Rural health work is the focus of China's health work, related to the protection of rural productivity, revitalization of the rural economy, and maintain rural social development and stability of the overall situation. In order to promote the development of health undertakings in our county, at the beginning of the year, the county people's Congress Standing Committee of rural health work as an important issue for consideration this year. Before the deliberation, organized a survey group, led by Zhang Jianping, deputy director of the county people's congress standing committee, the county rural health work. Has listened to the county health bureau relevant work report, in-depth visits to the next, Fu should be 12 townships, streets, field visits to the county people's hospital and other 5 county-level medical institutions and 8 townships (centers) health centers, respectively, the Food and Drug Administration and other 13 relevant departments and relevant medical institutions in charge of the symposium to listen to the views and understand the situation. Now the investigation is reported as follows:
A, the basic situation
In recent years, the county government and health departments adhere to the people-oriented, conscientiously implement the party and the state a series of guidelines and policies on rural health work and related laws and regulations, to strengthen the work of rural health, to establish and improve the rural health care service system, and to promote the development of the rural public **** health undertakings. Mainly embodied in the following three aspects:
(a) Rural health work has been the attention of the government at all levels
In recent years, the county government of rural health work as an important part of the construction of a new countryside, on the important agenda, included in the county "Eleventh Five-Year" economic and social development plan. Has developed and issued "on the strengthening of rural public **** the implementation of health work", "on the establishment of a new type of rural cooperative medical security system of the pilot opinions" and other related policy documents. Provinces, cities and counties attach importance to rural health investment, in 2006 **** invested 44.5 million yuan, of which 18.95 million yuan of the county financial input, increased investment in public **** health and medical care. Actively carry out publicity and education on health-related policies, laws and regulations and health knowledge. The townships (streets) attach importance to health work, clear leaders in charge, establish a working mechanism, strengthen the implementation of work, and grasp the rural health work in the region.
(2) rural public **** health work solidly. First, the implementation of farmers' health project has been effective. "Farmers Health Project" is the 2006 provincial, municipal and county governments to do practical work for the people. Our county comprehensively carry out rural public **** health three categories of 12 services, in 2006 for more than 130,000 farmers for free health checkups, and the establishment of health records, the implementation of classification management. The project has been recognized by the relevant leaders at higher levels, and CCTV and many other media have conducted interviews and reports. The new rural cooperative medical system is running in an orderly manner, over the past three years, has basically established the framework of the new rural cooperative medical care, the initial formation of an effective operation mechanism. 2007, the county's participation in the number of more than 330,000 people, the participation rate of 78%, the cumulative total of nearly 400,000 people to enjoy the new rural cooperative medical compensation to a certain extent to reduce the insured farmers and patients of the medical burden. Second, the prevention and control of disease in rural areas has been carried out effectively. Adhering to the policy of prevention, the government has attached great importance to the prevention of infectious diseases such as SARS and human avian influenza, and key infectious diseases have been effectively controlled. Immunization planning has been implemented, and the inoculation rate of the "five vaccines" for children has reached more than 95%. Actively carry out the knowledge propaganda of infectious disease prevention and control and the prevention and control of chronic non-communicable diseases, and no major epidemics occurred in the county. Thirdly, we are actively doing a good job in rural maternal and child health care. Solidly carry out the "Maternal and Child Health Project" work, in 2006 for the first time to achieve zero maternal mortality, child mortality rate declined year by year. Fourth, we are vigorously carrying out environmental health improvement activities. To change the water and toilet as the focus of sanitation and environmental remediation efforts to increase. At present, 560 natural villages in the county*** have built running water stations, and more than 190,000 people have access to running water; more than 8,000 open cesspits have been dismantled, 349 public toilets have been built, and 47,000 households have completed toilet reconstruction. Fifthly, blood donation has made outstanding achievements. The county's blood donation work has been recognized six times as the provincial and municipal "advanced county of blood donation." In October 2004, the county government as the only county-level unit won the National Blood Donation Promotion Award.
(3) the construction of rural medical and health service system gradually improved. First, the establishment of a sound county, township and village health service network. The formation of seven county-level medical and health institutions, 18 township (center) health centers for community health service centers, 42 village-level community health service stations. Secondly, the shareholding responsibility reform has been implemented for township (central) health centers, and the economic target management responsibility system has been fully implemented in central health centers. With the implementation of the Farmers' Health Project and the improvement of the service model, the operating conditions of township (central) health centers have improved to a certain extent. Third, the construction of rural health personnel has been strengthened. The entrance to the personnel is strictly controlled, and strict requirements are set for the recruitment of outstanding graduates to fill the rural medical institutions. The quality improvement project for rural health technicians has been implemented, and the business level of rural health technicians has been further improved through the selection of the "Ten Best Village Doctors", the holding of various types of business training, and the organization of various types of academic education. Fourth, we are fully committed to the construction of medical quality. Developed the "Xianju County medical quality construction work program", to strengthen the medical unit's own capacity building, through the implementation of the level assessment, improve the hospital's management level and service level. We have carried out the activity of "Strengthening Medical Quality Management, Striving for 100 Days without Accident", effectively strengthened medical safety education, implemented the medical quality accountability system, and strengthened the sense of responsibility and safety consciousness of medical personnel. Developed and improved the township (center) health center medical quality assessment standards, the establishment of a monthly supervision and notification system, and grasp the supervision and implementation. Fifth, health supervision is constantly strengthened. Conscientiously implement the "Food Sanitation Law" and "Prevention and Control of Occupational Diseases Law", to grasp the food safety, health licensing, occupational health and other special rectification, and increase the comprehensive law enforcement of rural health, to promote food hygiene and medication safety.
Two, the main problems
(a) the atmosphere of rural health work is still not strong. Governments at all levels and relevant departments to do a good job in rural health work is not enough to recognize the importance of people-oriented social development, human development and health-oriented awareness and the concept of health is not strong, not to form a rural health work. Health laws and regulations, policies and health knowledge of publicity and education is not enough, the general public health subject awareness is not strong, the lack of health care concept and basic health care knowledge, prevention-oriented thinking has not yet formed **** knowledge, treatment is light on the concept of prevention is still unchanged.
(2) rural health care service capacity is not strong enough. First, the infrastructure of medical institutions lagging behind. Our county medical institutions generally lack of development planning, operating space is very tight. County People's Hospital as the county's largest general hospital, covers an area of only 40 acres, medical rooms are very crowded, far from meeting the needs of the masses of medical services, hospital relocation project in 2003 to complete the project and land approval, but for a variety of reasons, has not yet begun, seriously restricting the construction and development of hospitals; hospitals, maternity hospitals, psychiatric hospitals and other county hospitals and Hengxi, Baita, under the various Central Health Center, such as insufficient operating space, psychiatric hospital housing tension, poor conditions, the county CDC, Chengguan Hospital is still renting housing office; most medical units generally backward facilities and equipment and other issues, township health centers have not been equipped with an ambulance, it is difficult to carry out effective medical and health services. Secondly, the medical and technical personnel team construction and medical and health care development does not match. Lack of medical and health care personnel in the county, especially the serious lack of highly educated and highly qualified personnel, in the county 1350 health care technicians, bachelor's degree accounted for only 14.9%, senior title accounted for only 6.8%; Rural health technical force is even weaker, 514 health care technicians, bachelor's degree of only 16 people, senior title of only 6 people, the intermediate title of only 96 people, the talent problem is seriously affected The problem of talents seriously affects the level of medical technology, medical quality and medical credibility; the working environment of grass-roots medical personnel is poor, the pressure is high, the salary is low, and the basic social security such as pension insurance and medical insurance has not yet been implemented. Third, the quality of medical care still needs to be improved, and the medical order needs to be standardized. Medical personnel service consciousness is not strong enough, the phenomenon of patient outflow; medical disputes are on the rise, medical incidents occur from time to time, dealing with more difficult; the number of individual medical units, management is more difficult to combat the illegal practice of medicine is difficult. Fourth, the village-level health service network is weak, the county's 722 administrative villages only 42 village-level service stations, the public inconvenience reflected in the larger.
(C) rural public **** health construction is slow. First, disease prevention and control and maternal and child health care are still weak. Various types of infectious disease prevention and control of major diseases is still a very heavy task, the masses of disease prevention concept is not strong. Secondly, food safety hazards and drug supervision problems are reflected in a large number of issues. Agricultural products into the problem is becoming more and more prominent, agricultural testing system is not sound, testing facilities and equipment backward, food, vegetables and other agricultural products quality and safety management problems. Rural drug supply network is not sound enough, drug supervision is relatively weak, and it is difficult to guarantee the safety of the public's medication. Thirdly, the task of rural environmental health improvement is arduous. Rural drinking water quality and safety issues are more prominent, cross streams, white tower and other townships and surrounding plains villages, suburban combination of no centralized water supply facilities, direct drinking groundwater, due to groundwater pollution, drinking water safety problems, the masses call for a greater; open cesspools are still prevalent, the task of changing the toilet is heavier, some villages, although the construction of a public **** toilets, but the follow-up management work to keep up with the failure to play a role; the county of domestic Garbage disposal project progress is slow, the lack of operational mechanisms for urban and rural life garbage disposal, the lack of sanitation facilities, garbage disposal problems; sewage problems have not attracted attention, sewage facilities are not supported, and underground pollution is serious. The existence of the above public **** health problems, the phenomenon of disease and poverty is prominent.
Four) relatively insufficient investment in rural health. County finances, although the annual investment in health continues to increase, but the proportion of health funds accounted for the same level of financial expenditure has been declining. Social capital investment in health channels are not wide, not a lot. Due to the lack of investment, constraints on disease prevention and control, health law enforcement and supervision, water and toilet and other public **** health construction and medical and health unit infrastructure construction and equipment renewal, affecting the speed of development of rural health undertakings in our county.
(E) the new rural cooperative medical system is not perfect. First, the policy of agricultural medical insurance is not enough publicity, some farmers on the agricultural medical insurance awareness of bias, the masses to participate in the enthusiasm is not high. Second, the agricultural medical insurance policy is not perfect. The masses have more opinions on outpatient reimbursement, reimbursement procedures for medical treatment outside the country, the amount of reimbursement, and the task indicators of the participation rate. Third, it is more difficult to raise funds. Our county has a large number of people out of the county, to collect the household as a unit is more difficult, some village cadres have a sense of reluctance. There is a collective economy of the village by the collective payment, affecting the village economic development, cadres have greater repercussions.
Three, a few suggestions
(a) to further strengthen the concept of health protection and development, to create a good atmosphere of the whole society *** with the good work of rural health. Health is life's greatest treasure. Do a good job in rural public **** health work, strengthen medical and health services, improve people's health, is a major event for the benefit of the people, is to build a harmonious society, promote the coordinated economic and social development of a major task, is the responsibility of the party committees and governments at all levels. The county government should start from the implementation of the duty of governance for the people, fully understand the great significance of strengthening rural health work, and further strengthen the comprehensive leadership of rural health work. To y implement the central, provincial and municipal guidelines and policies on rural health work, the development of rural health development planning, clear objectives, the implementation of the relevant departments and townships (streets) in the rural health work in the responsibilities and tasks, strengthen the organization and coordination, the formation of the relevant departments, townships (streets), close cooperation, and the overall synergy of the **** management. To attach importance to and strengthen the publicity and education on health laws and regulations, policies and health knowledge, improve the public's awareness of the main health, enhance the concept of preventive health care, mobilize the whole society *** with the work of rural health, and create a social atmosphere to protect health, and promote the development of the community.
(2) further strengthen the construction of rural health care, improve the level of medical technology services
One to strengthen the infrastructure of medical institutions. To make a comprehensive plan for the development of medical institutions, clear development scale. To attach great importance to the construction of the county people's hospital, as soon as possible to study, scientifically determine the construction program, and actively organize the implementation of the county people's hospital to accelerate the solution to the current outstanding problem of room tension. Attach importance to the development of county-level medical institutions and township (central) health centers, grasp the county CDC, Chengguan hospital relocation project construction, and actively help to solve the county hospitals, women's hospitals, and Hengxi, Baita, under the expansion of central health centers, pay attention to solving the county psychiatric hospitals with the shortage of rooms, medical conditions backwardness, the lack of funds, and other practical problems and some of the township hospitals of the dangerous housing problems. Update the facilities and equipment of medical institutions, improve the credibility of medical examination, to adapt to the needs of medical development.
The second to strengthen the construction of medical and technical personnel. The survival and development of medical institutions, the key depends on the level of medical technology, medical technology talent determines the level of medical technology. Therefore, it is necessary to increase the introduction and training of medical and technical personnel, establish and improve the mechanism for the introduction of talent, improve the introduction of talent and examination policy, and rational allocation of talent. Strengthen the education and training of in-service medical personnel, continuously increase the proportion of middle- and senior-level physicians and practicing physicians, and further enhance the overall quality of medical and technical personnel. Emphasis is placed on solving the basic social security problems of medical and health personnel, such as pension insurance and medical insurance.
Three to strengthen the construction of medical quality, standardize medical order. The county people's hospital to cultivate and gather high, precise, sharp medical experts, and constantly promote the county's medical and health technology to a new level, reduce the outflow of patients. Township (center) health centers should strengthen medical capacity building, and constantly improve the level of general medical skills. Strengthen medical quality management and reduce the occurrence of medical accidents. Attention should be paid to giving full play to the advantages and role of traditional Chinese medicine in rural health services, and actively excavating, collecting and organizing folk medicine techniques and ancestral recipes. We should strengthen the construction of medical and health care practices, improve medical ethics, and enhance the service consciousness and professional self-discipline of medical personnel. Strengthen the management of individual medical units, individual medical units to play a positive role in facilitating the mountainous areas of the masses to seek medical treatment, and resolutely crack down on all kinds of health hazards to the farmers of the illegal practice of medicine, standardize the medical order.
Four to deepen the reform of health care management system. To follow the government-led, social participation, conversion mechanism, strengthen the principle of supervision, starting from the solution of the most strongly reflected by the masses of the outstanding issues, deepen the reform of the medical and health management system, improve the operating mechanism of medical institutions, strengthen the function of public **** services, standardize service behavior. It is necessary to promote the reform of township (central) health hospitals, rationalize the allocation of resources, improve the mode of service, and form a vibrant and dynamic mechanism for employing and distributing incentives to improve efficiency. The construction of village-level health community service networks should be strengthened, and they should be responsible for the initial diagnosis and treatment of common diseases and for preventive health care. To give full play to the role of medical institutions organized by individuals in society, to improve the integration of rural health service management, and to enhance overall effectiveness.
(3) to further strengthen the rural public **** health construction, to provide basic protection for farmers' health. Public **** health is the source of people's health. One should strengthen disease prevention and control. To adhere to the prevention-oriented, prevention and treatment policy, strengthen the prevention and control of key infectious diseases, occupational diseases and other major diseases, improve the construction of rural public **** health emergency response system, improve the ability to deal with major epidemics and public **** health emergencies. Second, to strengthen maternal and child health care. It is necessary to earnestly implement the Maternal and Child Health Project, pay attention to the construction of obstetrics and pediatrics, strengthen maternal and child health care, and improve the basic quality of the birth population. Third, we must strengthen the safety management of medicines and food hygiene. It is necessary to establish and improve the rural drug supply and supervision network, increase the supervision of drug purchasing and selling, and organize inspections of the drug purchasing channels, quality, duration and drug prices of rural health institutions, so as to ensure that farmers have access to safe, effective and inexpensive drugs. To implement the "food safety project" as a carrier, and actively carry out comprehensive law enforcement supervision of health, increase the supervision of food production, processing, sales and catering industry, and increase the fertilizers, pesticides, veterinary drugs, feed additives and growth hormones and other agricultural inputs remediation efforts, to prevent the contamination of agricultural products from the source. Strengthen food safety standards and inspection and testing system construction, as soon as possible to establish a comprehensive testing center for agricultural products in the county drugs. Fourth, we should further emphasize the environmental health improvement work focusing on water and toilet. To speed up the construction of Hengxi water plant, early solution of Hengxi, Baita and other townships of the drinking water problem, strengthen the combination of suburban water pipeline network facilities construction, and effectively solve the problem of drinking water quality and safety of suburban residents. To strengthen the construction of rural sanitary latrines, public **** toilet construction should be adapted to local conditions, to play the role of the built public **** toilet. To grasp the county garbage disposal project construction, and strive to be completed on schedule. Improve the rural garbage disposal facilities, improve the processing capacity, the establishment of the actual towns and villages in line with the county's garbage hierarchical processing operation mechanism. To pay attention to the construction of rural sewage facilities, rural environmental health improvement to give full play to the residents, the main role of the villagers, guide the establishment of good hygiene habits, advocate scientific, civilized, healthy lifestyle, improve rural environmental health, improve the quality of life.
(4) further increase investment, to provide a strong guarantee for the development of rural health. To strictly in accordance with the central and provincial policies on rural health work, increase the investment in rural health, its growth rate is not lower than the growth rate of financial recurrent expenditure in the same period. The proportion of health investment in financial expenditure at the same level has increased year by year, and the annual increase in health funding is mainly used for the development of rural health, to ensure that health supervision, disease prevention and control, maternal and child health care and health education and other public **** health funding and rural health service network construction funds. It is necessary to rationalize the funding for basic medical services in township (central) health centers and for the development and construction of rural health undertakings, to strengthen the management of rural health funding, and to give full play to the effectiveness of the use of funds. To give full play to the role of the market mechanism, multi-channel to attract social capital investment in health undertakings, the formation of the main body of diversified investment, diversified investment mode of input system.
(E) to further improve the rural cooperative medical system, to solve the problem of farmers due to disease, poverty, poverty. First, we must further unify the thinking, and effectively raise the awareness of the masses of cadres and cadres of the new rural cooperative medical system, extensive and in-depth policy propaganda and typical guidance, to improve the farmers' awareness of self-protection, mutual ****ji consciousness and health risk awareness, mobilize the farmers to participate in the enthusiasm, improve the participation rate, reduce the economic burden of the village level. Second, we should seriously study the outstanding problems in the implementation of the new rural cooperative medical care, and strive to improve the management system. Medical reimbursement, procedures, reimbursement amount, participation rate of task indicators, designated hospitals set up and other issues, to be a special study to improve. Third, we must actively do a good job of agricultural health insurance financing, the formation of an effective financing mechanism, use, manage the rural cooperative medical fund, to ensure the orderly operation of the cooperative medical funds, to play the most effective role of rural cooperative medical care, improve the health of farmers.