Go homepage(回首页) Upload pictures (上传图片) Write articles (发文字帖)
The author:(作者)qqpublished in(发表于) 2013/11/15 12:53:43 Health Planning Commission spokesman：Our country the doctor-patient relationship was generally good
Recent incidents of violence injury-prone, give rise to the central leadership and the concerns of the community. National Health Planning Commission meeting, condemned the injury events, research and measures to promote the harmonious doctor-patient.
50 years of the national health and family planning, publicity Secretary, spokesman Mao Qunan, most recently very busy. He worked for 26 years in the health system, since 2003 "SARS" period be entrusted with a mission at a critical and difficult moment becoming spokesman for the Chinese Ministry of health, began to familiarize the public with. As new China's first batch of Ministry spokesman, he and the Ministry of education spokesman Wang, spokesman for the Chinese Ministry of public security spokesman Wu Heping was previously called "the three Musketeers". Many familiar with his assessment to the press, he has a wonderful low-key personality, a deep affection for medical and health services, there personality statements. Has had friction with the media, even being "misunderstood", "collateral damage", but also because of its openness to win the respect of journalists. Institutional reforms at the beginning of this year, the National Health Commission was established, his "coming out" to serve as spokesman.
Yesterday, he Nanfang daily press interviews in Beijing, told this newspaper recently launched "· governance – harmonious doctor-patient health dream" series of reports gave adequate affirmation, that report reflects the mainstream media to guide public opinion, promote a harmonious physician-patient communication responsibilities and roles. During the interview, he did not Mandarin-Laden, but frank talk has revealed his thinking on the relationship between doctors and patients.
Nanfang daily reporter yangchun China
Injury medical events
Violent injury and general medical disputes are two different things
Nanfang daily: wenling, Guangzhou injury medical event in the near future, the medical community's grief and the big rebound was not seen for many years. Medical disputes and increased incidents of violence injury in recent years, what are the reasons you think?
Mao Qunan: there have been many cases of malignant injuries nationwide in the near future, CPC Central Committee and the State Council attach great importance to Prime Minister Li keqiang, Liu yandong, Deputy Prime Minister made important instructions, respectively. Liu yandong, Deputy Prime Minister also held a meeting recently, called for effective measures to enhance hospital security, maintain normal health care order, protecting the safety of medical personnel.
Injury medical and general medical disputes are two different things, and to be treated differently. Which belongs to a criminal offence, to crack down, stressing that "zero tolerance". Physician and patient awareness of different disputes, within the scope of civil disputes, through such means as negotiation, mediation and Court. The two don't mix. For violent injuries hospital medical order, seriously disrupting the normal and malignant behavior, we should unequivocally against it.
Number of doctor-patient dispute reflects social contradictions. Some people living in penury, resentment, once the sick, difficulty, costs are high, it is easy for outbreaks. In addition, we built up the basic medical insurance system, medical costs much still need to be paid for. But do not like to eat or clothes to see a doctor, can decide according to their economic power consumption level. Whether it is money or no money, had wanted to go to a good hospital care burden still heavier. In addition, some lack of communication between the medical personnel and patients, it is also easy to escalate the conflict.
In my view, although the proportion of doctor-patient dispute happening now does much more than in the past, but our doctor-patient relationship is generally good. National health agencies clinic visitors last year reached 5 billion or 6 billion, even though a 99.99% of patients satisfaction, dissatisfaction with the 0.01% will also have a considerable number of disputes. Disputes between doctors and patients, we need to give serious attention to solving, but not exaggerated rendering.
Medical diagnosis and treatment system market to promote ratings
Nanfang daily: the view was expressed that the medical system is market-oriented institutional causes of the increase in doctor-patient dispute. National implementation of the new health reform in recent years, initially established the basic health care system. Current national healthcare reform from the affiliated Commission affiliated health planning Committee, focal point of healthcare will reveal the next step? How to further alleviate the difficult and expensive to see a doctor?
Mao Qunan: "health care system is market-oriented institutional causes of the increase in doctor-patient dispute", this is not quite accurate. "Marketization" connotation is more complex, academics are very controversial. A few years ago when the health care reform debate, which tend to be of its generalization, negative, and some even take this market mechanism, wanted to go back to the old planned economy era. In fact, Government-led, give full play to the market mechanism, is China's important principles of health reform. We must oppose the profit in public hospitals, but also continued to play well in the healthcare market deployment of resources.
Reformed, will make greater use of market mechanisms. Health reform is to get rid of mechanisms to hinder the healthy development of medical service system, just because something went wrong in the reform, said reforms were wrong. Before they could reform people's views on medical doctor just can't get over, to unmet demand for hospitalization, surgery, and this years an outpatient and surgical attendance is rather large, healthcare reform is meeting the medical needs of the common people.
Visiting doctor being difficult and expensive problems, and the health care system is relevant. Hospital doctors any more, the expert is still relatively small. Everyone is looking for experts, this couldn't solve it. If the condition selected hospitals and doctors, will be much easier. Now check the "ill get expert" impulse, don't let the patients disordered movements. Because of the limited resources, unlimited demand, limited resources to those who need it. This requires grading diagnosis and treatment, the promotion of community first contact care. Patients go to community, community physicians to decide whether a big hospital. Abroad, too, has no proof of community physicians, hospitals will not receive, or loose, solve visiting doctor being difficult to use this approach.
Free medical care
Based on national circumstances, rational view of health care reform challenge
Nanfang daily: recent Russia "free health care" became a hot topic, the World Health Organization and the National Planning Commission officials have said, but the network remains somewhat controversial. Could you talk a little bit about that?
Mao Qunan: "free health care" topic, there were different views on the network is normal, this is subjective, clue has already given.
People on the medical requirements are simple, the best doctors, best not. Subject to organise that service costs somebody out, hospital cannot solve problems. Initially established a universal coverage of medical insurance system in China, people want all inclusive, but there is no, we are developing countries, don't have the economic power. United States as rich did not completely free, also to argue about health care reform.
In some countries, "free health care", coverage levels are relatively low. Use an analogy, if altogether, only five different medications, need something else is not free, for everyone's opinions are you small? Hospitals now have lined up yet, if free, everybody wants to live in a good hospital, you can imagine how much congestion.
Healthcare reform is a worldwide problem, no system brings both advantages and disadvantages, and States of your choice of system and the associated economic, social and cultural situation, is part of the social system. We have to follow the situation rationally. For our country, still need to continue to deepen reform, gradually increase in the development and reform of basic medical coverage, reduce the burden on phenomena.
Exploration of Guangdong
Zhongshan medical governance experience worthy of promotion
Nanfang daily: Zhongshan, Guangdong Police through the establishment of hospitals and the Medical Commission, the "prevent" combined, created the first "medical trouble-free city", the city's police chief publicly "laissez-faire is the stigma, the police Chief of police incompetence." Zhongshan, Guangdong is promoting experiences. What is your opinion?
Mao Qunan: Zhongshan created "medical trouble-free city", which is good, worthy of promotion, increase of social harmony, people will appreciate. There are many reasons for multiple layers of, is not entirely the responsibility of public security, need for multisectoral efforts. Health Planning Commission and the Ministry of public security recently jointly issued the guidance on strengthening the construction of hospital security systems, of crack-related crimes according to law.
Response measures
Open Avenue doctor-patient dispute resolution proceedings
Nanfang daily: building a harmonious doctor-patient relationship, what measures in the near future?
Mao Qunan: according to the requirements of the central leadership to deploy, three things to focus on in the near future.
A strongly Conservative response to the doctor-patient contradiction emergencies, focus on a one-year initiative, implementation of hospital safety and security responsibilities, improve police linkage mechanism of hospital, medical disputes dispute resolution and risk investigation and crack down "doctor" and other medical-related illegal and criminal acts.
Second is to strengthen the doctor-patient conflict prevention resolution, improve the mediation mechanism of medical dispute, facilitate the mediation of medical dispute and litigation, strengthening medical quality management, enhancing good professionalism, reducing medical dissension from its source.
Three is the perfect long-term working mechanism, deepen the "green hospital" building, a sound regulatory regime. While accelerating the reform of health and further improve the basic medical insurance diagnosis and treatment, grading system, gradually relieve hospital overcrowding, illness insurance role to play.
Maintaining good relationship between doctor and patient, so that medical personnel have a good working environment, or for the consideration of the fundamental interests of the people. Hope to strengthen communication between doctors and patients, and join hands in combating the disease.
General Planner: mogaoyizhangdongming
Director: Cai Yuming Nong Yue Huang often open Cao Ke Wang Wei
Nanfang daily and Manpower: Duan Gongwei Lang Guohua Xu Lin, China
(Original title: enhancing communication between doctors and patients should, work together to fight against the disease)
近期暴力伤医事件频发，引起中央领导和社会各界关注。国家卫生计生委召开会议，严厉谴责伤医事件，研究措施促进医患和谐。
50岁的国家卫生计生委新闻发言人、宣传司司长毛群安，最近非常忙碌。他在卫生系统工作了26年，自2003年“非典”时期临危受命成为卫生部新闻发言人，开始为公众熟悉。作为新中国第一批部委新闻发言人，他与教育部原新闻发言人王旭明、公安部原新闻发言人武和平曾被称为新闻发言人“三剑客”。不少熟悉他的媒体记者评价，他个性敦厚低调，对医疗卫生事业感情很深，时有个性言论。因此与媒体有过摩擦，甚至被“误读”、“误伤”，但也因其坦诚赢得记者的尊重。今年初机构改革，国家卫生计生委成立，他重新“出山”，担任新闻发言人。
昨日，他在北京接受南方日报记者的专访，对本报近期推出的“医·治——和谐医患健康梦”系列报道给予充分肯定，认为报道体现了主流媒体引导社会舆论、促进医患沟通和谐的责任和作用。采访中，他没有官话套话，而是坦诚交谈，道出他对医患关系的思考。
南方日报记者 杨春 陈枫
伤医事件
暴力伤医和一般医疗纠纷是两码事
南方日报：近期温岭、广州等地伤医事件，医务界的悲愤和反弹力度之大，是多年未见的。医患纠纷和暴力伤医事件近年持续增多，您认为有哪些原因？
毛群安：近期全国发生了多起恶性伤医事件，党中央、国务院领导高度重视，李克强总理、刘延东副总理分别作出重要批示。刘延东副总理最近还召开会议，要求采取切实有效的措施，加强医院的安全保卫，维护正常的医疗秩序，保护医务人员的生命安全。
伤害医务人员和一般医疗纠纷是两码事，要区别处理。前者属于刑事犯罪，要严厉打击，强调“零容忍”。而医生和病人因认识不同有纠纷，那属于民事纠纷范畴，可以通过协商、调解和法院诉讼等途径解决。这两者不能混为一谈。对于暴力伤医、严重扰乱正常医疗秩序的恶性行为，我们要旗帜鲜明地打击。
一些医患纠纷反映了社会矛盾。一些群众生活困难，有怨气，一旦生了病，看病难，费用又高，就容易暴发。另外，现在我们的基本医保制度刚建立起来，医疗费用很大一部分还是需要个人支付。但看病不像吃饭或买衣服，可以根据个人经济实力决定消费档次。不管是有钱还是没钱，有了病都想去好医院，看病负担依然较重。另外，一些医务人员与病人缺乏沟通，也容易激化矛盾。
我认为，虽然现在发生的医患纠纷比例确实比过去多了，但我们国家的医患关系总体上是好的。去年全国医疗卫生机构的门诊人次达到五六十亿，即使其中99.99%的患者表示满意，0.01%的不满意，也会有相当数量的纠纷。对于医患纠纷，我们要认真重视解决，但也不能夸大渲染。
医疗制度 发挥市场作用推广分级诊疗
南方日报：有人认为，医疗体制市场化取向是医患纠纷增多的体制性原因。近年国家推行新医改，初步建立基本医疗卫生保障制度。目前国家医改办已从挂靠发改委变成挂靠卫计委，可否透露下一步医改工作的重点？如何进一步缓解看病难、看病贵？
毛群安：“医疗体制市场化取向是医患纠纷增多的体制性原因”，这个说法不太准确。“市场化”的内涵比较复杂，学术界还有不少争议。前几年医改大讨论时，往往将其泛化、负面化，甚至有人借此反对市场机制，想走回计划经济时代的老路。其实，政府主导、充分发挥市场机制作用，是我国医改的重要原则。我们既要反对公立医院一味趋利，也要在医改中继续发挥好市场机制调配资源的作用。
下一步改革，会更多利用市场机制。医改就是要改掉阻碍医疗事业健康发展的机制体制，不能因为在改革中碰到了问题，就说改革错了。没改革之前，老百姓对医疗的意见大，看病看不上，住院、手术的需求得不到满足，而这几年每年门诊和手术人次的增幅是相当大的，医改正在满足老百姓的医疗需求。
看病难和看病贵的问题，和医疗制度的安排有关。医院的医生再多，专家人数还是相对少。所有人都想找大专家，这就没法解决。如果根据病情需要选择医院和医生，就好办得多。现在就要抑制这种“一有病就要找大专家”的冲动，别让病人无序流动。因为资源有限，需求无限，要把有限的资源给需要的人。这就需要分级诊疗，推广社区首诊制。病人先去社区，由社区医生来决定是否上大医院。国外也是如此，没有社区医生的证明，大医院不会接收，否则就乱套，解决看病难要用这个办法。
免费医疗
根据国情理性看待医改难题
南方日报：近期俄罗斯“免费医疗”成为热点话题，世界卫生组织和国家卫计委的官员相继表态，但网络空间仍有些争议。可否请您再谈一谈？
毛群安：对于“免费医疗”的话题，网络上有不同意见很正常，这就是仁者见仁，智者见智。
老百姓对医疗的要求很简单，看最好的医生，最好不要钱。但要组织这种服务，费用总得有人出，医院不可能自己解决费用问题。我国初步建立了覆盖全民的医疗保险制度，老百姓希望全包，但目前还包不了，我们还是发展中国家，没这个经济实力。美国那么富有，也没能做到完全免费，还在为医改争吵。
有些国家的“免费医疗”，保障水平其实还是比较低的。打个比方，如果一共就只有五种药，需要别的药却没有，这样的免费，大家的意见就会小些吗？现在大医院收费还排着队呢，如果免费，大家都要住好医院，可以想象有多拥堵。
医改是世界性难题，任何一种制度都有利有弊，各国选择哪种制度和经济、社会、人文的状况是相关联的，是社会制度的一部分。我们要根据国情，理性看待。对于我国来说，还是要继续深化医改，在发展和改革中逐步提高基本医疗保障水平，减轻群众看病负担。
广东探索
中山治理医闹经验值得推广
南方日报：广东中山市通过设立医院警务室和医调委，“防堵”结合，创建国内首个“无医闹城市”，该市公安局长公开表态“放任医闹是警察的耻辱、公安局长的无能”。广东正在推广中山经验。您有何看法？
毛群安：中山创建“无医闹城市”，这很好，值得推广，社会和谐度增高，老百姓都会感谢。医闹的原因是多方面多层次的，并不完全是公安的责任，需要多部门一起努力。卫计委和公安部日前联合印发《关于加强医院安全防范系统建设的指导意见》，将依法严厉打击涉医的违法犯罪行为。
对策措施
畅通医患纠纷调解诉讼渠道
南方日报：建立和谐医患关系，近期有哪些措施？
毛群安：根据中央领导的要求部署，近期要重点做好三件事。
一是坚决稳妥应对医患矛盾突发事件，集中开展为期一年的专项行动，落实医院安全保卫责任，完善警医联动机制，开展医患纠纷大排解和隐患大排查，严厉打击“医闹”等涉医违法犯罪行为。
二是要加强医患矛盾预防化解，健全医疗纠纷调解工作机制，畅通医疗纠纷调解与诉讼渠道；加强医疗质量管理，弘扬良好医德医风，从源头上减少医患纠纷。
三是完善长效工作机制，深化“平安医院”建设，健全相关法规制度。同时加快推进医疗卫生体制改革，进一步完善全民基本医保、分级诊疗等制度，逐步缓解大医院人满为患问题，发挥大病保险的作用。
维护好的医患关系，让医务人员有一个好的工作环境，也还是为了老百姓的根本利益考虑。希望医患加强沟通，一起携手对抗疾病。
总策划：莫高义 张东明
总指挥：蔡玉明 欧阳农跃 黄常开 曹轲 王巍
南方日报统筹：段功伟 郎国华 徐林 陈枫
(原标题：医患双方应加强沟通，携手对抗疾病)
赞