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Weaknesses Let SARS Escape
Those in the know are calling for the allocation of increased resources to the health care sector. And they want better remuneration packages for medical workers.

Dr. Wei Jianing is with the Macro Economy Research Department under the State Council Development and Research Center. In an interview with the China Economic Times, this respected economist speaks of imbalance in economic and social development and also points squarely to ineffectual crisis management in the initial phase of the SARS outbreak. And so what might have been contained as a local incident became a full-blown crisis flying across international boundaries. Dr Wei looks behind the symptoms to the underlying systems failures that created the environment in which SARS could spread.

The roots of the SARS crisis can be found in omissions on the part of government coupled with an absence of competitive market conditions in the healthcare sector. The sector has found itself disadvantaged in the recent times of rapid economic development and social change.

The underlying failing on the part of government was not to pay due attention to the need to maintain an overall balance between sectors during the shift to a market economy. The development of the public health care system has lagged far behind the advances in urbanization, industrialization and opening-up to the outside world.

Despite the widespread move towards market forces elsewhere in the life of the nation, healthcare has remained a state monopoly in the hands of government authorities.

Despite a shortfall of investment in the sector, various levels of government still restrict the use of either private or foreign capital for development and market mechanisms have never been brought to bear.

The mechanisms necessary to alert the authorities to the impending crisis and evaluate the risk were just not in place. There was a missed opportunity to recognize the true gravity of the situation at an early stage. One of the routine tasks of crisis management is to evaluate potential risk.

Once the fight against SARS was in full swing, failures in the sharing of information and in crisis management facilitated the rapid and far-reaching spread of the disease.

Several failings combined and the best time to contain the outbreak was missed. The seriousness of the situation was not recognized early in the cycle and information was not effectively shared. Bureaucracy was to make matters worse with its buck-passing and disputed responsibilities. There are important lessons to be learned by the relevant departments.

In contrast to rapid economic growth elsewhere, investment in the public healthcare system has fallen behind. Development, systems reform and funding are all in short supply.

There is now a wide gap between increasing public expectations of healthcare and the ability of the sector to deliver. The current crisis has been a wake-up call. No time should now be lost in addressing the current imbalance between the limited progress in healthcare and the major advances fuelled elsewhere by rapid economic growth. Now is the time to increase salaries and conditions of service in the healthcare sector.

Clear indications of under-remuneration have been surfacing in recent years. There have been frequent reports criticizing healthcare workers for accepting hongbao (a gift of money in the red envelope traditional at New Year) and of incomes supplemented by commission on the sale of prescription drugs.

But where are the reports drawing attention to meager pay dwarfed by the rewards to be had in other sectors like finance, information technology, the auto industry and real estate not to mention the incomes enjoyed by healthcare professionals in foreign ventures in China and abroad. In other countries, the healthcare professions are amongst the best paid and medical doctors are in a position to earn more than government officials.

To attract the very best talent into this high-cost, high-risk and knowledge intensive industry, it will be necessary to create an environment where good salaries and benefits are seen as the norm.

There must be rigorous requirements for entry to the profession coupled with effective mechanisms for the removal of those who fail to live up to the required standards of professionalism and service.

The fulfillment of the dream of a prosperous nation depends on the wellbeing of the citizens. Many developed countries have laid the foundations of their revitalization and prosperity by promoting the cause of physical education and healthcare to ensure the good health of their most valuable resource, their citizens. "If we want to realize in full the dream of revitalizing China this will be achieved by paying due attention to fundamental rather than peripheral needs," said Dr. Wei.

(China.org.cn translated by Alex Xu, June 10, 2003)

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