"Whether a society is happy or not, it is very important to see whether the elderly are happy or not. ”
According to the National Bureau of Statistics, by the end of 2023, there were more than 210 million elderly people aged 65 and above in mainland China, accounting for 15.4% of the country's total population. It is the common aspiration of the whole society that the elderly should be supported, depended on, happy, and secure. How to improve the health service system for the elderly and how to ensure that everyone can live a stable and down-to-earth life in old age is a challenge facing China, which is accelerating its aging population.
Since the 18th National Congress of the Communist Party of China, under the leadership of the CPC Central Committee with Comrade Xi Jinping at its core, the mainland has implemented the "China Plan" to actively respond to the aging of the population, and promoted the solution of the practical needs of the elderly in terms of pension, health, spiritual and cultural life, and social participation. With the changes in social development, family structure, governance model and other aspects brought about by aging, how should procuratorial public interest litigation escort "providing for the elderly, respecting the elderly, and respecting the elderly"?
01
Caring for the elderly: adapting to the transformation of the elderly, so that the elderly can become "enjoy the old"
"Hang an ophthalmology number. As soon as the words fell, Uncle Zhang's mobile phone in Chengdu, Sichuan Province simultaneously opened the registration interface of the ophthalmology department of the People's Hospital of Tianfu New District, Sichuan. With one click of the "voice assistant" button, you can get information about departments and doctors without typing. With the help of this new feature, Uncle Zhang successfully hung up.
Uncle Zhang, who is in his 70s this year, told reporters while skillfully operating: "A few years ago, I suffered from Parkinson's syndrome, my hands trembled so badly, it was difficult to make and receive phone calls, let alone surf the Internet. Nowadays, the registration applet has added a 'elderly care version' interface, which can realize online card creation, registration, payment and other functions with your mouth, which is particularly convenient!"
What makes Uncle Zhang even more pleased is that the People's Hospital of Tianfu New Area, Sichuan Province, for elderly users, in addition to adding "voice assistant" to the "official account" interface that provides diagnosis and treatment services, also sets up functions such as font enlargement and "one-click call". If the elderly still have difficulties in operating their mobile phones, they can make an appointment with one click, and the manual customer service will help complete the registration.
Ye Liwen, the prosecutor of the Fourth Procuratorate Department of the Sichuan Tianfu New Area Procuratorate (Sichuan Pilot Free Trade Zone Procuratorate), who came to carry out the "look back" together, was very pleased to see this scene and told reporters about the process of adapting the Internet application to the elderly in the hospital.
In April 2022, the Sichuan Tianfu New District Procuratorate relied on the "two-way connection and transformation" mechanism of public interest litigation procuratorial suggestions, people's congress deputies' suggestions, and CPPCC members' proposals, and found from 289 deputies' suggestions and CPPCC proposals that the online appointment and registration procedures for Internet intelligent services in medical institutions in the jurisdiction are cumbersome and the page operation is complicated, resulting in difficulties for the elderly over 60 years old to seek medical treatment, and this problem has attracted great attention from the society.
Subsequently, the Sichuan Tianfu New District Procuratorate selected Huayang Street, which has the highest proportion of the elderly population and the largest base, as the entry point, and found that the service settings of the Sichuan Tianfu New Area People's Hospital and Huayang Community Health Service Center on the official website, WeChat "official account" and other interfaces are not in line with the Law on the Protection of the Rights and Interests of the Elderly and the Implementation Plan on Effectively Solving the Difficulties of the Elderly in Using Intelligent Technology Regarding the relevant requirements for the elderly, the work of adapting the Internet to the elderly is relatively lagging behind, and the implementation of social preferential treatment policies for the elderly is not in place, which harms the social and public interests. In order to demonstrate the necessity of supervision, the hospital and the volunteers of "Benefiting the Public" jointly carried out questionnaire surveys to the elderly, and also invited district people's congress deputies and CPPCC members to hold discussions, and organized people's supervisors and relevant units to hold public hearings. All parties believe that there is indeed a practical need for medical institutions to carry out Internet application adaptation for the elderly.
In September 2022, the Sichuan Tianfu New District Procuratorate sent a procuratorial recommendation to the relevant administrative units, urging them to perform their regulatory duties on the lagging transformation of Internet medical services for the elderly in the medical institutions involved in the case, and protect the legitimate rights and interests of the elderly. After receiving the procuratorial suggestion, the relevant administrative management unit immediately requested the relevant medical institution to rectify the problem of lagging Internet application for the elderly.
The Sichuan Tianfu New District Procuratorate invited representatives of the elderly to pay a return visit on the effectiveness of the administrative public interest litigation case of the Internet adaptation and transformation of medical institutions.
"In April 2023, our hospital organized some elderly people in the jurisdiction to conduct a discussion and return visit, and distributed more than 50 questionnaires, and the elderly fully affirmed the procuratorate's role in public interest litigation to promote the protection of the rights and interests of the elderly, and spoke highly of the convenience brought by the medical institution's App after the transformation of the app for the elderly. Ye Liwen said.
"Information accessibility is an important part of the construction of a barrier-free environment, and it is also an inevitable requirement for building an information society in an all-round way and promoting social fairness and justice. The procuratorial organs focus on the 'digital divide' caused by modern information technology to the elderly in seeking medical treatment, urge relevant functional departments to perform their regulatory duties in accordance with the law, promote the improvement of the level of information accessibility in medical institutions, so that the elderly can obtain medical services equally, conveniently and safely, and contribute to the construction of an age-friendly 'park city', so that the elderly can have a greater sense of gain, happiness and security in the development of informatization. Wang Qi, deputy to the National People's Congress, vice chairman of the Sichuan Federation of Industry and Commerce, president of the Chamber of Commerce of Sichuan Tianfu New Area, and chairman of Sichuan Qiyang Automobile Group, said.
This is just a microcosm of the judicial protection provided by the procuratorial organs to protect the legitimate rights and interests of the elderly. In order to strengthen the construction of a barrier-free environment and gradually improve and protect the life, health, and safety of the elderly, procuratorial organs in many places have successively carried out special supervision activities for public interest litigation on the construction of a barrier-free environment.
The public interest litigation prosecution department of the Baodi District Procuratorate of Tianjin Municipality and the prosecutors of the criminal prosecution department discussed the evidence and public interest damage in cases involving the elderly.
Prosecutors from the Zhenjiang Municipal Procuratorate in Jiangsu Province went to the elderly care facility to supervise safety issues.
Since 2020, the Zhejiang Provincial Procuratorate has taken the lead in exploring and carrying out public interest litigation on barrier-free environment construction in the country, and has successively deployed and carried out special supervision of public interest litigation on barrier-free environment construction and the promotion action of "Benefiting the Disabled and Helping the Disabled", so as to promote the improvement and iteration of barrier-free environment construction in facility construction, information exchange, and social services. Over the past three years, the provincial procuratorate has filed and handled 330 public interest litigation cases for the construction of a barrier-free environment, issued 307 pre-trial procuratorial suggestions to administrative organs, and promoted the improvement of 3,586 barrier-free facilities, information exchanges, and social service sites.
The Shanghai Pudong New Area Procuratorate has carried out special supervision work on public interest litigation on the construction of a barrier-free environment, focusing on the practical problems faced by the elderly and other groups in transportation, medical treatment, daily life, cultural needs, etc., focusing on the problems of the barrier-free environment in public service venues, major roads, commercial districts, residential areas and other key areas, and promoting the transformation of 1,167 barrier-free facilities in the whole region, so as to comprehensively improve the level of regional barrier-free environment construction.
The procuratorate has used public interest litigation to promote the improvement of barrier-free construction and effectively protect the rights and interests of the elderly and other groups, which has achieved remarkable results and won unanimous praise from the public.
02
Retirement in peace: a happy life in a senior care center
Approaching the Spring Festival, the weather in Tongcheng County, Hubei Province, is cold and there are few pedestrians on the street, but the elderly rehabilitation center near the county's old passenger station is very lively. A condolence activity is being carried out, and the community dance team has performed a wonderful cultural program for the elderly.
This "hidden" elderly care center in the old community has a relatively secluded environment and can accommodate 260 elderly people. Here, Aunt Li's care problem has been solved, and it is more convenient for her children to visit the elderly.
Hold monthly forums to listen to the opinions of the elderly on diet, and try their best to meet their individual needs while ensuring a reasonable diet; cooperate with medical and health institutions that have signed contracts for the integration of medical care and elderly care to provide professional services for the elderly; regularly bathe, haircut, and pedicure for the elderly...... Living in such an elderly care center, Aunt Li feels both down-to-earth and comfortable.
There are still many elderly people like Aunt Li who live alone in Tongcheng County. How to promote the comprehensive rectification of pension institutions with a systematic concept, continuously improve the health management and service level of the elderly, and promote the pension cause and pension industry are the topics that the procuratorial organs continue to explore.
In March 2023, the Tongcheng County Procuratorate found that there may be hidden dangers in food, fire safety and other aspects of elderly care institutions in the jurisdiction in the performance of their duties. Through on-site access to relevant license business certificates, nursing home management ledgers, access to administrative records of administrative organs, and questioning relevant staff, the hospital found that 13 elderly care institutions in the county have not applied for food business licenses, employees have not applied for health certificates, and use expired and spoiled food materials. At the same time, four of the elderly care institutions have infirmaries or nursing stations that have not been registered with the Health Bureau. In April 2023, the Tongcheng County Procuratorate filed a public interest lawsuit on this clue.
"Township public pension institutions have the nature of basic and non-profit, and are ideal places for the local elderly to retire. Therefore, the problems that threaten the life, health and safety of the elderly must be solved as soon as possible. Li Hongying, deputy director of the Fourth Procuratorate Department of the Tongcheng County Procuratorate, told reporters that a month after the case was filed, the court organized relevant administrative organs and local township governments to hold public hearings to clarify the responsibilities of all parties and form a joint rectification plan. The hospital also issued procuratorial suggestions to the Tongcheng County Market Supervision and Administration Bureau, the County Health Bureau, and the County Fire and Rescue Brigade, and issued consultation opinions to the six territorial township governments.
In July 2023, the relevant administrative units replied to the procuratorate in writing that all rectifications have been implemented in accordance with the law: the Tongcheng County Government issued the "Tongcheng County Elderly Care Institutions Safety Inspection Work Plan" after research, and the County Market Supervision and Administration Bureau punished the illegal acts of the relevant elderly care institutions, and urged them to apply for food business licenses and other documents. A food safety management system has been formulated, and training has been conducted for the managers and employees of 13 pension institutions; the county health bureau has supervised and urged the employees of the pension institutions to apply for health certificates, improve the medical service filing system, and arrange regular physical examinations for the elderly; the county fire and rescue brigade, together with the heads of the county civil affairs bureau, the county market supervision bureau, the townships and other departments and units under its jurisdiction, carried out joint fire safety inspections on the 13 pension institutions involved in the case, and rectified the 57 problems found. Three months later, the Tongcheng County Procuratorate carried out a "retrospective" to verify that all the problems involved in the case had been rectified.
In the field of pension services, there are not only hidden dangers that threaten the life, health and safety of the elderly, but also the risk of crimes that infringe on property safety. In this regard, the procuratorate continued to follow up, resolutely eradicate the breeding ground for pension crimes, squeeze the "space for fraud" to the greatest extent, and protect the "pension money" of the elderly.
Since 2017, there have been a number of illegal and criminal acts of elderly care institutions selling pension apartments and beds to the elderly in the name of "social welfare centers" or "healthy pension projects" in Baotou City, Inner Mongolia Autonomous Region, resulting in more than 3,400 elderly people being deceived and losing 93.09 million yuan. At the same time of pursuing the criminal responsibility of the relevant criminal suspects in accordance with the law, the Baotou Municipal Procuratorate has not been able to prevent, monitor and warn the illegal fundraising of pension service institutions in place, resulting in the infringement of the legitimate rights and interests of unspecified elderly people, through the formulation and issuance of procuratorial suggestions, urging them to establish a "red, orange, yellow and green" risk management and control list with hidden risk levels from high to low, and make use of the advantages of streets and communities to extend publicity and monitoring tentacles, increase the publicity of the rule of law, and promote the establishment of a normalized mechanism for preventing pension fraud.
The Baotou City Procuratorate of the Inner Mongolia Autonomous Region held a public hearing on the protection of the rights and interests of the elderly, and formulated and issued procuratorial recommendations.
In a developing country with a population of 280 million elderly people over 60 years old, how to achieve peace of mind for the elderly? In recent years, the supply capacity of elderly care services in mainland China has been continuously enhanced, and by vigorously improving the community home-based elderly care service network, it has gradually built a pension service system that coordinates home-based community institutions and combines medical care and health care, and by the end of 2022, there are 387,000 old-age care institutions and facilities of various types in the country.
"In the new era, the 'smart pension' model spawned by new technologies such as intelligence and digitalization has enabled more and more elderly people to enjoy safe and comfortable products and services. At present, there is still a gap between the quality and level of elderly care services in urban and rural areas. Under the circumstance that the ability to pay is not strong and the market-oriented mechanism is limited, it is urgent to tap and integrate the unique resources of rural areas and explore a pension service model that is more suitable for rural characteristics. Li Longqi, deputy to the National People's Congress and vice president of Taihe Hospital in Shiyan City, Hubei Province, told reporters.
In 2024, the "No. 1 Document of the Central Committee" clearly requires that the rural elderly care service system be improved, the construction of regional elderly care service centers will be promoted according to local conditions, and the development of rural elderly meal assistance and mutual aid services will be encouraged. Improve the incentive mechanism of basic old-age insurance for urban and rural residents. The Supreme People's Procuratorate has made corresponding arrangements in the Notice on Giving Full Play to the Procuratorial Functions of Public Interest Litigation to Serve the "Three Rurals" and Promote Rural Revitalization. "We have always adhered to the bottom-line thinking when carrying out procuratorial public interest litigation for the protection of the rights and interests of specific groups, identified weak links and outstanding problems, and supervised and safeguarded the implementation of relevant legal and policy measures. In this regard, Qiu Jinghui, deputy director of the Eighth Procuratorate of the Supreme People's Procuratorate, made a further interpretation.
03
Rely on the elderly: Establish a sound social support system
"If one person is disabled, the whole family is out of balance", which expresses the pressure of countless disabled elderly families.
Wang Haidong, director of the Department of Aging and Health of the National Health Commission, said at a press conference held by the National Health Commission that an important reason for the serious shortage of health services for the disabled elderly is that a stable mechanism for the payment of care fees for the disabled elderly has not been established.
In interviews, a number of experts said that the aging population in the mainland has the characteristics of growing old before getting rich, and a long-term care insurance can ensure that the elderly can pay for and enjoy the care services they need.
The so-called long-term care insurance refers to a system that shares and compensates the insured for the expenses incurred by long-term care services by giving full play to the risk sharing and mutual aid functions of insurance, mainly for the disabled and dementia elderly. In 2016, the mainland issued the "Guiding Opinions on Carrying out Pilot Long-term Care Insurance Systems" to pilot long-term care insurance systems in 15 cities. The report of the 20th National Congress of the Communist Party of China clearly called for the establishment of a long-term care insurance system.
Shanghai, one of the first pilot cities in China, launched a pilot program for long-term care insurance in 2016. In May 2022, in the process of handling the fraud case of Xu Moumou and others, the criminal prosecution department of the Jiading District Procuratorate of Shanghai found that the criminal suspect took advantage of the management loophole that could settle the workload and issue remuneration only by punching in and out of the mobile phone and signing and confirmation of the object being cared for, borrowed other people's nursing certificates, falsely reported the frequency and duration of work, and defrauded the medical insurance fund, exposing the negligence of the administrative organ in the management of long-term care insurance, so the clue was transferred to the public interest litigation prosecution department.
The prosecutor of the Jiading District Procuratorate of Shanghai went to the nursing station in the jurisdiction to carry out a "retrospective".
"By consulting the ledger records of the nursing station and related medical assessment institutions involved in the case, and at the same time in-depth interviews with nurses and nursing objects, medical assessment personnel and staff of estimation institutions, we analyzed and judged the regulatory problems existing in the design and material review of long-term care insurance related systems in the region, and further promoted the development and application of data supervision models, compared the social security payment records, attendance records, and nursing records of nursing workers, screened out abnormal data, investigated and dealt with them in a timely manner, and did a good job in the integration and supervision of procuratorial public interest litigation. Zhang Fangyong, director of the Public Interest Procuratorate of the Jiading District Procuratorate of Shanghai, who handled the case, told reporters.
In view of the Jiading District Medical Security Bureau, which has management responsibilities for the long-term care insurance business, The Jiading District Procuratorate issued procuratorial suggestions to the two departments respectively, urging them to conduct self-inspection of the long-term care insurance business and nursing institutions in the jurisdiction, formulate and implement the review and review of the assessment results and the third-party supervision mechanism, and strengthen the special governance of the nursing industry in the district and improve the nursing institutionsand the supervision and management system of nursing staff.
Within the two-month rectification period, the Jiading District Medical Security Bureau and the Health Commission formulated and issued the "Key Points of the Pilot Work of Long-term Care Insurance in Jiading District in 2022", "Pilot Work Plan for Initiating Long-term Care Insurance Status Assessment by Management Departments", "Notice on Carrying out Financial Self-examination and Self-Correction Work" and other documents. The five aspects of organizational security were further standardized, multiple information methods were used to plug management loopholes, and 18 home service institutions and 1 assessment agency in the jurisdiction were jointly inspected, and a total of more than 130,000 yuan of long-term care insurance funds were recovered and more than 50,000 yuan were fined.
"With the in-depth promotion of the construction of financial powers such as inclusive finance, pension finance and digital finance, the elderly group and pension security have become the top priority of financial consumption and financial support. The procuratorial public interest litigation on the loophole of 'long-term care insurance' has exemplary significance and warning effect. Qiu Jinghui told reporters.
In recent years, procuratorial organs across the country have focused on the protection of the rights and interests of the elderly, striving to provide high-quality and efficient procuratorial services, and continuously strengthening the legal protection of the elderly while reducing the burden of litigation among the elderly. In order to solve the problem of weak litigation capacity of the elderly and other groups, the Supreme People's Procuratorate issued the Guidelines for the Support of Prosecution by Civil Procuratorial Departments in March 2022, in December 2022, the Supreme People's Procuratorate released a series of typical cases of "procuratorial work for the people" with the theme of safeguarding the legitimate rights and interests of the elderly (the tenth batch), and in June 2023, the Supreme People's Procuratorate released six typical cases of cracking down on pension fraud......
Qiu Jinghui introduced that although there is no procuratorial public interest litigation clause in the Law on the Protection of the Rights and Interests of the Elderly, the elderly and their legitimate rights and interests have always been given special protection as key targets in the statutory areas of procuratorial public interest litigation such as personal information protection, anti-telecom network fraud, protection of women's rights and interests, and barrier-free environment construction. Each region's carrying out procuratorial public interest litigation for the protection of the rights and interests of the elderly may rely on the relevant legally-prescribed fields to pinpoint illegality, grasp the justiciability, and strive to achieve the best case-handling results with higher efficiency and lower costs.
The old and the old. In a society with an increasing proportion of elderly people, promoting the construction of an age-friendly society is not only to reflect humanistic care, but also to meet the rigid needs of society. This requires the government, social organizations and the people to work together to gather a strong synergy of co-construction and co-governance, and implement the development of the national aging cause in action, so that more elderly people can have a higher quality of happy life in their old age.
(Source: Procuratorate Daily, Public Welfare Weekly Author: Yang Lujia)