid and tender process reduced prices on some drugs by up to 90%. MNCs watched as domestic Chinese pharmaceutical companies bid prices down in an effort to use volume gains to offset collapsing margins.

Despite the caution flags, large MNCs continue to devote substantial resources to cracking the Chinese market. Both Pfizer and GlaxoSmithKline have made major moves to re-orient sales resources away from developed economies towards China. Eli Lilly and Novartis , among others, have opened new R&D facilities in China, primarily in Shanghai. And given the country's mammoth diabetes problem, Sanofi is moving deeper into the country. The company's Lantus insulin product is estimated to have 17% of the Chinese market.

Large pharmaceutical companies hoping to stake a claim in China may be eyeing two of the country's largest medical research testing companies as a vehicle to gain entry. Both WuXi PharmaTech  and ShangPharma have been mentioned as possible takeover targets.

Even insurance company WellPoint has announced its entry with the hopes that it can develop a private healthcare insurance business. And medical device companies like Boston Scientific, Johnson & Johnson and Medtronic are also aggressively expanding into China. For more information about stocks in this space, our real time trading reports help investors identify opportunities before they happen.
Source: MSN Money

Hong Kong health providers allowed to set up mainland institutions

Hong Kong hospitals will be able to set up health institutions on the mainland next year

Hong Kong and Macao health service providers can set up institutions on the Chinese mainland starting from January 1, 2013, the Ministry of Health said on Friday.
They can set up health institutions wholly-owned by themselves, jointly-invested ones and cooperative ones partnering with mainland health establishments or enterprises.
Except for wholly-owned hospitals or senior houses, other forms of entities established by Hong Kong and Macao investors will be subject to administrative approvals of health authorities at provincial level, rather than national level, meaning simpler procedures, the Ministry of Health said.
The plans are based on agreements of the Closer Economic Partnership Arrangements between the mainland and Hong Kong and Macao. Supplemental agreements were signed this year.
The Ministry of Health said the arrangements signal greater liberation of the health sector on the mainland. It will also provide opportunities for Hong Kong, Macao health professionals to practice on the mainland as well as for the health industries of Hong Kong and Macao.
Source: China Daily

Orthopods offer answers to reform China's health system

Leading Chinese orthopaedic surgeons have highlighted the challenges to China's health care that include overuse of medical resources and medical disputes, as they called on more input to address such challenges and ensure sound development of the health sector.
Wang Yan and Wang Manyi, both from the Chinese Orthopaedic Association (COA) and delegates to the Seventh COA International Congress that closed Sunday in Beijing, offered some insights on how to tackle such challenges.
In China, government sponsors less than 10 percent of the operating costs of public hospitals, COA statistics showed.
Doctors sometimes prescribe excessively and overuse medical equipment to fill the operating costs, a practice that often lead to medical disputes.
In 2010, a septuagenarian patient died after 11 heart stents were put into his body and blocked his blood vessels.
The excessive use of medical equipment is both a waste and harmful to people's health. To stop such practice, COA President Wang Yan proposed institutional improvement.
In the realms of orthopaedics, the COA had pushed for the establishment of the Chinese Joint Registry and Information System in 2012.
The system enforces entry standards for hospitals, which saw joint replacement surgeries a profitable business and vied for qualifications.
So far, 27 major hospitals have already been registered into the system, Wang said.
Unlike the United States, where medical graduates have to go through tough examinations and residency programs before they become doctors, the majority of Chinese medical students go straight to work after graduation.
Chinese medical graduates go through residency training as hospital employees. The quality of training depends on hospitals.
At the government level, neither standards for residency programs nor a unified certification system for fellowship training exist.
Experts from the COA congress have advocated more training for young doctors. They also believed it necessary to establish national policies on residency training.
Wang Manyi, chair of the trauma society, a sub-specialty society under the COA, called for adding standardized residency training into law on medical practitioners.
Wang said it important to send doctors to prestigious medical institutions, where they might improve clinical skills through reinforced study.
Medical disputes are not uncommon in China, in which doctors often become targets of anger that resulted from misdiagnosis or patients' misunderstanding on treatment programs.
In March, a teenager stabbed a doctor to death and injured three others at a local hospital in northeastern city of Harbin as he misunderstood his treatment prescribed by doctors.
A similar case occurred in September 2011, when a patient stabbed and seriously injured a surgeon at Beijing Tongren Hospital following a medical dispute, in which the patient alleged that the surgeon had committed malpractice during an operation.
Lack of communication between doctors and patients, uneven technical level of medical staff, loopholes in China's health legal system, complex and costly legal procedures, as well as excessive medical treatment are among the leading causes for medical disputes, Wang Yan said at the conference.
In a bid to reduce the number of medical disputes, Wang proposed to use a patient-centered, team approach to increase patients' understanding on procedures and risks and use a third-party mediation mechanism to improve the medical arbitration system.
COA President Wang also advocated promotion of medical liability insurance which is suitable for both doctors and patients and ensuring the doctors' self-protection and rights.

Read more: China Daily

Health minister launches China's GP training program

2012 will be the first year of formal implementation of general practitioners standardised training system. At a meeting of the national medical education reform work conference, Health Minister Chen Zhu pointed out that the cultivation of high-quality GPs is a priority for the current reform of medical education and medical and health system. The establishment and implementation of the GP training system will be at the core of the new reform of medical education.
　　Currently qualified GPs are in very short supply. Of the General Medical Register, GPs account for only 8 million practitioners, accounting for 4.3% of the total number of practicing physicians. Of great importance to the the grassroots health of countries and regions,  GPs generally account for more than a third or half of the total number of physicians. Minister Chen Zhu pointed out that for reforms to establish a system of general practitioners a priority is to promote the reform of medical education, and speed up the high-quality medical and health personnel training. If it is possible to train a large number of qualified GPs, primary health care teams can establish a GPs at the centre of care, and this will enable the effective prevention and control of major diseases, and raise the level of people's health and achieve reasonable control of  medical expenses.
　　For standardisation of GP training system to be implemented, Chen Zhu proposed a four -point proposal:
1. To focus on the overall planning, development of a practical phased training plan;
2 Establishing the GP management system and business incentives;
3. Selection and construction of qualified general practitioner training base, focusing on the general medicine faculty training;
4. Emphasis on the culture of quality control to ensure that the standards of qualified general practitioner training.
Minister Chen Zhu pointed out that the current system of training general practitioners in China has made ​​it clear "a model for the two paths, three unified, four channels of top-level design. This is a model that will gradually standardise training GPs in a "5 +3 "mode: five years  clinical medicine undergraduate education, then three years as a GP internship. There will be "two paths" that "standardized training after graduation" and "clinical professional degree education" to gradually transition to graduation.
Uniformity in training will be achieved after standardization via "three unities": unified GP standardized training methods and content, the unified GP practice access conditions, and unified general medical degree award criteria.
There will be "four channels" that the transition to GP practice in four main ways, including vigorous grassroots on-the-job medical training and retraining, enhanced skills training, targeting of training GPs to enhance grassroots educational levels in the postgraduate doctors, to encourage large hospital doctors to offer basic services.

Read more: China General Practice

Xi Jinping emphasises health care as priority in inaugural address

Xi Jinping, the new general secretary of the Central Committee of the Communist Party of China (CPC), led the other newly-elected members of the Standing Committee of the 18th CPC Central Committee Political Bureau to meet the press Thursday morning at the Great Hall of the People.
During his speech he said:

"Our people have an ardent love for life. They wish to have better education, more stable jobs, more income, greater social security, better medical and health care, improved housing conditions, and a better environment."

Read more: China Daily