Municipal Health Bureau, Municipal Development and Reform Commission and Municipal Finance Bureau
Municipal Bureau of Civil Service Municipal Committee for Restructuring the Economy
(20 12 April)
In order to implement the Notice of the General Office of the People's Government of Fujian Province on Forwarding the Opinions of the Provincial Health Department and Other Departments on Strengthening the Training and Enrichment of Grassroots Health Talents (No.[2011]1) and the Notice of the General Office of the People's Government of Fujian Province Forwarding the Opinions of the Provincial Health Department and Other Departments on Promoting the Implementation of the Personnel System Reform in Grassroots Medical and Health Institutions () 438+065438+438 and other documents, further strengthen the construction of health talents in our city, enrich the grassroots health talents through training, stabilize the grassroots health talents through preferential policies, improve the service ability of grassroots health talents through on-the-job training, and play the role of grassroots health talents through strengthening management to solve the shortage of talents in grassroots medical and health institutions in our city. Within five years, the goal of "no less than 90% of the total number of medical nursing posts in general hospitals and no less than 85% of the total number of medical nursing posts in central hospitals and community health service centers" will be achieved to meet the basic medical and public health service needs of urban and rural residents. Now combined with the actual situation in our city, we put forward the following implementation opinions.
First, further enrich the health technical personnel in primary medical and health institutions.
20 1 1 March, the township hospitals and community health service centers in our city approved the establishment of 6,365 people, but only 3,990 people, accounting for 62.7% of the establishment, and the vacancy rate was as high as 37.3%. There is a serious shortage of primary health technicians, which restricts the fairness and accessibility of basic medical and health services to some extent. Through the implementation of the "five batches" measures, we will effectively strengthen the construction of grassroots health talents.
(a) to recruit a number of medical practitioners for primary medical and health institutions.
Recruit a number of special post practitioners for the city's grassroots medical and health institutions (township hospitals, community health service centers). The recruitment targets are those who have graduated from clinical medicine, traditional Chinese medicine, integrated traditional Chinese and western medicine, preventive medicine, medical imaging, medical examination and clinical pharmacy and obtained corresponding professional qualifications. Those who meet the above conditions and pass the examination after the expiration of the "three supports and one support" service can be directly employed as special post medical practitioners. The municipal administrative department of personnel and health shall, according to the relevant provisions of public institutions and the division of responsibilities, formulate and organize the implementation of the recruitment plan for practicing doctors in special positions, adopt special open recruitment methods, and determine the candidates to be hired through interviews and practical operation ability tests. Medical practitioners in special posts sign employment contracts with corresponding primary medical and health institutions, with a service period of three years, and their salary income is implemented according to the relevant policies of the state, province and city. After the expiration of 3 years' employment, the special post practicing doctors in township hospitals will give priority to work in county-level medical institutions.
Special post medical practitioners employed by township hospitals under the jurisdiction of Yongtai County and Minqing County, which are guaranteed by the basic financial resources of the province, are given a special subsidy of 1 10,000 yuan per person per year in addition to the original salary, which is directly distributed to individuals by the county-level health department for three consecutive years. In addition to the provincial financial subsidy of 80%, the city and county financial subsidy 10%, and the funds needed for preventive medicine, medical imaging, medical inspection and clinical pharmacy are subsidized by the municipal finance. Special post practitioners who receive special subsidies no longer enjoy the tuition compensation policy for medical graduates in provinces and cities. Special post employees who have enjoyed the tuition compensation policy will no longer receive special subsidies repeatedly.
(2) Entrusted to train a group of undergraduate graduates for primary medical and health institutions.
1, targeted training of suitable talents. Our city plans to recruit 240 clinical undergraduates for township hospitals and community health service centers within three years, and entrust a group of suitable talents. County (city) district health department in conjunction with the personnel department, the preparation department according to the grassroots vacancy audit report training plan, the municipal health department in conjunction with the personnel department, the preparation department audit to determine the specific quota allocation. After examination and approval, the entrusted training post will be retained. After graduation, students obtain graduation certificates and school employment recommendation letters, which are directly examined and hired by the personnel and health departments of counties (cities) and districts, and have worked continuously in entrusted training positions for more than five years. Entrusted medical colleges and universities are organized and contacted by the municipal health department. Commissioned to train students before entering the school and the local health administrative department signed a post service agreement, and the tuition fee for targeted training was subsidized by the municipal finance according to the charging standard of the entrusted school.
Strengthen the management of directional training students, and the directional medical students who can't graduate normally should return the subsidy they have enjoyed according to the regulations; Those who fail to work in grassroots medical and health institutions as agreed after graduation will be refunded the subsidy fees they have enjoyed, and pay 5 times of liquidated damages as required. Graduates entrusted to non-designated grassroots medical and health institutions for internship will not be registered within 10 years. Compensation is included in the municipal extra-budgetary income, and two lines of revenue and expenditure management are implemented. After being collected by the local county (city) District Health Bureau, it will be paid into the municipal financial special account through the financial non-tax revenue collection system. Directed undergraduates who are entrusted to train no longer enjoy the tuition compensation policy for medical graduates.
2. Implement the tuition compensation policy. Fresh graduates of clinical medicine (traditional Chinese medicine) from non-directional general medical colleges who have worked in township hospitals in Yongtai County and Minqing County for five consecutive years, as well as previous graduates who have not yet been employed, continue to enjoy the provincial financial subsidy of 0.5 million yuan per person per year for five consecutive years.
From 20 11June1day, those who have worked in township hospitals in other counties (cities) for five consecutive years should be graduates of previous undergraduate courses, and enjoy a subsidy of 0.5 million yuan per person per year for five consecutive years; Non-directional general medical colleges that have worked in the community health service center of this Municipality for five years should be previous undergraduate graduates, and non-directional general medical colleges that have worked in remote township health centers of this Municipality for three years (see Annex 1) should be previous college graduates, and the municipal finance will give subsidies of 0.36 million yuan per person per year for five consecutive years and three consecutive years respectively.
The tuition subsidy majors are clinical medicine undergraduate, preventive medicine undergraduate, clinical medicine specialist, medical imaging specialist and medical laboratory specialist. The scale of tuition subsidy shall be reviewed and announced by the county (city) district health department in conjunction with the personnel department according to the establishment of township hospitals and job requirements.
Students who receive tuition compensation fail to work in primary medical and health institutions as agreed, and the subsidy fees they have enjoyed will be refunded as required. They are not allowed to apply for administrative institutions in Fuzhou and counties (cities) within 10 years.
Students who have participated in full-time study for more than half a year are not included in the service time.
(three) to improve the academic level of a number of primary medical and health institutions.
1. Continue to implement the project of "recruiting college graduates to work in township hospitals after standardized training". While recruiting medical undergraduates, relying on Fujian Medical University, Fujian University of Traditional Chinese Medicine and other universities, we will expand the enrollment scale of entrusted training for clinical medicine majors.
2, grassroots medical and health institutions on-the-job personnel approved by the unit, to participate in on-the-job education, 50% tuition reimbursement by the unit after graduation.
(4) Support grassroots medical and health institutions to re-employ a number of retired doctors.
Give full play to the role of "passing, helping and leading" of senior doctors, and encourage them to re-employ healthy senior and middle-level retired doctors (the age is no more than 65 years old, and the chief physician can be appropriately relaxed to 68 years old) to continue working in primary medical and health institutions. The employment candidates and re-employment benefits shall be reported to the county (city) district health administrative department for examination and approval by the township hospitals and community health service centers after collective research by the leading bodies, and the list and re-employment benefits shall be reported to the finance department at the same level for the record. Re-employment labor remuneration can refer to the wages of similar personnel on the job, implement health technical personnel allowance, and give appropriate transportation subsidies. The labor remuneration of re-employed personnel shall be paid monthly by township hospitals and community health service centers. The financial departments of counties (cities) and districts shall arrange the income and expenditure generated by employing retired doctors into the total personnel funds when carrying out the check of income and expenditure of primary medical and health institutions.
Counties (cities) and districts should strengthen the service and management of rehired talents, actively do a good job in matters such as living arrangements and practice changes of rehired personnel, assist in the implementation of preferential policies for talent introduction, provide convenience for rehired personnel to live and work in peace and contentment, and ensure that rehired personnel play an exemplary and guiding role. The municipal and county health administrative departments shall assess the re-employed talents and commend those with outstanding performance and remarkable results.
(five) hospitals at or above the county level should send a certain number of senior health technicians.
Continue to carry out medical and health institutions at or above the county level to help grassroots medical and health institutions. Each municipal hospital and county hospital helps 1 ~ 4 primary medical and health institutions with a period of 3 years. Each supporting hospital sends 2 ~ 3 doctors every year, and the time limit for sending doctors is one year. Give priority to the selection of doctors needed by primary medical and health institutions and receive free training for primary health technicians. City, county (city) district health administrative department is responsible for the construction of rural services and urban advanced training personnel demand information platform, guide the basic medical and health institutions to choose supporting personnel, to ensure that the dispatched personnel to play their strengths, basic medical and health institutions to send senior training personnel after the post is not vacant. The municipal and county health administrative departments shall evaluate the relief situation and commend the hospitals and individuals who have made outstanding performance and achieved remarkable results.
Two, to further strengthen the management of primary health personnel.
(A) straighten out the management system
Counties (cities) and districts should straighten out the management system of township hospitals in accordance with the Opinions of Fujian Provincial People's Government on Further Accelerating the Reform and Development of Township Hospitals (Min [2009]1No.), and the county-level health administrative department shall be responsible for the management of personnel, business and funds of township hospitals, and deploy and exchange township hospital personnel within the approved establishment. The personnel relations of township health center staff are managed by the county health administrative department. The appointment system for the presidents of township hospitals shall be implemented. The dean is proposed by the health administrative department at the county level with reference to the requirements of the "Regulations on the Selection and Appointment of Leading Cadres of the Party and Government", appointed after soliciting the opinions of local party committees and governments, and reported to the competent department of county (city) district organizations for the record. The management system of community health service center shall be implemented with reference to these measures.
(B) play a preparatory role
1. Review and hire temporary employees. Township hospitals and community health service centers that implement the reform of zero difference rate of drugs can directly adopt the assessment method within the approved establishment for supernumerary personnel who have worked in medical and health professional and technical posts 1 year before February 26, 2008 and have full-time medical college education or above and corresponding professional qualifications. For supernumerary personnel who have worked in medical and health professional and technical posts in township hospitals and community health service centers for 1 year before June 26, 2008, and have technical titles of secondary school education, practicing assistant doctors and above (or internship nurses, clinical pharmacy, etc.) and junior (including undergraduate) and above, they shall be assessed and employed with reference to the above measures.
2. Rational use of staffing. Township hospitals and community health service centers put forward employment plans according to the existing surplus staffing and work needs, and the staffing department is responsible for them. In addition to the reserved targeted trainee establishment, at least 50% of the remaining standby establishment is used for recruiting personnel every year.
(C) improve the recruitment methods
Township hospitals and community health service centers shall, in principle, implement open recruitment. Recruiters from township hospitals and community health service centers in the same county (city) district can apply for unified registration and unified examination for similar positions, and choose positions in turn according to the scores, so as to improve the admission rate of public examination positions.
Township hospitals and community health service centers recruit health technicians on the premise of public registration. If the ratio between the number of applicants and the number of recruits does not reach 3: 1, the administrative department for industry and commerce of the health department shall report it to the municipal personnel department for examination and approval, which is not limited by the proportion of applicants.
Township hospitals and community health service centers can relax the recruitment of doctors and technicians to health technicians with college education or assistant education or above, and nurses can relax to secondary school education or above. Class A township hospitals and community health service centers recruit full-time medical graduates with bachelor degree or above, while Class B and Class C township hospitals (see Annex 2 for the classification list of township hospitals) recruit full-time medical graduates with college degree or above. The health administrative department of the county (city) district may report to the establishment department and the personnel administrative department at the same level for examination and approval, and report to the municipal personnel administrative department for approval, and adopt a special open recruitment method to determine the candidates to be hired through interviews or practical operation ability tests.
On the basis of organizing the recruitment examination for primary health technical personnel in various places, with the consent of the county (city) district government, the Fuzhou Municipal Health Bureau and the Civil Service Bureau can uniformly organize the recruitment examination for township hospitals and community health service centers.
(D) to strengthen post management
It is strictly forbidden for newly hired non-health technical personnel to occupy health technical posts. Non-health technicians who have been in health technical posts in township hospitals and community health service centers and overstaffed personnel who do not have corresponding professional qualifications shall be arranged by the county (city) district government as a whole and gradually diverted. After emptying, health professionals should be replenished in time.
(5) improve the treatment of personnel.
1, implement performance pay. Under the guidance of the local personnel department, formulate performance appraisal methods for primary medical and health institutions, establish a performance appraisal mechanism centered on service quantity, quality and effect, and improve the salary of staff in primary medical and health institutions.
All kinds of college graduates who work in township hospitals will be given a high salary of 1 when they become full members. Those who have obtained professional and technical positions with a master's degree or above can get a floating salary of 1, those who have enjoyed floating salary for eight years will get a fixed salary of 1, and those who have been transferred will get rid of floating salary.
2, the implementation of health technical personnel incentive system, the establishment of grassroots health technical personnel incentive fund, to encourage grassroots health technical personnel to work at the grassroots level. On-the-job staff of grassroots medical and health institutions who have passed the annual assessment will be rewarded, and the reward standard will be paid according to the original subsidy standard for health technicians, totaling 3,600 yuan per person per year. The work of full-time medical and health technicians with bachelor degree or above in remote township hospitals (see annex 1) will be raised to not less than 1.2 million yuan per person per year, and the work of community health service centers and non-remote township hospitals will be raised to not less than 0.6 million yuan per person per year. The reward system for primary health technicians should be implemented in combination with performance appraisal, and those who fail to pass the examination and are not in primary posts will not be issued.
In addition to the provincial financial subsidies, the incentive funds for primary health technical personnel shall be arranged by the municipal and county finance as a whole. Yongtai and Minqing two general transfer payment counties are subsidized by the municipal finance by 50%, and other counties (cities) are fully arranged by the county (city) district finance.
3. Professional title evaluation and employment shall be tilted. The proportion of primary posts of health technicians in high schools in township hospitals is inclined. Small-scale, small-scale, decentralized township hospitals can be centralized management according to the actual situation. Engaged in health professional and technical work for more than 20 years, after obtaining intermediate titles, those who have worked in township hospitals for 8 years can apply for associate senior qualifications, and their academic qualifications can be relaxed to have corresponding professional secondary school qualifications.
General practitioners and community nurses who have worked in community health service institutions for 2 years can take the national intermediate qualification examination of health professional technology one year in advance after being recognized by the district (county) level health administrative department.
4. Provide housing security. Grassroots health technicians working in towns and villages have no personal housing, and the employer shall make overall arrangements for temporary housing in the local area. When applying for affordable housing, grassroots health technicians with bachelor degree or above or intermediate title are treated as talents in urgent need in Fuzhou, and are not subject to household registration and income restrictions.
Conditional counties (cities) can explore the introduction of affordable housing and price-limited housing every year to allocate a certain proportion to primary medical and health institutions, specifically to solve the housing of primary medical staff, or allocate state-owned land to township hospitals to build revolving houses.
(six) the establishment of financial security
Grassroots medical and health institutions that implement the zero-difference rate reform of drugs will strengthen the funding guarantee in accordance with the principle of "approved tasks, approved revenues and expenditures, performance appraisal and financial subsidies". For the part of the approved recurrent income that is not enough to make up for the difference of the approved recurrent expenditure, it shall be fully arranged through the government budget and other channels, and the year-end settlement shall be made in combination with the performance appraisal results.
Among them, the personnel funds of township health centers are guaranteed according to Opinions of Fujian Provincial People's Government on Further Accelerating the Reform and Development of Township Health Centers (2009) 1No.) and Opinions of Fujian Provincial People's Government on Implementing the Reform of Basic Medicine System in Primary Medical and Health Institutions (No.[2010]1No.4).
Three, to further strengthen the medical education and training of primary health technical personnel.
1, strengthen the training of recruits. New medical graduates from township hospitals and community health service centers must participate in general practitioners and community nursing training. During the training period, the trainees' salary will be paid according to their own file salary. Training units should enhance their sense of responsibility, strengthen their own construction, improve their training ability, and pay certain labor remuneration to students.
2. Select business backbones for further study. Every year, 100 business backbones of township hospitals are sent to secondary and tertiary hospitals for further study. The selection and transfer personnel shall be carried out in combination with the opinions of Fujian Provincial Health Department on rural doctors taking up their posts before promotion and rural health technicians learning before promotion, and the promotion of middle and senior titles in the near future is given priority.
3, to carry out applicable technical training. City, county (city) district health administrative departments should go deep into grassroots research, master the medical needs of township hospitals and community health service centers, and arrange short-term training for medical technology, pharmacy, nursing, public health and other personnel in township hospitals and community health service centers.
4. Continue to implement the "Fujian Province 20 10 ~ 20 12 General Practitioner Ability Improvement Plan", and incorporate the education of primary health technicians into the important content of continuing education. Through the standardized training of general practitioners, backbone training, on-the-job training and adult medicine (general medicine direction) education at the specialist level, 3 general practitioners will be trained for every 10,000 service population in urban communities, each township 1 person.
5. Establish a unified and standardized training system for general practitioners and take various measures to train qualified general practitioners. Reform the practice mode of general practitioners and allow general practitioners to register more as needed. Promote the establishment of contract service relationship between general practitioners and residents, establish a new incentive mechanism based on obtaining service fees according to the number of contracted residents, and link it with medical insurance payment and basic public health service fund allocation, and innovate general practitioners' incentive policies and methods. By 20 12, every urban community health service institution and rural township health center will have qualified general practitioners; After several years' efforts, a unified and standardized general practitioner training model and primary service model have been basically formed, so as to better provide the people with sustained, coordinated and convenient basic medical and health services.
Fourth, further improve the overall quality of rural doctors.
(A) to improve the academic level of rural doctors.
1, organize rural doctors to participate in rural medical professional secondary education. According to the Notice of the Ministry of Health on Relevant Issues Concerning the Qualification Examination and Practice Registration of Rural Medical Graduates in Secondary Vocational Schools (No.Wei Ban Fa 10), starting from 20 1 15, Fuqing Health School will apply for the qualification examination of practicing assistant doctors for junior middle schools in this city within the enrollment plan approved by the provincial education administrative department and the health administrative department. After obtaining the qualification of practicing assistant physician, he shall practise in the village clinic of our city according to the regulations.
2, organize rural doctors to participate in the pilot work of college education. Promote the training of rural doctors with college degree and improve the overall quality of rural doctors.
3. On-the-job rural doctor education. On the basis of secondary medical education for in-service rural doctors, starting from 20 1 1, medical colleges in the province are entrusted to carry out adult education for in-service rural doctors with professional qualifications, so as to improve their professional quality.
(2) Strengthen the standardized on-the-job training of rural doctors.
We will continue to provide theoretical and clinical skills training to rural doctors who have obtained the practicing certificate of rural doctors, the qualification of practicing assistant doctors or practicing doctors according to law and practiced in village clinics after being registered by county-level health administrative departments. According to the needs of the construction of village clinics in our city, we will focus on strengthening first-aid technical training, infectious disease prevention and public health services.
Five, to provide organizational guarantee for the construction of talent team in primary medical and health institutions.
(A) to strengthen organizational leadership
Departments at all levels should strengthen the construction of talent teams in township hospitals and community health service centers, and county (city) district governments should regularly study health reform and development, formulate plans for the construction of grassroots health talent teams, and regard the construction of grassroots health talent teams as an important indicator for the performance evaluation of leading cadres in various departments. On the basis of the above-mentioned preferential policies, we can further increase efforts to attract and retain talents and accelerate the pace of building grassroots health talents; County (city) district staffing departments should strengthen the staffing management and security of health technical personnel in primary medical institutions, and handle relevant procedures in a timely manner for those who meet the enrollment conditions; County (city) district personnel departments should cooperate with the recruitment of talents; County (city) District Finance Department should ensure the timely disbursement of funds and subsidies; County (city) district health departments should give full play to the functions of business departments and lead this work.
(2) Strengthen coordination and cooperation.
The county (city) district government should establish a supervision mechanism, establish and improve the management system of talent team construction in township hospitals and community health service centers, organize and coordinate relevant departments, regularly conduct special supervision on talent team construction in township hospitals and community health service centers, grasp the shortcomings and development needs of talent team construction in township hospitals and community health service centers in time, and take effective measures to solve the problems faced by talent team construction in township hospitals and community health service centers to ensure the completion of all basic health work. The municipal public health administrative department shall, jointly with the financial, staffing, personnel and other departments, regularly inspect the construction of talent teams in township hospitals and community health service centers, guide counties (cities) to strengthen the construction of talent teams in township hospitals and community health service centers, follow up the implementation of policies and the implementation effect, and put forward further improvement measures. County (city) districts with poor talent team construction in township hospitals and community health service centers should promptly report and supervise the implementation.
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