Municipal Health Bureau, Municipal Development and Reform Commission, Municipal Finance Bureau
Municipal Civil Servants Bureau, Municipal Editorial Office
(April 2012)
For the implementation of the "Notice of the General Office of the People's Government of Fujian Province Transmitting the Opinions of the Provincial Department of Health and Other Departments on Strengthening Efforts to Cultivate and Enrich Grassroots Health Talents The Notice of Opinions" (Minzhengban [2011] No. 111) and "Fujian Provincial People's Government General Office forwarded to the Provincial Department of Health and other departments on the promotion of the implementation of the reform of the personnel system of primary health care institutions notice" (Minzhengban 〔2011〕 No. 160) and other documents, and to further strengthen the construction of the city's health care personnel, through the cultivation of talents to enrich the grass-roots level of health care personnel, through preferential policies to stabilize the grass-roots level of health care personnel, through job opportunities, through the training of talents to enhance the health care personnel. grass-roots health talent, through job training to enhance the service capacity of grass-roots health talent, through strengthening the management of grass-roots health talent to play the role of grass-roots health talent, to solve the problem of the lack of talent in the city's primary health care institutions, within five years to achieve the "general health hospitals, medical and nursing positions not less than 90% of the total number of positions, the center of the health hospitals and community health service centers of the medicine, nursing and technical positions not less than 85% of the total number of positions". 85% of the total number of positions" goal, to meet the needs of urban and rural residents of basic medical and public **** health services. Now combined with the actuality of the city, put forward the following implementation views.
One, further enrich the primary health care institutions, health and technical personnel
March 2011, the city township health centers and community health centers *** approved establishment of 6,365 people, but only 3,990 people in the staff, accounting for 62.7% of the number of the establishment, the rate of empty as high as 37.3%. There is a serious lack of technical personnel in primary health care, which to a certain extent restricts the fairness and accessibility of basic medical and health services. Through the implementation of the "five batch" measures, to effectively strengthen the grass-roots health personnel construction.
(A) for primary health care institutions to recruit a batch of practicing physicians
For the city's primary health care institutions (township health centers and community health service centers) to recruit a batch of special-purpose practicing physicians. Recruitment object for clinical medicine, Chinese medicine, Chinese and Western medicine, preventive medicine, medical imaging, medical testing and clinical pharmacy and other shortage of professional undergraduate graduates and obtain the corresponding licensing qualifications. Meet the above conditions, "three support a help" service period of qualified personnel, can be directly employed as a special-purpose practitioners. Municipal personnel and health administrative departments shall formulate and organize the implementation of the recruitment plan for special-post medical practitioners in accordance with the relevant regulations on open recruitment of public institutions and division of responsibilities, adopt special open recruitment methods, and determine the candidates to be recruited in a simple and effective way through interviews and tests of practical operation ability. Special-purpose practitioners sign a three-year employment contract with the corresponding primary medical and healthcare institutions, and their wages and incomes are implemented in accordance with the relevant policies of the state, provinces and municipalities. After three years of employment, the township health hospitals of special-purpose practitioners are preferred to be employed to work in county-level medical institutions.
Provincial basic financial resources to ensure that Yongtai County, Minqing County, townships under the jurisdiction of the health hospitals employed by the special-purpose practitioners, in addition to wages and other original treatment, and then give each person 10,000 yuan per year special subsidies for three consecutive years of subsidies, by the county-level health departments directly to the individual. In addition to the provincial financial subsidy of 80% of the funds required for clinical specialties, the city and county financial matching subsidies of 10%, preventive medicine, medical imaging, medical testing and clinical pharmacy and other specialties required by the municipal financial subsidies. Receive special subsidies for special-purpose physicians no longer enjoy the provincial and municipal medical graduates tuition reimbursement policy. The special-purpose practitioners who have already enjoyed the tuition reimbursement policy will not receive the special subsidy again.
(2) for primary health care institutions commissioned a batch of undergraduate graduates
1, directed to cultivate suitable talents. The city plans to enroll 240 undergraduates in clinical medicine for township health centers and community health centers within three years, commissioning a batch of suitable talents. By the county (city) district health department in conjunction with the personnel, the preparation of the department according to the grass-roots level of vacant posts to review the commissioning plan, the city health department in conjunction with the personnel, the preparation of the department to determine the specific allocation of quotas. After the finalization of the commissioned positions to be reserved for the preparation of students after graduation to obtain a diploma and school employment letter of recommendation, by the county (city) district personnel, health departments directly assessed and hired in the commissioned positions should be at least five years of continuous work. Commissioned by the higher medical school by the municipal health department organization contact, commissioned students before enrollment and the school and the local health administration signed a fixed service agreement, directed to commissioned tuition according to the commissioned school fees by the municipal finance unified subsidies.
Strengthen the management of directed commissioned students, can not be normal graduation of directed medical students, according to the provisions of the refund has been entitled to the cost of subsidies; after graduation did not work according to the agreement to primary health care institutions, according to the provisions of the refund has been entitled to the cost of subsidies and pay five times the liquidated damages, the commissioned graduates to the non-designated primary health care institutions to practice within 10 years will not be registered. The compensation is included in the municipal extra-budgetary income, the implementation of two lines of management, by the county (city) district health bureau on behalf of the collection of financial non-tax revenue collection system into the municipal financial account. Undergraduate students entrusted with the training of orientation no longer enjoy the policy of tuition reimbursement for medical graduates.
2, the implementation of tuition reimbursement policy. To Yongtai County, Minqing County township health centers for five consecutive years of non-directional general higher medical school undergraduate graduates of clinical medicine (Chinese medicine), not yet employed graduates, continue to enjoy the provincial financial subsidies for five consecutive years of 0.5 million yuan per person per year.
June 1, 2011 onwards, to other counties (cities) township health centers for five consecutive years of non-directional medical graduates of general colleges and universities of medical sciences, enjoy the municipal finance for five consecutive years of 0.5 million yuan per person per year subsidies; to the city's community health service centers for five consecutive years of non-directional medical graduates of general colleges and universities of medical science, to the city's remote township health centers (the city's remote township health centers). The city's remote township health centers (see Annex 1) for three consecutive years of non-directional medical graduates of general colleges and universities of medical specialties, the municipal finance for five consecutive years and three years of 0.36 million yuan per person per year subsidies.
The tuition subsidy specialties are clinical medicine undergraduate, preventive medicine undergraduate, clinical medicine specialist, medical imaging specialist, medical testing specialist. Tuition subsidy scale by the county (city) district health department in conjunction with the personnel department according to the township health center establishment and job demand review announced.
The tuition fee in lieu of students not according to the agreement to work in primary health care institutions at the end of the period, to return the subsidies already enjoyed in accordance with the provisions of the cost, and within 10 years may not apply for Fuzhou city level as well as the counties (municipalities) district administrative and public institutions.
The participation of tuition fee-reimbursing students and directed and commissioned students in full-time study for more than half a year is not counted as service time.
(C) to enhance the qualifications of a number of primary health care institutions in the workforce
1, continue to implement the "recruitment of graduates of undergraduate specialties after standardized training to fill the township health hospitals work" project. In the recruitment of medical undergraduates at the same time, relying on Fujian Medical University and Fujian University of Traditional Chinese Medicine and other colleges and universities, to expand the commissioned training of clinical medicine professional "specializing in the enrollment scale.
2, the primary health care institutions in the staff approved by the unit, to participate in on-the-job academic education, after graduation by the unit to reimburse 50% of the tuition.
(D) support for primary health care institutions to rehire a number of retired doctors
To give play to the role of senior doctors to "pass on, help and lead", encourage the rehiring of middle and senior retired doctors in good health (age not more than 65 years old, the chief physician can be appropriately relaxed to the age of 68 years old) to continue to work in primary health care institutions. The role of the organization is to encourage the reappointment of middle and senior retired physicians in good health (age over 65 years old, the age of chief physician can be appropriately relaxed to 68 years old) to primary health care institutions. Employment candidates and rehiring treatment by the township health centers, community health service centers by the leadership team collective study reported to the county (city) district health administrative departments for finalization, and the list and rehiring treatment reported to the same level of the financial sector for the record. Re-recruitment of labor compensation can refer to the wages and salaries of similar personnel on duty, and the implementation of health personnel allowance, appropriate transportation subsidies. Re-employment of labor compensation by the township health centers, community health service centers on a monthly basis. Each county (city) district financial departments in carrying out primary health care institutions revenue and expenditure approval work, the income and expenditure generated by the employed retired physicians to be included in the total personnel costs of the arrangement.
The counties (cities) should strengthen the service and management of rehired talents, and actively do a good job of rehired personnel living arrangements, practice changes and other matters, to assist in the implementation of the relevant preferential policies for the introduction of talent, to rehire personnel to live and work in a convenient manner to ensure that rehired personnel to play a demonstration of the role of guidance. Municipal and county health administrative departments of the reappointment of talent assessment, outstanding performance, significant results to be recognized.
(E) county hospitals above the counterparts to send a number of senior health professionals
Continue to carry out above-county medical and health institutions to help grass-roots medical and health institutions. Each municipal hospital and county hospitals to help 1 to 4 primary health care institutions, a cycle of 3 years. Each supporting hospital sends 2 to 3 doctors each year, with a time limit of one year for doctors to be sent. Priority selection of primary health care institutions in need of doctors, while receiving free further training for primary health care technicians. Municipal and county (city) health administrative departments are responsible for building information platforms for people who need to go to the countryside for service and to the city for further training, guiding primary healthcare organizations to choose the support staff, ensuring that the dispatched staff can give full play to their specialties, and that there are no vacancies in the positions of primary healthcare organizations after dispatching the further training staff. Municipal and county health administrative departments to help the assessment of the situation, the outstanding performance, effective support hospitals, individuals to be recognized.
Two, to further strengthen the management of grass-roots health workforce
(a) rationalize the management system
Counties (cities) in accordance with the "Fujian Provincial People's Government on further accelerating the reform and development of township health hospitals," (Min Zheng [2009] No. 1), rationalize the township health hospitals management system, by the county-level health administrative departments responsible for the township health hospital personnel, management of operations and funding, and the deployment and exchange of township health center personnel within the approved establishment. The personnel of township health centers are transferred to the county health administration department. The appointment system for the directors of township health centers is implemented, with the directors being appointed by the county-level health administrative departments with reference to the requirements of the Regulations on the Selection and Appointment of Party and Government Leading Cadres, and appointed after consulting with the local Party committees and governments, and reported to the organization departments in charge of the counties (municipalities) for the record. Community health service center management system according to this way together.
(2) play the role of the establishment
1, assessment and recruitment of temporary staff. The implementation of drug zero-differential rate reform of township health centers and community health service centers, on December 26, 2008 has been employed in the medical and health care professional and technical positions for 1 year, full-time medical college education and above and have the corresponding licensing qualifications of the supernumerary, by the county (city) district health department according to the needs of the job setup, approved by the personnel administration department of the county (city) district, can be taken directly in the approved establishment Assessment of the way to be publicized after hiring, the above personnel in the first unit of service in principle shall not be less than five years. On December 26, 2008 has been employed in township health centers and community health service centers in health care professional and technical positions for one year, with secondary school education, assistant physician and above (or nurse practitioner, clinical pharmacy and other licensing qualifications), junior (including sergeant level) and above the technical title of the supernumerary, with reference to the above approach to be assessed and recruited.
2. Rational use of staffing. Township health centers and community health centers according to the existing spare staffing and work needs to put forward the employment plan, by the personnel, preparation department **** with the gatekeeper. In addition to reserving the preparation of directed commissioned students, the rest of the spare preparation of at least 50% each year for the recruitment of personnel.
(C) improve the recruitment method
The township health centers and community health service centers, in principle, the implementation of open recruitment. The same county (city) district township health centers and community health service center recruiting personnel can be implemented in the same type of position not unit unified registration, unified examination, according to the score in order to choose the employment position, to improve the acceptance rate of the open position.
Township health centers and community health service centers to recruit health technicians in the premise of open enrollment, in case of the number of applicants and the number of recruits in the ratio of less than 3:1, by the health department of the business administration and reported to the municipal personnel department for review and approval, may not be subject to the application ratio limit.
Township health centers and community health centers to recruit physicians, technicians can be relaxed to college education or obtain assistant qualification health technicians, nurses can be relaxed to secondary school education. Class A township health centers and community health centers to recruit full-time medical undergraduate degree or higher graduates, class B and C township health centers (township health centers classification list see annex 2) to recruit full-time medical college degree or higher graduates, can be reported by the county (city) health administrative department of the same level of the establishment of the department and the personnel administration department for review and report to the municipal personnel administrative department for approval, to take the special public recruitment The way, through the interview or practical ability test and other simple and effective way to determine the candidates to be recruited.
In each place to organize their own grassroots health technician recruitment examination based on the consent of the county (city) district government, Fuzhou Municipal Bureau of Health, Civil Service Bureau may be for the township health centers and community health service centers to organize a unified recruitment examination.
(D) strengthen position management
Strictly prohibit the newly hired non-health technicians to occupy health technology positions. Already in the township health centers and community health service centers on the health technology positions of non-health technicians and do not have the appropriate qualifications of the over-allocation of personnel, coordinated by the county (city) district government to coordinate the overall arrangements, and gradually diverted, after the clearing of the establishment of a timely addition to the health professionals and technicians.
(E) improve the treatment of personnel
1, the implementation of performance pay. Under the guidance of the local personnel department to develop primary health care institutions performance appraisal methods, the establishment of the number of services, quality, effectiveness as the core of the performance appraisal mechanism, to improve the primary health care institutions staff wages and salaries.
To the township health center work of various types of universities, colleges and universities graduates, the transfer of the grade when the pay scale salary is set at a higher level; obtaining the rank of sergeant and above the professional and technical positions of the personnel, can be upwardly floated 1 level of pay scale salary, enjoy the floating salary for eight years to be fixed at a level of pay scale, transferring the floating salary that is to be canceled.
2, the implementation of health care personnel incentive system, the establishment of grass-roots health care personnel incentive funds to encourage grass-roots health care personnel to work at the grass-roots level. The annual assessment of qualified primary health care institutions on duty to give incentives, incentive standards according to the original health personnel subsidy standards, 0.36 million yuan per person per year, full-time undergraduate degree and above, medical professionals and health technicians working in remote township health centers (see Annex 1) increased to no less than 12,000 yuan per person per year, in community health centers and non-remote township health centers increased to no less than 0.6 million yuan per person per year. not less than 0.6 million yuan per person per year. The incentive system for grass-roots health technicians should be implemented in conjunction with the performance appraisal, and those who fail the appraisal and are not in grass-roots positions will not be paid.
Basic health technician incentive funds in addition to the provincial financial subsidies, municipal and county financial co-ordination arrangements, Yongtai, Minqing, two general transfer payment counties by the municipal financial subsidies of 50%, the other counties (municipalities) by the counties (municipalities) district financial arrangements in full.
3, title evaluation to be tilted. Township health center health technicians in high school junior position structure ratio set up to give a preference. On the small scale, fewer personnel, more dispersed township health centers can be centralized according to the actual situation, unified management. Engaged in health professional and technical work for more than 20 years, after obtaining the intermediate title, in the township health hospitals employed for 8 years, the declaration of deputy senior qualifications of the educational conditions can be relaxed to have the corresponding professional secondary school education.
Any general practitioner and community nurse practitioner who has worked in a community health service organization for two years can take the national health professional and technical intermediate qualification examination one year in advance after being recognized by the health administrative department at the district (county) level.
4. Provide housing security. Grass-roots health technicians working in townships without personal housing, the employer in the location of the coordinated arrangement of temporary housing. Bachelor's degree and above or intermediate and above title of grass-roots health technicians applying for guaranteed housing, compared to Fuzhou City, shortage of urgently needed talents treatment, not subject to household registration and income restrictions.
Conditional counties (cities) and districts can explore the annual launch of affordable housing, price-restricted housing set aside a certain percentage of arrangements for grass-roots medical and health institutions, specifically for the solution of grass-roots medical personnel housing, or the allocation of state-owned land to the township health centers to build swing space.
(F) Establishment of financial security
The implementation of zero-differential-rate reform of drugs in primary health care institutions in accordance with the "approved tasks, approved income and expenditure, performance evaluation, financial subsidies," the principle of strengthening financial security. The approved recurrent income is not enough to make up for the difference between the approved recurrent expenditures, through the government budget and other channels to be arranged in full, and at the end of the year combined with the results of the performance appraisal to be settled.
In which the township health center personnel funds in accordance with the "Fujian Provincial People's Government on further accelerating the reform and development of township health centers," (Minzheng [2009] No. 1) and "Fujian Provincial People's Government on the implementation of basic health care reform of basic medicines system of a number of opinions," (Minzheng [2010] No. 14) to be guaranteed.
Three, to further strengthen the medical education and training of primary health care personnel
1, strengthen the training of new recruits. Township health centers and community health centers newly hired graduates of relevant medical specialties must participate in general practitioner and community nursing training. During the period of outgoing training, the trainer's salary is paid according to the salary of my file. Training units should enhance their sense of responsibility, strengthen their own construction, improve their training capacity, and pay a certain amount of labor remuneration for training subjects.
2, selected business backbone training. Each year, more than 100 township health center business backbone to secondary and tertiary hospitals for further study, selected personnel to be combined with the Fujian Provincial Department of Health "on the promotion of urban doctors to rural areas before service and rural health technicians before the promotion of the implementation of the views of further study," giving priority to the selection of the recent need to promote senior titles of the personnel.
3, applicable technology training. City, county (city) district health administrative departments to in-depth grass-roots research, grasp the township health centers and community health service centers medical needs, targeted arrangements for township health centers and community health service centers medical technology, pharmacy, nursing, public **** health and other personnel for short-term training.
4, continue to implement the "Fujian Province 2010 ~ 2012 general practitioner capacity enhancement plan", the grass-roots health care personnel education into the important content of continuing education, through the standardized training of general practitioners, backbone training, transfer training, job training and this level of adult medicine (direction of general medicine) academic education, etc., to achieve the urban community per 10,000 people served by the training of three The goal is to train three general practitioners for every 10,000 people in urban communities and four general practitioners in each township health center.
5. A unified and standardized system for training general practitioners is being established, and various measures are being taken to train qualified general practitioners. Reform the practice of general practitioners, allowing them to register for practice at multiple locations as needed. Implementing the establishment of contractual service relationships between general practitioners and residents, establishing a new incentive mechanism based on obtaining service fees according to the number of contracted residents, and linking it to health insurance payments and the allocation of funds for basic public *** health services, and innovating incentive policies and methods for general practitioners. By 2012, there will be qualified general practitioners in every urban community health service organization and rural township health center; after a few more years of effort, a unified and standardized model for the training of general practitioners and a service model in which the first diagnosis is made at the grassroots level will basically be formed, so that the public can be better provided with continuous, coordinated and conveniently accessible basic medical and health care services.
Four, to further enhance the overall quality of rural doctors
(A) to improve the educational level of the rural doctor team
1, the organization of rural doctors to participate in the rural medical specialty secondary education. In accordance with the Ministry of Health "on secondary vocational school graduates of rural medical specialties to participate in the physician qualification examination and practice registration of the relevant issues of the notice" (Wei Office of the medical government issued [2010] No. 115), from 2011 onwards in the provincial education administrative department and the health administrative department of the enrollment plan approved by the Fuqing School of Health for the city domicile of the junior high school graduates above the level of education to organize the rural medical specialties. After graduation, students can enroll in the licensed physician assistant qualification examination. After obtaining the qualification of practicing assistant physician, according to the provisions of the city's village health office practice.
2, the organization of rural doctors to participate in post-secondary education pilot. The implementation of village doctors college degree training, improve the overall quality of the rural doctor team.
3, on-the-job rural doctors academic education. On the basis of the implementation of secondary medical education for on-the-job rural doctors, from 2011 onwards, the province commissioned medical colleges and universities for on-the-job rural doctors with practicing qualifications to carry out "secondary to post-secondary" adult academic education, in order to improve the professional quality of on-the-job rural doctors.
(2) strengthen the standardized training of on-the-job rural doctors
Continue to obtain a rural doctor's practice certificate according to the law, physician assistant or licensed physician qualification, and by the county-level health administrative department after registration in the village health office practice of rural doctors for a period of 10 days of theory and clinical skills training. According to the city's village health room construction needs, focusing on strengthening emergency first aid technology, infectious disease prevention and control, public **** health services and other content training.
V. Organizational safeguards for the construction of primary health care talent team
(A) Strengthening organizational leadership
Departments at all levels should strengthen the construction of township health centers and community health service center talent team, the county (city) district government should regularly study the health reform and development, and do a good job of planning for grass-roots health talent team, grass-roots health talent team building As an important indicator of the performance appraisal of the main leading cadres of various departments to be assessed, can be based on the above preferential policies, and further increase efforts to attract talent, retain talent, and accelerate the pace of construction of grassroots health personnel; county (city) district preparation departments to strengthen the primary health care institutions of the preparation of health technical personnel management and security work, meet the conditions of the personnel, and timely processing of the relevant formalities; counties (city) district Personnel department to cooperate with the talent recruitment work; county (city) district financial departments to ensure that the work of the funds and subsidies allowances in a timely manner; county (city) district health department to give full play to the function of the competent department, leading the work carried out.
(2) strengthen coordination and cooperation
County (city) district government to establish a monitoring mechanism, establish and improve the township health centers and community health service centers talent team building management system, organization and coordination of the relevant departments, the township health centers and community health service centers on a regular basis to carry out special supervision of the construction of health centers and community health service centers, and in a timely manner, to grasp the township health centers and community health service centers talent team building deficiencies and development needs. The construction of deficiencies and development needs, to take effective measures to solve the problems faced by township health centers and community health service centers talent team construction, to ensure that the grass-roots health of the completion of the work. Municipal health administrative departments should regularly carry out inspections of the construction of township health centers and community health service centers in conjunction with the departments of finance, preparation, and personnel, guide counties (cities) and districts in strengthening the construction of township health centers and community health service centers, follow up and investigate the implementation of the policy and the effect of implementation, and put forward measures for further improvement. The counties (cities) of township health centers and community health service centers that are ineffective in building their talent teams are promptly notified and urged to implement them.
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