The Shanghai municipal authorities, backed by the central government, are launching ever-sterner campaigns to crack down on bribes received by hospital doctors.

Giving "red envelopes" -- a Chinese term for cash gifts -- to doctors is common among patients in China, especially for those going to have a surgery.

Some pharmacies and medical equipment producers also give doctors commissions to promote their medicines and products.

The Ministry of Health recently proposed that any doctor receiving "red envelopes" could be disqualified for medical practice.

Encouraged by that, eight Shanghai academicians appealed that all 140,000 medical workers in the city refrain from accepting gifts from patients.

"We should keep ourselves away from 'red envelopes,' commissions and any other forms of corruption," they said in the letter.

To facilitate the implementation of the Ministry of Health's new rule, Shanghai has launched a new campaign among medical systems and the public to strengthen supervision over medical workers so as to weed out the cash-taking practice.

The Shanghai Health Bureau recently reiterated that any medical worker receiving such "bonuses" will be punished. Those receive large amounts of money or repeatedly receiving red envelopes could have their qualifications as doctors revoked.

It is believed it will take time to eliminate such bribing. Many doctors and patients say red envelopes have become a tradition deeply rooted in the medical system, both among doctors and patients, which won't be changed by a rule.

Bribing doctors and nurses is now part of patient's mentality, particularly when surgery is involved. Patients are worried that if they don't give a gift to the doctor, their operation won't be handled meticulously enough.

"Actually the measures taken in Shanghai are already very strict and serious," said a doctor with a local hospital who did not want to be identified.

He said most doctors are cautious and prudent when dealing with "red envelopes."

Some doctors don't accept gifts from patients directly, but prefer receiving the money from a reliable friend or colleague, which makes red-envelope-giving a delicate art.

Many point out that the salaries offered to doctors doesn't match their education, contributions to society and career risks.

Another source of supplemental income for physicians are the commissions from pharmacies and medical equipment manufacturers.

It is common for doctors to receive commissions from them by prescribing their medicines, products, or using their equipment.

According to Shanghai's new rule, not only will doctors who receive such kick-backs will be deprived of their qualifications for medical practice, but also the pharmacies will be weeded out from the local market.

(China Daily May 12, 2004)