Written Record of the Press Conference of the National Health and Wellness Committee on July 14th, 2022

Time:2022yearsevenmoon14sun

　　Place:National Health and Wellness Committee Xizhimen Office Press Release Hall

　　Moderator:Hu Qiangqiang, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department

Jiabin:Nie Chunlei, Director of Grass-roots Department of National Health and Wellness Commission

             Xu Gangzhu   Member of the Party Committee of Hebei Provincial Health and Wellness Committee and full-time vice president of Family Planning Association.

             Ran Chongqing   Deputy Secretary of Xishui County Committee, Zunyi City, Guizhou Province, and county magistrate of the county people’s government.

             Zhang Yalan   Director of Nanmofang Community Health Service Center, Chaoyang District, Beijing

 

 

Hu Qiangqiang, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department:

Good morning, media friends! Welcome to the press conference of the National Health and Wellness Commission. First of all, I would like to inform you about the recent important health policy documents.

The first is to issue "2021Statistical bulletin on the development of China’s health undertakings in 2000, which pointed out that the average life expectancy of Chinese residents was increased by2020Annual77.93Raise the age to2021Annual78.2Years old, maternal mortality rate from16.9/10Ten thousand fell to16.1/10Ten thousand, the infant mortality rate from5.4‰drop to5.0‰Positive progress has been made in all fields of medical and health care. The second is to issue "2020The annual Bulletin on the National Monitoring and Analysis of the Performance Appraisal of the Second-and Third-level Public Hospitals in China, evaluates and analyzes the second-and third-level public hospitals in China from the aspects of medical service quality, operational efficiency and internal management, information construction and application level, sustainable development mechanism, and people’s satisfaction, so as to optimize the development environment, improve management level, and meet people’s health needs. The third is to issue "About Doing Well"2022Notice on the work of basic public health services in ",clear the main tasks and overall requirements of basic public health services, do a good job.“One old and one young."Health management services, promote the integration of medical care and prevention in urban and rural communities, comprehensively promote the popularization and application of electronic health records, and promote the equalization of basic public health services. The fourth is to issue the "On the Development"2022Notice of National Medical Team’s Touring Medical Work in, focusing on areas with weak medical service capacity, such as counties where ethnic minorities live in concentrated communities and land border counties, organized national medical teams to carry out touring medical work in relevant areas, and consolidated and expanded the achievements of health poverty alleviation with rural revitalization through effective measures such as roving medical treatment, technical support and management guidance, personnel training, and strengthening the construction of telemedicine cooperation network. The above is a recent briefing.

The party and the government have always attached great importance to rural and grass-roots health work. Since the 18th National Congress of the Communist Party of China, the CPC Central Committee has put people’s health in a strategic position of giving priority to development, put forward the health and health work policy in the new era, and will“Focus on the grassroots"Put it in the first place Taking the construction of primary medical and health service system as the basic work, constantly improving the basic infrastructure conditions and improving the ability of disease prevention and treatment and health management at the primary level, after years of continuous efforts, positive progress and results have been achieved.

Today’s press conference will focus on the progress and effectiveness of grassroots medical and health services since the 18 th National Congress of the Communist Party of China, which is also the National Health and Wellness Commission.“Everything is for people’s health.——Our ten years"In the tenth session of the series of conferences, the guests attending this conference are:

Mr. Nie Chunlei, Director of Grass-roots Department of National Health and Wellness Commission;

Mr. Xu Gangzhu, member of the Party Committee of Hebei Provincial Health and Wellness Committee and full-time vice president of Family Planning Association;

Mr. Ran Chongqing, Deputy Secretary of Xishui County Committee, Zunyi City, Guizhou Province, and County Governor of County People’s Government;

Ms Zhang Yalan, Director of Nanmofang Community Health Service Center, Chaoyang District, Beijing.

I am Hu Qiangqiang, spokesperson of the National Health and Wellness Commission.

First of all, please invite Director Nie Chunlei to introduce the progress and effectiveness of the construction of primary health care service system.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Dear media friends, primary health care is related to the health of hundreds of millions of people. Since the 18th National Congress of the Communist Party of China, the National Health and Wellness Commission has implemented the Party’s health and wellness policy in the new era. Together with relevant departments, it has persisted in focusing on grassroots units, increased capital investment, strengthened the construction of grassroots institutions, improved the operational mechanism of grassroots units, and innovated the grassroots service model. The ability of grassroots units to prevent and treat diseases and health management has been continuously improved, and positive progress and results have been achieved.

First, the network of primary medical and health institutions has been continuously improved. by2021By the end of the year, there were nearly all kinds of primary medical and health institutions in China.98Ten thousand, more than health personnel.440Ten thousand people, to achieve full coverage of streets, communities, towns and villages. The sixth statistical survey of health services shows that,90%Our family15You can reach the nearest medical point within minutes. Second, the capacity of primary health care services has been continuously enhanced. We have successively carried out“Establish a demonstration community health service center”“Township hospitals satisfied by the masses”“Quality service grass-roots bank"And other activities, to carry out the construction of community hospitals, the introduction of hospitals, community health service center capacity standards, grassroots infrastructure conditions continue to improve, facilities and equipment upgrade, the service environment is more warm, and the proportion of primary diagnosis and treatment has been maintained for a long time.50%Above. Third, the new mechanism of grass-roots operation is more perfect. Adhere to the government’s leadership, promote the implementation of the government’s medical responsibility, cancel the drug addition, improve the multi-channel compensation mechanism such as basic public health subsidies and basic drug subsidies, effectively resolve the historical debts of grassroots institutions, and bring all eligible grassroots institutions into the previous new rural cooperative medical care and the current urban and rural residents’ medical insurance and urban workers’ medical insurance. It is much more affordable and low-cost for the masses to go to the grassroots to see a doctor. Fourth, public health services have been further consolidated. Projects carried out by grass-roots institutions are from10Class extends to12Class, every year for patients with key diseases such as hypertension, diabetes, tuberculosis and so on0-6Years old children, pregnant women,65Provide key groups such as the elderly and above.10Health management services for more than 100 million people. In addition, promote the establishment.32Ten thousand villages live in public health committees, laying a solid foundation for community prevention and control of COVID-19 epidemic. Fifth, the innovative development of family doctor contract service. by2021By the end of the year, all cities and counties (cities, districts) in China have basically implemented family doctor contract services, and more thanforty-twoA team of 10,000 family doctors provide medical and health services including long-term prescriptions and on-site services for contracted residents, especially key groups such as chronic patients and the elderly. Sixth, the construction of a close county medical community has been fully promoted. across the countryeight hundredA number of counties (cities, districts) carried out pilot projects to promote the implementation of medical insurance package payment, promote the sinking of resources, and promote the integration of medical care and prevention. While guiding the medical community to improve its medical capacity, it turned more work to disease prevention, and the proportion of inpatients and residents’ medical insurance reimbursement in counties increased steadily. Strengthen telemedicine and informatization construction, and gradually realize grassroots inspection, superior diagnosis and service homogeneity.

In the next step, in accordance with the decision-making arrangements of the CPC Central Committee and the State Council, we will always focus on the grass-roots units and constantly provide the masses with better and more efficient medical and health services nearby. thank you

Hu Qiangqiang, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department:

Thank you, Director Nie. Let’s enter the question session. Please inform your news organization before asking questions.

Xinhua news agency reporter:

We know that,“Strong base"It is an important principle and work content to deepen the reform of medical and health system.10In recent years, the construction of primary medical and health service system in China has made positive progress and achievements. However, the data shows that the proportion of outpatient visits in primary health care institutions has declined in recent years. How do you interpret it? Does it mean that the ability of primary health care service is not as good as before? Thank you.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Thank you for your question, which is really very important. Many people may have this misunderstanding, so it is very necessary to clarify it here. In recent years, the proportion of outpatients in primary health care institutions has declined, but it does not mean that the capacity of primary health care services has weakened. We can see from the picture that the blue one is2012Year, red is2021Year, from the perspective of the number of grass-roots institutions, from91.3Ten thousand has increased to97.8Ten thousand, the number of institutions is increasing. Judging from the number of beds in grassroots institutions, from2012Annual132.4Ten thousand sheets have arrived.2021Increase to171.2Ten thousand, the number of beds is also increasing. From the perspective of health workers in grass-roots institutions,2012Nian is343.7Ten thousand people, to2021Nian is443.2Ten thousand people, the organization’s health staff is also increasing. Moreover, among health personnel, the number of medical practitioners and assistant medical practitioners has also increased, from100.9Ten thousand people increased to161.5Ten thousand people. From the number of institutions, beds, and grass-roots staff, the proportion of practicing doctors at the grass-roots level has increased, and the proportion of health workers and practicing doctors in township hospitals and community health centers has also increased. Township hospitals,2012Bachelor degree or above is10%, the community center is33%, respectively increased to2021Annual32%and59%From the perspective of academic structure, it is also rising. This shows that our grass-roots institutions have been developing, so has our staff, and our service capacity has not actually declined. From the perspective of service volume,2012-2021The service volume of outpatient service in primary medical institutions in41.1Hundreds of millions of people have increased to42.5Due to the epidemic, the number of outpatients in various medical institutions in China has generally declined in the past two years, and the number of primary medical institutions has also declined, but overall, it has steadily increased. Our service ability does not mean that the proportion of outpatients in primary medical institutions has decreased, but the actual number of outpatients has increased. At the same time, I want to explain to you here that primary health care institutions are different from hospitals and disease prevention and control institutions. They not only undertake basic medical services, but also undertake a large number of public health services, with hundreds of millions of hypertensive patients and3500More than 10,000 diabetic patients need their follow-up, and each year there are more than.1000Tens of thousands of pregnant women and newborns need them to do prenatal and postnatal visits and neonatal visits. Every year, tens of millions of children need vaccination and they need to provide services, and we have to provide services for them every year.oneYiduo65In fact, the time and energy spent in providing these services for the elderly aged 18 and over are not less than those spent in visiting an outpatient clinic, and some will be longer. Therefore, to measure primary health care institutions, we should not only look at the proportion of outpatient visits, but also look at the comprehensive service capacity. If we add a lot of manpower and material resources invested in the prevention and control of normalized epidemic situation, the grass-roots level has undertaken a lot of work, and its service capacity is still steadily improving. Of course, from the perspective of outpatient service, the decline in the proportion shows that the speed of improving our medical service ability can’t keep up with the growth of the health demand of the people, especially now that the demand for high-quality medical services and diversified medical services is growing rapidly, there is still a gap in our grassroots development. Therefore, in the next step, we will be problem-oriented, vigorously improve the service capacity of primary health care institutions, and leave more patients at the grassroots level. Thank you.

China news service reporter:

Ordinary people mainly consider the service ability and level of medical and health institutions when choosing medical and health institutions. Excuse me, by what means does the state improve the service capacity of primary medical and health institutions? How to optimize the order of medical treatment so that more patients can stay at the grassroots level? Thank you.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Thank you for your question. In recent years, in order to adapt to the economic and social development and meet the growing health needs of the people, we have taken improving the ability of primary medical services as the most basic and fundamental important work, and taken various measures to keep patients at the grassroots level. First, the service capacity standards of township hospitals and community health service centers were introduced to guide local self-evaluation, self-construction, rectification and upgrading. till/extremely2021At the end of the year, there have been accumulated2.3Tens of thousands of grass-roots organizations have reached the basic standards and recommended standards of service capacity. The second is to build community hospitals based on community health service centers and township hospitals, and introduce the basic standards of community hospitals and the key points of medical quality and safety core system. till/extremely2021By the end of the year, more than 100 community hospitals had been built.2600Home. Third, various means are used to expand the ranks of grassroots health personnel and recruit rural order-oriented free medical students.sevenMore than ten thousand, of which3.5Ten thousand people have served at the grassroots level. Complete the general practitioner transfer training.23More than 10,000 person-times. Add the qualification examination for assistant doctors in rural general practice,15.4Ten thousand people have obtained the corresponding qualifications. Implement the project of improving the ability of primary health personnel and train all kinds of primary health personnel.59Ten thousand people. In the past two years, medical college students have been registered as rural doctors without examination, exceeding4300College students enter the ranks of rural doctors. The fourth is to promote the construction of county medical community, highlighting“Strong county territory and strong grassroots"Guide, determine Shanxi, Zhejiang and Xinjiang.threePilot provinces and other provinces551A pilot county. The monitoring data shows that the effect of medical service sinking in the county is constantly emerging. The fifth is to speed up information construction, empower primary health care services, and initially establish a national primary health care comprehensive management platform, which has been realized.23Network connectivity and data transmission in 20 provinces. arrive2021By the end of the year, telemedicine had covered all poor counties and extended to rural areas. Through the above measures, the ability of preventing and treating diseases and health management at the grassroots level has been steadily improved, and more patients have been kept at the grassroots level. Thank you.

China health talent reporter:

It is the key to improve the talent team of primary medical and health services, but compared with large hospitals, some primary medical institutions are facing talents.“Can’t recruit or stay."problem Excuse me, what measures has Hebei Province taken to strengthen the construction of medical and health talents in recent years? What progress has been made in strengthening the treatment guarantee for rural doctors? Thank you.

Xu Gangzhu, member of the Party Committee of Hebei Provincial Health and Wellness Committee and full-time vice president of Family Planning Association.:

Thank you for your question and concern about the health cause in Hebei Province. In strengthening the construction of primary medical and health personnel, our province has mainly taken the following measures and achieved certain results.

First, strengthen training and introduce talents.2019Since, our province has used the rural order-oriented medical students’ free training program and the higher medical college’s education promotion program for grassroots health personnel to comprehensively improve the education level of rural medical and health personnel. Up to now, it has recruited free medical students from rural areas.1682People. In addition, the localization training mode of rural doctors is promoted in the whole province, funded by local finance, and medical colleges are entrusted to train local and high school graduates or rural doctors’ children to reach the secondary medical professional level, and then directly work in village clinics after registration according to procedures. For example, Chengde City has been cultivated through this model.1616People have solved the problems of getting down, staying and not using. The second is to implement the treatment and leave the talents behind.2019In, our commission, together with the Provincial People’s Social Welfare Department, formulated the salary reform measures for grass-roots medical and health institutions in Hebei Province, allowing medical service income to deduct costs and withdraw various funds according to regulations, which will be mainly used for personnel rewards.,In principle, it can be independently extracted from the balance of income and expenditure in the previous year.50%The proportion is used for additional performance pay, and the additional part is not included in the total performance pay management. The third is to reform the evaluation and appointment of professional titles and broaden the space for talent development. Optimize the post setting of primary medical and health institutions, set up senior titles at the grassroots level, and obtain intermediate titles for primary medical staff to work continuously at the township and village levels.10Those who have passed the examination for more than years will be given priority to participate in the evaluation of deputy senior titles and work continuously.15After passing the examination for more than years, priority will be given to the evaluation of senior titles at the grassroots level; Relax the evaluation conditions and increase the proportion of senior and middle-level health titles at the grassroots level. In the past, the more you go to the grassroots level, the less the proportion of senior and middle-level titles is. Now, the proportion is gradually increased, and the channels for promotion of grassroots talents’ titles are unblocked.

In strengthening the protection of rural doctors’ treatment, our province mainly implements rural integrated management and“Rural employment and village use"To solve the problems of rural doctors’ salary and old-age security.2020In, the integrated management of township health centers and village clinics was fully implemented in our province. All township health centers signed labor contracts with rural doctors who were brought into the integrated management, and paid endowment insurance for them according to the regulations. The salary was determined according to the salary level of similar on-the-job staff in local township health centers. After the implementation of basic public health service subsidies, general medical expenses, special subsidies for essential drugs and other subsidies, the difference was still low compared with the salary of similar on-the-job staff in township health centers, and the basic salary was paid monthly by the county finance. Up to now, our province has been integrated into management.62757All the rural doctors paid the old-age insurance, which effectively solved the long-awaited old-age security problem of rural doctors.

Central Radio and Television General Station Yang Guang reporter:

We are concerned that National Health Commission has just issued a document, that is, some requirements for implementing the Party’s health and health work policy in the new era with grassroots as the focus. We know that the health work at the grass-roots level can not be separated from the attention and promotion of local party committees. I would like to ask, what are the highlights of Xishui County in strengthening grassroots health work, especially rural health work? What are the feelings of the grassroots? Thank you.

Ran Chongqing, Deputy Secretary of Xishui County Committee and County People’s Government of Zunyi City, Guizhou Province:

Thank you very much for your concern. The Xishui County Party Committee and the county government have always regarded health work as the biggest livelihood fact, earnestly fulfilled the main responsibility of the government to run medical services, and constantly increased the protection of people and property. The following work has been carried out in strengthening rural health and grassroots health work.

The first is to strengthen infrastructure construction.“Thirteenth five-year plan"Since then, the financial expenditure on primary health care has not been lower than the general budget expenditure.8.3%, medical and health expenditure is not less than the total expenditure14.5%To support the development of medical and health undertakings. So far, we have accumulated investment.18100 million yuan was used to standardize the construction of tertiary medical institutions in counties and villages, and the service capacity at the grassroots level was greatly improved.

The second is to optimize the construction of talent team.“Thirteenth five-year plan"Since, the county has increased1200A health technical staff, every year we open recruitment.200Undergraduate and above personnel have been enriched to county and township medical institutions. Township hospitals fully implement the full financial salary and carry it out.“Two permits"Policies to mobilize the enthusiasm of medical staff. At the same time, we openly recruit students every year.20Famous village doctors have been established, and the employment mechanism of recruiting townships and managing villages in counties has been established and improved. The identity of village doctors has changed, the treatment has been improved, the old-age care has been guaranteed, and the grassroots medical team has become more stable.

The third is to strengthen service capacity building. We have always insisted on paying equal attention to Chinese and western medicine, and all township hospitals in the county have built Chinese medicine clinics, providing an average of10More than a suitable technology of traditional Chinese medicine to promote the inheritance and innovation of traditional Chinese medicine. All county and rural medical and health institutions have completed information construction, realized interconnection, and achieved deep integration of grassroots medical prevention. Central township hospitals have purchasedCTAnd other large equipment, all hospitals are equipped.BSuper,DR, automatic biochemical analyzer and other equipment, and effectively improve the diagnosis and treatment level of primary medical institutions.

Fourth, innovation system reform. We actively explore two county-level hospitals as leaders,fiveHome-centered township hospitals are medical sub-centers, and radiation drives the development of other remote township hospitals step by step, which promotes the sinking of high-quality medical resources and the orderly promotion of graded diagnosis and treatment system.

In recent years, the whole medical and health level of Xishui has changed greatly, and the people’s sense of medical treatment and happiness have been further enhanced, and the rate of medical treatment in the county has reached.92.6%. In the next step, we will continue to increase investment in health care, truly do a good job in people’s livelihood and provide people with better and more efficient medical and public health services.

Xishui is the old revolutionary base area and the main battlefield of Sidu Chishui Campaign. We sincerely welcome media friends to take a walk and have a look at Xishui. Thank you.

Beijing News reporter:

We understand that residents in some places report that they exist after signing up for family doctors.“Sign without an appointment”“It is difficult to sign an appointment."The phenomenon. Grass-roots doctors are busy with their own work, and the number is relatively small. I would like to ask, what services can residents get after signing the contract? As a medical institution, what measures can be taken to improve the compliance rate and residents’ satisfaction? Thank you.

Zhang Yalan, Director of Nanmofang Community Health Service Center, Chaoyang District, Beijing:

Thank you for your question. After signing up for family doctor service, residents can get basic medical care, preventive health care and health guidance. Take Chaoyang District as an example. What we are promoting is“1+6+N”The characteristic service mode of family doctor contract, different service packages correspond to different service objects and different service contents. What I just saidoneIs the basic service package, suitable for the general population, the content of the service includes basic medical care, public health and general health management.sixIs a personalized service package, mainly aimed at six key groups, including the elderly,0-6Children, pregnant women, disabled people and patients with chronic diseases such as severe mental disorders, hypertension and diabetes are provided with services mainly for follow-up of chronic diseases, including physical examination of the elderly and preventive health care for women and children.NIt is a customized service package, which is aimed at some special people identified by civil affairs, disabled persons’ federations and other departments, and these people can enjoy on-site service. In these processes,NIt is infinitely expanding. For example, our center has also formulated a service package for health housekeepers for office workers, mainly to improve sub-health status.

In terms of improving residents’ feelings of signing contracts and promoting effective performance, we have mainly done the following four aspects: First, we should strengthen publicity and guidance. We make extensive publicity by entering the community, the family and the unit, so that residents can deeply understand the connotation of signing a contract for home doctors and improve their awareness rate and utilization rate. The second is to optimize the service process. The contracted residents practice appointment and directional triage, which means that they are assigned to contracted doctors at the same time when they register for treatment. We use information technology. Before the diagnosis, we will manage his health in the health cabin, so that he can have a personal feeling about signing a contract with a family doctor. For residents of Chaoyang, we have also developed a healthy Chaoyang.APPResidents can use this without leaving home.APPMake an appointment for registration and online consultation. The third is to carry out special services. For example, we are demand-oriented and carry out vision and hearing screening for children in our jurisdiction. If there are problems, we will refer them in time and make corresponding corrections. For women’s postpartum rehabilitation, we have set up pelvic floor rehabilitation service. For patients with chronic diseases, we have carried out the evaluation of cardiopulmonary function and fundus examination. Fourth, we pay more attention to assessment and evaluation. In our center, we set up a signing return visit center, and we use intelligent means to carry out return visits to the contracted people every month. From the aspects of service quantity, service quality, satisfaction and authenticity, the assessment results will also be linked to performance. Through the above work, I hope to be able to sign a contract, perform a contract and do it.

In view of what you just mentioned“Sign without an appointment"may be“It is difficult to sign an appointment."In my opinion, there may be problems in providing service capacity caused by inadequate staffing, heavy tasks and insufficient job attraction in primary medical institutions, but there are also problems that some residents may have a biased understanding of the connotation of our family medical work. At present, many residents think of family doctors as private doctors, and they think of going home. In fact, what I want to say is that family doctors are by no means home doctors. The service of family doctors signing contracts is actually a change in service mode, and it advocates a long-term and stable contractual service relationship. Therefore, we especially hope that media friends can help us strengthen publicity and hope that everyone can have a correct understanding of the work of family doctors signing contracts. Of course, we will also work harder and take the expectations of residents as the focus and direction of our future work. Thank you.

CCTV News Center reporter at the reception desk:

In recent years, the age structure of rural doctors in our country is aging, and the number of rural doctors is also decreasing. As the gatekeeper of residents’ health, how will our country strengthen the construction of rural doctors next? Thank you.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Thanks to this reporter friend, this question is really complicated. First of all, I explain two concepts, that is, village doctors and village doctors. Most people think that village doctors are village doctors and village doctors are village doctors. Actually, strictly speaking, the concept is different. Rural doctor is a specific concept, which is clearly put forward in the Medical Law and the Regulations on the Management of Rural Doctors. Rural doctors provide medical and health services to rural residents in village clinics, but they do not have the qualifications of practicing doctors or assistant doctors, but only have the certificate of rural doctors. This group of people is actually a specific group. Historically, this group of people gradually evolved from the barefoot doctors in the past, but they do not have the qualifications of practicing doctors and assistant doctors. They provide services for the people and have the qualifications of rural doctors. The rural doctor certificate is a certificate for their practice, so these people are rural doctors in a strict sense. However, there are not only rural doctors, but also some practicing doctors and assistant practicing doctors who provide services for the people in the village. Usually, many times, the two concepts will be mixed, saying that a village doctor is a village doctor and a village doctor is a village doctor, which is actually different. Statistically, rural doctors strictly refer to doctors working in this part of the village who do not have the qualifications of practicing doctors or practicing assistant doctors, so that everyone can understand it better. The direction of our efforts now is to turn rural doctors into practicing doctors or practicing assistant doctors, because all localities are making active efforts and our work has been promoted.Therefore, the number of rural doctors is decreasing, but in fact, the number of rural doctors working in rural clinics has not decreased much. from2012-2021In 2000, village doctors working in village clinics all over the country went from125.5Ten thousand fell to114.7Ten thousand, the number of decline is not much, because the population in our countryside has decreased, so it is reasonable to reduce the number of doctors serving. In fact, the number of village doctors per thousand rural residents is from2012Annual1.25Rise to2021Annual1.3In a real sense, the number of village doctors per capita has increased. The number of rural doctors is declining, from2012Annual102Ten thousand fell to2021Annual67Ten thousand, we think the decline is obvious, but the number of practicing doctors and practicing assistant doctors in the village medical team is rising, from23.3Million has risen to47.6This shows that the number of rural doctors is decreasing, but the number of practicing doctors and assistant practicing doctors serving the people in the village is increasing, and the total number has not actually decreased. The quality and ability of the personnel who provide medical services to the residents in village clinics have been significantly improved, which is a positive phenomenon and the result we expect.

With the construction of a healthy China and the implementation of the national strategy of rural revitalization, village doctors have played an irreplaceable role in providing medical and health services for the people in villages. Improving their quality is a very important task. Our Committee will actively work with relevant departments to integrate the construction of village doctors into the overall plan of the construction and development of the whole rural medical and health system, strive to promote the local mature experience to become a national policy, and create a good policy environment for the development of village doctors, especially to implement the local main responsibility and solve the problems of village doctors’ treatment and old-age security in a classified way. Just now, President Xu of Hebei Province introduced that the problems of providing for the aged and salary of village doctors are better solved in Hebei Province. We should further guide all localities to transform rural doctors into practicing doctors and assistant practicing doctors, improve the overall service capacity of the rural medical service system, and lay a solid foundation for comprehensively promoting the construction of healthy China and realizing rural revitalization. Thank you all.

China Youth Daily reporter:

Grassroots medical and health institutions are close to the people, but some places report that patients go to primary medical and health institutions to see a doctor, especially those who are transferred from the superior to the lower level, can’t prescribe medicine in primary medical and health institutions. What policies and measures are there to meet the people’s demand for drugs nearby? What is the current situation of primary medical and health institutions? Thank you.

Xu Gangzhu, member of the Party Committee of Hebei Provincial Health and Wellness Committee and full-time vice president of Family Planning Association.:

Thank you for your question. In order to meet the people’s demand for drugs for common diseases, frequently-occurring diseases and chronic diseases, our province has formulated a plan to accelerate the construction of a close county medical community, vigorously promote rural integration, and build“County and township integration, rural integration"The pattern of medical treatment. On the one hand, we encourage the unified procurement and equipment of drugs within the medical community to meet the drug demand of patients with common diseases or chronic diseases with clear diagnosis and stable condition in the primary medical institutions of the medical community. On the other hand, through township hospitals to village clinics“Unified management of medical equipment"According to the clinical needs, the medicines in village clinics are uniformly purchased, distributed and managed by township hospitals, and the medicines in village clinics are effectively connected with those in township hospitals. Once there is a shortage of medicines in village clinics, township hospitals can allocate them at the first time. At present, our province requires village clinics to have no less than drugs.260Species, which require40%Our drugs are mainly used for common diseases, including diabetes, hypertension and other common diseases, frequently-occurring diseases and chronic diseases, which can basically meet the needs of the general public. Now the people are more convenient to use drugs, and their sense of acquisition and happiness is constantly improving. Thank you.

Macao Monthly, Macao News Agency reporter:

We are concerned that the goal of equalization of basic public health services is to ensure that urban and rural residents get the most basic and effective basic public health services and narrow the gap between urban and rural residents. Excuse me, what tangible benefits have been brought to people’s health since the equalization of basic public health services has been promoted for more than ten years? Thank you.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Thank you, reporter friend. Basic public health service is indeed a new task of medical reform. Especially since the deepening of medical reform, we have actively promoted the equalization of basic public health services with the guidance of fair enjoyment by the masses, and the connotation of services has been gradually enriched, and the number of beneficiaries has been expanding. In the past ten years, the equalization of basic public health services has achieved positive results.

The first is to promote the establishment of a basic public health service system in line with China’s national conditions. Basic public health services are provided by the state to residents free of charge, from scratch, from small to large, from pilot to legal form, which is a major institutional innovation to implement prevention first and protect residents’ health. The central and local governments have combined and promoted together, and gradually improved the security system, management system, operation and supervision and evaluation mechanism, and incorporated them into the national basic public service standards, providing a basic guarantee for the realization of education for young children, medical care for the sick and a sense of security for the old.

Second, the level of equalization of basic public health services has gradually improved. From the service population, urban and rural residents in our country, as long as they are permanent residents in the jurisdiction, regardless of gender, age, occupation, nationality, household registration, etc., can have equal opportunities to obtain corresponding basic public health services; In terms of service content, we have successively formulated three editions of National Basic Public Health Service Standard, defining the service object, service content, service provider and evaluation index, so as to ensure the standardization and unification of service content. From the perspective of service provision, basic public health services are mainly provided by grassroots medical and health institutions, namely township hospitals, community health service centers, village clinics and community health service stations. These institutions have basically achieved full coverage of counties, townships, villages and communities, making it convenient for residents to get basic public health services fairly and easily nearby.

Third, the implementation of basic public health services has effectively promoted the health level of urban and rural residents. For example, it should be provided to urban and rural children every year2More than 100 million injections of immunization program vaccination services to prevent polio, measles, hepatitis B and so on.12An infectious disease has built a strong firewall. The monitoring of the health literacy level of urban and rural residents in China shows that the health literacy level of Chinese residents has changed from2012Annual8.8%Raise to2021Annual25.4%The improvement of residents’ health literacy and the implementation of basic public health services have contributed greatly. Of course, we also see that the work of basic public health service projects in some places is not in place enough, and the people’s sense of acquisition is not strong and their feelings are not deep. In the next step, we will focus on improving the people’s sense of gain and feeling, especially strengthening services and improving quality, and further improving the level of equalization of basic public health services. Thank you.

Red star journalist:

The construction of close county medical community is an important measure and a powerful starting point to promote the construction of graded diagnosis and treatment system. Excuse me, how is the compact county medical community built in Xishui County? What benefits can ordinary people get from it? Thank you.

Ran Chongqing, Deputy Secretary of Xishui County Committee and County People’s Government of Zunyi City, Guizhou Province:

Thanks to this reporter friend. Xishui county from2019Since it became a pilot county of national county medical community in, we have mainly promoted the construction of medical community from three aspects. The first is to strengthen the government’s leadership. In the process of building a medical community, there are many departments and large groups involved, and many times it may be necessary for the party and government leaders to personally come forward to promote it. Therefore, we have specially set up a leading group and management committee for the construction of medical community led by the main leaders of the Party committee and government, specially worked out a list of powers and responsibilities of the government, health and health departments and medical community, and delegated the management authority of people and property to the hospital led by medical community. The second is to explore the path of improving construction. At first, we followed the general hospital.+Branch mode, by the county people’s hospital and county hospital of traditional Chinese medicine respectively13Each township health center has set up a medical community, but because there are too many townships in our country, the leading hospital is facing“Xiao Niu la da che"The situation. Later, we adjusted our thinking in time according to the actual situation and will26Towns are divided intofiveEach district elects a central health center, which will be built into a county-level medical sub-center according to the standards of secondary hospitals, and a new medical community construction framework will be built for the upper general hospital and the lower radiation district health centers. Third, we should focus on strengthening the grassroots. We will improve the service and management level of township hospitals through five sinks: reconstructing resources under the leadership of the grassroots, experts sinking to teach, funds sinking to update equipment, quality control sinking to improve standards, and management sinking to enhance services. In the past three years, the construction of medical community in our county has achieved remarkable results, which are mainly reflected in four aspects: First, the staff is more stable. Second, medical coordination is more powerful. Third, the ability of diagnosis and treatment has been greatly improved. Fourth, the scope of services has been comprehensively expanded. Two-way referral has been established, which has realized the linkage between county and township, and the masses have gained more benefits. Similar diseases, especially surgical treatment, can now enjoy the services of county-level hospitals at their doorsteps. While the masses run less, the nursing cost has been greatly reduced. More importantly, the reimbursement rate of medical insurance is higher, which reduces the medical expenses of the masses.

As an important part of the current medical and health system reform, the construction of close medical community has explored some experiences and achieved some results, but there are still some institutional bottlenecks that have not been solved. In the next step, our county government will continue to promote the construction of medical community around solving the problems of difficult, expensive and far-reaching medical treatment for the masses, so that the fruits of reform can benefit thousands of households and promote the high-quality development of health care. Thank you.

Southern Metropolis Daily reporter:

Basic medical and health services contain very important chronic disease management, which is also in basic public health services. What are the main contents? Compared with the past, what new tools and means are there in the management and control of chronic diseases at the grassroots level, and what problems need to be solved? In addition, I would like to ask Director Nie, I read a figure, and the control rate of chronic disease management in China is not very high. Do you have any new figures? How to evaluate the current level? Thank you.

Zhang Yalan, Director of Nanmofang Community Health Service Center, Chaoyang District, Beijing:

Thank you for your question. To answer your first question first, according to the requirements of the specification, our management of chronic diseases mainly includes the following four aspects: screening, follow-up evaluation, classified intervention and health examination.

At the grassroots level, we are now doing chronic disease management, which is actually a very important basic public health service project and the most important task. In the process of chronic disease management, we feel that both doctors and patients must work together, and the two sides can work together in Qi Xin to do this work well. Without either side, it is impossible. For us to do chronic disease work, we should first improve our own ability, because we have to be hard while the iron is hot. Only when we have excellent skills can we really solve the problems of chronic patients and truly recognize our work from the heart. Therefore, we have been strengthening the establishment of special outpatient clinics for hypertension and diabetes rehabilitation, including strengthening the construction of medical associations.“Full-time team"The construction of chronic disease management team is the construction of general practitioners and specialists to improve our service ability.

In addition, we make full use of information technology, such as wearable devices, smart watches, smart bracelets, smart medicine boxes that can remind patients to take medicine on time, including one-click tools for family doctors, and intelligent monitoring platforms for health management to improve our management efficiency. Third, we are trying a multi-disciplinary team cooperation model. We take family doctors as the core, and gradually bring rehabilitation and pharmacy personnel into the chronic disease management team. We will work together to do a good job in the health management of chronic diseases and improve the management effect. Fourth, pay attention to the characteristics and advantages of Chinese medicine, because as we all know, Chinese medicine has outstanding characteristics and functions in improving symptoms and improving quality of life, including preventing and treating complications. At present, we feel that there are some problems in chronic disease management, and the manpower is relatively tight. Then, at the end of residents and patients, residents’ understanding should be improved first. It is not our wishful thinking to do chronic disease management. Only by actively cooperating with us and improving compliance can we do the work better. In this regard, I think we should also strengthen publicity to let the people deeply realize that they are the first responsible person for health. Only after realizing this, can he take the initiative to accept it and actively cooperate with us in the management of chronic diseases. We must also improve the self-health management ability of ordinary people through our own efforts, such as the training of family health workers we are carrying out now, including health classes, including the activities of organizing chronic disease groups, hoping that through these, patients with chronic diseases can gradually master the ability of blood pressure and blood sugar monitoring.Understand the effects and side effects of drugs, including what is a correct lifestyle and habit, and how to adhere to and guide it. I hope that everyone will think in one place and work hard in one place to do a good job in chronic disease management. Thank you.

Hu Qiangqiang, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department:

The second question mentioned by this reporter just now is about the data related to chronic diseases. As far as we know, the relevant data and responsibilities are not in the grass-roots department, but in other departments. After coming down, we asked the comrades in the Information Office to connect with this reporter, including contacting and communicating with relevant departments and providing relevant data as much as possible. One last question.

Health news reporter:

We are concerned that,2020Since the epidemic in COVID-19 in, grass-roots medical and health institutions have undertaken a lot of work in epidemic prevention and control. Excuse me, what tasks do grass-roots organizations mainly undertake in epidemic prevention and control? Under the prevention and control of normalized epidemic situation, how to ensure the daily basic medical and health service needs of residents? Thank you.

Nie Chunlei, Director of the Grassroots Department of the National Health and Wellness Commission:

Thank you for your question. Thank you very much for your attention to the prevention and control of epidemic situation at the grass-roots level. After the outbreak of the epidemic in COVID-19, the majority of grassroots medical workers played an important supporting role in the prevention and control of the epidemic in urban and rural communities, especially their professional supporting role and active implementation.“Sizao", fully participated in the whole process to guide the community prevention and control, which laid a solid foundation for effectively controlling the increase of infected people in Covid-19. Under the prevention and control of normalized epidemic situation, we have also instructed all localities to make efforts to maintain normal medical order. The grassroots medical personnel, especially the grassroots medical and health institutions, continue to provide basic medical and public health services to residents and isolated people in their jurisdictions, thus ensuring the basic medical needs of the masses. I would also like to take this opportunity to express my heartfelt thanks to the medical staff at the grassroots level for their work in epidemic prevention, control and security. At the same time, it is also emphasized that primary medical staff, as an important force in community epidemic prevention and control, are the gatekeepers of urban and rural residents’ health. Governments at all levels and health administrative departments should pay more attention to primary medical staff and create conditions to protect their rights and interests. I also hope that the whole society will pay more attention to and support grassroots health work. Today, there is director Zhang Yalan, a representative of primary medical and health institutions. You can ask her to introduce the situation to you in combination with specific work.

Zhang Yalan, Director of Nanmofang Community Health Service Center, Chaoyang District, Beijing:

Thank this friend for his concern for our work. Indeed, since the outbreak, grassroots medical and health institutions have undertaken a lot of epidemic prevention and control work on the basis of completing basic medical and public health tasks. The first thing we have to do is to play our best.“Shaodian"and“probe"Function, that is to say, we should screen out the patients with suspected COVID-19’s symptoms who come to the institution for treatment, and then transport them to the fever clinic through closed loop. After the diagnosis and treatment, we should follow up in time. At the same time, we are also responsible for nucleic acid sampling, health monitoring, medical care and isolation and transshipment of residents in the closed control area, including the flow adjustment, sampling and transshipment of close contact personnel and household sampling of middle and high-risk household personnel. In addition, we also undertake the management of the medical team in the isolation point and the protection of the medical staff in the isolation area. When returning to work and production in the jurisdiction, we should also check the places where the work is resumed. When the school starts, we will make a patrol at the station. When the college entrance examination is held, we will be the deputy examiner for epidemic prevention, and we will also undertake various tasks such as large-scale nucleic acid sampling and vaccination in our jurisdiction. During the epidemic period, we went deep into the nursing homes under our jurisdiction to give corresponding guidance on the prevention and control of nosocomial infection, including the training of nucleic acid sampling. In view of the needs of the community, we will also formulate corresponding work points and disposal processes for them. When there are confirmed cases in our area, we will also take the initiative to give guidance to avoid panic. Although the work pressure is great, in this process, we feel hard, but more moved. Taking this opportunity today, I also want to say thank you to the community workers, including residents and patients, who have given us great support and full understanding in our work.

Under the situation of normalized epidemic prevention and control, we have also done a lot of work to ensure the daily medical needs of residents. The first is to strictly implement the prevention and control of nosocomial infection and provide a good and safe diagnosis and treatment environment for residents and patients. At the same time, give full play to the role of family doctors, make appointments by time, and reduce their waiting time in our institution. We also actively promote long-term prescriptions,“Minimally taking medicine"And other convenience measures to meet the medication needs of patients with chronic diseases. For departments with long stay time and high exposure risk, such as oral cavity and massage, we adopt the method of one doctor, one patient and one disinfection to ensure the safety and effect of treatment. Our center is also the first batch of community health service institutions in Beijing to complete rehabilitation and transformation. We use“Remote online mode"Guide rehabilitation patients to carry out home rehabilitation training to ensure the continuity of treatment. Thank you.

Hu Qiangqiang, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department:

Thank you, Director Nie and Director Zhang, for answering this question together, and our on-site questioning session is here. At this press conference,fourA guest introduced the construction of primary medical service system and some related problems, and we will continue to focus on it next.“Everything is for people’s health.——Our ten years"Hold a series of press conferences, and welcome everyone to continue to pay attention. That’s all for today’s press conference. Thank you.