A complaint from the head of The University of Hong Kong-Shenzhen Hospital that it had to battle red tape for about 18 months before it was allowed to buy vital medical equipment has highlighted one of the problems plaguing the mainland's health system.
Professor Grace Tang, chief executive of the 3.5 billion yuan (HK$4.3 billion) public hospital, funded by the Shenzhen government, said that the bureaucratic application procedures for buying medical equipment and opening departments made her feel "poorly acclimatised", China News Service reported.
She said some equipment that the hospital needed had not been purchased yet, even though it held its "soft opening" in the middle of last year, and she hoped the Shenzhen government could simplify procedures so that the "hardware" could be in place as soon as possible to serve patients.
The hospital in southern Shenzhen has 2,000 beds and is operated by a joint team from the Shenzhen authorities and the University of Hong Kong. By the end of July, it had hired 106 Hong Kong-licensed doctors, the People's Daily reported.
Tang said they were most anxious that a linear accelerator - essential for radiotherapy treatment of cancers - was not yet on board. She said they had received a purchase permission licence from the authorities a year ago, but had yet to begin the tendering process because some government departments had not signed off on the proposed purchase, insisting on trivial and time-consuming application procedures.
That means the hospital's oncology centre, which opened on March 1, can only provide chemotherapy services, the Shenzhen-based Daily Sunshine reported.
Tang said that Hong Kong public hospitals had autonomy in purchasing equipment and the whole process would last half a year.
Shenzhen's Health, Population and Family Planning Commission said the city's Public Hospital Management Centre should be responsible for administering the hospital. However, the centre has not been established yet and so could not be reached for comment.
Dr Guo Hui , a leading mainland neurosurgeon and one of the founders of the Shanghai Neuromedical Centre - a Sino-US joint venture - said the problem the Shenzhen hospital had encountered was "too common" across the mainland and government officials were not motivated to speed up their work.
"Many of those procedures and requirements are unnecessary and unreasonable," Guo said. "They should have been scrapped a long time ago."
In Shanghai, a quota restricts all hospitals - public or private - to purchasing no more than four or five computed tomography (CT) scanners a year. The authorities organise experts to discuss the necessity of hospitals' purchase application for CT scanners and other machines and the discussions were held once every four months, Guo said.
"I think the authorities set up those complicated and time-consuming procedures and requirements so that there are more opportunities for corruption," he said.
"I guess the chief of that Shenzhen hospital said she was not suited to the local policy environment mainly because she does not understand the under-the-table rules on the mainland. She can succeed in a 'pure' environment, like in Hong Kong, but not on the mainland."
Professor Liu Bao , of the public health school at Fudan University, said mainland cities had their own health development plans governing infrastructure investment to avoid duplication. All big equipment purchases by hospitals and the opening of new departments had to be in line with the authorities' plan.
Dr Zhang Lufa , from the public administration faculty at Shanghai Jiao Tong University, said the rationale behind the authorities' complicated and drawn-out approval procedures was ostensibly to make sure that no public money would be wasted, but that was not the reality.