Notice of the General Office of the People’s Government of Guangdong Province on Printing and Distributing the Implementation Plan of Promoting Social Medical Services and Accelerating Development in

General Office of Guangdong Provincial People’s Government on Printing and Distributing the Promotion of Guangdong Province

Notice of the implementation plan for accelerating the development of social medical services

Yuefuban [2016] No.51

People’s governments at the local level and listed, people’s governments of counties (cities, districts), departments and institutions directly under the provincial government:

　　"Guangdong province to promote the implementation of social medical accelerated development plan" has been agreed by the provincial people’s government, is issued to you, please earnestly organize the implementation. Problems encountered in the implementation process, please report to the provincial health and family planning commission and other relevant departments.

General Office of Guangdong Provincial People’s Government

June 2, 2016

Implementation plan of Guangdong province to promote social medical service and accelerate development

　　In order to implement the spirit of the Notice of the General Office of the State Council on Printing and Distributing Several Policies and Measures to Promote the Development of Social Medical Services (Guo Ban Fa [2015] No.45) and the Decision of the Guangdong Provincial People’s Government of the Guangdong Provincial Committee of the Communist Party of China on Building a Strong Health Province (Yuefa [2015] No.15), we will further break the institutional obstacles and policy constraints existing in social medical services, accelerate the scale and level development of social medical institutions in the province, and combine the actual situation in our province.

　　I. Work objectives

　　Give full play to the decisive role of market mechanism in allocating social medical resources, create a policy environment to promote the accelerated development of social medical services and promote the development of health service industry in accordance with the principles of government encouragement, market drive, revitalizing resources and strengthening supervision. By 2018, the number of beds and the amount of medical services in social medical institutions will account for about 30% of the total, forming a new pattern of complementary advantages, healthy competition, division of labor and cooperation and healthy development between public medical institutions and social medical institutions, and constantly meeting the people’s growing demand for diversified and multi-level medical and health services.

　　Second, the key work

　　(a) public planning. All localities should, in accordance with the requirements of the Outline of National Medical and Health Service System Planning (2015-2020) and Guangdong Medical and Health Service System Planning (2016-2020), issue regional health resource allocation standards and medical institution setting plans in 2016, and make them public. Under the premise of conforming to the national and provincial planning total amount and structure, local planning shall not restrict the category, scale, quantity and location of social medical institutions. If the plan is not publicly announced, social forces shall not be refused to hold medical institutions on the grounds of planning. New commercial housing projects in cities and towns should plan the corresponding number and scale of medical institutions according to the floor area ratio and the expected population. Actively expand the space for social medical development, and the prefecture-level public medical institutions with more than 4 beds per thousand permanent residents will be listed. In principle, the incremental space should be mainly reserved for social medical institutions. By 2020, the planning space will be reserved for social hospitals according to no less than 1.5 beds per thousand permanent residents, and the allocation space for large medical equipment will be reserved simultaneously. Strictly control the extraordinary allocation of large medical equipment in public hospitals. Open up the allocation of Class B large medical equipment for social medical institutions. Social medical institutions equipped with large medical equipment, who meet the planning conditions and access qualifications, shall not be restricted for any reason. The grade and bed size of social medical institutions shall not be regarded as the necessary preconditions for determining the allocation of large-scale equipment, and the qualifications and technical service capabilities of institutional personnel shall be mainly assessed. (The Provincial Health and Family Planning Commission is responsible for,Provincial Development and Reform Commission, Department of Land and Resources, Department of Housing and Urban-Rural Development, Chinese Medicine Bureau and other departments to participate)

　　(2) Simplify administrative examination and approval. In accordance with the principle of "non-forbidden entry", comprehensively clean up and cancel unreasonable pre-approval items, integrate the examination and approval links such as the establishment and practice license of social medical institutions, promote the standardization of administrative examination and approval of social medical institutions, further clarify and shorten the time limit for examination and approval, simplify the examination and approval process, and streamline the application materials. The relevant administrative departments of the province shall, within 3 months after the issuance of this plan, formulate corresponding guidelines for the handling of social medical administrative licensing according to their responsibilities, and report them to the provincial medical reform office for summary and release them to the public. In addition to overseas (including Hong Kong, Macao and Taiwan) capital and other provincial management authority, the approval of the establishment of social medical institutions is retained in the provincial health and family planning (Chinese medicine) department according to regulations, and the establishment of other social medical institutions is subject to localized approval management. Cancel the step-by-step application and step-by-step approval, and the applicant directly submits the application for setting to the examination and approval authority. Applicants who set up social medical institutions are allowed to apply to the departments of health and family planning, Chinese medicine, public security, fire protection, civil affairs, land and resources, environmental protection, housing and urban construction, planning, commerce, industry and commerce, food and drug supervision, taxation and other departments for relevant procedures. For more than three standardized management chain institutions, the health and family planning department can only make a formal review of their permission and complete it within a time limit. The departments of industry and commerce, health and family planning should include the name of the medical institution (company) registered by the other party on the copy of the license issued by the department. Social medical institutions can choose to use the registered name when issuing relevant bills. Encourage all localities to implement the "one network, one door" government service model, and actively explore effective methods for parallel approval. (Provincial Health and Family Planning Commission(Medical Reform Office) is responsible for the participation of Provincial Development and Reform Commission, Public Security Department, Civil Affairs Department, Department of Land and Resources, Environmental Protection Department, Housing and Urban-Rural Construction Department, Department of Commerce, Industry and Commerce Bureau, Food and Drug Administration, Chinese Medicine Bureau, Local Taxation Bureau and other units)

　　(3) Relaxing institutional access. Give priority to supporting social forces to set up non-profit medical institutions. Encourage social forces to set up rehabilitation hospitals, geriatric hospitals, nursing homes and high-end medical service institutions, as well as Chinese medicine specialized hospitals and Chinese medicine clinics that only provide traditional Chinese medicine services, and accelerate the development of Chinese medicine institutions run by the society. Foreign investors are allowed to set up medical institutions in the form of joint ventures and cooperation. Except for investors from Hongkong, Macau and Taiwan Province, other overseas investors are not allowed to set up Chinese medicine hospitals. Encourage social medical institutions to implement chain and group management. Social medical institutions can choose to set up medical examination, pathology, medical imaging, disinfection supply and other medical subjects (departments); If the relevant diagnosis and treatment subjects (departments) are not set up, other qualified hospitals, independent medical inspection, medical imaging and disinfection supply institutions can undertake related business. Encourage the establishment of independent medical inspection, medical imaging, hemodialysis, health examination, disinfection supply and other third-party technical service institutions. (The Provincial Health and Family Planning Commission is responsible, with the participation of the Provincial Development and Reform Commission, the Civil Affairs Department, the Department of Commerce, the Food and Drug Administration and the Hong Kong and Macao Affairs Office)

　　(4) Promoting doctors to practice more. Accelerate the promotion and standardization of doctors’ multi-point practice, promote the flow of medical personnel between different types and levels of medical institutions, and encourage doctors to practice at the grassroots level, remote mountainous areas, areas with scarce medical resources and other medical institutions in need. Encourage medical institutions to establish full-time and part-time employment systems, and promote the transformation of medical personnel from "unit people" to "social people". Allow doctors to open clinics in qualified pharmacies according to regulations. Encourage part-time medical practitioners to set up clinics, traditional Chinese medicine clinics and traditional Chinese medicine clinics, and encourage part-time practical nurse to set up nursing institutions. Encourage the establishment of medical human resources management institutions such as doctor groups. In the whole province, the first practice place registration system, provincial registration system and multi-point practice registration network filing system for all types of doctors and nurses will be implemented. Medical staff are not affected by multi-point practice in academic status, professional title promotion and business training. (The Provincial Health and Family Planning Commission is responsible, with the participation of the provincial office, the Development and Reform Commission, the Department of Human Resources and Social Security, the Bureau of Traditional Chinese Medicine and other departments)

　　(five) the implementation of medical insurance equal treatment. All kinds of medical institutions can voluntarily apply to the medical insurance agencies in the overall planning area according to the needs and conditions of medical insurance services. After evaluation, the medical insurance agency signed a medical insurance service agreement with the qualified social medical institutions. The nature of ownership of medical institutions shall not be regarded as a precondition for the management of medical insurance agreements, and social medical institutions shall not be refused to be included in the management of medical insurance agreements on the grounds that the number of medical insurance agreement management institutions is full and other non-medical service capacity factors. Standardize all kinds of medical bills, non-profit medical institutions use unified medical bills, and for-profit medical institutions use invoices that meet the requirements, which can all be used as payment vouchers for medical insurance funds. Refine the settlement methods of fees and bills used by medical institutions of different natures and medical insurance funds. (The Provincial Department of Human Resources and Social Security is responsible for the participation of the Provincial Development and Reform Commission, the Department of Finance, the Health and Family Planning Commission, the State Taxation Bureau, the Local Taxation Bureau, the Bureau of Traditional Chinese Medicine and other departments)

　　(6) Promoting the flow and sharing of resources. Encourage public medical institutions to run medical institutions for the society to train medical personnel and carry out technical exchanges and cooperation. Promote the co-construction and sharing of large-scale medical equipment, and explore the establishment of regional inspection centers in various ways, which are open to all medical institutions. All medical institutions, including public medical institutions, are not allowed to add large-scale medical equipment in areas where large-scale medical equipment is saturated, and all localities are encouraged to integrate existing large-scale medical equipment resources in various ways to improve the efficiency of use. On the premise of ensuring medical safety and meeting medical core functions, mutual recognition of medical images, medical tests and other results and sharing of resources such as disinfection supply centers (rooms) of medical institutions can be realized. (The Provincial Health and Family Planning Commission is responsible, with the participation of the Provincial Development and Reform Commission, the Department of Human Resources and Social Security, the Bureau of Traditional Chinese Medicine and other departments)

　　(7) promoting integrated development. Encourage the development of a health service group integrating medicine, medical care and commercial health insurance. Encourage qualified regions to innovate the service model, promote the separation of management and management, introduce a competitive mechanism, and explore ways to entrust qualified commercial insurance institutions to participate in health management services by means of government purchase services under the premise of ensuring the safety and effective supervision of medical insurance funds. Encourage grassroots medical and health institutions to improve the level of medical and health services for community pension service institutions and elderly people at home. Encourage social pension institutions to set up medical institutions, encourage social medical institutions to build pension service facilities, set up medical points in pension institutions or provide telemedicine services for pension institutions. Encourage social forces to rely on tourism and leisure resorts to build healthy tourism facilities with multiple functions, such as medical rehabilitation, health care and health care for the elderly, and explore the middle and high-end medical care tourism market. (The Provincial Health and Family Planning Commission and the Civil Affairs Department are responsible, and the Provincial Development and Reform Commission, the State-owned Assets Supervision and Administration Commission, the Tourism Bureau, the Bureau of Traditional Chinese Medicine, the Guangdong Insurance Regulatory Bureau and other units participate)

　　(eight) to encourage public-private cooperation in medical treatment. On the premise of clarifying the relationship between power and responsibility, public hospitals are allowed to cooperate with social forces to run medical services through brand licensing and purchasing services, and to revitalize surplus medical resources through overall restructuring; Public hospitals are allowed to cooperate with social forces in the form of public construction and private operation, private office assistance or medical association. Encourage social forces with medical management experience to explore ways to participate in the management of public medical institutions through hospital management groups. (The Provincial Health and Family Planning Commission is responsible, with the participation of the Provincial Development and Reform Commission, the Department of Finance and the Department of Human Resources and Social Security)

　　(9) Standardize the restructuring of public hospitals. In accordance with the principles of total control, structural adjustment and moderate scale, the number and scale of public medical institutions should be reasonably controlled. In the county, promoting the development of social medical service should be combined with the reform of county-level public hospitals, and the main role of public hospitals and the supplementary role of social medical service should be brought into play to complement each other. On this basis, orderly guide and standardize the restructuring of public hospitals to avoid the loss of state-owned assets. All localities should combine the regional health resource allocation standards and the establishment planning of medical institutions, clarify the scope and quantity of government-run medical services, implement the responsibility of government investment, and strictly limit the scale of special needs services in public hospitals. (The Provincial Health and Family Planning Commission is responsible, with the participation of the Provincial Development and Reform Commission, the Department of Finance and the State-owned Assets Supervision and Administration Commission)

　　(ten) to improve the clinical level and academic status. Encourage social medical institutions to introduce new technologies, carry out new projects and provide characteristic diagnosis and treatment services. Incorporate the talent team construction, specialty construction and informatization construction of social medical institutions into the overall planning and give the same policy support. Support social medical institutions to introduce middle and high-end talents. Social medical institutions enjoy the same treatment as public medical institutions in standardized training of residents, training of general practitioners, continuing medical education, scientific research, specialty construction, professional title evaluation, grade evaluation and participation in academic activities. Social medical institutions enjoy the same right to know public policy information as public medical institutions. Encourage qualified social medical institutions to declare and identify standardized training bases for residents, regular assessment institutions for doctors, and clinical teaching bases in medical colleges (middle schools). Support social medical institutions to participate in various medical industry associations, academic organizations, professional title evaluation and medical institution review committees, continuously increase the proportion of their personnel under the conditions of meeting standards, and further ensure that medical personnel in social medical institutions enjoy the opportunity to hold positions that are suitable for their academic level and professional ability. (The Provincial Health and Family Planning Commission is responsible, and the Provincial Development and Reform Commission, the Education Department, the Science and Technology Department, the Civil Affairs Department, the Human Resources and Social Security Department, the Chinese Medicine Bureau and other departments participate)

　　(eleven) improve the supervision mechanism. Promote the construction of supervision standards, norms and systems during and after the social medical administrative examination and approval. According to the provisions of the state, for-profit and non-profit social medical institutions shall be classified and managed. Guide social medical institutions to establish a sound governance structure and practice independently according to law. Strengthen the training of the heads of social medical institutions and relevant management personnel, promote standardized management, and improve the management level. Strengthen the supervision system and capacity building, severely crack down on illegal medical practice, severely investigate and deal with acts such as renting practicing licenses to open medical institutions and renting contracting departments, and severely punish acts such as verified malignant medical accidents, defrauding medical insurance funds, false advertising, over-medical treatment, and shirking patients. Incorporate social medical institutions into the management system of medical dispute prevention and disposal. Strengthen the information disclosure of medical institutions, all localities should formulate measures for the information disclosure of social medical institutions, regularly disclose information such as service quantity, quality, fees and bad records of regional social medical institutions, and accept social supervision. Promote the construction of credit system for medical institutions and practitioners, establish and implement the open system of credit commitment for medical institutions, improve the scoring system for bad practice behaviors of medical institutions and medical staff, and improve the system of verification, assessment, registration and withdrawal. Encourage third-party evaluation agencies to carry out professional evaluation of social medical institutions and medical personnel. Encourage social medical institutions to participate in medical liability insurance, medical accident insurance and other forms of practice insurance. (The Provincial Health and Family Planning Commission is responsible for,Provincial Development and Reform Commission, Public Security Department, Civil Affairs Department, Human Resources and Social Security Department, Industry and Commerce Bureau, Chinese Medicine Bureau, Guangdong Insurance Regulatory Bureau and other units participated)

　　Third, safeguard measures

　　(a) to implement the tax policy of medical institutions. Actively implement various tax policies for social medical institutions. After the pilot reform of the camp has been carried out in an all-round way, the preferential tax policies for providing medical services to social medical institutions will be implemented in accordance with relevant state regulations. Property tax and urban land use tax shall be exempted from real estate and land used by non-profit medical institutions that meet the requirements; Property tax and urban land use tax shall be exempted for three years from the date of obtaining the practice registration for the real estate and land used by the social for-profit medical institutions that meet the requirements. If a social medical institution is recognized as a non-profit organization in accordance with the provisions of the enterprise income tax law, it shall be exempted from enterprise income tax on the qualified income such as medical services it provides. Donations made by enterprises and individuals to social non-profit medical institutions through public welfare social organizations or people’s governments at or above the county level and their departments shall be deducted before tax in accordance with the provisions of the tax law. (Provincial State Taxation Bureau and Local Taxation Bureau are respectively responsible, with the participation of Provincial Health and Family Planning Commission, Civil Affairs Department, Finance Department, Department of Land and Resources, Housing and Urban-Rural Construction Department, Chinese Medicine Bureau and other units)

　　(2) Strengthen financial support. All localities can, in light of the actual situation, include social non-profit medical institutions that provide basic medical and health services into the scope of government subsidies according to regulations, and implement the same subsidy policy as public medical institutions in the construction of key clinical specialties and personnel training. For social medical institutions to undertake the tasks of public health services, health support for agriculture, border support and counterpart support issued by the government, compensation will be given through the way of government purchasing services; The medical emergency rescue expenses borne by it shall be subsidized according to the provisions after verification by the relevant departments. Eligible social medical institutions can be included in the 120 emergency network after applying for filing. Governments at all levels can adopt comprehensive performance evaluation methods, and reward social medical institutions according to the evaluation results. (The Provincial Health and Family Planning Commission is responsible for the participation of the Provincial Development and Reform Commission, the Department of Finance, the Bureau of Traditional Chinese Medicine and other departments)

　　(3) Standardize the charging policy. Resolutely implement the national and provincial policies on administrative fees, exempt non-profit medical institutions run by the society from administrative fees, and levy administrative fees by half for profit medical institutions run by the society. Further clean up and cancel unreasonable and illegal charging items for social medical institutions, and implement the same charging policies and standards for social non-profit medical institutions as public medical institutions in accepting various charging items managed by the government, and implement the same price for water, electricity and gas as public medical institutions. (Provincial Development and Reform Commission, Department of Finance, Department of Land and Resources, Department of Housing and Urban-Rural Development, Health and Family Planning Commission, Administration for Industry and Commerce, Administration of Traditional Chinese Medicine, State Taxation Bureau, Local Taxation Bureau and other units are respectively responsible)

　　(4) Ensuring the demand for land. Social forces are allowed to set up medical institutions in accordance with the regulations by using the stock of construction land and existing idle houses. To use the stock of construction land to organize social medical institutions, involving the transfer (lease) or transfer of the right to use construction land, it is allowed to pay the land transfer fee (rent) and go through the formalities of agreement transfer or lease on the premise of conforming to urban and rural planning. For the use of existing vacant rooms to hold social medical institutions, the use function of the house can be adjusted according to the regulations after approval by the relevant departments of the local government. According to the principles and requirements of construction planning, if the construction area of social non-profit medical institutions is increased in the completed residential area, the land price may not be increased; Subsequent adjustment to for-profit medical institutions, should pay the corresponding land price. (The Provincial Department of Land and Resources is responsible for the participation of the Provincial Health and Family Planning Commission, the Department of Finance, the Department of Housing and Urban-Rural Development, the Bureau of Traditional Chinese Medicine and other departments)

　　(5) Broaden investment and financing channels. Encourage all localities to provide construction funds and discount subsidies for social medical institutions by setting up health industry investment funds. Encourage social medical institutions to raise start-up expenses and development funds by means of equity financing and project financing. Support qualified social for-profit medical institutions to go public for financing or issue bonds. Explore medical trust investment and medical health bonds, support social medical institutions to set up medical funds by using medical balances and donations in accordance with regulations, and the proceeds will be used for the development of medical institutions. Encourage social medical institutions registered as enterprise legal persons to explore the establishment of medical private equity investment funds. Encourage all kinds of venture capital and financing guarantee institutions to carry out business in innovative formats and small and micro enterprises in the medical field. Broaden the scope of credit mortgage collateral. Encourage financial leasing institutions to carry out large-scale medical equipment financial leasing for social medical institutions. Support policy guarantee institutions to provide guarantees for the financing of social medical institutions. (The Provincial Health and Family Planning Commission and the Financial Office are responsible, and the Provincial Development and Reform Commission, the Department of Finance, the Provincial Bureau of Traditional Chinese Medicine and other departments participate)

　　Fourth, the job requirements

　　(1) Strengthen organizational leadership. All localities and relevant units should attach great importance to the development of social medical service, and incorporate social medical service into the important content of deepening the reform of medical and health system and deepening the reform of economic system to promote it. Municipal governments at or above the local level shall, according to the objectives and tasks, formulate work plans in a timely manner in light of the actual situation. All relevant departments should strengthen communication and coordination according to work requirements, cooperate closely, and formulate or revise relevant plans, norms, standards and policies and measures in a timely manner.

　　(2) Strengthen assessment. The Provincial Health and Family Planning Commission and the Development and Reform Commission should take the lead in monitoring, tracking, evaluating and assessing the implementation of this implementation plan in all localities and relevant departments, and the implementation should be included in the province’s deepening the reform and assessment of the medical and health system and the key work of supervision and supervision to ensure that all policies and measures are implemented. For those who fail to implement the reform measures to promote the development of medical services in society according to regulations, they should be ordered to make corrections in time and be held accountable according to regulations.

　　(3) create a good atmosphere. Make full use of newspapers, radio, television, internet and other media, widely publicize policies and measures to promote the accelerated development of social medical services, publicize advanced models emerging in social medical services, expand the influence of social medical institutions, and form a good atmosphere conducive to the accelerated development of social medical services.