Behind the resignation of 36 village doctors: double confusion of treatment and identity

 Behind the resignation of 36 village doctors: double confusion of treatment and identity

On July 5, the article entitled 36 village doctors resigned collectively in Zhusha Town, Tongxu County, Henan Province circulated online, which not only attracted the attention of netizens, but also attracted the attention of the government.

On July 9, Song Chengdu, spokesman of the State Health and Health Commission, formally expressed his opinion on the resignation of village doctors: Rural doctors are thegatekeepersof the health of rural residents and play an important role in safeguarding the health of rural residents. The state has taken a series of measures to consolidate and develop the county-level rural medical and health service network, and has taken many measures to improve the treatment of rural doctors, stabilize the team of rural doctors, so that they can better serve the health of rural residents. The attitude of the Health Commission is already there. The press conference held today is the attitude.

Song Jiansheng introduced that the government work report in 2019 clearly pointed out that the new basic public health financial subsidies should be used entirely in villages and communities, and the grassroots people must benefit. The policy is clear, and good measures have been taken in many places to ensure the stability of the medical team at the village level and to ensure good medical services for rural residents at the grass-roots level.

The relevant policies of the state are very precise, including the subsidy of the essential drug system and basic public health services, which are declining by 40% and the subsidy of basic medical services, etc.

First Financial Journalist found that these policies and measures were discounted when implemented locally. This phenomenon is reflected by the resignation of village doctors and the loss of grass-roots medical personnel.

Collective resignation

On June 29, a resignation report of all village doctors in Dagang Li Township with the signature and handprint of village doctors began to circulate.

Resignation report said: work pressure, higher allocation more and more, less and less money to the hands of village doctors, wage payment is not in place, higher levels of withholding, village doctors have been unable to take care of their own lives... hereby to apply for resignation to the hospital...

In response to the resignation incident, the Tongxu County Government of Henan Province issued a circular on July 6, saying that at present, village doctors in the county are sticking to their posts and working actively. Relevant issues are being investigated and verified in an orderly manner, and the investigation will be reported in a timely manner.

At noon on July 8, the Tongxu County Government issued a circular again that 30% of the new rural cooperative medical system should be deducted and 5% of the security deposit is not a problem, which has been verified by the vouchers; there is no double price increase of essential drugs; and the annual increase of national basic public health services makes the work of village doctors overwhelming. u201d The problem does not exist.

Secondly, in view of the problems of the funds for basic public health services allocated to village doctors in 2018 are less than 10 yuan per capita, general treatment fees, basic medicine subsidies, and no subsidies for village clinics and the funds for basic public health services in 2019 have not been paid up to now, it is reported that the funds for basic medicine subsidies in Zhusha Town in 2018 are per capita. 5.07 yuan, up to the standard of 5 yuan stipulated by the state; Zhusha Town Health Hospital fully allocates the general medical fee to village clinics according to the standard, and there is no problem that there is no general medical fee; at present, village doctors enjoy public health service items, essential drugs and general medical fee subsidies, while the rest have no relevant policies, reflecting the situation. Reality. The national subsidy fund for basic public health service projects in 2018 has already allocated 14.53 yuan per capita, which reflects that less than 10 yuan is not true. In the first half of 2019, state subsidies for basic public health services and essential medicines were allocated by the county Party committee and the county government before July 20.

The investigation shows that the reasons for the resignation of village doctors are not true. However, the report said that the above problems reflect the delays in the allocation of funds for basic public health services projects by the relevant county departments, which has affected the smooth development of grass-roots health work.

Villagers cant be recruited and cant be retained. Its more realistic for them to have large workload, low salary and no attraction.

In fact, the state has a clear document on the distribution of public health expenditure. In 2019, the per capita subsidy standard for basic public health services increased from 55 yuan to 60 yuan. On October 30, 2018, the State Health and Health Commission issued a Response to the Questions Relevant to Village Doctors, specifying that about 40% of the basic public health services provided by village doctors will be allocated to village clinics after performance appraisal.

At the national level, each person is required to spend 60 yuan a year on basic public health services, and 40% of them are given to village doctors. The treatment of village doctors will be much better. He Jinguo, Director of Poverty Alleviation Office and Director of Finance Department of the State Health and Health Commission, said at a press conference of the State Health and Health Commission on July 9.

However, for per capita public health expenditure, Tongxu County village doctors only received 14.53 yuan, which is still far from 40% - 24 yuan of 60 yuan.

Public health services, more by grass-roots medical personnel, especially millions of village doctors, serve hundreds of millions of farmers, but due to historical reasons, village doctors have not been compiled, there is no state financial support, so subsidies from public health services projects are given to reflect the value of work. A public health expert said that if this money is not available, the income of village doctors will be even less guaranteed, and the landing of healthy China policy will face serious challenges. The national level is trying to keep these people, but now they are losing.

Confusion of Identity

Resignation, that is to say, resignation of post, is the act of workers to propose to employers the termination of labor contracts or labor relations.

The group of village doctors has been wandering outside the national establishment. The term resignation is indeed a bit of luxury for village doctors.

Without a written labor contract, as long as the unit has the record of paying social security, it will prove that the labor contract actually exists, but without the labor contract and the record of paying social security by the unit, it is impossible to determine the labor relationship, and it can not be regarded as resignation. Feng Jia, associate professor of Law School of Suzhou University, told First Finance and Economics.

The only legal contact we have with the government is the public health service agreement, nothing else. Guo Genxin, a doctor in Jinshan Village, Xinqiaohe Town, Ziyang District, said.

The agreement on the purchase of basic public health services for village clinics by the government has become the only link between village doctors and the government. The principle of this link is how much to do, how much to pay, how much to do, how much to do and how much to buy services.

The core of the agreement is how much work to do and how much money to take, how little money to do without work, how much reward to do well and how much punishment to do poorly, and how much risk to take in the service by the village doctors themselves. But if you want to quit, you just need to make a statement and you dont need to go through any formalities. Guo Genxin said.

Many resigned village doctors also expressed the same experience to First Finance and Economics: Just say no, do not take money.

Although it seems easy to walk, in fact it is very heavy. Because this status is directly related to the treatment and pension of village doctors. However, the existing stock of village doctors seems to be difficult to solve this problem.

On September 11, 2018, the State Health and Health Commission, in its letter of reply to Proposal No. 2854 (No. 270 of Medical and Sports) of the First Session of the 13th National Committee of the CPPCC, said that since the deepening of the medical reform, the direction of personnel system reform in township health centers is to fix jobs indefinitely, the core of which is to change from identity management to post management. Li. In view of the national situation, under the background of strict control of the establishment of the cause, it is not yet possible to integrate all village clinic personnel into the establishment and management of township health centers.

In order to solve the confusion of treatment caused by identity, the national level is also constantly recruiting.

At present, after the implementation of the essential medicine system in village clinics, there are three main channels for rural doctors to compensate: one is to compensate for the basic public health services they provide by purchasing services. According to the 12th Five-Year Plan of Medical Reform, about 40% of the workload of basic public health services should be undertaken by village doctors and compensated accordingly. Funds for basic public health subsidies have become an important source of income for village doctors. In 2018, the per capita funding standard for basic public health services was raised to 55 yuan, and in 2019 it was 60 yuan, which will be raised in the future.

Secondly, the establishment of general medical fee items. The basic medical services provided by village doctors are compensated through the medical insurance fund for urban and rural residents. Most provinces have issued the standard of general medical fees, most of which are 5-10 yuan per person.

In addition, the village doctors are compensated for the implementation of the essential drug system through the quota subsidy. The central government allocates 2.1 billion yuan annually to support village clinics to implement the essential drug system, while requiring conditional areas to further improve the level of subsidies for village doctors in areas with long service life, remote location and difficult conditions.

However, the resignation of 36 village doctors shows that these policies still need to be further implemented at the national and local levels.

In response to the incident, Song Jiansheng said that no matter where the problem appeared, it should be investigated clearly and rectified immediately. The government should conscientiously perform its duties.

Source: First Financial Responsibility Editor: Gu Yunting_NBJS8499