Nancai fast comments: How to improve the salary of grassroots medical staff?

"Basic, strong grassroots, and mechanisms" are the core strategies to achieve the goal of healthy China. The Party Central Committee has always attached great importance to grass -roots and rural health work, and proposed that the health and health work in the new era put "focusing on the grassroots" in the primary position. Grassroots medical and health institutions are the network bottom of the health service system. Grass -roots medical staff are providers of the "six -in -one" service functions such as medical, health care, prevention, and rehabilitation of grass -roots medical institutions. It is the basis for building a system of medical, disease control, and maternal and child health care systems in my country. However, the construction of primary medical and health talents in my country generally faces the problem of "difficulty in recruiting people, difficult to keep people". How to achieve grassroots medical talents "lead, keep, and use well", ensure and improve the treatment of grass -roots medical staff.

To this end, the National Health and Health Commission has issued a special "health and health system implementation of the new era of the new era of the new era of the party's health and health work policy" (hereinafter referred to as the "Requirements"), and proposed that the health administrative departments at all levels must actively actively actively Promote the implementation of the "two allowed" policies, improve the salary of grassroots medical staff, and the relationship between the performance and salary level of the local county (district) level public hospitals, and gradually reduce the income gap. Performance salary reform is the key to improving the salary of grassroots medical staff.

In fact, as early as 2018, the National Health and Health Commission issued the "Notice on improving the performance and salary policy of improving primary medical and health institutions to ensure the signing service of family doctors' contract services", and put forward detailed measures for improving the income treatment of grassroots health personnel, including: ((((((including: ((including 1) The relationship between the performance and salary of the local county -level public hospitals at a coordinated balance, and reasonably approve the total performance wages and levels of primary medical and health institutions; Line in performance salary; (3) improve the salary level of general doctors, so that they are connected with the salary level of the same conditions as the local county -level public hospitals at the same conditions; For components, it can be used for personnel salary distribution. It can be seen that the performance salary of grassroots medical staff involves several core issues such as the total performance salary, level, composition, and source.

In this regard, the National Health and Health Commission issued the "Opinions on improving the Incentive Policies of Incentives for Basic Medical Persons" on November 30, 2020 (hereinafter referred to as "Opinions"), which pointed out Improve the system of village medical pension guarantee to improve the salary and benefits of grass -roots medical staff. Among them, the "Improvement of Makeup Incentives" clearly states that (1) Strictly implement the financial security policy such as public welfare, allow grass -roots medical and health institutions to break through the level of wage regulation and control of the current public institutions, and independently determine the proportion of internal performance and salary; (2) grassroots medical care The health institution can extract more than 60%of the balance of medical service revenue and the balance of various funds in that year. Subsidies, night shift subsidies, subsidies to the countryside, toxic and harmful subsidies; (3) Family doctors sign service revenue, in principle, not less than 70%of the internal distribution of the contract team, and the family doctor for signing the internal distribution of the contract signed a contract to sign a contract to sign a contract. Service fees and general doctors' post allowances are included in total performance salary management, and they are listed in performance salary.

Therefore, it can be seen from the above -mentioned policy documents that the current ways to improve the salary of grass -roots medical staff in all parts of my country include the following paths:

First, implement the "two allowable" policy.

The first is to increase government financial investment, strictly implement the financial security policies such as public welfare, and allow grass -roots medical institutions to break through the level of wage regulation and control of the current public institutions and break the restricted conditions from the total amount. This path requires the coordinated efforts of local people and social and financial departments, and in the specific implementation process, it depends on the local fiscal revenue.

Second, grass -roots medical institutions have increased income. After the cost of deduction of medical service income and extracted various funds in accordance with the regulations, the corresponding proportion can be extracted to increase the reward performance salary. The proportion of the extraction ratio is different in various places, such as 90%of Henan Province withdrawn. The premise of the implementation of this path is that the revenue and expenditure of grass -roots medical institutions was balanced in that year, and it is the key to increasing the medical service income of that year. Different provinces and cities have carried out different paths, such as the dynamic adjustment of the hospital in Shaoxing in Zhejiang in the prices of grassroots medical services, the performance reform of the medical communist in Huanggang, Hubei, and the increase in the proportion of medical insurance reimbursement in primary medical institutions.

Second, increase special funds for public health services. With the continuous improvement of public health subsidy standards and the increase in public health content and projects, the public health subsidies of grassroots doctors will also be continuously improved. At present, the implementation of this path is relatively easy, and it has basically realized the inclined grass -roots medical staff with the requirements of national policy requirements.

Third, realize equal rewards in the preparation of internal and external workers. Due to the restrictions on the total number of preparation, there are large differences in the compilation of grass -roots medical staff internal and external, and localities are also constantly reforming the corresponding personnel systems. The filing system is used to work hard to make equal pay for internal and external work. The implementation of this path depends on the revenue and expenditure status of various grass -roots medical and health institutions, and also on the reform of the local personnel system, and the situation of various provinces and cities is different.

On the whole, to enhance the salary and treatment of grass -roots medical staff and reduce the income gap, it requires the strong support of the local government's financial investment, and the continuous improvement of the autonomous vitality of grass -roots medical institutions.It is a systematic project to achieve personal value on the basis of the health service of the people.(Author is an associate professor at the School of Health and Economics, Nanjing University of Traditional Chinese Medicine)

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