The State Council City Community Development Committee
Guiding opinions on health services
Guo Fa [2006] 10 No.
People's governments of all provinces, autonomous regions and municipalities directly under the Central Government, ministries and commissions and institutions directly under the State Council:
Community health service is an important part of urban health work and a basic link to realize the goal of primary health care for all. Vigorously developing community health service and building a new urban health service system based on community health service, with reasonable division of labor and close cooperation between community health service institutions and hospitals and preventive health care institutions, is of great significance for adhering to the policy of putting prevention first and combining prevention with treatment, optimizing the urban health service structure, facilitating people to seek medical treatment, reducing the burden of expenses and establishing a harmonious doctor-patient relationship.
Since the reform and opening up, China's urban health undertakings have made great progress, the service scale has been continuously expanded, the level of science and technology has been continuously improved, the medical conditions have been significantly improved, and the ability to prevent and treat diseases has been significantly enhanced, which has played an important role in improving people's health. At the same time, there are still some problems in the development of urban health services, such as excessive concentration of high-quality resources in large hospitals, shortage of community health service resources and weak service capacity, which can not meet the basic health service needs of the masses. This is one of the important reasons why it is difficult and expensive for ordinary people to see a doctor. In order to deepen the reform of urban medical and health system, optimize the structure of urban health resources, develop community health services, and strive to meet the basic health service needs of the masses, the following guiding opinions are formulated:
First, the guiding ideology, basic principles and working objectives of developing community health services
(1) guiding ideology. Guided by Deng Xiaoping Theory and Theory of Three Represents, we should fully implement Scientific Outlook on Development, adhere to the direction of serving people's health, take the development of community health service as an important measure to deepen the reform of urban medical and health system, effectively solve the problems of difficult and expensive medical treatment for urban residents, build a new urban health service system on this basis, and strive to promote institutional and institutional innovation to provide residents with safe, effective, convenient and economical public health services and basic medical services.
(2) Basic principles.
-Adhere to the public welfare nature of community health services and pay attention to the fairness, efficiency and accessibility of health services.
-Adhere to government leadership, encourage social participation, and develop community health services through multiple channels.
-adhere to regional health planning, based on the adjustment of existing health resources, supplemented by expansion and construction, and improve the community health service network.
-Adhere to paying equal attention to public health and basic medical care, Chinese and Western medicine, and combining prevention and treatment.
-Adhere to local priorities, adjust measures to local conditions, explore and innovate, and actively promote.
(3) Work objectives. By 20 10, cities above the prefecture level and county-level cities with conditions will establish a relatively complete urban community health service system. The specific objectives are: reasonable establishment of community health service institutions, sound service functions, high personnel quality, scientific operation mechanism and standardized supervision and management, so that residents can enjoy public health services such as disease prevention and basic medical services for common and frequently-occurring diseases in the community. Cities at or above the prefecture level in the eastern and central regions, provincial capitals in the western region and qualified prefecture-level cities should accelerate their development and strive to make significant progress in two or three years.
Two, promote the construction of community health service system
(four) adhere to the nature of public welfare, improve the function of community health services. Community health service institutions provide public health services and basic medical services, which are public welfare and not for profit. It is necessary to take communities, families and residents as the service targets, and women, children, the elderly, patients with chronic diseases, disabled people and poor residents as the service focus, giving priority to active services and door-to-door services, and carrying out health education, prevention, health care, rehabilitation, family planning technical services and diagnosis and treatment services for common and frequently-occurring diseases.
(five) adhere to the government, encourage social participation, establish and improve the community health service network. Local governments should formulate development plans and establish and improve a community health service network with community health service centers and community health service stations as the main body, supplemented by clinics, clinics, nursing homes and other grassroots medical institutions. In large and medium-sized cities, in principle, the government shall set up 1 community health service centers with 354.38+million residents or under the jurisdiction of street offices, and a number of community health service stations may be set up according to needs. Community health service centers and community health service stations can implement integrated management. Community health service institutions mainly set up primary medical institutions such as first-class hospitals and some second-class hospitals organized by the government and affiliated medical institutions of state-owned enterprises and institutions by adjusting existing health resources. The existing health resources are insufficient and should be supplemented and improved. In accordance with the principles of equality, competition and merit, we will make overall plans for the development of community health service institutions, encourage social forces to participate in the development of community health services, and give full play to the role of community health service institutions organized by social forces.
(six) to establish a reasonable division of labor and cooperation between community health service institutions and preventive health care institutions and hospitals. Adjust the functions of prevention and health care institutions such as disease prevention and control, maternal and child health care, and hand over public health services suitable for community development to community health service institutions. Disease prevention and control, maternal and child health care and other preventive and health care institutions shall provide business guidance and technical support for community health service institutions. Implement various forms of joint and cooperation between community health service institutions and large and medium-sized hospitals, establish graded medical care and two-way referral system, explore the pilot system of community first diagnosis, and community health service institutions will gradually undertake general outpatient, rehabilitation and nursing services in large and medium-sized hospitals.
(seven) to strengthen the construction of community health service team. Strengthen general practice and community nursing education in medical colleges, actively train general practitioners and nurses for the community, and encourage medical college graduates to serve in community health service institutions. Improve the qualification system of general practitioners, nurses and other health technical personnel, formulate employment methods, strengthen on-the-job training, carry out standardized training, and improve personnel quality and professional and technical ability. It is necessary to take various forms to encourage and organize senior and middle-level health technicians from large and medium-sized hospitals, preventive health care institutions and family planning technical service institutions to regularly provide technical guidance and services to community health service institutions, and community health service institutions should organize health technicians to go to hospitals and preventive health care institutions for further study and participate in academic activities in a planned way. Encourage retired medical personnel to participate in community health services in accordance with relevant regulations.
(eight) improve the operation mechanism of community health services. The community health service institutions run by the government belong to public institutions, and the personnel management system should be reformed according to the principles of the reform of public institutions. In accordance with the requirements of service and high efficiency, measures such as quota, open recruitment, contract employment, post management and performance appraisal should be implemented. Reward people who perform well in their work; If the training still fails to meet the requirements, the employment relationship shall be terminated according to the relevant provisions of the state. It is necessary to reform the income distribution management system, implement the income distribution method with post salary and performance salary as the main content, and strengthen and improve the management of total wages. The income of community health service practitioners shall not be directly linked to the service income.
All regions should actively explore the establishment of a scientific and reasonable revenue and expenditure management mechanism for community health services, standardize revenue and expenditure management, and implement pilot projects of two lines of revenue and expenditure management where conditions permit. Local governments should, according to the way of purchasing services, approve financial subsidies according to the quantity, quality and related costs of public health services provided by community service population and community health service institutions; Those who do not have the conditions can be approved according to the basic salary of personnel and the funds needed to carry out public health services, and actively explore and create conditions to improve financial subsidies. All regions should take effective measures to encourage pharmaceutical production and operation enterprises to produce and supply drugs commonly used in community health services with high quality and low price, and carry out pilot projects of centralized government procurement, unified distribution and zero-difference drug sales.
(nine) to strengthen the supervision and management of community health services. Standardize the conditions and standards for setting up community health service institutions, strictly access community health service institutions, employees and technical service projects according to law, clarify the scope and content of community health service, improve the technical operating rules and working system of community health service, improve the evaluation system of community health service, and promote the construction of community health service information management system. Strengthen the standardization of community health services, timely adjust and withdraw from community health service institutions and staff who do not meet the requirements, and ensure the quality of service. Strengthen the supervision of community health service practice, establish a social democratic supervision system, and take the satisfaction of residents in receiving services as an important criterion for evaluating the performance of community health service institutions and employees. Give play to the role of industry self-regulatory organizations in providing services, reflecting demands and standardizing behaviors. Strengthen the management of drugs and medical devices to ensure medical safety. Strict financial management, strengthen financial and audit supervision.
(ten) give play to the advantages and functions of traditional Chinese medicine and ethnic medicine in community health services. Strengthen the capacity building of community Chinese medicine and ethnic medicine services, rationally equip professional and technical personnel of Chinese medicine or ethnic medicine, actively carry out basic knowledge and skills training of Chinese medicine for community health service practitioners, and popularize and apply appropriate Chinese medicine and ethnic medicine technologies. In prevention, medical treatment, rehabilitation and health education, we should make full use of the resources of traditional Chinese medicine and ethnic medicine and give full play to their respective characteristics and advantages.
Third, improve the policies and measures to develop community health services.
(eleven) to formulate and implement the development plan of community health service. Local governments should formulate medium-and long-term plans and annual development plans for the development of community health services, incorporate the development of community health services into local national economic and social development plans and regional health plans, and implement policies and measures for planning and implementation. In the construction and reconstruction of urban residential areas, community health service facilities should be planned, constructed and put into use simultaneously with residential buildings. In principle, the people's governments of municipal districts will no longer hold hospitals, focusing on the development of community health services.
(twelve) increase investment in community health services. Governments at all levels should adjust the financial expenditure structure, establish a stable financing and investment mechanism for community health services, and increase investment in community health services. Local governments should provide necessary housing, medical equipment and other facilities for community health service institutions, give appropriate subsidies for business training, and approve subsidies for community public health services such as preventive health care according to community population, service items and quantity, quality and related expenses. The expenses of retirees from community health service institutions organized by the government shall be arranged by the local government according to the relevant provisions before the reform of the old-age security system of public institutions. Local governments should further increase their efforts to arrange community public health service funds according to local actual conditions, and gradually increase with economic development. Since 2007, the central government has subsidized the development of community public health services in the central and western regions according to certain standards. The central government gives necessary support to the infrastructure construction, basic equipment configuration and personnel training of community health service institutions in the central and western regions.
(thirteen) to play the role of community health services in medical security. In accordance with the principle of "low level and wide coverage", we will continue to expand the coverage of medical insurance, improve the fixed-point management methods of basic medical insurance for urban employees and the settlement methods of medical expenses, incorporate qualified community health service institutions into the designated medical institutions of basic medical insurance for urban employees, and incorporate qualified medical services into the payment scope of basic medical insurance, and guide the insured to make full use of community health services. Explore the establishment of urban medical assistance system based on community health services.
(fourteen) to implement the responsibilities of relevant departments and promote the development of community health services. All relevant departments should earnestly perform their duties and promote the development of community health services.
-The health department is responsible for formulating the development plan, access standards and management norms of community health services, formulating community public health service projects, and strengthening industry supervision and management. In accordance with the relevant provisions of the state, organize on-the-job training and continuing education for community health service practitioners.
—— The organization department takes the lead in studying and formulating the staffing standards of community health service institutions organized by the government.
-The development and reform department is responsible for bringing the development of community health services into the national economic and social development plan, and arranging the infrastructure construction investment of community health service institutions according to the needs. The price department should study and formulate community health service charging standards and drug price management measures.
-The education department is responsible for general practice and community nursing education, and regards community health service skills as an important part of medical education.
—— The civil affairs department is responsible for incorporating community health services into community construction planning, exploring the establishment of urban medical assistance system based on community health services, and doing a good job in democratic supervision of community health services.
-the financial department is responsible for formulating the financial subsidy policy and financial revenue and expenditure management measures for community health services.
-The personnel department is responsible for improving the qualification system of general practitioners, nurses and other health technicians, formulating employment methods and related policies for community general practitioners, nurses and other health technicians, and attracting outstanding health talents into the community.
-The labor and social security department is responsible for formulating relevant policies and measures to promote the insured persons of basic medical insurance for urban workers to visit community health service institutions.
—— The construction (planning) department is responsible for incorporating community health service facilities into urban construction planning in accordance with relevant national standards and strengthening supervision according to law.
-the population and family planning department is responsible for the guidance and management of community family planning technical services.
-The food and drug supervision department is responsible for the quality supervision and management of drugs and medical devices needed for community health services.
-The Chinese medicine department is responsible for formulating relevant policies and measures to promote Chinese medicine and ethnic medicine to serve community residents.
Four, strengthen the leadership of community health services.
(fifteen) the development of community health services is an important part of the government to perform social management and public service functions, and the main responsibility lies with local governments. Local governments should fully understand the significance of developing community health services in maintaining residents' health and promoting community harmony, conscientiously implement relevant national policies, and incorporate the development of community health services into the annual work target assessment of the government. It is necessary to set up a leading group headed by the government in charge of the leadership and attended by responsible comrades of relevant departments to strengthen the leadership over the development of community health services. The people's governments at the provincial level shall, in accordance with the requirements of the Guiding Opinions, formulate specific implementation policies and measures, clarify responsibilities at all levels, strengthen investigation and study, make overall plans and coordination, supervise and guide, and implement tasks. The State Council has set up a leading group for urban community health work headed by Vice Premier the State Council, who is in charge of health work, to study and formulate policies and measures to promote the development of community health, study and solve major problems in the work, strengthen the inspection and guidance of local community health services, and promote the sustained and healthy development of community health services.
the State Council
February 2, 20061day