The Health Commission once again stressed that it is strictly forbidden to issue income-generating tasks to medical personnel

Recently, the Yunnan Provincial Health Commission, the Yunnan Provincial Development and Reform Commission and other seven departments issued the "Several Measures of Yunnan Province on Further Standardizing Medical Behavior and Promoting Reasonable Medical Examination" (hereinafter referred to as "Several Measures"), proposing that the construction of the medical insurance intelligent supervision platform be fully completed by the end of 2022 to promote more accurate, efficient and transparent medical insurance supervision.

The "Several Measures" clearly requires that medical security departments should strengthen supervision and supervision of medical examination behaviors and medical expenses included in the scope of medical security and promptly investigate and deal with violations of laws and regulations. Focus on rectifying unsubstantiated inspections, repeated inspections, duplicate charges, induced inspections, bundled inspections, and other violations of laws and regulations. It is strictly forbidden to directly or covertly issue income-generating tasks to departments and medical personnel, so that the income of medical personnel truly reflects the value of labor and technical value, and achieves excellent performance and remuneration.

Multi-sectoral publications have been issued for many years to emphasize

"It is strictly forbidden to directly or covertly issue income-generating tasks to departments and medical personnel", similarly, whether at the national or provincial level, which has been emphasized for many years.

In October last year, the Fujian Provincial Health Commission, the Fujian Provincial Medical Security Bureau and other four departments issued the "Fujian Province Deepening the Implementation Plan for the Reform of the Remuneration System of Public Hospitals".

The plan issued by Fujian aims to establish and improve the salary system of public hospitals that adapts to the characteristics of the medical industry, and emphasizes that it is strictly forbidden to issue income-generating targets to departments and medical personnel, and the salaries of medical personnel must not be linked to business income such as pharmaceutical consumables and inspection and testing.

According to Sichuan Daily, the province's Implementation Plan for Expanding the Pilot Reform of the Remuneration System for Public Hospitals in Sichuan Province, issued in March 2018, also mentioned that public hospitals are strictly prohibited from issuing income-generating targets to departments and medical staff, and the individual salaries of medical personnel must not be linked to business income.

According to Guangzhou Daily, as early as 2006, Guangzhou Province issued a notice: hospitals are strictly prohibited from issuing income-generating targets.

At a meeting, the then director of the Guangdong Provincial Health Department said that the hospital has income-generating indicators, as do various departments, and the doctor's concern is "how much is the income of the department?" Some hospitals link medical service income to personal income, and even issue income-generating indicators to doctors, resulting in some doctors prescribing "big prescriptions" and using high-end expensive drugs that could have been used for ordinary and cheap drugs.

At the national level, on August 31 last year, the National Medical Insurance Bureau, the National Health Commission and other 8 departments jointly issued the "Pilot Program for Deepening the Reform of Medical Service Prices", which also mentioned that it is strictly forbidden to issue income-generating targets, and medical salaries and department incomes must not be directly linked.

Earlier, when the General Office of the State Council issued the "Key Tasks for Deepening the Reform of the Medical and Health System in 2014", it was strictly forbidden to issue income-generating targets to medical personnel, and it was strictly forbidden to link the income of medical personnel such as bonuses and salaries with the income of drugs, medical examinations and other businesses.

……

It can be said that this requirement is repeated and re-emphasized by the old saying.

The former Ministry of Health was harshly criticized

Hospitals issue revenue-generating targets

The "hospital issued income-generating indicators" is really well known to the people, stemming from the "Jinta County People's Hospital of Gansu Province falsified clinical test results" incident in 2008.

On December 24, 2008, CCTV's ace column "Focus Interview" exposed the incident of the Jinta County People's Hospital in Gansu Province cheating and falsifying the test results. The former Ministry of Health immediately conducted an on-site investigation with the former Gansu Provincial Health Department.

The former Ministry of Health issued a circular on 4 February 2009 stressing:

It is strictly forbidden for all types of public hospitals at all levels throughout the country to issue income-generating targets to departments, and it is strictly forbidden to directly link the income of medical personnel with the economic income of departments.

The circular was made on the basis of the investigation and handling of the "falsification of clinical test results by the Jinta County People's Hospital of Gansu Province".

According to public reports and media exposure, the former Ministry of Health sent clinical laboratory experts to Jinta County to investigate at the end of 2008, confirming:

In the 2008 health examination of employees in the county, the hospital conducted clinical tests on thousands of people such as blood routine, liver function and blood lipid tests, but there was no corresponding original test record, and no real and effective test results were issued; since January 2007, the hospital issued serum iron, serum inorganic phosphorus test report, most of the test results are false; the hospital has other problems such as irregular amylase testing.

The survey pointed out that the Jinta County People's Hospital issued a clear economic income target to the laboratory department every year, and directly linked 30% of the salary of the laboratory staff to the department's business income, which triggered the distortion of medical behavior and the loss of medical ethics, and falsified clinical test results.

According to the results of the investigation, Jinta County People's Hospital was warned and revoked its title of second-class first-class hospital, and the physician practice certificate of Chen Moumou, director of the laboratory department, was revoked. The Jinta County PARTY Committee and the county government decided to dismiss the president of the Jinta County People's Hospital and give the vice president the punishment of staying in the party for two years and administrative dismissal; giving the director of the county health bureau a warning within the party and an administrative demerit punishment; the deputy director of the county health bureau a serious warning within the party and an administrative demerit punishment; and ordering the deputy county magistrate in charge to make an in-depth inspection.

The investigation found that the staff of the hospital had reflected the quality of the work of the department to the leaders of the hospital, but they were not taken seriously and corrected. Due to the government's financial compensation for public hospitals for many years, the government's annual fixed investment only accounts for about 2% to 3% of the hospital's operating costs in the same period, which is only enough to pay the retirees of the hospital, and the hospital has to make this decision.

A doctor in a public hospital in Beijing said that the hospital has issued economic indicators to the department, and doctors have to rely on the department to generate income to earn wages and bonuses, which has become an unspoken rule in the industry.

Source: Medical Community Think Tank

Author: Song Kunlun