Source:
https://scmp.com/article/319946/shanghais-hospital-hope

Shanghai's hospital hope

AS A PLASTIC SURGEON, Dr Peng Shaocheng has snipped here and padded there to give his patients the good looks they have always craved. But he is about to take on his most challenging 'remake' yet - trying to transform a struggling state medical centre into Shanghai's first private hospital.

'I've wanted to run a private hospital for years,' he says. 'This was my dream.' Dr Peng, who studied and practised in Japan for seven years, is familiar with the shortcomings of the state-run health sector on the mainland. For years, he worked in state hospitals where he got to see the highs and lows of health care, which at its worst can be truly dreadful.

'There is a shortage of professionalism at state hospitals. They can't fire anyone so people get lazy,' he says. 'This has been a state monopoly. We need some competition.' The mainland has opened up much of its economy to market-style reforms, but it has kept a tight clamp on its health-care system. While it provides basic health care for many of its 1.2 billion people, it has been unable to eliminate some eye-popping shortcomings. Outdated equipment, filthy conditions and jammed waiting rooms attended by indifferent staff are some of the problems at the bottom end of the health-care chain.

Some private hospitals have squeezed through the cracks, particularly in the adventurous south or in poorer areas where health care is in such short supply that ideology can be conveniently overlooked. But Shanghai and many other big cities have been slow to embrace reform. For the most part, general hospitals have been the preserve of the state.

In February, however, the State Council backed a faster opening of the sector, and that has spurred Shanghai to move ahead more boldly. Dr Peng and an associate took over the Shanghai Light Industry Hospital in October last year after paying 20 million yuan (about HK$18.7 million). The hospital was set up 21 years ago to serve the 300,000 factory employees and their families under the light industry bureau of the Shanghai city government. The bureau no longer exists, however, and its factories have become companies that have taken themselves out from under the government's protective wing.

Patients on the mainland usually endure lengthy queues from the moment they enter a state hospital to the time they pay the cashier and are discharged. But at the Light Industry Hospital, a patient might feel lonely. Its quiet halls echo with the footsteps of a visitor and a handful of elderly patients. 'They had tried to sell this hospital for several years,' says Dr Peng. 'But they wanted 50 million yuan and no one was willing to pay.' Shanghai has lots of health centres - 473 hospitals of various sizes and many more clinics - but what the city is short of is quality care, and that is where Dr Peng hopes to fill a void. His work in Japan gave him much of the capital needed to realise his dream. He now believes he can recover his investment fairly quickly.

'Look at all the people in this country. A good hospital will certainly make a profit,' he says, adding that he expects a 30 per cent annual return. He hired 80 people, 40 of them doctors, out of 1,800 who applied. 'I will give them high pay, but their pay will be based on performance. I want good doctors here.' Dr Peng has been planning his project since he returned from Japan in 1994. When he took over the Light Industry Hospital he used a corporation to make the purchase, though he kept the original licence. He has been waiting for months to clear the last hurdle, winning a new licence under a new name - the Humanity Hospital. 'We should have our licence this month. They [city authorities] have given us the green light.' The Humanity Hospital will cater for Shanghai's well-to-do, many of them living near its present site, just off the fashionable Huaihai Road. 'Many of Shanghai's wealthiest people - athletes, television personalities and movie stars - live not far from here. We will cost about twice the average price of state hospitals, but wealthier people will pay for better care.' It has not been easy convincing an uncertain, and at times unhelpful, government bureaucracy. 'The problem is that we are the first. There are no guidelines.' Health department officials declined to discuss the issue with foreign reporters, but they defended themselves to domestic journalists, saying they could not go beyond existing regulations.

Dr Peng says Shanghai officials were uncertain of what to write on the licence itself - how to describe a privately-owned hospital.

Other hospitals in the city were unhappy that a private hospital would compete for patients. They tried to take away a government-set quota for hospital beds, though that issue has since been resolved. State hospitals also opposed Dr Peng's plans to buy a CAT (computed axial tomography) scan, fearing this would cut into their own CAT scan revenues.

Then there was the question of insurance. Dr Peng says patients at his hospital should be eligible for insurance coverage even though the Humanity Hospital will charge more for its services. He says government insurance should cover basic fees, with anything above those levels borne by the individual, perhaps with the help of supplemental commercial insurance. 'This has now been agreed to.' Once the Humanity Hospital receives its licence, it will spend 63 million yuan to buy a plot next to the existing site and build a new wing. The money will also pay for the relocation of current residents on the site.

Dr Peng has also faced staff problems since he took over the state-run hospital. He has raised salaries twice for more than 40 employees from the former hospital, but still there is wariness.

Those employees used to have job security but now worry their jobs could disappear. Dr Peng says he wants those employees to stay on and work, but that they must perform.

If the Humanity Hospital manages to overcome its final hurdles, it is likely to bring big changes to Shanghai's medical system. Other private institutions are likely to eventually follow in its footsteps.

And just how dramatic would the changes be? 'We would make house calls.' William Kazer ([email protected]) is a member of the Post's Shanghai bureau