Health authority orders China's public hospitals to stop expanding
Health authority blames growth for rising bills, but hospitals say they chase business to survive
The state health authority has ordered mainland public hospitals to halt their rapid expansion, blaming it for rising medical bills.
"[The expansion] has led to an irrational increase in medical expenses, squeezed the growth of grass-roots and private hospitals and also hampered those big hospitals from improving their services and management."
Some 10 public hospitals have 4,000 or more beds, including the First Affiliated Hospital of Zhengzhou University with 10,000 beds, Huaxi Hospital in Chengdu with 4,300 beds and Tongji Hospital in Wuhan with 4,000.
Patients at mainland public hospitals often complain about long lines and impatient doctors who are under pressure from treating up to 200 patients a day, a hospital source said.
The circular said regional health bureaus should not allow public hospitals to add more beds, build luxury wards or borrow for expansion.
Chen Shaoxian, a public health professor at Guangzhou's Sun Yat-sen University, said the motivation behind expansion was survival in the marketplace because more beds and cutting-edge medical devices meant they could attract more patients.
"Although those hospitals are called 'public', they operate like private institutions by making a living by themselves," he said.
On average only 10 per cent of mainland public hospitals' budgets come from government agencies, health experts say.
"We also want to receive fewer patients, but …we are worried that fewer patients will lead to less income," Jiang Jie, president of the First Hospital of Xiamen , told Xinhua.
Dr Zhang Lufa, of Jiao Tong University's school of international and public affairs, said after opening more wards and upgrading facilities, public hospitals tended to be more "profit-driven" and would charge higher fees in order to pay their debts incurred during expansion.
He said the authorities would like to create a system in which people with minor ailments visited "grass roots" hospitals - rural hospitals and community centres in cities - and the market was not dominated by public health giants.
This could happen only when such health institutions were competitive, he said.
Many mainland patients view doctors working in grass-roots hospitals as being less capable.
Chen, the public health professor, said hospital chiefs would only agree to the authority's order if there were supporting policies to help grass-roots hospitals become more competitive.
