中共中央、国务院关于卫生改革与发展的决定
(January 15, 1997) That everyone enjoys health care and the continuous improvement in the quality of health of the whole nation constitute an important objective of socialist modernization, an important hallmark of the improvement in the quality of people's life, an important content of socialist spiritual civilization and an important guarantee of sustainable socio-economic development. The whole party and the whole society should pay great attention to the cause of public health, protect and promote people's health. Since the founding of the People's Republic of China, and especially since the implementation of the policy of reform and opening up, great advancements have been made in the cause of public health in our country and achievements scored which have attracted worldwide attention. Public health ranks on a considerable scale has been formed, public health service system has basically taken shape and scientific and technical standards of public health have witnessed rapid improvement. There has been marked improvement in the production and supply of medicine and the cause of traditional Chinese medicine and pharmacology has been inherited and expanded. Public health reform has achieved results and has been gradually deepening and legislation continuously stepped up. With the in-depth unfolding of the patriotic public health movement, some diseases which seriously endanger people's health are under control or have been basically eradicated. The standards of people's health have been markedly raised with average life expectancy raised to 70 years from 35 years before the founding of the People's Republic and infant mortality reduced to 31.4%. from 200%…… In the past four decades or more, public health work has played an important role in promoting the development of socialist modernization of our country and the broad masses of public health workers have made major contributions in the protection and promotion of people's health. Meanwhile, it should be noted that the growth of the cause of public health at present cannot yet keep up with the requirement of economic construction and social progress, regional imbalances exist in the development of public health work, there are weak links in rural public health, prevention and health care, imperfection in medic are system, inadequacy in public health input, irrational resources allocation, excessive rise in medical cost, there are still inadequacies in public health service quality and attitude as desired by the people and public health work fail to win sufficient attention of the whole society. Party committees and governments at all levels should further step up their leader ship over public health work and public health reform needs urgent deepening. In the next 15 years, public health work is entrusted with heavy tasks. With the development of the economy, scientific and technological advancement and improvement in the living standards of the people, they will have more and higher requirements in respect of improved health services and quality of life. With acceleration of the process of industrialization, urbanization and aging of the population, health problems connected with ecological environment and lifestyles will increasingly aggravate and rate of chronic non-infectious diseases will increase. A number of infectious diseases and endemic diseases still endanger people's health and some new infectious diseases pose a great threat to people's health. All this calls for a big development and improvement of the cause of public health in our country. The period from the present to 2010 is an important one during which the past shall be inherited and the future ushered in, and the cause of the older generation carried forward and new ground broken in the building of socialism with Chinese characteristics. To put into practice the spirit of the Fifth and Sixth Plenary Sessions of the Fourteenth Central Committee of the Communist Party of China and carry out the public health tasks put forth in the I. THE OBJECTIVES TO BE STRIVEN FOR AND GUIDING THOUGHT IN PUBLIC HEALTH WORK (1)The objectives to be striven for in public health work are as follows: with Marxism-Leninism, Mao Zedong Thought and Deng Xiaoping's theory of building socialism with Chinese characteristics as guidance, adhering to the Party's basic line and policy and continuously deepening public health reform, by the year 2000, a preliminary public health system including health services, medic are security and public health law enforcement and supervision with Chinese characteristics shall be established, with basic realization of primary health care enjoyed by everyone and further improvement in health standards of its nationals. By 2010, a complete public health system catering for the requirements of the system of socialist market economy and people's health shall be established throughout the country, with main national health targets in economically developed regions reaching or being close to average standards of medium developed countries in the world and the less developed regions reaching the advanced standards of developing countries. (2)The policy of public health work in the new period is as follows: put the stress on the rural areas, put prevention first, pay equal attention to Western medicine and traditional Chinese medicine, rely on science and technology and education, mobilize the whole society to participate, render service for people's health and socialist modernization. (3)Public health work in our country is a non-profit social undertaking while the government pursues a certain welfare policy. The development of public health work must be in coordination with national socio-economic development, and the welfare level of security of people's health must correspond with the level of economic development. The government bears important responsibilities in the development of public health work. Governments at all levels should make efforts to increase public health input and mobilize various circles of the society in an extensive way to raise funds for the development of the cause of public health. Citizens themselves should also, step by step, increase their own input for medic are. By the end of the century, efforts will be made that total public health expenditure of the whole society shall be approximately 5% of gross domestic product. (4)Public health reform and development shall abide by the following basic principles: Adhere to the aims and purposes of serving the people, correctly handle the relations between social benefit and economic performance and put social benefit first. The tendency of seeking lopsided economic benefit to the neglect of social benefit should be prevented. Center round the improvement in the standards of people's health, give priority to the development and guarantee of basic health service, embody social fairness and satisfy step by step the diversified requirements of the masses of people. Proceed from the state of the nation in the development of the cause of public health, allocate resources rationally and put the stress on the improvement in quality and efficiency. Put the stress on the strengthening of public health in the rural areas, prevention and health care and traditional Chinese medicine and pharmacology. Narrow the gap between regions by giving guidance to different types of areas suiting local conditions. Medical institutions run by the state and collectives shall constitute the main body while those run by other social institutions and individuals serve as a supplement. Expand opening up to the outside world, promote international exchange and cooperation in the field of public health and actively make use of and draw on advanced foreign science and technology and expertise in management. Adhere to the principle of grasping the two links of socialist material civilization and spiritual civilization and both should be tough. Strengthen the building of professional ethics in health service and raise continuously the ideological and moral quality and professional and technical levels of public health workers. II. ACTIVELY PROMOTE PUBLIC HEALTH REFORM (5)The aim of public health reform is to reinvigorate the cause of public health, fully mobilize the enthusiasm of public health institutions and public health workers, continuously improve the quality and efficiency of health service and serve the cause of people's health and socialist modernization in a better way. Adapt to the development of socialist market economy, abide by the inherent rules of the development of public health and establish step by step the new mechanism of strong macro regulation and control and vigorous micro operation. (6)Reform the medic are system for urban workers and staff members. Establish the medical insurance system based on the combination of unifiedly raised social medical funds and individual accounts, expand step by step its coverage and provide basic medic are for all urban workers. The level of medic are should correspond with the level of development of social productivity and the tolerance of the different sectors of society. The insurance cost shall be rationally borne by the state, the employer unit and the worker or staff member. Social medical insurance for workers and staff members shall practise dependency administration. Strengthen in real earnest administration and supervision of medical insurance fund. Establish the mechanism of checks on medical institutions and patients, actively explore scientific and rational mode of payment and effectively control the irrational growth of medical cost. Medical institutions and medical personnel who play an important role in doing a good job of medic are system reform for workers and staff members should actively participate in the reform, treat patients according to their ailments, conduct rational examinations, prescribe medicine rationally so as to curb waste. Meanwhile, the government should, in real earnest, solve the problem of compensation for medical institutions. During the “Nineth Five-Year Plan” period, social medical insurance system for urban workers and staff members shall basically be set up on the basis of successful experiments and summing up experiences, and actively develop supplementary medical insurance in diverse forms. (7)Reform public health management system. Departments of public health administration at all levels shall transform their functions and strengthen public health administration by applying laws and regulations, policies, plans and guidances, information services and economic means. Rationally allocate and fully exploit existing public health resources to raise the rate of exploitation of public health resources. Regional public health planning is an important means of the government in the macro regulation and control of the development of the cause of public health. Its goal is to satisfy the requirements of all residents in a region in basic health service and it practises unified planning and rational allocation of such public health resources as the medical institutions, hospital beds, personnel, equipment and funds. Municipal(prefectural) governments shall, in accordance with the guiding principles and standards for public health resources allocation for regional public health planning formulated by the Central People's Government and the provincial people's governments, work out Regional public health plans of the localities and organize their implementation. Departments of public health administration shall, in accordance with the regional public health plans, conduct policy guidance, organize coordination and carry out supervision and inspection with regard to the development of public health in their respective regions; adjustments should be made step by step with regard to existing public health resources, and new additions to public health resources shall be subjected to strict examination and approval and management. Public health institutions of enterprises which are an important component part of public health resources, should actively explore and realize step by step socialization of public health institutions of enterprises in the light of the actual conditions in the process of deepening enterprise reform. (8)Reform urban health service system, actively develop community health service and form step by step health service networks with rational functions and convenient for the masses. Grass-roots level public health institutions should target at the communities and families, carry out prevention of diseases, diagnosis and treatment of commonly encounted diseases and frequently encounted diseases, recovery of the injured and disabled, health education, planned parenthood technical service and health care for women, children, the elderly and the disabled. Community medical service should be integrated into medical insurance for workers and staff members and two-way diagnosis transfer system established. Medical personnel should be diverted in a planned way and medical personnel in society organized in setting up health service networks in residential areas which should be integrated into the community health service system. Major urban hospitals shall mainly engage in the diagnosis and treatment of emergent and serious cases and suspected and difficult cases, carry out medical education and scientific research in combination with clinical practice, continuously raise the level of medical science and technology. They should also develop suitable techniques, provide guidance and training for grass-roots medical personnel. Social groups and individuals shall practise self-operations in running medical institutions and be responsible for profits and losses. The government shall actively provide guidance and examine and approve such institutions according to law and carry out strict supervision and administration. (9)Reform the operational mechanism of public health institutions. Public health institutions should establish an operational mechanism which is responsible and with incentives, restraints, competition and vitality by way of reform and strict management. Public health institutions shall practise and perfect the responsibility system of the president of the hospital(director of the institute or station)。The independent operational and managerial powers of public health institutions shall be further enlarged. Continue to deepen the reform of the personnel system and distribution system, break egalitarianism by employing correct policy guidance, ideological education and economic means to mobilize the enthusiasm of the broad masses of public health workers. Accelerate formulation of standards for the establishment of public health institutions and authorized size of personnel, standardize financial input for public health institutions, reform and perfect the price system of health service. Adjust the revenue structure of medical institutions, reduce the proportion of income accrued from medicine in the revenue of medical institutions, rationally control the range of growth of medical expenses and there shall be separate accounting and separate management of medical revenue and expenditure and medicinal revenue and expenditure. Under the prerequisite of guaranteed completion of basic health service, medical institutions may engage in services related to their domain of profession, institutions of preventive health care may engage in suitable compensatory service to meet the social requirements of different tiers, and in the meantime, supervision and administration should be reinforced. III. STRENGTHEN PUBLIC HEALTH WORK IN THE RURAL AREAS FOR THE REALIZATION OF THE GOALS OF PRIMARY PUBLIC HEALTH AND HEALTH CARE PLAN (10)Public health in the rural areas concerns the overall interests of the health of peasants and invigoration of rural economy to which Party committees and governments at all levels should pay close attention and take strong measures to strengthen it in good earnest. Primary public health and health care plan has put forth the main tasks and goals for rural public health work indifferent regions by the year 2000. Implementation of the primary public health and health care plan is the key in doing a good job of rural public health work. Governments at all levels should integrate this work into the plan for national economic and social development and practise management by objectives to create necessary conditions for the building of well-to-do counties, xiangs(?) and villages. (11)Actively, steadily and satisfactorily develop and perfect cooperative medical service. Cooperative medical service plays an important role in ensuring that peasants enjoy basic medical service, implementation of preventive health care tasks, and prevention of impoverishment caused by diseases. Establishment of cooperative medical service should abide by the principle of being run by local people with some state subsidies and voluntary participation. Individual input shall be the main source in fundraising with collective support and appropriate government support, raise peasants' awareness of self-health care and mutual assistance and mutual support and mobilize peasants to actively participate through propagation and education. The mode of cooperation, standards for fund-raising and percentage Of reimbursement shall be determined in the light of local conditions and insurance level raised step by step. Preventive health care compensatory system should continue as a form of cooperation. Scientific management and democratic supervision of cooperative medical service shall be enhanced to ensure that peasants reap actual benefits. Efforts should be made to establish cooperative medical service in various forms in most rural areas by the year 2000 and the extent of socialization increased step by step; where conditions are ripe, transition to social medical insurance can be effected step by step. (12)Step up the building of rural public health organization and perfect the county-, xiang- and village-level health service networks. The scale and distribution of public health institutions shall be determined rationally and their structure and functions adjusted. County-level hospitals should be managed well in real earnest to upgrade their integrated services capabilities. Continue to step up the building of county-level epidemic prevention organs, maternal and infant health care institutions and rural and township health centers. Strive to realize in the main the goal of “one without and three matchings”, i.e., without condemned houses and with matching houses, staff and equipment during the “Nineth Five-Year Plan” period. Rural and township health centers should do well preventive health care, make efforts to upgrade medical quality, and put the stress on strengthening the building of emergency and maternity wards. Village-level public health institutions shall mainly be run by collectives. Modes of operation and management of xiang and village public health institutions may be determined in the light of actual local conditions. Perfect channels of rural medical supplies to ensure safety and effectiveness of medicine. (13)Consolidate and upgrade the ranks of rural basic health workers. Rationally solve the salary problem of rural health workers, the income of rural doctors in collectively-run village public health institutions shall be no lower than the level of income of local village cadres. 80% of rural doctors shall reach the level of vocational high school by the year 2000 through various forms of training. Non public health technical personnel are strictly forbidden to take up technical positions in public health. Medical and public health colleges and schools should do well direction oriented admission of students and on-job training and train for the rural areas public health technical personnel who are prepared to stay on in the localities and apply the knowledge acquired. Preferential policies shall be formulated to encourage intermediate college graduates and above to work in county and xiang public health institutions. (14)Establish the system of urban public health institutions rendering support to their counterpart units in the rural areas and help rural public health institutions raise their capabilities in services in the form of personnel training, technical guidance, mobile medical service and equipment support. Urban public health technical personnel must work for a period of six months and one year respectively in county or xiang public health institutions before their promotion to the positions of visiting physician and assistant visiting physician. (15)Great importance should be attached to public health work in poverty stricken areas and minority nationalities regions which should be done well. Governments at all levels should incorporate assistance in public health to poor areas into local plans of assistance to poor areas, arrange necessary funds to assist poor areas, and help these areas mainly in building infrastructure in public health, improving conditions for drinking water and prevention of endemic diseases and infectious diseases. Support for the development of public health work in those regions shall be important contents of financial transfer payment. Developed regions shall be encouraged to render assistance to their counterpart units in public health work in poverty-stricken areas and minority nationalities regions. IV. DO A GOOD JOB OF PREVENTIVE HEALTH CARE IN REAL EARNEST, CONDUCT IN-DEPTH PATRIOTIC HEALTH MOVEMENT (16)Governments at all levels shall be fully responsible for public health and preventive health care, step up the building of preventive health care institutions by providing necessary input and ensuring the required funds for the prevention and control of major diseases. Preventive health care institutions should do a good job of preventive healthcare of social groups. Medical institutions should also actively engage in preventive health care in close association with their own professional fields. Carry out publicity and motivation among masses, take integrated measures and concentrate efforts to eradicate or control a number of infectious diseases and endemic diseases which seriously threaten people's health; step up prevention and control of diseases spread through blood; actively carry out prevention and treatment of such chronic non-infectious diseases as cardiovascular and cerebral-vascular diseases and tumors. Enhance contingency powers in dealing with injuries and diseases caused by accidents and outbreak of epidemics. Attach importance to surveillance of occurences and spreading of infectious diseases in and outside the country. (17)Earnestly do a good job of food hygiene, environmental hygiene, occupational hygiene, radiation hygiene and school hygiene. Improve the sanitary conditions of places of living, production, work, learning and entertainment, step up surveillance and monitoring of environmental hygiene and prevention and treatment of occupational diseases, protect people's rights to health. It is not allowed to seek economic growth one-sidedly at the expense of environmental pollution and endangering people's health. (18)Health education is an important content of citizens' quality education. Great importance should be attached to health education to enhance the consciousness of health and self-healthcare capability of the broad masses of people, and actively promote “health education action of 900 million peasants”。 Popularize knowledge of medical science. Educate and guide the masses to break away from superstition and old customs and take part in national fitness activities, promote rational nutrition, nurture good health habits and civilized way of life, cultivate health and psychological quality. Publicize and promote in a big way voluntary blood donation. (19)Protect the health of major human groups in accordance with law. Enhance maternal and infant health care, upgrade population quality of new births, reduce infant mortality and mortality of women in pregnancy, and realize the goals set in the (20)Patriotic public health movement is a good form of our country in mobilizing the masses to take part in health work. Activities to create hygienic cities should continue to be carried out in cities to upgrade the level of modernized management, enhance the awareness of citizens in public health and civility and promote the building of civil cities. In the rural areas, priority should continue to be given to reconstruction of water supply and renovation of lavatories to push ahead improvement in environmental hygiene, prevention and reduction of occurences of diseases to promote the building of civil villages and towns. Both urban and rural areas should persevere in carrying out activities of “four eradications”, i.e., eradication of mosquitoes, flies, rats and cockroaches. V. LAYING EQUAL STRESS ON TRADITIONAL CHINESE MEDICINE AND WESTERN MEDICINE, DEVELOPING TRADITIONAL CHINESE MEDICINE AND PHARMACOLOGY (21)Traditional Chinese medicine and pharmacology which constitute fine traditional culture of the Chinese nation is an important component part of the cause of public health of our country with unique characteristics and advantages. The traditional medicine and pharmacology and modern medicine and pharmacology of our country which are mutually complementary, jointly shoulder the task of protecting and promoting people's health. Party committees and governments at all levels should earnestly implement the policy of laying equal stress on traditional Chinese medicine and Western medicine, strengthen leadership of the work of traditional Chinese medicine and pharmacology, increase input step by step to create good material conditions for the development of traditional Chinese medicine and pharmacology. Medical personnel, Chinese and Western style, should enhance unity, learn from each other, complement each other, achieve mutual improvement and promote the integration of traditional Chinese medicine and Western medicine. The medicine and pharmacology of all nationalities constitute component parts of traditional medicine and pharmacology of the Chinese nation and efforts should be made to discover, compile, summarize and improve upon them to give them full play in the protection of people's health of all nationalities. (22)Correctly handle the relationship between inheritance and innovation. On the one hand, features and advantages of traditional Chinese medicine and pharmacology should be earnestly inherited; on the other, there should be creative spirit in actively employing modern science and technology, promote the development of the theory and practice of traditional Chinese medicine and pharmacology to realize the modernization of traditional Chinese medicine and pharmacology. Persevere in the policy of “Let hundred flowers bloom, let hundred thoughts contend” and bring about prosperity in academic research of traditional Chinese medicine and pharmacology. Medical institutions of traditional Chinese medicine should step up the building of disciplines with special features, improve technical equipment, expand areas of service so as to continuously satisfy the requirements of masses for traditional Chinese medicine. Attention should be paid to give full play to the advantages and role of traditional Chinese medicine and pharmacology in rural health work. Actively train all types of specialized personnel in traditional Chinese medicine in an effort to train famed new-generation physicians of traditional Chinese medicine. Seriously sum up experiences in running seats of higher learning of traditional Chinese medicine and pharmacology and manage well existing seats of higher learning of traditional Chinese medicine and pharmacology by continuously deepening reform. Continue to do a good job of inheriting the academic thoughts and experiences of well-known senior specialists of traditional Chinese medicine and pharmacology. Step up studies in the prevention and treatment of major diseases, key techniques in the production of traditional Chinese medicine, compounds of traditional Chinese medicine and research in basic theory, strive for new break throughs and improvement in overall academic standards. Actively create conditions for traditional Chinese medicine to be applied more extensively in the world. (23)Actively develop pharmaceutical industry of traditional Chinese medicine, promote modernization of production of traditional Chinese medicine. Reform and perfect the form of production organization and management of traditional Chinese medicinal herbs and implement preferential policies to protect and develop resources of traditional Chinese medicine. Actively carry out reform of production enterprises of traditional Chinese medicine and realize step by step intensive and scale operations. Business operations of traditional Chinese medicine should follow the principle of less links, diverse forms, clear-cut channels and standardized conduct and gradually form a unified, open, competitive and orderly distribution system. Accelerate the formulation of quality standards for traditional Chinese medicine to enhance scientific management of the production and quality of traditional Chinese medicine. VI. PROMOTE SCIENTIFIC AND TECHNOLOGICAL ADVANCEMENT, STRENGTHEN THE BUILDING OF THE RANKS OF HEALTH WORKERS (24)Put into practice the thought that science and technology is primary productive force. Single out priorities and concentrate forces in jointly tackling diseases which seriously endanger Chinese people's health in key applied research, high-tech research and basic medical research, strive for new breakthroughs to ensure that main disciplines and key techniques in the field of public health gradually approach or reach advanced international standards. Deepen the reform of public health scientific and technological system, optimize the structure, divert its personnel to enhance the vitality of public health scientific research institutions. The input and building of major public health research institutions, key disciplines and laboratories should be guaranteed. Promote the integration of public health science and technology and prevention and treatment of diseases, accelerate the transformation and application of scientific and technological achievements, and extend in a big way suitable techniques. Great importance should be attached to the development, exploitation and dissemination of scientific and technological information and enforcement of information management. Expand international exchange and cooperation in the field of public health. Actively introduce advanced technology, brainpower and management expertise in the forms of bilateral, multilateral, official and unofficial cooperation. Do a good job of foreign assistance in public health. (25)Manage medical education successfully in the training of a force of professional health workers meeting the requirements of society, rational in structure and with ability and moral integrity. Deepen the reform of higher medical education and improve the quality and efficiency of education. Perfect the system of training post-graduates, the degree system as well as the system of continuing education. Emphasis should be put on basic theories in training clinical doctors, all the more so on integrated clinical skills. Accelerate the development of all-disciplinary(?) medical science and training of all disciplinary doctors. Great importance should be attached to the training of public health managerial personnel and bring up a force of professional managers commensurate with the development of the cause of public health. Attention should be paid to the training of leaders in academic research and techniques and strive to create conditions so that the best talents especially young and middle-aged talents can emerge and show themsleves. Public health technical personnel living abroad should be encouraged to return to the country for work or other services indifferent forms. Specialized secondary medical education should adjust its specialities according to the requirements of society with emphasis on the regular training of the force of rural health workers. With regard to specialized medical schools run by communities, the departments of education and public health should be strict in examination and approval and strengthen administration. All types of specialized public health education at all levels should give prominence to the education of professional ethics to lay a good foundation for the all-round improvement in the quality of public health workers. Establish qualification system for practice of such specialized technical personnel as doctors and pharmacists. Continuously perfect the evaluation and determination of technical titles and employment of positions of urban and rural public health workers. (26)Step up education of professional ethics and carry out activities to create civilized practice. Educate the broad masses of public health workers to carry on the spirit of Dr. Bethune and foster the custom of the medical profession in healing the wounded, rescuing the dying, being dutiful, loving one's job, being enthusiastic, pioneering and enterprising, trying hard to be better, being ready to contribute one's share and civil in medical practice, and consciously boy cottmammonism, individualism and any such other acts detrimental to the interests of the masses. Carry out activities to create civilized medical practice which should be combined with the resolution of practical problems about which them asses are most concerned and the promotion of the reform and development of public health service, and persevere in the efforts for practical results. Great publicity should be conducted in respect of model health workers and advanced collectives, and citations and rewards given. Perfect the system of internal supervision and social supervision and resolutely rectify the incorrect styles in the medical profession. VII. STRENGTHEN THE ADMINISTRATION OF MEDICINE AND PROMOTE COORDINATED DEVELOPMENT OF THE MEDICAL SERVICE AND THE PHARMACEUTICAL INDUSTRY (27)Medicine is a special commodity for the prevention and treatment of diseases and protection of people's health. Administration of the various links of the research, production, distribution, price, advertisements and use of medicine must be stepped up in accordance with law and there should be strict quality supervision to really ensure the safety and effectiveness in the use of medicine by the people. The State shall formulate and perfect basic rules for drugs, the system of administration according to the classifications of prescription drugs and non-prescription drugs and there serve system of medicine at the central level and the provincial level. Actively explore the reform of the management system of medicine and gradually form a unified, authoritative and efficient management system. (28)Formulate development plan for medicine to ensure coordinated development of the pharmaceutical industry and the cause of public health. Strengthen macro control and adjust the structure of pharmaceutical enterprises and the structure of products. State-owned large- and medium-size pharmaceutical production enterprises should establish modern enterprise system and bring about scale economy. Accelerate technical transformation of pharmaceutical production and operational enterprises and strengthen scientific management in strict accordance with the quality control standards for pharmaceutical production and business operations. Encourage and support the research and development of new drugs to upgrade the competitive capabilities of the pharmaceutical products of our country in domestic and world markets. (29)Improve and tighten price control of medicine. The State formulates the price policy of medicine and exercises administration according to classifications. Price ceilings should be fixed and profit ratio under control. Policies should be formulated to encourage production and distribution of drugs included in the State basic drugs catalogs and good-quality low-price drugs. Step up the examination and approval and price control of import drugs. (30)Consolidate and standardize the distribution order of medicine. Tighten control of business operations and sale of drugs, serious penalties shall be meted out to illegal criminal acts of manufacturing and selling fake and inferior medicine, firmly ban illegal medicine markets and commercial sales points, firmly curb such illegal acts as giving and accepting commissions in marketing and purchasing activities related to medicine. Institutions of medicine sales should consciously boycott all kinds of acts of unfair competition and provide services which will let people rest assured and feel satisfied. (31)Importance should be attached and active support given to the research and development and quality upgrading of medical instruments, medical equipment, medical materials and medical apparatus, and step up supervision and control of their production and uses. VIII. PERFECT PUBLIC HEALTH ECONOMIC POLICY AND INCREASE PUBLIC HEALTH INPUT (32)Input in the cause of public health by the Central Government and local governments shall increase year by year with the development of the economy, and the range of increase shall not be lower than that of the increase in financial expenditure. Actively expand channels of fund-raising for public health, and extensively mobilize various walks of life of society and raise funds for the development of the cause of public health. Public-run public health institutions which are non-profit units shall continue to enjoy preferential policies in respect of taxes and fees. Local governments should, in good earnest, resolve the problem of social overburdening. Capital construction, purchase and maintenance of major equipment of all types of public health institutions run by the government shall be arranged by the government in accordance with the requirements of regional public health plan. Expenditures for honorary retirees and other retirees and medical insurance costs of public health workers shall be guaranteed in accordance with the provisions of the State. Expenses of preventive health care institutions and business expenses for basic preventive health care shall be arranged in financial budget, their revenues from compensatory services shall be included in budget management but shall not offset financial appropriations. Expenses for public health law enforcement shall be guaranteed by finance and shall follow the principle of “two lines of revenue and expenditure”。 Normal expenditure of medical institutions shall be partially compensated by providing services. The government shall give a certain percentage of subsidy in respect of personnel expenses in accordance with the different circumstances of the medical institutions and the missions undertaken by them, and necessary subsidy will be given for the development of major disciplines. The level of subsidy for rural and township health centers and public Health institutions in poverty-stricken areas shall be appropriately raised. The Central Government shall continue to retain and gradually increase special-purpose funds for such major fields as rural public health, preventive health care and traditional Chinese medicine and pharmacology; local governments should also increase input correspondingly. (33)Adopt diverse forms and multi-channels in public health fund-raising. The State formulates preferential policies to encourage voluntary donation by enterprises and institutions, social groups and individuals in support of the cause of public health. Foundations shall be set up to render medical assistance to critical and emergency patients incapable of making the payment. A certain amount of funds unifiedly raised by xiang shall be used for the purposes of rural public health, a certain amount of funds withdrawn and retained by the village shall be used for cooperative medical service, revenue of rural and township enterprises and other rural collective economic units should also support rural public health work and cooperative medical service. Specific measures for fund-raising and its percentage shall be determined by Local governments or collective economic organizations. Cooperative medical service fees paid voluntarily by peasants belong to the category of expenditure of personal consumption and shall not be calculated as part of funds unifiedly raised by xiang and withdrawn and retained by the village. All localities may expand other channels of fund-raising in the light of local conditions. Foreign friend ship associations and friendly personages shall be welcome to support the cause of public health of our country. (34)Perfect government's price control of health services. Different pricing principles should be followed differentiating the nature of health services. The rate of basic medical service shall be determined on the basis of cost upon deduction of regular financial subsidy. The rate of non-basic medical service shall be slightly higher than cost. The rate of specialized services for voluntary selection shall be liberalized. There should be an appropriate difference in the rate to be charged by medical institutions of different grades to guide rational diversion of patients. At present, items for technical service charges should be added and their rates raised, rates of over charge for items of examination and treatment with major equipment should be reduced. Price regulatory mechanism of health services adapting to changes in prices and system of effective control and supervision should be established. Price control authority of health services shall be appropriately decentralized. Government at all levels should incorporate health service price reform into plan, implement it in steps and strive to resolve the question of existing irrational price of health service in two to three years. (35)Public health institutions should strengthen financial management and run public health service frugally. Rules and regulations for financial management should be perfected, accounting should be improved, distribution system of labor income should be improved, financial actions should be standardized, quality of financial and accounting personnel shall be upgraded so as to continuously improve the performance of public health funds. Auditing and financial supervision should be stepped up. IX. STRENGTHEN IN REAL EARNEST PARTY AND GOVERNMENT LEADERSHIP OVER PUBLIC HEALTH WORK (36)Party and government leadership is the basic guarantee for the development of the cause of public health. Hygiene, health, birth, aging, sickness and death involve the practical interests of every household and individual. Party committees and governments at all levels should put public health work on the agenda as an important issue and tackle it as a major issue of care for the diseases and sufferings of the masses, of closer relationship between the Party and the masses, of promoting economic and social development and discussion of the same should be held at least once or twice every year. Public health reform and development should be listed in the overall plan for national economic and social development and carried out synchronously, and practical steps taken to resolve practical difficulties and problems in public health work and efforts are made to create necessary conditions for public health reform and development. All departments concerned should seriously fulfil their responsibilities, closely cooperate with one another and jointly do a good job of public health work. Strengthen Party building. Bring into full play the role of basic Party organizations as the political core and the pioneering and model role of Communist Party members and do a good job of purpose-oriented ideological and political work among the ranks of public health workers. Leading cadres who are Communist Party members should forge close links with the masses, set an example and be honest and clean in performing official duties. (37)Public health work shall practise the responsibility system and administration according to different levels and powers of the Central Government and the localities should be rationally divided. The Central Government which provides leadership for national public health work, is mainly responsible for the formulation of public health regulations, policies and the national plan for the cause of public health, provides guidance and coordination for the resolution of major national or intra_provincial, intra-regional public health problems, and help the local governments develop the cause of public health by employing various means. Local governments at all levels shall be fully responsible for the public health work in their respective regions, and it shall be an important content in the evaluation of the target responsibility system and the political achievements of leading cadres during their term of office. Governments at all levels shall regularly report to the people's congresses of the corresponding level on public health reform and development, and accept the latter's supervision and guidance. (38)Push ahead public health legislation. Accelerate the pace of public health legislation. Perfect public health laws and regulations with supervision and administration of health-related products, public health institutions and specialized personnel as main contents and establish and perfect all types of matching public health standards. Strengthen publicity and education of public health legislation to enhance the sense of legality of citizens about public health. Governments at all levels shall intensify the function of public health administration and law enforcement, reform and perfect public health law enforcement supervision system, adjust and strengthen law enforcement and supervision forces and continuously improve the quality of law enforcement and supervision forces so as to ensure justice in law enforcement. Strive to improve the conditions for law enforcement and supervision and the technical means, and upgrade technical arbitration capabilities. All illegal acts shall be firmly dealt with and penalties and punishments meted out. (39)Party committees and governments at all levels should care for and protect the ranks of public health workers, raise their social position, improve their working, learning and living conditions, resolve their practical questions of salary and housing satisfactorily to fully motivate their enthusiasm. Care should be shown politically for the growth and maturity of young and middle-aged public health workers. Young and middle-aged public health workers with ability and moral integrity, administrative and leading talents and skills should be selected to take up leading positions at different levels. In the meantime, attention should be paid to let senior public health workers play their role. Efforts should be made to bring about the social atmosphere of respect for medical science and respect for public health workers in the whole society, good doctor-patient relations should be established, and legitimate rights and interests of medical service personnel and patients shall be protected in accordance with law. (40)Public health work of the Chinese People's Liberation Army and the Chinese People's Armed Police Force shoulders the special mission for the protection and promotion of the physical health of all the officers and men, for ensuring national defense building and successful fulfillment of military missions. It also has the glorious tradition of serving the people and supporting local public health work. Leadership should be strengthened to ensure the implementation of various public health missions and national public health laws. All regions and all departments shall, in accordance with the spirit of this Decision and in the light of their respective actual conditions, work out plans and measures for deepening public health reform and accelerating public health development and go all out for their implementation so as to continuously raise the health level of people of all nationalities of our country. |