In the 1950s, relying on "one needle, one handful of grass", a group of unlicensed traveling doctors cured countless citizens.
They are farmers, medical workers, and the guardians of China's health. At a time when China's rural medical care is at a loss, these "grass and Taiwan teams" have provoked the beam of national health and health.
From hygienists, barefoot doctors to rural doctors, a white coat has always lived up to the trust of the state and villagers.
In an agricultural country with a population of 1.4 billion, the countryside is the foundation of the country. The countryside is inseparable from rural doctors, and China is prosperous today, and they have made great achievements.
From 1952 to 2021, 70 cold and hot summers, rural doctors and Chinese medical storms and rains. The experience of growing up with New China was also the imprint of the times that belonged to rural doctors.
The passion of the revolution, the sweat of hard work, the smile of relief, and the tears of bitterness are all intertwined with the torrent of the times.
Taking history as a mirror, we can know the rise and fall. Rural doctors also have a vast history of ups and downs, whether it is lonely or brilliant, these 70 years of memory, is the common wealth of all rural doctors -
Barefoot doctors, practicing revolutionary humanitarianism
The problem left over from the history of the lack of medical treatment and medicine in old China cannot be tolerated in the new China, where the people are the masters of their own affairs. Medicine should civilize its spirit and health its physique, and a huge exploration has also been quietly launched throughout the country, during which the "Barefoot Doctor's Manual" with circulation second only to "Mao Xuan" was born...
In 1952
This year, they took the first step in the Long March.
The Ministry of Health's "Regulations on the Organizational System, Establishment and Tasks of Grass-roots Health Organizations Below the County Level" points out that natural villages have health rooms and are equipped with hygienists. Not separated from production, the main responsibility is to handle the village-wide vaccination, maternal and child health care, infectious disease isolation and reporting, environmental health guidance, health publicity and simple medical and first aid work.
June 26, 1965
(Source: Chinese Communist Party News Network, "Mao Zedong's Anger Changed the Lack of Medical Care and Medicine in Rural China" Author: Chen Lixu)
Put down the medicine box and go to the ground, pick up the medicine box and go to the clinic. Since then, a group of barefoot doctors of the practical school have grown rapidly, and have begun to brave the wind and snow, climb mountains and rivers, thousands of households have their footprints, and the medicine box also carries the fragrance of the soil in the countryside.
August 10, 1966
The first rural cooperative medical pilot in China's history, the "Dujia Village Brigade Clinic of Paradise Commune", was listed.
Qin Xiangguan, the father of China's rural cooperative medical treatment, voluntarily resigned from the "iron rice bowl" of the commune health center and became a barefoot doctor who kept work points and ate rural rations in the brigade clinic.
The peasants each pay 1 yuan per year for cooperative medical expenses, and the brigade then retains 5 dimes per capita from the collective public welfare fund as a cooperative medical fund. Except for a few old diseases that require perennial medicine, the masses only pay a registration fee of 5 cents each time they see a doctor, and they do not need money to take medicine.
In 1968
This year, the barefoot doctor had his own name.
Shanghai Wen Wei Po published an article entitled "From the Growth of "Barefoot Doctors" to the Direction of the Medical Education Revolution", which was actually an investigation report on the training of barefoot doctors in Jiangzhen Commune, Chuansha County, Shanghai, introducing the deeds of Huang Yuxiang and Wang Guizhen in serving the peasants wholeheartedly.
Since then, "barefoot doctor" has become a specific title for rural doctors who are half-peasant and half-doctors, and Wang Guizhen is regarded as the first "barefoot doctor", and her image has been printed on the food stamp issued in Shanghai in 1977.
In 1969
The Handbook of barefoot doctors, known to all the people of the country, was officially published. For nearly half a century, it has not only contributed to solving the medical problems of hundreds of millions of people in an era of extreme poverty, but has also been the Chinese national health guidance manual, second only to the "Selected Works of Mao Zedong".
The Handbook for Barefoot Doctors has also attracted the attention of the international community, and has been translated into more than 50 texts and distributed around the world. To this day, the English version of the Handbook of the Barefoot Doctor can still be seen in bookstores in some Western countries.
In 1977
Cooperative medical treatment is implemented in 85% of the country's production brigades, and the number of barefoot doctors once reached more than 1.5 million.
In 1979
Since 1979, the state has successively assessed barefoot doctors, and those who pass the assessment have issued "barefoot doctor certificates", and those who are unqualified have been eliminated, and a large number of health personnel have been dismissed.
In 1983
Communes and cooperative medical care collapsed, barefoot doctors lost their organizational support and the support of the collective economy, and the number continued to decline.
The village doctor stirred at the turn of the century
January 1985
From barefoot doctors to country doctors, it's not just two words that have changed.
The National Conference of Directors of Health Departments decided to change "barefoot doctors" to "village doctors", stipulating that those who reach the level of doctors should be called "village doctors" and those who do not reach the level of doctors should be called hygienists.
"People's Daily" published an article titled "No longer use the name of "barefoot doctor", consolidate and develop the team of rural doctors", and the four words "barefoot doctor" officially withdrew from the stage of history.
February 1985
This year, they had their first work permit.
The State Council's "Notice on Approving and Forwarding the Report of the Ministry of Health on Reasonably Solving the Problem of Subsidies for Barefoot Doctors" mentions that all barefoot doctors who have passed the examination and are equivalent to the secondary school level will be issued with a "rural doctor" certificate.
1986
The number of "rural doctors" certificates awarded reached 640,000, and the number of hygienists who did not pass the qualification examination of rural doctors reached 650,000, for a total of 1.29 million.
In 1991
Rural doctors have a systematic training system, and the team has become more and more effective.
The Ministry of Health issued the "National Rural Doctor Education Plan for 1991-2000", which officially proposed to implement systematic and formal secondary medical education for rural doctors (hereinafter referred to as "two education").
In 1992
This year, "capital" is still a bit vague, but it has entered rural medical care.
The Ministry of Health and the Ministry of Finance issued the "Notice on Several Opinions on Strengthening Rural Health Work", the main content of which is: the establishment of cooperative medical care on the principle of voluntary mutual benefit; the beneficiaries, the whole people, collective enterprises, public institutions and social groups raise funds from various sources.
In 1994
The Regulations on the Administration of Medical Institutions and supporting regulations were promulgated, and the basic standards for village clinics were promulgated.
It clarifies the basic conditions that the village clinic should have, and regulates the behavior of rural doctors to a certain extent. However, the "standard" only defines rural doctors in terms of the conditions for practicing medicine, and lacks effective constraints on medical practice.
January 15, 1997
This year, secondary school education and income improvement have become high-frequency words for everyone to communicate.
The "Decision of the CPC Central Committee and the State Council on Health Reform and Development" proposes that by 2000, 80% of rural doctors in the country will reach the level of secondary school. The income of village doctors organized by village collectives is not lower than that of local village cadres.
June 26, 1998
The Standing Committee of the National People's Congress passed the Law on Practicing Physicians, and the management of doctors nationwide began to have a law to follow.
Article 45 of the Supplementary Provisions stipulates that rural doctors who provide preventive, health care and general medical services to villagers in rural medical and health institutions may obtain the qualifications of practicing physicians or practicing assistant physicians in accordance with the relevant provisions of this Law.
Rural doctors who do not have the qualifications of practicing physicians or practicing assistant physicians as provided for in this Law shall be separately formulated by the State Council for the management of administrative measures.
October 16, 1999
With the well-known grassroots integration, the state has taken shape in the last century.
The Basic Department of the Ministry of Health has "Several Opinions on Further Actively and Steadily Promoting the Integrated Management of Township (Town) and Village Health Organizations", and the integrated management of townships (towns) and villages has become relatively common throughout the country.
2000 AD
May 24, 2001
This year, practicing physician assistants became the focus of heated discussions.
The state issued the Guiding Opinions on the Reform and Development of Rural Health, and strived to complete the transformation of rural doctors into practicing assistant physicians in most rural areas in 10 years.
December 29, 2001
The Ministry of Health promulgated the National Rural Doctor Education Plan for 2001-2010, which stipulates that rural doctors born after December 31, 1970 must obtain the qualification of practicing assistant physician.
February 27, 2002
In this year, the township health center had a new ownership, which also laid the rudiments for a series of subsequent reforms.
The General Office of the Ministry of Health and the General Office of the Ministry of Personnel issued the "Emergency Notice on Temporarily Freezing the Personnel of Township Health Centers", and the township health centers will be transferred to the county-level health administrative departments for management, and the personnel system will be further reformed.
In order to ensure the smooth implementation of the reform and adjustment of township health centers, before the specific reform measures of county-level government departments are introduced, the personnel of township health centers are temporarily frozen and may not be transferred at will.
January 1, 2004
The Regulations on the Administration of rural doctors' practice were officially implemented, and rural doctors were officially licensed to practice in the name of the village doctors after passing the corresponding registration and training examinations.
The "Regulations" also clearly stipulate the access, training, and assessment of rural doctors, and block people who have not undergone academic education from entering this team.
August 2006
During the year, preventive health tasks gradually moved into their work.
The State issued the "Rural Health Service System Construction and Development Plan", which pointed out that other medical and health institutions run by society and individuals are part of the rural health service network, and in addition to providing medical services, they can also undertake preventive health care tasks.
December 21, 2006
The Ministry of Health promulgated the Measures for the Qualification Examination of Traditional Medicine Teachers and Physicians with Real Expertise. Fellow doctors who do not have a formal diploma but have rich practical experience have a new opportunity to allow a group of unqualified people to take the traditional medicine examination through the teacher examination.
September 10, 2007
The Ministry of Health, the Ministry of Finance and the State Administration of Traditional Chinese Medicine issued the Guiding Opinions on Improving the New Rural Cooperative Medical Compensation Scheme.
It is pointed out that it is necessary to gradually standardize the overall planning model; rationally formulate compensation plans; standardize the use of funds; clarify the scope of fund compensation; standardize hospitalization compensation; strengthen outpatient compensation management; improve the utilization rate of funds; and improve referral and settlement methods.
August 1, 2008
The Ministry of Health issued the Measures for the Assessment of Rural Doctors, which stipulates that the assessment of rural doctors shall be organized every 2 years.
August 18, 2009
This year, the essential medicines system was officially introduced.
The State Council issued the Implementation Opinions on the Establishment of the National Essential Drugs System, the Measures for the Administration of the National Essential Drugs List (Provisional) and the National Essential Drugs List (Grassroots Part).
It is required that all essential drugs be equipped for use in grass-roots medical and health institutions, and other types of medical and health institutions must be used in accordance with regulations and determine the proportion of use.
March 13, 2013
The Ministry of Health published the 2012 edition of the National Essential Medicines List.
Compared with 2009, essential drugs are no longer divided into primary medical institutions equipped with the use part, other medical institutions equipped with the use part, and the list of essential drugs is the basis for the allocation and use of drugs in medical and health institutions at all levels.
August 23, 2013
This year, there was an important notice on the issue of pension and treatment that has attracted much attention.
The National Health and Family Planning Commission issued the Notice on Further Improving the Pension Policy for Rural Doctors and Improving the Treatment of Rural Doctors.
All localities are required to fully understand and attach great importance to the important role of rural doctors in the grass-roots medical and health service system, regard the construction of rural doctors and old-age security as an important part of deepening the reform of the medical and health system, and strictly implement relevant policies.
The "Circular" requires that all localities should speed up the formulation and improvement of the pension policy for rural doctors, adopt various forms to improve the pension treatment of rural doctors, and ensure that their pension income is not lower than the minimum living security level of local residents. Localities with the capacity may combine the integrated management of rural health services to include rural doctors who have obtained the qualification of practicing (assistant) physicians into the establishment and unified management of township health centers.
The "Notice" proposes that it is necessary to effectively guarantee the treatment of rural doctors and fully implement the compensation policy for rural doctors. All localities shall adopt the method of pre-allocation first and settlement later to issue subsidies to rural doctors, and the county-level financial departments shall directly allocate more than 80% of the subsidy funds to rural doctors on a monthly basis, and the balance shall be issued after assessment, and must not be misappropriated or withheld.
October 18, 2013
The state issued the "National Rural Doctor Education Plan (2011-2020)". The county-level health and family planning administrative department is required to train rural doctors practicing in village clinics for free of charge at least 2 times a year, and the cumulative training time is not less than 2 weeks.
In principle, rural doctors should go to county-level medical and health institutions or qualified central health centers for full-time training every 3-5 years, and the duration of further study is not less than 1 month in principle.
January 19, 2015
The meeting once again decided to increase the basic public health service fee in 2015 and use it to subsidize village doctors through the government's purchase of services.
On the one hand, it is necessary to effectively guarantee the reasonable income of rural doctors, on the other hand, it is also necessary to improve the pension treatment of rural doctors.
July 1, 2016
This year, the title of grassroots doctor began to be based on clinical heroism.
The Ministry of Human Resources and Social Security issued the Opinions of the Ministry of Human Resources and Social Security on Strengthening the Construction of the Team of Grass-roots Professional and Technical Personnel.
The "Opinions" pointed out that there are no mandatory requirements for papers, scientific research, etc., and can be replaced by work summaries, teaching plans, medical records, technical promotion summaries, engineering project plans, patent achievements, etc. that can reflect the performance and level of professional and technical work.
In 2017
Hospitals above the second level across the country have successively ordered the cessation of outpatient infusions. The restrictions on the grass-roots level are also becoming more and more stringent, and Hunan, Shaanxi, Zhejiang and other places have proposed that the infusion of the village clinic should be approved and filed, and the infusion service shall not be carried out without approval.
There is another big thing, the family doctor contract is officially rolled out nationwide. In provinces (autonomous regions and municipalities), more than 85% of the prefectures and cities have carried out family doctor contract service work, and the coverage rate of the contracted service population has reached more than 30%.
In 2019
The state began to build 500 county medical communities, and the reform of primary medical care has undergone tremendous changes.
Strive to have 1 general practitioner per health center in poor areas by 2020, and the open recruitment of township health centers can appropriately relax the conditions and promote the reform of the salary system of grass-roots medical institutions. With a series of drastic reforms, China's grass-roots medical reform has officially entered the deep water area.
In 2021
This year, the National Rural Revitalization Bureau was officially listed, and the Rural Revitalization Promotion Law was officially implemented. The construction of the rural medical team has been written into the 2021 government work report, and the significance is self-evident.
2021 marks the centenary of the founding of the Communist Party of China and the 72nd anniversary of the founding of the People's Republic of China. They also grew up with New China, working tirelessly through ups and downs, and some generations stuck to their posts as village doctors and silently dedicated themselves.
There are 70 years of grassroots medical care, and there are also generations of wonderful youth. Present this article, along the way, thank you for your companionship!
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Hats off to the village doctor!