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Reform to Hit Rural Doctors, Clinics
Jiang Shanying, a 28-year-old doctor working in a village in Junan County in East China's Shandong Province, is unaware that a national rural health care system could soon change his way of working and the fate of his hospital.

A document calling for this reform has been recently released by the central government and is aimed at comprehensively improving the health care network in rural areas by the year 2010.

The reform is also aimed at Jiang and the other 1.28 million village doctors working at more than 690,000 village clinics as well as the 1.16 million doctors working at nearly 48,000 township hospitals.

By 2005, all clinic doctors at township hospitals must hold the required qualification of "assistant professional practitioner" or higher. By 2010, all doctors in rural areas should meet the standard.

China set up its national medical network in the early 1950s, which currently meets the World Health Organization standard of providing a clinic within half an hour's walk from people's homes.

But the biggest problem is the poor quality of their services, said Wang Lusheng, vice-director of the China National Health Economics Institute.

About one third of employees at township hospitals do not have a professional medical education, said Li Changming, director-general of the Department of Community Health and Maternal and Child Health at the Ministry of Health.

These village doctors, who have contributed much in providing cheap and practical basic medical services to China's millions of farmers, will be gradually replaced by doctors who have formal and systematic medical training, Li added.

Like many Chinese village doctors, Jiang is also a farmer. He earns about 200 to 300 yuan (US$24-36) per month, depending on price differences between wholesale medicine he gets at the township hospital and the retail medicine given to patients after his diagnosis.

This may all change with the new reform which states that one State-owned medical unit must be set up in each town. In addition, township medical clinics and their branches can no longer be profit-making.

(China Daily November 21, 2002)

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