Local doctors are expressing doubt that a new Ministry of Health regulation announced late last week will be effective in stopping doctors from taking gifts from patients or commissions from drug companies.

The ministry called on health officials around the country to stop the practice by threatening to pull the license of any doctor caught breaking the rules.

It has long been a popular practice in China for patients to give doctors a red envelop filled with cash before or after undergoing surgery to express their gratitude. Envelopes would generally contain at least 1,000 yuan (US$120), which would be split between all of the doctors and nurse who take part in the operation.

"The low income doctors earn is the root of the irregular practice," said Lu Ye, an official with Yangpu District Central Hospital.

Lu points out that newly graduated doctors earn about 2,000 yuan a month, less than many other university graduates around the city, and even those who rise to become hospital directors only take home 4,000 yuan a month.

"Those salaries are not in line with a doctor's qualifications and skills."

While the city has been pushing to stop the practice of giving red envelopes over the past few years, many doctors have found new ways to supplement their incomes, such as taking commission from drug companies to prescribe medications not covered by the city's health insurance system, according to those in the health sector.

Some of the money raised that way is put into hospital funds for professional training and academic exchanges, while the rest is distributed to doctors and nurses, said a local pediatrician surnamed Wu.

"It is a public secret in many hospitals. Our income can't support various academic moves and other expenditures. There will still be loopholes even after the ministry's order."

Gao Qiang, China's vice-minister of Health, has called on health officials around the country to set up complaint hot lines and mailboxes and let the public know where they can report doctors taking gifts or commissions.

"Though it is only some medical workers' improper behavior, it has hurt the image of the whole industry," Gao said.

(Shanghai Daily April 12, 2004)