Chapter 063 Meeting with the Minister of Health

Provincial Party Committee Office Building, No. 2 Reception Room.

Under the flickering of the magnesium lamp, Xiao Chen, Secretary of the Jiangdong Provincial Party Committee and Director of the Standing Committee of the Provincial People's Congress, had a cordial meeting with Liu Mingquan, Minister of Health, who came to Jiangdong to investigate the prevention and treatment of occupational diseases.

Xiao Chen expressed his gratitude to the Ministry of Health for its long-term support to Jiangdong. He said that under the strong leadership of the CPC Central Committee and the Government Affairs Yuan, Jiangdong has achieved sound and rapid economic and social development in recent years in accordance with the requirements of the Scientific Outlook on Development, and the province's medical and public health undertakings have made great progress. The Provincial Party Committee and the Provincial Government attach great importance to the prevention and treatment of occupational diseases, and the province conscientiously implements the "Law on the Prevention and Treatment of Occupational Diseases" and other relevant laws and regulations, adheres to the people-oriented, in accordance with the work policy of prevention first and prevention and treatment combined, initially establishes a comprehensive coordination mechanism for prevention and control, strengthens the construction of professional teams and institutions, actively carries out the investigation of occupational disease hazards and the monitoring and health examination of occupational hazard factors, comprehensively launches the health protection action of migrant workers, and effectively deals with occupational disease hazards and related environmental pollution incidents. It has effectively curbed the rising trend of occupational disease hazards and protected the health and life safety of workers. It is hoped that the Ministry of Health will continue to give guidance and support to Jiangdong.

Liu Mingquan fully affirmed the achievements made by Jiangdong Province in the development of medical and health undertakings in recent years. He said: The purpose of this visit to Jiangsu to investigate and investigate the prevention and treatment of occupational diseases is to sum up the experience created by Jiangdong and popularize it throughout the country. The Ministry of Health also hopes to cooperate with Jiangdong in the prevention and control of occupational diseases, schistosomiasis, and medical assistance for serious diseases through cooperation between ministries and provinces, so as to jointly explore the reform of the medical and health system.

Of course, the above are all statements when broadcasting news to the outside world, in fact, Minister Liu Mingquan's visit to Jiangdong this time is not just as simple as investigating the prevention and treatment of occupational diseases.

When Xiao Chen was the secretary of the Wucheng Municipal Party Committee, Liu Mingquan had a relationship with Xiao Chen, and that time it was Liu Mingquan who Xiao Chen took the initiative to contact in order to introduce Liu Mingquan and Zheng Denggao, the two directors of the Ministry of Health, to Su Ning (see Chapter 032 "Xiao Shao's Appointment"). Since then, especially after Xiao Zheng became a member of the Standing Committee of the Political Bureau of the Central Committee of the Communist Party of China and vice premier of the Government Council, Liu Mingquan has been prosperous all the way.

As for Zheng Denggao, who was recommended by Xiao Chen to his uncle Xiao Zheng at that time, he also served as Vice Minister of Health, member of the Party Leadership Group, Director of the State Food and Drug Administration, and Secretary of the Party Leadership Group since March 2008. He also became a member of the 17th Central Commission for Discipline Inspection of the Communist Party of China.

Liu Mingquan came to Jiangdong because of the "Implementation Opinions on Deepening the Reform of the Medical and Health System" recently issued by the Jiangdong Provincial Party Committee and the Provincial Government.

On the 29th of last month, the Standing Committee of the Jiangdong Provincial Party Committee held a meeting to study and discuss the deepening of the reform of the medical and health system, the construction of affordable housing projects, and energy conservation and emission reduction. Xiao Chen, Secretary of the Provincial Party Committee, presided over the meeting.

The meeting conveyed and studied the spirit of the National Conference on Deepening the Reform of the Medical and Health System and studied the implementation opinions of Jiangdong Province. The meeting believed that this year is a critical year to complete the three-year goal and task of deepening medical reform, and it is necessary to focus on the following aspects: First, continue to strengthen the construction of the basic medical security system and continuously improve the level of security and service. The second is to accelerate the realization of full coverage of the basic drug system at the grassroots level, and establish a new mechanism for the operation of primary medical and health institutions. The third is to intensify the pilot reform of public hospitals and actively explore the basic path of public hospital reform. Fourth, we should conscientiously do a good job in deepening the basic work of medical reform at the grassroots level, and earnestly enhance the capacity of medical and health services at the grassroots level. Fifth, encourage and guide social capital to set up medical institutions and accelerate the formation of a diversified medical pattern. Sixth, we will continue to improve the overall promotion mechanism and earnestly implement the tasks of medical reform.

The meeting demanded that party committees and political parties at all levels should further strengthen the organization and leadership of deepening the work of medical reform, and put the promotion of medical reform in an important position, the main responsible comrades of the city and county party committees should personally inquire about the key work of medical reform, the main responsible comrades of the city and county government departments should take overall responsibility for the local medical reform work, and the comrades in charge of the standing work of the city and county governments should be directly in charge of the medical reform work, and the coordination and promotion should be strengthened. It is necessary to speed up the implementation of performance-based wages in primary medical and health units, and solve new problems in medical reform with reform and innovation.

The meeting conveyed and studied the spirit of the National Conference on Affordable Housing Projects and studied the housing security work in Jiangdong Province. The meeting held that the Provincial Party Committee and the Provincial Government have always attached great importance to housing security, and during the "Eleventh Five-Year Plan" period, Jiangdong Province is in a leading position in the country in terms of housing security standards, policy support, guaranteed family coverage and total supply of public rental housing. This year is the first year of the implementation of the "Happy Jiangdong" housing security plan, the province's housing security work should closely focus on the realization of "housing and housing", focus on vigorously developing public rental housing, continuously expand the coverage of housing security, actively guide the rational consumption of housing, accelerate the construction of a housing security system in line with the actual situation in Jiangdong, and strive to solve the housing difficulties of urban lower-middle-income families, new employment and migrant workers on the basis of comprehensively solving the housing difficulties of urban low-income families. It is necessary to intensify the construction and raising of affordable housing, give priority to the implementation of land for the construction of affordable housing, solve the demand for funds for the construction of affordable housing through multiple channels, and further improve relevant policies and measures. It is necessary to fully implement the main responsibility of the city and county governments for housing security work, adhere to the policy of adapting measures to local conditions and cities, conscientiously solve new problems that arise in housing security work, and strive to ensure that the construction of affordable housing projects in Jiangdong Province will continue to be in the forefront of the country.

The meeting discussed the achievement of "Happy Jiangdong" and the energy conservation and emission reduction work of Jiangdong Province in 2008. The meeting pointed out that all departments at all levels should fully understand the extreme importance and urgency of doing a good job in energy conservation and emission reduction from the overall and strategic height of "two firsts" and "happy Jiangdong", and firmly establish the concept of green, low-carbon and sustainable development with a highly responsible attitude for future generations and long-term development, accelerate the transformation of economic development mode, and promote new breakthroughs in energy conservation and emission reduction. It is necessary to persist in studying countermeasures with the idea of reform and innovation and adapting measures to local conditions. It is necessary to further implement responsibilities, increase law enforcement and supervision, and ensure the full completion of Jiangdong Province's "Happy Jiangdong" energy conservation and emission reduction goals.

Of course, housing security and energy conservation and emission reduction are not within the scope of Minister Liu Mingquan's concern, but he is concerned about medical reform.

In front of the spotlight, whether it is Secretary Xiao Chen introducing the current situation of Jiangdong's medical care to Minister Liu Mingquan, or Minister Liu Mingquan praising Jiangdong for being at the forefront of the country's medical security, they are all dialogues on the face of some officials, and the actual value is not equal to zero, and it is really not high. The real pivotal meeting was followed by a separate meeting after this one.

The individual meeting was transferred from the office building of the Jiangdong Provincial Party Committee to the meeting room of the secretary of the provincial party committee in the standing committee building of the provincial party committee. Under the large "Xiao Fei out of Sichuan" in the reception room of the secretary of the provincial party committee, the guests and hosts sat down separately, and Chen Dang, secretary of Secretary Xiao Chen, gave two cups of good Pu'er tea, exited the door and gently closed the door.

Xiao Chen changed to Pu'er this year, and this change was a decision made by Ye Yiling for him, on the grounds that "Pu'er can be anti-aging". In fact, Xiao Chen is not half old, if he didn't usually deliberately dress simple and serious, put on a denim kù and wear a tight T-shirt to go out, people who don't know him will see it, and he will definitely call "Hi, handsome guy".

Liu Mingquan was not in a hurry to talk to Xiao Chen about business, but first greeted Xiao Lao's widow Mu Lao and Chairman Xiao before starting a formal conversation.

"Secretary Xiao, medical reform is a big matter, and there are many key and difficult problems that need to be solved in the reform process, I don't know where Jiangdong Province plans to start?" Minister Liu Mingquan asked with a smile, and then praised: "Good tea!" ”

"This is from Chairman Ye, and I usually don't give it to others to drink, because it's really not much." Xiao Chen smiled, "I have always believed that under the premise that the overall framework of public hospitals is not greatly changed, the basic drug system is the top priority in medical reform, which depends on whether our provincial party committee, provincial government and local cities are determined to implement it." ”

Liu Mingquan nodded: "Yes, but the problem is that after selling essential drugs according to the zero price difference, the income brought by the drugs has dropped sharply, and the huge funding gap caused by this will be difficult for the operation of medical institutions to continue if the financial authorities are unable to fully compensate for it, coupled with the lack of other sources of compensation." ”

Xiao Chen was also very touched by this, and he bowed his head and said: "That's right, in the eastern region, although we have some favorable conditions, we still dare not have the slightest slack and relax, always work seriously, and at the same time actively learn from other brother provinces and cities." The view of the provincial party committee is that the focus of this year's work is that we still take the basic drug system as the top priority. Because the essential medicines system is not just a matter of medicines, but a comprehensive issue. For example, the integration of urban and rural health construction and the construction of the grassroots health system are inseparable from the basic drug system. When the basic drug system was first set up, it was based on the actual situation in Gangdong Province, and there are many so-called high-grade drugs in our country, and the basic medicine is to solve this problem. According to the data I have at hand, as of April 10, the first batch of 37 counties to implement the basic drug system have 3,788 primary medical and health institutions equipped with basic drugs, the implementation of zero difference sales, covering 18.09 million urban and rural population, the average outpatient cost of primary medical and health institutions decreased by 26% year-on-year, the total amount of basic drug sales is 98.78 million yuan, and the burden of drug costs for the masses is reduced by 51.39 million yuan, which marks the initial results of the implementation of the basic drug system in Jiangdong Province. ”

Liu Mingquan nodded in affirmation, and then asked: "When it comes to drug prices, drug bidding is probably a better way at present, but many places are facing many constraints in implementation, what is the situation in Jiangdong Province?" ”

Xiao Chen smiled slightly: "Speaking of which, I want to praise our Jiangdong Provincial Health Department." Jiangdong Province's drug bidding work is under great pressure, involving the interests of some enterprises, but with the joint efforts of all the staff of our Provincial Department of Health, we have resolutely withstood the pressure from all parties, although some companies will have some other different feelings and even some criticism, but their work has been unanimously affirmed by the bidding enterprises, including some large international pharmaceutical companies, discipline inspection units, and relevant social departments, and won the respect of the society. ”

Xiao Chen paused and continued: "Regarding the bidding for medicines, Jiangdong may not be the most advanced, but it should not be backward. I know that some provinces can now be said to be full of wars and gunsmoke, and some provinces have even stopped bidding, but our province has still done this work in accordance with the norms. At present, this work has been successfully completed in our province. We mainly start from two aspects:

One is the establishment of an essential drug system. In accordance with the principles of safety, effectiveness, necessity and low price, the government formulates a list of essential drugs, organizes the production, procurement and distribution of essential drugs through bidding, and gradually standardizes the names and prices of the same drugs, ensures the use of basic drugs, strictly manages the use of drugs, and reduces the cost of medicines.

The other is to establish a scientific and standardized public hospital management system. The essence of "separation of medicine" is to reform the mechanism of "supplementing medicine with medicine" in hospitals, gradually abolish the policy of drug markup, give corresponding financial subsidies to hospitals, and implement two-line management of drug revenue and expenditure, so as to cut off the economic connection between drug income and medicine. ”

Minister Liu Mingquan praised with a smile: "Jiangdong has done a good job in this matter, I have always felt that this matter is not impossible to do, the key is to see whether the local party committee and government attach importance to it, whether the intensity is enough, the intensity is enough, like Jiangdong, there is no way to push forward." ”

Xiao Chen smiled and didn't answer.

Minister Liu Mingquan restrained his smile and asked: "The degree of influence of urban and rural medical institutions on drug addition is usually quite different, is Jiangdong also facing the same situation?" ”

Xiao Chen pondered for a moment before answering: "This problem is actually a question of how to make up for the finances, and solving this problem will inevitably involve the sale of Linchuáng, and all drugs are sold at a zero difference rate, so the problem of the compensation mechanism arises." Therefore, it is still very prominent to use medicine to maintain medicine and supplement medicine with medicine.

It is a problem of the whole system, and the simple situation is that we will make up as much as the medical institutions have a drug difference. But we did not adopt such a method, because this method has two disadvantages: one is that the accounts are not easy to calculate clearly, and it is easy to become confused; Second, such a mechanism is not conducive to promoting rational drug use. If it is still according to the difference rate, it is still encouraged to take more drugs. ”

When Liu Mingquan heard this, he nodded with a calm face, it seems that the Minister of Health knows this situation very well.

Xiao Chen continued: "Some primary medical institutions have a high markup rate of 70% to 80%. In this case, if the difference rate is removed, the medical institution will definitely not be able to bear it. Therefore, Comrade Xu Anqiu (the first vice premier, see above) asked that the performance appraisal of primary medical institutions be included in the medical reform.

It can be said that the basic drug system is the starting point for urban and rural medical reform, and we have put a lot of effort into it. Therefore, we are in accordance with the method of making up for the head, for example, how much is the basic operation of a township health center, and how much is the number of chuáng places per capita, we make up according to this situation, but not immediately, but also depends on his work efficiency, but also depends on his performance appraisal. At present, the performance appraisal method of our rural health centers has begun to be implemented. ”

Liu Mingquan was still frowning, and sighed: "There will definitely be many difficulties in this process. ”

Xiao Chen also put away his relaxation, and said with a serious expression: "Yes, for this, the provincial party committee and the provincial government have considered it. I also personally asked the Department of Health about this. According to the Department of Health, the main aspects are:

The first is medication habits. The Department of Health said that they have organized training many times, level by level and down, we have done some statistics in Jiangdong Province, especially in some places in southern Jiangsu, among the 307 kinds of drugs set by the state, some drugs are not used for a long time, and only forty or fifty kinds of drugs are used, so we have added 292 kinds of drugs to the grassroots drug catalog according to our actual situation and according to our drug characteristics, which basically meets the needs of the grassroots level.

In addition, the current medical service model we are promoting is that minor diseases go into the community and major diseases go into the hospital, so what about the urban and rural grassroots hospitals, some chronic diseases are managed, and some are not in the 307 and 292 kinds of management we manage, but what about long-term use by patients?

So we have a two-way referral relationship, and these drugs can be provided from higher level hospitals to secondary and tertiary hospitals. In this process, there will be economic ties with primary medical institutions, but primary medical care is not allowed to take the price difference, because if it is not changed, patients will still not be able to experience the changes in medical reform, and it is still inconvenient to see a doctor.

Then there is the problem of bidding, the bidding not only to recruit drug manufacturers, the scale is not large, according to the situation is not qualified for bidding, but we have also made a specific deal according to the actual situation, by the city and county to determine one or two. This requires a transition, and reform cannot be achieved overnight, but must be realistic.

In addition, there is also the financial aspect, as the secretary of the provincial party committee, I think our provincial party committee is very active in financial support, and the provincial government is also very cooperative, at the provincial mobilization meeting in early April, Governor Wang Mingcheng put forward a clear request, in solving the problems of people's livelihood to be willing to invest, huā money to buy the mechanism of money to invest.

That's why I said, the key to this lies in how to make up for the finances, mainly for the areas with weak economic links, and the relevant measures have been introduced. ”

Minister Liu Mingquan finally smiled a little: "I am very pleased to hear Secretary Xiao's introduction." Now many experts regard the reform of public hospitals as the number one project, and many regions are also doing pilots, Jiangdong Province has taken Jingkou as a pilot, Secretary Xiao, what are their current work? ”

Xiao Chen smiled slightly. This question has a deep relationship with Tianxin Group.