Those in the know are calling for the allocation of increased
resources to the health care sector. And they want better
remuneration packages for medical workers.
Dr. Wei Jianing is with the Macro Economy Research Department under
the State Council Development and Research Center. In an interview
with the China Economic Times, this respected economist
speaks of imbalance in economic and social development and also
points squarely to ineffectual crisis management in the initial
phase of the SARS outbreak. And so what might have been contained
as a local incident became a full-blown crisis flying across
international boundaries. Dr Wei looks behind the symptoms to the
underlying systems failures that created the environment in which
SARS could spread.
The roots of the SARS crisis can be found in omissions on the part
of government coupled with an absence of competitive market
conditions in the healthcare sector. The sector has found itself
disadvantaged in the recent times of rapid economic development and
social change.
The underlying failing on the part of government was not to pay due
attention to the need to maintain an overall balance between
sectors during the shift to a market economy. The development of
the public health care system has lagged far behind the advances in
urbanization, industrialization and opening-up to the outside
world.
Despite the widespread move towards market forces elsewhere in the
life of the nation, healthcare has remained a state monopoly in the
hands of government authorities.
Despite a shortfall of investment in the sector, various levels of
government still restrict the use of either private or foreign
capital for development and market mechanisms have never been
brought to bear.
The mechanisms necessary to alert the authorities to the impending
crisis and evaluate the risk were just not in place. There was a
missed opportunity to recognize the true gravity of the situation
at an early stage. One of the routine tasks of crisis management is
to evaluate potential risk.
Once the fight against SARS was in full swing, failures in the
sharing of information and in crisis management facilitated the
rapid and far-reaching spread of the disease.
Several failings combined and the best time to contain the outbreak
was missed. The seriousness of the situation was not recognized
early in the cycle and information was not effectively shared.
Bureaucracy was to make matters worse with its buck-passing and
disputed responsibilities. There are important lessons to be
learned by the relevant departments.
In
contrast to rapid economic growth elsewhere, investment in the
public healthcare system has fallen behind. Development, systems
reform and funding are all in short supply.
There is now a wide gap between increasing public expectations of
healthcare and the ability of the sector to deliver. The current
crisis has been a wake-up call. No time should now be lost in
addressing the current imbalance between the limited progress in
healthcare and the major advances fuelled elsewhere by rapid
economic growth. Now is the time to increase salaries and
conditions of service in the healthcare sector.
Clear indications of under-remuneration have been surfacing in
recent years. There have been frequent reports criticizing
healthcare workers for accepting hongbao (a gift of money in
the red envelope traditional at New Year) and of incomes
supplemented by commission on the sale of prescription drugs.
But where are the reports drawing attention to meager pay dwarfed
by the rewards to be had in other sectors like finance, information
technology, the auto industry and real estate not to mention the
incomes enjoyed by healthcare professionals in foreign ventures in
China and abroad. In other countries, the healthcare professions
are amongst the best paid and medical doctors are in a position to
earn more than government officials.
To
attract the very best talent into this high-cost, high-risk and
knowledge intensive industry, it will be necessary to create an
environment where good salaries and benefits are seen as the
norm.
There must be rigorous requirements for entry to the profession
coupled with effective mechanisms for the removal of those who fail
to live up to the required standards of professionalism and
service.
The fulfillment of the dream of a prosperous nation depends on the
wellbeing of the citizens. Many developed countries have laid the
foundations of their revitalization and prosperity by promoting the
cause of physical education and healthcare to ensure the good
health of their most valuable resource, their citizens. "If we want
to realize in full the dream of revitalizing China this will be
achieved by paying due attention to fundamental rather than
peripheral needs," said Dr. Wei.
(China.org.cn translated by Alex Xu, June 10, 2003)