Medical network - on February 4, 2015, public hospital on-the-job worker salary income 89000 yuan, the average per person in grassroots medical institutions for 55000 yuan. Average income than other industry, the healthcare industry ranked after; With a doctor of education degree, working strength, professional risk factors such as compared to income treatment does not match. Grassroots medical staff income less, difficult to attract and retain talent. The doctor whether or not to be high income groups? The doctor pay to reach the level of how? For kickbacks, a red envelope, such as unreasonable income, and how to regulate? The reporter interviewed the relevant person in charge of national health development planning commission experts and local. - the editor
▍ doctors should earn much money
Reporter: how is the overall income level of the medical staff?
Who planning commission health development research center, developed countries should investigate member and Jane: medical staff overall income level is low at present. One is the health care industry average income level compared with other industries in the whole society, the ranking. In 2006-2013, the China labor statistical yearbook, the health of social security FuLiYe personnel salary ranking ninth in the country. The personnel structure similar to financial industry ranked first. In the United States and other developed countries, the doctor is the highest income group. The second is the degree of education and medical staff, working strength, professional risk factors such as compared to income treatment does not match. Three are lower, grassroots medical staff income is difficult to attract and retain talent, the serious influence of grassroots organization ability of the medical and health services.
According to "the national family planning financial information" shows that in 2015, the public hospital on-the-job worker average wage income was 89000 yuan per person in, the city hospitals, district hospitals, county hospitals of 105000 yuan, 81000 yuan and 105000 yuan respectively. Grassroots medical institutions for 55000 yuan, of which the urban community and in towns and townships 69000 yuan and 52000 yuan respectively.
Reporter: whether the doctor should be a society of high income group? How do you think different title, age, hospital level and the gap between the department?
Should the Jane: I think, from the perspective of the doctor manpower value and current work load conditions, and the doctor a unique contribution to the productivity factors, the ultimate pursuit of man himself, the doctor should be a society of high income group. It is necessary to realize the goal of reform focus on and solve the problem.
National health development planning commission health development research center researcher Zhang Guangpeng: in theory, the doctor's income should reflect the value of her replacement. Post value evaluation factors, we should uphold fair comparable, outstanding technology, risk, responsibility and so on, not affected by the title, age, etc.
Hospital doctors at different levels, due to the knowledge and skills, responsibility and pressure, the difficulty and complexity, risk and the difference of the intensity of labor, etc, should pay the difference. Between the same level hospital according to the hospital service level, task, service scope, risk degree and specialized subject hospital setting, personnel structure elements, appropriate fall behind. In a word, reasonable gap is the main factor should be its service level, ability, risk factors, such as does not cause too much because of different hospital medical income gap.
▍ how should pay rise
Reporter: the doctor salary system reform of the basic principles and thinking is what? What is the salary system in accordance with the doctor industry characteristics?
Should the j: in the context of public hospital, industry overall level pay deviating from the labor value, grassroots organization personnel salary is too low, post level income between the lack of specification, income structure of basic salary bonuses and inversion phenomenon is more and more serious, etc., are all in the health care industry diminished appeal, grassroots health workforce problem difficult to solve, the hospital internal incentive system of the cause of the distortion.
The doctor the principles and ideas of the salary system reform should be: overall ascension, total amount control, structural optimization, standardization of assessment, performance. In line with the salary system characteristic of medical industry, to deal with the following relations:
One is the current level and the relationship between long-term goals. Salary system reform on the operation is likely to be gradual, but as a system, should be able to pay levels to make scientific positioning for industry.
Secondly, public hospitals and medical personnel salary relations between grassroots organization. Relatively speaking, more greatly improve grassroots medical staff salary treatment, should be incorporated into the policy.
A third is the relations of distribution among the hospital internal between different level duty personnel. Such as the hospital internal management, clinical, medical, nursing, logistics between jobs; Basic medical and public health between jobs; Different length, different titles for the same position and so on personnel allocation relationship should be between the specification, there is a certain quantitative proportion relationship. , of course, this ratio should have certain floating range, operable.
The fourth is the guarantee, the relationship between incentive and constraint. Scientific design base salary and bonus proportion relations, to ensure the basic income treatment, medical staff deal with the relationship between protection and incentives.
At the same time, the establishment of performance appraisal and the income distribution mechanism, must implement effective incentive and constraint. Specifically, must fully consider the complexity of medical service and uncertainty, as well as arouse the enthusiasm of services, and implementation of the "effective incentive", guarantee the compensation amount reaches a certain level, but also the total amount of "cap", set "ceiling", the interest in a "cage", "hard constraints" interest, resolutely avoid hospital service revenue, the more people income level to the practice of unlimited increase.
Reporter: do concerned controller put forward reform of the state council, allowing the regulation and control of medical and health institutions to break through the current institution wage, allow the medical service revenue after deducting costs and in accordance with the provisions, extraction of various funds is mainly used for reward. How to understand this?
Zhang Guangpeng: the state shall implement a authority institution total wages plan, total wages is the country in a certain period of direct payment all worker total wages. All localities and departments wages use plan shall not exceed the annual total wages.
Hospital increase personnel, must be linked to the total wages. For medical and health institutions, need according to responsibility, service quantity, service quality elements such as closely linked, and lower the organic combination of hospital personnel management authority, giving the hospital salary allocation autonomy, play to autonomy and the enthusiasm of the doctor at the hospital.
Should the Jane: "two allow" shows the characteristics of the medical industry, admitted that the medical staff salary should be higher than the general utility. At the same time, from medical institutions to strengthen economic management incentives, save cost, optimize the structure of balance point of view, gives greater financial allocation of medical institutions, is conducive to the scientific and standardization of the public hospital internal management and refinement.
▍ gray income zha specification
Reporter: the boundaries of the doctor income is reasonable and unreasonable?
Should the Jane: the doctor income is reasonable and unreasonable, is not very good answer, because a lot of policy changes to keep pace with the actual situation actually, some policy innovation in the process. So, just use current policies to discriminant is reasonable and unreasonable, probably leads to problems in the operation. Objectively speaking, policy is unlikely to dock with the complicated and changeable situation completely.
In theory, the doctor provides patients with needed services, calculate, should be conform to the principle of distribution. Such as part-time or external service, at present is still in the normal fuzzy zone, but in general, patients with labor is should the doctor needs, to achieve a certain reward, has its reasonable.
Reporter: what is the cause of recessive income? What regulation?
Health development planning commission, deputy director of the shaanxi province Ma Guolin: take a red envelope, to take kickbacks, earn commission these hidden project is the behavior of the individual doctors, it is not in conformity with the provisions. Existence of the reasons for the phenomenon is one of the doctors working strength is big, need to assume the risk is high, the income level can not reflect the real labor value, combined with medicine to cure mode after cancel, corresponding fiscal subsidies did not reach the designated position, and because of archives to jump out of the system, such as limit part forced doctors charge hidden income. And doctors themselves age, title, level, department, etc can cause hidden income gap enlargement.
Should the Jane: the doctor unfair income in the income, mostly drugs and consumables "rake-off". It must begin from fountainhead, and cutting off "kickbacks" sources, is fundamental. Such as fujian sanming drug action mechanism reform, ningbo, zhejiang province health materials procurement mechanism reform, the depth of the squeezing circulation price "moisture", related subject illegitimate interests source to reduce or disappear, this is very critical, and emphasis on "3 d linkage" reform of public hospitals. The future drug consumables, action mechanism, realize the online trading system public procurement, sunshine, medicare settlement, should be a key link in the process of reform.
On medical service, strengthen the service behavior regulation, such as regulation of pharmaceutical affairs, prescription reviews, medical care and settlement of the audit control, etc., are necessary. Promote the reform of medical insurance payment methods, external supervision to internal incentives, also cannot be ignored |
