Chinese doctors and patients will soon be required to sign a special agreement banning them from exchanging money in red envelopes before medical transactions.
Called hongbao in Putonghua and laisee in Cantonese, red envelope money is often given to doctors on the mainland as a form of bribery, usually by patients hoping to receive more comprehensive medical treatment.
With many Chinese hospitals understaffed and unprofitable, little has been done to successfully regulate this practice.
According to The Beijing News , change may be on the way in the form of an official decree from China’s National Health and Family Planning Commission, which announced a new policy on February 20 that would require physicians and patients to sign contracts within the first 24 hours of treatment agreeing to not exchange or accept red envelopes.
Aside from outlawing hongbao, clauses in the contract for patients include the need to “actively co-operate with treatment activities, truthfully provide medical history information…and respect medical personnel."
Doctors, on the other hand, must show “due diligence in treatment [and must] fully fulfill the obligation to respect the rights of the patient.”
The National Health and Family Planning Commission did not specify how the new policy would be implemented and regulated, and only indicated that supervision and inspection at all hospital administrative departments would be enforced.
The policy will be implemented on May 1 and will take effect in the mainland’s secondary and tertiary health institutions – referring to larger hospitals at the city, provincial and national level responsible for research and comprehensive medical services.
Private and smaller medical centres containing less than 100 beds were encouraged to follow the policy but not specifically required, The Beijing News reported.
Three hospital doctors speaking with The Beijing News on the condition of anonymity agreed that despite the new regulations, any contracts signed by doctors and patients were ultimately “only pieces of paper,” and the status quo would be difficult to change.
A female Beijing resident surnamed Yan said that even if both parties were made to sign contracts, it was unlikely the paperwork would be elaborated upon or fully understood in a crowded hospital environment.
“In a large hospital where people have been queuing for hours, the doctor may give patients only a few minutes,” Yan said. “How can they go [in-depth] with signed agreements?”
Online netizens were also sceptical, and many pointed out that it was not necessarily so easy to stop the proliferation of red envelopes in China’s “corrupted” medical system.
“[Giving hongbao] is an open practice,” one online commentator wrote. “My…colleague had his throat operated on twice because he hadn’t [given enough hongbao] to his surgeon the first time around.”
“[Chinese doctors] are grossly underpaid for the services they do,” another netizen wrote, explaining the logic behind hongbao. “Basically, the government knows this and obviously supports the whole corruption system [of] doctors, since they don’t pay them a higher salary… Would you want an underpaid, overworked doctor…feeling extremely bitter working on you? Don't be cheap!”