Beijing municipal government issued a document last week saying that a move will be accelerated to turn B and C-level hospitals into community health centers by 2008.

Costly medical bills and crowded hospitals have been a headache bothering many patients for years. To solve this problem, the State Council called for the development of a community health service in urban areas early this year. This provides citizens with easy access to medical service and reduce the cost for visiting doctors by a large margin.

Government preference towards big state-owned hospitals in terms of medical resources in the past years has resulted in a lack of basic healthcare service at the grass-roots level. The psychological impact on patients is that they prefer big hospitals to small community clinics whatever their health complaint.

Efforts by the Beijing municipal government will try to change this situation by putting both human resources and funds into the development of community clinics. Basic medical functions, such as nursing care, will be taken care of by community clinics. Big hospitals will focus on complicated operations and serious diseases.

To cut down medical bills for patients, the revenue and expenditure for community clinics will be managed in a separate manner. They are required to turn their income to the financial coffer of the government, which will pay salaries of medical workers in the clinics.

If this mechanism can be successfully applied, the community clinics will not have to depend on selling of drugs for their revenues and thus the prices of drugs will be able to be lowered.

To further guarantee reasonable prices of medicines, the government will collectively purchase drugs for these clinics. Therefore they will not have any connection with pharmacies or drug producers and thus doctors will have no way to get kickbacks from drug salespeople.

If the move could be successfully materialized, the medical bills for patients in Beijing will be reduced by 432 million yuan (US$54 million) a year, according to health authorities.

However rosy the picture is, realization of such a goal requires even more efforts in pushing the plan into practice. A lack of planning will ruin the entire strategy.

Without effective supervision, the extra income from drugs for the various B and C-level hospitals will flow into the pockets of corrupt people. There is also another possibility that this income will find way to the coffer of district-level health bureaus or the municipal health bureau.

A process is needed for patients to build confidence in community clinics. A channel is also needed for community clinics to refer patients whom they cannot treat to big hospitals.

(China Daily August 14, 2006)