20 10 on may 24th, nearly 300 rural doctors from Yuexi county jointly sent 10 representatives to petition the provincial bureau of letters and calls, the health department, the agriculture and health department and the labor department, demanding to solve practical problems in the medical reform. Gao Kaiyan Hall met with petition representative 0.
Anhui Provincial People's Government:
As early as the 1970s, when the country's economy was weak, rural health conditions were extremely poor, various diseases were rampant, rural areas lacked medical care and medicines, and farmers were poor and sick, Chairman Mao issued the instruction of 6.26: "Focus medical and health work on rural areas". So "barefoot doctors" came into being. According to the spirit of the State Council [1981] No.24 document, barefoot doctors are examined and certified, and those who pass the examination become "village doctors". For decades, this team has responded to the call of the government, completed a large number of prevention and protection tasks assigned by the government for free, and provided medical services to farmers in a simple, convenient and low-cost way, becoming an important force that is not included in the health system, but is struggling at the forefront of the health front. In the new round of health system reform, we actively cooperate with the government to participate in this reform, relying only on the document "Implementation Plan for the Construction and Management of Standardized Village Clinics in Yuexi County". We obey completely without hesitation, and the personnel are at their disposal. We took out all their medical equipment, medicines and clinic property for free to participate in the rural integration reform and accept the management of the hospital, and each person was forced to charge 10 thousand yuan for the so-called practice risk.
After the integration, the village clinics are completely operated by the personal funds of rural doctors. Since the implementation of zero price difference sales of drugs, our income has dropped sharply and our livelihood has become more and more difficult to maintain. We have repeatedly reported to the leaders of the relevant health authorities, and the answer is: "Do whatever you want, and go home to farm if you don't want to do it." At this point, we are disheartened In the past two years, the government has not paid any attention to the labor relations, endowment insurance, practice risks, wages and other related interests of rural doctors. We can't see our future, and we can't see any hope. Is this fair to rural doctors? In a desperate situation, we put forward objective and realistic problems to the government and demanded solutions.
First, it is required to solve the labor relations problem of rural doctors.
As government documents at all levels show, village clinics are one of the three pillars of rural health in China. Rural health reform has changed the ownership and business model of village clinics through the implementation of rural integration, hospital construction and hospital management, and zero price difference sales of drugs. Township hospitals, which are also one of the three pillars of rural health, are fully staffed and fully funded, but the labor relations of the staff working in village clinics cannot be established and are not protected by labor law. Rural doctors are the concrete implementers and cashiers of the policies of the party and the government in rural health work, and we shoulder heavy tasks in medical services and public health services. Since the country brought the village clinic into the rural three-level public health network, it has given the village clinic a clear position as a rural grass-roots public health institution, but so far it has failed to give a clear legal position to the labor relations of the employees in the village clinic. For example, when rural doctors with legal qualifications change jobs, they can't standardize the employment system of rural health institutions, calculate the length of service, and calculate whether industrial accidents belong to industrial injuries. They lack the legal basis for obtaining labor and financial security, leaving many sequelae for rural medical and health undertakings. All rural doctors can't help asking: Who are we working for, the country, the collective or the boss? There must always be a clear positioning, why our labor can not be protected by the labor law!
Second, the issue of endowment insurance.
For decades, we have undertaken basic preventive health care, health education and health publicity services, and made unremitting efforts for a long time, which fundamentally solved the situation of lack of medical care and medicine in rural areas. The national investment in this team is low-cost, but the benefits of this team to farmers' health services are high. Many dead rural doctors have devoted their lives to rural health in poverty, but they have not received any economic compensation and political comfort from the government. There are still many rural doctors who are over 70 years old and nearly 60 years old, still struggling at the forefront of rural health front. We don't support the elderly. While solving labor relations, the government should solve the problem of endowment insurance for rural doctors as soon as possible. The government should not regard the reasonable vital interests of rural doctors as begging for government charity and burden, but should regard this reasonable appeal as the legitimate rights and interests of rural doctors and the responsibility that the government should bear. In rural health work, whether we are practicing doctors or rural doctors, our first attribute is people, and our second attribute is people's health guards. We have to dress and eat, support our families, be recognized and respected, and seek personal development needs. The government should pay full attention to and solve these problems.
Third, the practice risk.
As we all know, medical treatment is a high-risk occupation. No matter what level of doctors, as long as there is a medical accident, they must be dealt with by corresponding laws and regulations. As long as there is a medical accident, rural doctors will lose their money. For example, there is a village doctor in the clinic of Qianjin Village in Gufang Township, our county. After the medical accident this year, the patient's family offered to compensate 400,000 yuan, and paid 80,000 yuan after many consultations. Finally, the children paid for it with the income from working. After the sale of drugs with zero price difference, the income of rural doctors dropped sharply, and the average monthly income was less than 1,000 yuan, which obviously could not afford such a high compensation for medical accidents. However, according to the county government documents, each person paid 1 000 yuan for practicing risk, but it was deposited in the account of the township health center. The government does not have any other medical malpractice insurance measures. Once there is a medical accident in the future practice, rural doctors still have to bear high medical accident compensation alone as before. The income is limited, and the compensation is determined according to law. The government cannot resist the practice risk by collecting the practice risk fund. This is the government's extremely irresponsible behavior towards rural doctors. As a three-level medical network, county hospitals and township hospitals are how to stipulate and operate medical accident compensation. The government should formulate corresponding plans for the compensation for medical accidents of village clinic workers managed by the lower house of rural integration and implement zero price difference sales.
Fourth, the salary of rural doctors.
China has always implemented the system of supporting doctors with medicine, which maintains the operation of the medical market. In the process of rural health reform, farmers have gained real benefits by implementing zero price difference sales and canceling drug profits. In this reform, township health centers have implemented the government payment method of full employment, full financial allocation and two lines of revenue and expenditure, while village clinics, which are also stipulated by the government to implement zero price difference sales, have not received any relevant compensation.
The government subsidizes 8,000 yuan per person per year in village clinics for public health service projects. Because Yuexi is a mountainous area, the land is vast and sparsely populated, and the workload of rural doctors is heavy. If a rural doctor is equipped with 1.200 people, it is obviously unable to meet the needs of the masses. According to the calculation of existing rural doctors, each rural doctor in more than 80% towns can only get 200-400 yuan per month, so rural doctors only have a small amount of public health services. The work of rural doctors is standardized, but their interests are marginalized. If this goes on, it will inevitably lead to the instability of rural doctors, the bottom of the three-level health network will inevitably not be improved and consolidated, and the problems of farmers' difficulty and expensive medical treatment will certainly not be fundamentally solved. The government should investigate and solve these problems according to objective reality.
Fifth, the advice of rural doctors.
The unfair treatment of our rural doctors is not to solve the problem of establishing and identifying general labor relations, but its significance has risen to the political issue of whether our rural doctors are legally recognized, respected in personality, discriminated against politically and protected in legitimate rights and interests. Looking at the spirit and reality of government documents at all levels, since it is necessary for rural doctors to exist in the rural health service system, the government should attach importance to this team, correctly evaluate the work of rural doctors, give them due social status and economic treatment, and create a good practice environment for rural doctors. After the implementation of the integration, rural doctors should refer to the system of workers, private teachers and agricultural technicians in township hospitals to solve labor relations and obtain labor security. Only in this way can township hospitals and village clinics be equally unified in the rural cooperative medical security system. We look forward to real rural integration, not rural alienation in the name of rural integration. Only in this way can we really solve the problem of farmers' difficulty and expensive medical treatment. It is not feasible to sacrifice the interests of rural doctors for the success of the so-called rural health reform. I hope the government can solve our practical problems and not put a heavy burden on rural doctors.
I hereby take the liberty of writing a book and hope to answer it.
Yuexi county village doctor
20 10 May 24th