I. Overall Requirements and Main Objectives
(1) General requirements. Adhere to the basic, strong grassroots, and build mechanisms. Starting from China's national conditions and the long-term construction of the basic medical and health system, we should reform the service mode and incentive mechanism of rural doctors, implement and improve the salary, pension and training policies of rural doctors, strengthen the supervision of medical and health services, stabilize and optimize the team of rural doctors, and comprehensively improve the level of village-level medical and health services.
(2) Main objectives. Through 10 years' efforts, we will strive to make rural doctors have technical secondary school education or above, and gradually have the qualifications of practicing assistant doctors or above, ensure that rural doctors are treated reasonably in all aspects, basically build a team of rural doctors with high quality and meet the needs, promote the establishment of the system of first diagnosis and graded diagnosis and treatment at the grassroots level, and better ensure that rural residents enjoy equal basic public health services and safe, effective, convenient and cheap basic medical services.
Second, define the functions and tasks of rural doctors.
(3) Defining the responsibilities of rural doctors. Rural doctors (including practicing doctors and assistant doctors in village clinics, the same below) are mainly responsible for providing public health and basic medical services for rural residents and undertaking other medical and health services entrusted by the health and family planning administrative department.
(4) Rational allocation of rural doctors. With the in-depth development of basic public health services and the gradual establishment of graded diagnosis and treatment system at the grass-roots level, all localities should comprehensively consider the factors such as serving population, service status, expected demand and regional conditions, rationally allocate rural doctors, and in principle, equip rural doctors according to the standard of not less than 1 per thousand serving population.
Third, strengthen the management of rural doctors.
(5) Strict access to rural doctors. Medical staff practicing in village clinics must have corresponding qualifications and be registered according to regulations. Persons who enter the village clinic to engage in prevention, health care and medical services shall have the qualifications of practicing doctors or practicing assistant doctors. In areas where conditions are not available, the provincial people's government should formulate specific measures in strict accordance with the requirements of the Regulations on the Management of Rural Doctors, so that personnel with secondary medical professional qualifications or those who have reached the secondary medical professional level after training can practice in village clinics.
(six) standardize the business management of rural doctors. County-level health and family planning administrative departments shall, in accordance with the Law of People's Republic of China (PRC) on Medical Practitioners and the Regulations on the Administration of Rural Doctors, strengthen the practice management and service quality supervision of rural doctors, promote rational drug use, and improve the safety and effectiveness of medical and health services.
(seven) standardize the assessment of rural doctors. Under the unified organization of county-level health and family planning administrative departments, township hospitals regularly carry out rural doctors' assessment. The assessment contents include the quantity, quality and mass satisfaction of basic medical and public health services provided by rural doctors, the study and training of rural doctors and medical ethics. The assessment results serve as the main basis for the registration and funding of rural doctors.
Fourthly, optimize the academic structure of rural doctors.
(8) Strengthen continuing education. All localities should strengthen the education and training of rural doctors in accordance with the requirements of the National Education Plan for Rural Doctors (20 1 1-2020). Encourage qualified in-service rural doctors to enter secondary and higher medical (health) colleges (including Chinese medicine colleges) to receive medical academic education and improve the overall academic level. The government can give appropriate subsidies to the on-the-job rural doctors who have participated in academic education and obtained the corresponding doctor qualifications according to regulations.
(nine) the implementation of order training. Strengthen the free training of rural order-oriented medical students, focusing on the free training of three-year secondary and higher vocational medical students in village clinics. Free medical students mainly recruit rural students.
Fifth, improve the attractiveness of rural doctors.
(ten) to broaden the development space of rural doctors. Under the same conditions, township hospitals give priority to rural doctors who have obtained the qualifications of practicing doctors and assistant doctors, and further attract practicing doctors, assistant doctors and medical college graduates to work in village clinics. Encourage all localities to carry out rural integrated management pilot projects in light of the actual situation, and employ rural doctors with the qualifications of practicing doctors and practicing assistant doctors in accordance with the procedures and requirements stipulated by national policies.
(eleven) standardize the post training of rural doctors. All localities should rely on county-level medical and health institutions or conditional central township hospitals to carry out on-the-job training for rural doctors. Rural doctors receive free training not less than 2 times a year, and the cumulative training time is not less than 2 weeks; All localities can send outstanding rural doctors with the qualification of practicing doctors or practicing assistant doctors to provincial and municipal hospitals for free training; Rural doctors go to county-level medical and health institutions or conditional central township hospitals for full-time study every 3-5 years, and the study time is not less than 1 month in principle. Rural doctors should learn Chinese medicine knowledge and use Chinese medicine skills to prevent and treat diseases. Medical college graduates working in village clinics have priority to participate in standardized training for residents.
Sixth, change the service mode of rural doctors.
(twelve) to carry out contract services. All localities should explore the contract service between rural doctors and rural residents in light of the actual situation. Rural doctors or teams composed of business backbones of township hospitals (including general practitioners) and rural doctors sign service agreements with rural residents for a certain period of time, establish a relatively stable contractual service relationship, provide agreed basic medical and health services, and charge service fees according to regulations. The service fee is shared by the medical insurance fund, the basic public health service fund and the contracted residents. The specific standards and scope of protection are determined by local governments according to the local medical and health service level, the contracted population structure and the affordability of medical insurance funds and basic public health service funds. Rural doctors who provide contract services shall not charge other fees except for the service fees as required. Increase the promotion of appropriate technologies, encourage rural doctors to provide personalized health services, and charge fees according to relevant regulations.
(thirteen) the establishment of rural general practice assistant physician system. Do a good job in the connection between rural doctors and general practitioners. Add the rural general practice assistant doctor qualification examination to the current practice assistant doctor qualification examination. In accordance with the relevant provisions of the National Physician Qualification Examination, the national industry authorities shall formulate the examination outline, organize it in a unified way, make a separate proposition, issue rural general practitioner qualification certificates to those who pass the examination, and limit their practice scope to township hospitals or village clinics. Persons who have obtained the qualification of assistant doctors in rural general practice may participate in the doctor qualification examination as required.
Seven, to ensure the reasonable income of rural doctors.
(fourteen) to effectively implement the multi-channel compensation policy for rural doctors. All localities should comprehensively consider the actual situation, service capacity and service cost of rural doctors, and adopt the method of purchasing services to ensure the reasonable income level of rural doctors.
For the basic public health services provided by rural doctors, the corresponding basic public health service funds will be allocated to rural doctors through the way of government purchasing services and according to the approved task volume and assessment results. In 20 14 and 20 15, the subsidies for rural basic public health services were added, and all of them were used by rural doctors in 5 yuan. In the future, the new subsidies for basic public health services will continue to tilt towards rural doctors and strengthen village-level basic public health services.
Rural doctors and rural residents do not have contracted services, and the basic medical services provided by rural doctors should be shared by medical insurance funds and individuals through the establishment of general medical expenses and other measures. Under the premise of considering the service level of rural doctors, the affordability of medical insurance fund and not increasing the personal burden of the masses, the standard of general medical treatment fee in village clinics is determined by scientific calculation, which is not higher than that in primary medical and health institutions in principle, and is paid by medical insurance fund according to regulations. All localities should bring eligible village clinics and individual clinics into the management of designated medical institutions for medical insurance.
For rural doctors practicing in village clinics where the basic drug system is implemented, compensation for basic medical care and basic public health services will be comprehensively considered and fixed subsidies will be given. The quota subsidy standard shall be approved by the people's governments of all provinces (autonomous regions and municipalities) according to the number of in-service or rural doctors.
With the development of economy and society, we will dynamically adjust the subsidy standards for rural doctors in various channels and gradually improve the treatment level of rural doctors.
(fifteen) to improve the treatment of rural doctors in difficult and remote areas. For rural doctors who serve in hard and remote areas and contiguous destitute areas stipulated by relevant state departments, local finance should appropriately increase subsidies.
Eight, establish and improve the rural doctors pension and exit policy.
(sixteen) improve the rural doctors' pension policy. All localities should support and guide qualified rural doctors to participate in the basic old-age insurance for employees according to regulations. Rural doctors who are not included in the basic old-age insurance for employees can participate in the basic old-age insurance for urban and rural residents at their domicile.
For rural doctors who have reached the age of 60, all localities should take various forms such as subsidies to further improve the pension benefits of rural doctors.
(seventeen) the establishment of rural doctors exit mechanism. All localities should establish a withdrawal mechanism for rural doctors in light of the actual situation. When necessary, the village clinic can re-employ rural doctors to continue their practice.
Nine, improve the working conditions and practice environment of rural doctors.
(eighteen) to strengthen the construction of village clinics. All localities should rely on rural public service platform construction and other projects, and adopt public-private joint construction and government subsidies to further support the housing construction and equipment purchase of village clinics. Accelerate information construction, use mobile Internet technology to establish an information system with rural residents' health records and basic diagnosis and treatment as the core and extending to village clinics, and support the instant settlement management of the new rural cooperative medical system, linkage of health records and basic diagnosis and treatment information, performance appraisal, distance training and telemedicine.
(nineteen) the establishment of rural doctors practice risk resolution mechanism. Establish a medical risk sharing mechanism suitable for rural doctors, and medical and health institutions in the county can effectively resolve the practice risks of rural doctors and continuously improve the practice environment of rural doctors by participating in medical liability insurance.
X. Strengthening organizational leadership
(twenty) to formulate the implementation plan. All localities and relevant departments should take strengthening the construction of rural doctors into the overall consideration of deepening the reform of the medical and health system. Provinces (autonomous regions and municipalities) should formulate specific implementation plans before the end of March 20 15, and report them to the State Council Medical Reform Office, Health and Family Planning Commission, Development and Reform Commission, Ministry of Education, Ministry of Finance and Ministry of Human Resources and Social Security for the record.
(twenty-one) the implementation of capital investment. The people's government at the county level shall incorporate the relevant funds for the construction of rural doctors into the fiscal budget. The central finance and provincial people's governments support the construction of rural doctors and further increase subsidies to difficult areas. Finance at all levels should timely and fully allocate funds related to the construction of rural doctors, ensure earmarking, and shall not be withheld, misappropriated or misappropriated.
(twenty-two) to carry out supervision and inspection. All localities should earnestly safeguard the legitimate rights and interests of rural doctors, and it is strictly forbidden to collect or apportion fees from rural doctors outside the provisions of the state in any name. Rural doctors who have made outstanding achievements in rural preventive health care, medical services and emergency treatment can be commended in accordance with relevant state regulations. All localities and relevant departments should establish supervision and notification mechanisms to ensure the implementation of relevant policies for rural doctors.
References (People's Republic of China (PRC) and Ministry of Finance):
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