This article is written by Guan Lin
Some time ago, the 2020 Fudan University Hospital Ranking List was released, the hospital's official website was illuminated, the public number was even more happy, everyone's progress progress, the consecutive wins, you forwarded me to like, for a time, the circle of friends was full of festive atmosphere.
It's just that the list is from the beginning to the end, this time the hospital in addition to the old friends in the north, Shanghai and Guangzhou, unexpectedly has a completely unfamiliar new name - Shenzhen Third People's Hospital, which is also the first hospital in Shenzhen to show its face on the Fudan comprehensive ranking, and this shot also took the fourth place in the country in the Fudan tuberculosis discipline ranking.
If the Third People's Hospital of Shenzhen is only the tip of the iceberg, then under the water surface, there are more hospitals and a huge operating system.
Has Shenzhen Medical, which has been quiet for many years, really taken off?
Image source: Screenshot of Fudan leaderboard
Cover the airport
Just in November, the Shenzhen Health Commission issued the "Largest Doctor Recruitment Announcement in History", recruiting 7,734 doctors in one go, causing great concern. The announcement shows that in 2017, Shenzhen recruited 1691 doctors, 3934 in 2018, 5873 in 2019, and 7125 in 2020, showing a trend of continuous increase.
Behind the numbers is the development of the city and the huge demand for people's livelihood brought about by it.
First of all, it is the huge population of Shenzhen. According to the statistics of the Shenzhen Health Commission, according to the statistics of the "Seven Censuses" of the national population in 2020, the permanent population of Shenzhen reached 17.5601 million (plus the floating population may actually be 23 million), an increase of about 7.14 million people compared with 2010, an increase of 68.5%.
In the past ten years, Shenzhen's new population has ranked first in the country, exceeding the increase of "Beijing + Shanghai + Tianjin + Anhui Province".
Secondly, Shenzhen's high-speed growth economy. There are 23 cities in the national GDP "trillion club", and Shenzhen ranks third, with a GDP of 2,767.024 billion yuan in Shenzhen's economy in 2020.
In contrast, Shenzhen has long had a weak medical foundation.
Shanghai and Beijing, which rank in the top two in GDP, have been covering half of Fudan's rankings all year round, while the number of hospitals in several other cities with similar rankings has far exceeded that of Shenzhen.
Guangzhou has the old eight schools of medicine "Sun Yat-sen Medical", Southern Medical University and Guangzhou Medical University, and there are also 9 hospitals on the 2019 Fudan list. Chongqing City, on the other hand, has Chongqing Medical University, which is well-known throughout the country. The difference in the distribution of medical resources is not insignificant.
In 2009, there were only 21,538 beds in Shenzhen, far less than the 59,038 in Guangzhou, and only 54,212 health technicians, far less than the 89,179 in Guangzhou. Before 2020, only Shenzhen University and Southern University of Science and Technology in Shenzhen opened clinical medicine majors in the local area, and had affiliated hospitals of their own medical schools.
Xue Tian, executive director of the Life Sciences and Medicine Department of the University of Science and Technology of China, pointed out in an interview that it takes more than ten years, or even decades, to run a medical school well.
And these two local universities are as young as Shenzhen.
Shenzhen University is located in the western suburbs of the local area, only 30 years after its establishment. Although relying on Shenzhen's strong economic background and the strong support of various government departments in the city, it has rapidly developed into one of the top universities in South China, and many subject rankings have also made rapid progress, but its medical school has not been able to stand out among Chinese medical schools and make achievements.
Shenzhen has also tried to directly introduce high-quality medical universities in the province to participate in the construction of medical highlands.
Sun Yat-sen University has the oldest hospital in China, the BoChao Hospital, founded in 1835, has undergone several changes and evolved into today's Sun Yat-sen Memorial Hospital of Sun Yat-sen University.
In November 2015, Sun Yat-sen University and the Shenzhen Municipal Government signed a cooperation agreement to establish the Shenzhen Campus of Sun Yat-sen University and the Seventh Affiliated Hospital of Sun Yat-sen University.
It can be said that the airport of Shenzhen Medical has been built.
Pyramid effect
However, it is worth noting that among the hospitals on the list in Shenzhen, there is a significant feature: strong specialty and weak synthesis.
We can find that the number of hospitals on the Fudan list in Shenzhen is greater than that of the comprehensive list (1), and even the Third People's Hospital of Shenzhen is positioned as "strong specialty, large comprehensive", known for tuberculosis.
On the other hand, Shenzhen proposed that in order to solve the lack of high-quality medical resources in Shenzhen, Shenzhen officials launched the "Three Projects" of Shenzhen's medical and health care focusing on "famous doctors (famous departments), famous hospitals and famous clinics" in 2014, with the goal of investing a total of 100 billion yuan in Shenzhen to build and develop medical and health undertakings by 2020.
The implementation of the three projects so far, but also for Shenzhen to recruit including the Seventh Hospital of CUHK, the University of Hong Kong Shenzhen Hospital, the Chinese Academy of Medical Sciences Cancer Hospital Shenzhen Hospital and many discipline leaders from all over the country, the major well-known hospitals to Shenzhen to build branches, has also become a new trend.
Their arrival is like a locomotive, which has a strong "pulling effect" on the development of medical care in Shenzhen.
According to the statistics of the Shenzhen Health Commission, during the "13th Five-Year Plan" period, Shenzhen planned 117 medical and health construction projects, new, renovated and expanded 33 medical and health institutions, 23 new tertiary hospitals, 125 social welfare institutions, from 2016 to 2021, the number of tertiary hospitals increased from 10 to 24, and 7 hospitals were selected as "high-level hospitals in Guangdong Province".
But the problem remains.
According to the 2018 report of the Shenzhen Bureau of Statistics, the management of the "three projects" of the Municipal People's Hospital is not standardized enough, and the operation performance has declined. First, the "three projects" agreement did not stipulate the liability for breach of contract. In 2015, the Municipal People's Hospital introduced two "three project" teams, and the agreement cooperation period was 5 years. Since the above teams did not work in depth according to the agreement, they were all D-grade (lowest grade) in the 2 performance appraisals, and the financial support for the 2 teams was terminated from 2018. Since the cooperation agreement does not stipulate the liability for breach of contract and the way to deal with it, the Municipal People's Hospital has not yet gone through follow-up legal procedures with the above team.
Second, the "Three Projects" goal did not meet expectations. From 2015 to 2017, since most of the leaders and members of the "three projects" team were the original unit presidents or section directors, the 22 teams introduced generally had insufficient working hours for leaders, with an average attendance rate of 48.72%.
Similar issues remain in the 2020 audit report
Image source: Shenzhen Audit Bureau
Due to the large workload of medical services in the municipal people's hospital departments, the performance distribution system is unreasonable, and the enthusiasm of the dispatched learners is not high, 6 departments have not studied in the hospital or discipline where the "three projects" have introduced the team, accounting for 27.27%. Third, the overall ranking of the Municipal People's Hospital in the operational performance appraisal has declined.
According to the 2015-2017 municipal public hospital operation performance appraisal report, among the 10 to 12 public hospitals participating in the assessment, the ranking of the municipal people's hospital dropped from third to fifth. The evaluation results of the overall experience of medical treatment (public satisfaction of medical services) show that the Municipal People's Hospital has ranked last in the past three years.
Taking a pyramid as an example, the social welfare part of Shenzhen Medical is doing well, the network is large, and the foundation is also firmly laid, which is equivalent to the basic layer of the pyramid; and the backbone of the original demand is large, and it is also the backbone of the hospital - and the shenzhen gap is very large, which is currently being filled; as for the spire, Shenzhen has a number of discipline leaders, but it has not played its due role. On the other hand, due to the early and perfect construction of the Guangzhou system and the progress of the road, a considerable number of Shenzhen residents still retain the concept of entering Guangzhou with serious illness.
Shenzhen's sincerity
For medical workers, Shenzhen's sincerity has always been sufficient.
The policy is also clear: give treatment.
Image source: Shenzhen Health Commission
The 2568 public hospital fee prices were adjusted in three steps, the diagnosis fee, surgery fee and nursing fee that reflected the "content" of medical staff's technology were increased, and the one-time living allowance of up to 350,000 yuan was given according to academic qualifications for graduates who obtained the training certificate and worked in the social welfare center.
Just one district in Yantian, in 2019, really sent 7.4 million.
Image source: Yantian Health Commission
In recent years, medical talents have come to Shenzhen, and hospitals will arrange special personnel to assist in applying for government public housing. Taking Shenzhen Bao'an District as an example, those who meet the high-level talent standards of Bao'an District and are certified (such as: full-time doctors under the age of 40) can enjoy a living subsidy of 200,000 yuan and rent-free accommodation for talents of 90 square meters.
After recruiting a group of discipline leaders, more and more backbone forces have also begun to flow to Shenzhen. It can be observed that cities and regions represented by the northeast and with a perfect medical system (including the training system) are gradually less attractive to doctors due to economic reasons, and it is not uncommon for their entire disciplinary teams to leave Shenzhen.
The day the construction of the backbone echelon in Shenzhen is completed, it is the time for medical treatment to take off. (Planner: Leu.)