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Registration fees at community health centers in Shanghai will be covered by the city to encourage more people to visit the smaller facilities for minor ailments instead of crowding into city-level hospitals which are far more expensive to run, government spokeswoman Jiao Yang announced yesterday.

Jiao Yang, Spokeswoman of Shanghai municial government

She said the city would also take steps to improve the training of doctors at community health centers.

Previously city residents had to pay a seven yuan (US$87 cents) registration fee every time they visited a health center. As part of the new rules patients will only be charged half the normal registration fee at larger hospitals if a community health center sends them there, according to Ma Qiang, deputy director of the Shanghai Health Bureau.

The exempt fees will be covered by the city's medical insurance fund for those covered and by district and municipal governments for those who aren't, he added.

The city's community health centers deal with 27-30 million visits a year and that number is expected to increase significantly under the new policies, said Ma. "Our ultimate purpose is to cut down medical costs," he said. "Community medical service will be safe, convenient and economical for local residents."

The health bureau will now handle the accounting for all community health centers, collecting all income and paying the bills under an annual budget it draws up. Doctors will no longer be paid based on how much revenue they generate, the bureau said.

Ma said the rules would stop health centers from padding the bills in order to drive up profits...a tactic city residents have complained about for years.

The bureau will also set up a consortium to buy drugs for the health centers in bulk to slash costs and push medical centers to accept the results of tests done at other facilities to cut down on duplication.

The average medical bill for people visiting community health centers in the first half of this year was 108.69 yuan. This is down 8.6 percent from the same period last year, according to the bureau.

To help the centers deal with an expected influx of patients more general practitioners will be trained at large hospitals to work in the small health facilities.

(Shanghai Daily November 17, 2006)