Focus

Radical treatment for healthcare

By Hu Yinan (China Daily)
Updated: 2010-09-16 07:43

Doctors' fears

In rural areas, problems generated by previous market-driven reforms are causing fresh headaches as officials try to restructure village clinics into public health facilities.

Under the new initiative, provincial health authorities pay annual compensation of 8,000 yuan to each clinic in a village with a population of more than 1,200.

However, 17 of the 32 pilot sites said in their assessment that the earnings of rural doctors had gone down exponentially and needed immediate intervention.

Dongzhi, one of the pilot counties, reported that its doctors on average made 20,000 yuan a year before the reform - 70 to 80 percent coming from drug profits. The regulation of drug prices will cut estimated incomes this year to just 35 percent of that, according to the submitted assessment.

Zhang Gongyong has been the only doctor in the mountainous Qianshan village since 1974 but is not qualified to receive the 8,000 yuan compensation as he serves only 400 people.

The 56-year-old made 8,000 yuan at his clinic in 2009, as well as 2,000 yuan from growing tea and oranges and 1,200 yuan from government subsidies. However, the latest drug pricing regulations mean his total net income will fall by 5,000 yuan this year.

For the time being, Zhang is fine with the changes. "If other people can survive, so can I. Somebody's going to have to work for public health in villages," he said.

Rural youngsters have become much less motivated to join village clinics in recent years and more than half of the 400 village doctors in Shexian county are older than 50.

"Fewer kids are studying medicine," said the veteran medic. "People can make at least 30 to 40 yuan a day as migrant workers. That's not the pay you can expect as a village doctor."

He added: "I'll be here until I'm too old for it. There's no retirement."

Zhang Gongyong has been the only doctor in the impoverished Qianshan village since 1974. He is one of many village medics who will be affected by the rural medical reform in Anhui, with his annual income expected to fall by 5,000 yuan this year.