General office of the state council concerning the deepening medical and health system reform in 2016 key tasks

 

The national health and family planning commission of the People's Republic of China

The 2016-04-26

Countries do hair [2016] 26

 

The provinces, autonomous regions and municipalities directly under the central government, the relevant departments of the state council:

The deepening medical and health system reform in 2016 key tasks, have agreed to under the state council, printed and distributed to you now, please combined with the actual, to organize and implement carefully.

The state council general office

On April 21, 2016

We will deepen reform of the medical and health system in 2016 key tasks

Since the launch of a new round of reform under the correct leadership of the CPC central committee and the state council, all localities and departments concerned together with reform, continuously improve the top-level design, the key difficulty gradually breakthrough, difficulty and high cost of the crowd to see a doctor problem was significantly reduced, deepen the reform made significant stage results. In 2015, the highest average life expectancy at 76.34 years, 1.51 years higher than that of 2010, the people's health level, on the whole, to achieve high income countries average, residents' personal health spending accounts for the proportion of the total health expenses dropped to below 30%, its lowest level in nearly 20 years. Positive progress was made in reform and results, and laid a solid foundation for deepening reform.

2016 was the start of the implementation of "much starker choices-and graver consequences-in", is by 2017 we will deepen reform of the medical and health system of the milestones crucial years, is also to 2020 the key to realize the goal of everyone will have access to basic medical and health services. Will fully implement the party's eighteen big eighteen class 3, 4, and fifth plenary session of the spirit, earnestly implement the CPC central committee and the state council decision deployment, firmly establish and earnestly implement the innovation, the coordination, the development of green, open, sharing ideas, adhere to the basic, strong base, building mechanism, further highlight key areas and crucial links, enhance the reform and innovation efforts, to further advance medical treatment, health care, medical 3 d linkage, strengthen the reform of integrity, systematic and co-ordinated, further improve the reform action ability, promote the policy implementation, for the implementation of "much starker choices-and graver consequences-in tasks set out the reforms of health care reform plan" cloth bureau, a good step, ensure that make greater achievements, promote to establish the basic medical and health system covering both urban and rural residents, promote healthy construction in China.

A, comprehensively deepen reform of public hospitals

(a) strengthen improve public hospitals at the county level comprehensive reform. Strengthen classified guidance and demonstration lead, qidong city, jiangsu province, anhui tianchang, youxi county, fujian province, mutual aid minority autonomous county in qinghai province, to carry out the reform of public hospitals at the county level comprehensive demonstration work, reform and improve the drive surface. (health and family planning commission, ministry of finance shall be responsible for, the public sector, human resources, social security, national development and reform commission, bureau of traditional Chinese medicine. The first one to lead departments, hereinafter the same)

(2) to expand public hospital comprehensive reform pilot city. 100 new pilot cities, make the national pilot cities to about 200. The central government budget for each new pilot city in accordance with the standard of 20 million yuan one-time subsidies; For all the municipal district of pilot city has a public hospital in accordance with the standards of every 1 million yuan subsidy. At the same time, comprehensive pilot reform of public hospitals will be carried out effect evaluation, establish the evaluation results and the central fiscal subsidy funds allocated to link mechanism. Leading to promote 10 national health family planning committee who hospital dependency for public hospital reform, and establish performance appraisal system. Actively promote hospital to participate in the reform of public hospitals run by state-owned enterprises. Research for military hospital to participate in urban public hospital comprehensive reform pilot guidance document. (health and family planning commission, ministry of finance, state-owned assets supervision and administration, logistics security bureau of the central military commission is responsible for respectively, public sector, human resources, social security, national development and reform commission, bureau of traditional Chinese medicine)

(3) the implementation of government responsibility. Carrying out the general office of the state council concerning the national medical and health service system planning (2015-2020) notice do hair [2015] no. 14 (countries), all the provincial, city and county respectively, formulation and implementation of health resource allocation standard (medical and health service system planning), regional health planning, medical and health service system planning of the county. The full implementation of the government for responsibility in public hospitals. (health and family planning commission, national development and reform commission, ministry of finance, respectively responsible for)

(4) a sound scientific compensation mechanism. Consolidate public hospitals to cancel the reform achievements of drug addition, the new pilot cities all public hospitals cancelled drug addition (except traditional Chinese medicine yinpian). Improve the adjustment of medical service prices, increase government subsidy, reform of payment, strengthen hospital accounting and save running cost share of compensation mechanism. To carry out the relevant national medical service price adjusting policy, established on the basis of cost and income structure change of the medical service price dynamic adjustment mechanism, in accordance with the "total amount control, structural adjustment, mixed, gradually in place" principle, through different level medical institutions and medical service price comparison between relations. , structure, cohesion between according to "fly" the steps to straighten out the medical service price: through the centralized purchasing, health control, regulating the behavior of diagnosis and reduce the cost such as medicines and chemical reagents, equipment, consumables, strictly control the unreasonable inspection fees, make room for adjustment of medical service prices; Adjustment of medical service prices step by step, can not only adjust the price for cancel the drug addition part, adjustment part according to the rules in medical insurance to pay limits; To strengthen the medical service price, payment, medical fee, classification of diagnosis and treatment policies such as cohesion, as a whole to ensure the sustainable development of medical institutions, medical insurance fund can withstand, generally do not increase the burden. Public hospital reform pilot city to carry out medical service price adjustment, to take the lead in implementing comprehensive reform pilot provinces. (health and family planning commission, national development and reform commission, human resources, social security, ministry of finance, bureau of traditional Chinese medicine, respectively responsible for)

(5) improve public hospital management system. Develop guidance document of modern hospital management system, the implementation of public hospital personnel management, internal distribution, such as operation management autonomy. Pilot cities to establish and improve the comprehensive performance evaluation index system of public hospital, the introduction of a third party to carry out the performance evaluation. Promote the realization of professionalization and specialization, establishment of training certification, term target responsibility appraisal and the corresponding mechanisms of incentive and constraint. Strengthen the financial budget management, comprehensive budget management in public hospitals to promote the tertiary public hospital to carry out the system of chief accountant. (health and family planning commission, human resources, social security, public sector, the ministry of finance, the ministry of education, administration of traditional Chinese medicine)

We will deepen reform of the preparation of the personnel system (6). Existing in place within the total amount, total sensible organization for approval to carry out the comprehensive reform of public hospitals. Measures for the management of innovation management mode, perfect preparation for the record, step by step to prepare the records. Where the conditions are ripe to explore trial preparation of management reform of public hospitals will be carried out. In the post setting, income distribution, title evaluation, management, use, etc., to prepare the treatment of internal and external personnel to plan as a whole to consider. In accordance with the regulations of the state, promote the reform of endowment insurance system. We will further improve the employment system, post management system and the system of open recruitment. For the shortage of hospital, high-level personnel, can be in accordance with the provisions, shall be hiring by hospital take the way of investigation, the results made public. (public, human resources, social security, health and family planning commission, the ministry of finance is responsible for respectively, bureau of traditional Chinese medicine)

(7) to speed up the establishment conforms to the characteristics of the medical and health industry salary system. Efforts to improve the reform of public hospital salary system in groups, make greater efforts to explore, summarize experience in a timely manner. Encourage pilot cities to explore for public hospital performance salary amount for approval, the establishment and responsibility, work performance, closely linked to the actual contribution of allocation of incentive mechanism, strive to manifest the value of medical personnel technical services, standardize the order of income distribution, gradually increase the medical staff income treatment, arouse the enthusiasm of the medical staff. The dean of the public hospital performance salary is decided by government agencies. Set revenue target is strictly forbidden to medical staff, medical staff shall be compensation and the hospital drugs, materials, inspection, testing and other business income. (human resources social security, ministry of finance, health and family planning commission is responsible for)

(eight) strict control unreasonable medical expenses growth. Promote implementation of health and family planning commission and other departments concerning the control of public hospital medical expense unreasonable growth of several opinions of the provinces, autonomous regions and municipalities according to different regional medical level and the growth rate and the cost of the different categories of hospital function positioning, classified control requirements and dynamic adjustment. Set the national medical expenses growth control goals. Around the end of June 2016, according to the actual reasonable and quantify regional medical expenses. Strengthen the supervision and inspection on a regular basis to the provinces, autonomous regions and municipalities directly under the medical expense control is the ranking of the public. Public hospital reform pilot cities to list the specific listing, such as auxiliary, nutritional, and the price is unreasonable drug usage implement key monitoring, preliminary control unreasonable medical expenses growth momentum. (health and family planning commission, national development and reform commission, human resources, social security, ministry of finance, bureau of traditional Chinese medicine, the local people's governments at various levels are responsible for)

Public hospital of traditional Chinese medicine (nine) synchronization and promote comprehensive reform. Detailed implementation of TCM hospital investment preferential policy, formulate the implementation of differentiation of price adjustment, performance appraisal, such as policy, establish maintenance public welfare, highlight the characteristics of TCM advantages of public hospital operation mechanism of traditional Chinese medicine. To strengthen clinical pathway applied to guide scientific and rational adjustment of traditional Chinese medicine medical service price around. (bureau of traditional Chinese medicine, health and family planning commission, the ministry of finance, human resources, social security and national development and reform commission is responsible for)

(10) to improve the medical service. In various medical institutions at all levels to further implement the action plan to improve medical services focus on diagnosis and treatment, and an appointment in ambulatory surgery, settlement, information push service, pharmaceutical service, emergency first aid, such as high quality nursing work, the full implementation of appointment of the third class hospitals and treatment, improve the medical service level, improve medical experience, enhance people's feeling. Comprehensive reform pilot provinces take the lead in urban tertiary hospital pilot to promote ambulatory surgery, constantly expanding the scope of the ambulatory surgery diseases. Implement health poverty alleviation projects, ensuring the poor will have access to basic medical and health services. Establish and improve the prevention of medical dispute mediation mechanism, both doctors shall protect the lawful rights and interests, efforts to build a harmonious doctor-patient relationship. (health and family planning commission, the administration of traditional Chinese medicine, China disabled persons' federation to participate in)

(11) for eligible public hospital medical staff to provide public housing safeguard nearby, the specific conditions and measures shall be formulated by the people's governments at or above the county level. (housing urban and rural development and national development and reform commission, ministry of finance, the ministry of land and resources, health and family planning commission is responsible for)

Second, we will speed up the establishment of a classification system of diagnosis and treatment

(a) pilot implementation speed up grading diagnosis and treatment. According to "first option at the grass-roots level, two-way referral, acute slow partition, the upper and lower linkage" requirements, to comprehensive reform pilot provinces and public hospital comprehensive reform pilot cities as the key point, accelerate the classification diagnosis and treatment, carry out pilot in about 70% of the cities. Pilot areas to high blood pressure, diabetes patients with standardized diagnosis and treatment and GuanLiLv above 30%. (health and family planning commission, human resources and social security bureau of traditional Chinese medicine, test district people's government shall be responsible for, the China disabled persons' federation to participate in)

(2) to expand family doctor signing service. Promoting summarizes place to promote family doctor sign contracts mature experience, formulate policy document on sound contract signing and management, establish and perfect the system of general practitioners. In 200 public hospital comprehensive reform pilot cities for signing the family doctor service, actively carry out pilot encourage other conditional area. Signing by the end of 2016, the city family doctor service coverage rate of 15% or more, key crowd signing service coverage rate of 30% or more. Clear sign service connotation and standard, the standard contract service charges, perfect the contract service incentive constraint mechanism. Signing service expense of medical insurance fund, for the basic public health service, and individual citizens share the signing. (health and family planning commission, human resources and social security, ministry of finance, national development and reform commission of traditional Chinese medicine administration, China disabled persons' federation to participate in)

(3) improve service capability at the local level. Continue to strengthen the ability construction of grassroots medical institutions and hospitals at the county level, outer surrounding county, higher rates of disease, to strengthen the appropriate technical promotion and improving the capacity of county-level hospitals disease diagnosis and treatment. Least encouraging urban secondary hospitals to grassroots health institutions more practice. To accelerate the grassroots and rural health resources flow. To further improve the basic medical and health institutions merit pay system, can be approved in accordance with regulations of the financial system in balance of payments to extract the worker welfare funds and rewards. Implement the basic medical and health institutions approved verification tasks, balance of payments, performance evaluation measures for the financial management of subsidies to strengthen the performance appraisal and take effective measures, both to mobilize the enthusiasm of the grassroots medical institutions and medical personnel, and to prevent the emergence of new profit behavior. (health and family planning commission, national development and reform commission, ministry of finance, human resources, social security, ministry of science and technology, administration of traditional Chinese medicine)

(4) improve the supporting policies. Exploring a variety of division of labor, including medical association, counterpart support cooperative mode, improve and standardize the city and county of the construction of the medical association in policy measures. Improve the level of different medical institutions differentiation to pay for health care policy, appropriate opened for different level medical institutions starting line and the proportion of pay gap, explore grassroots health institutions on a per head pay package, a chronic disease in patients with medical institutions to carry out the function orientation, rational selection form effective incentive to guide medical institutions. To develop common grade of cancer, coronary heart disease and cerebrovascular disease diagnosis and pathology of independent setting, inspection institution related technical documents, images, hemodialysis, clear common ChuRuYuan standards and two-way referral specifications, to carry out the second level 3 general hospital function orientation, clear standard medical service ability. Drive slow partition. New 50 disease clinical pathway and revising, expand the clinical path coverage, improve the quality of management. For more than 80% of the country's all tertiary hospitals, secondary hospitals in clinical pathway management. (health and family planning commission, human resources, social security, administration of traditional Chinese medicine)

Three, consolidate the perfect universal health care system

(a) establish a stable and sustainable financing and guarantee for level adjustment mechanism. Rate steady at more than 95% of the basic medical insurance, urban and rural residents health care per capita government allowances to 420 yuan, per capita individual pay cost increases accordingly. New financing is mainly used to improve the basic medical security level, and enhance the support to the urban and rural residents a serious illness insurance. Urban and rural residents health policy within the scope of hospitalization expense ratio stable at around 75%. Combined with the medical insurance fund budget management comprehensively advancing paid the total amount control. Speed up to establish stable and sustainable financing and reimbursement of insurance of primary medical treatment to proportion adjustment mechanism. Actively promote the basic medical insurance plan as a whole level up to the municipal, encourage conditional region implement provincial plan as a whole. Accelerate the basic medical insurance network and long-distance medical settlement work throughout the country, set up perfect national different ground settlement platform, gradually with the provinces, the long-distance medical billing system to realize a butt joint basic implementation across the province relocated retiree hospitalization expense settlement directly. By 2017, the basic implementation meet the requirements of referral long-distance medical hospitalization expense settlement directly. Promote the basic medical insurance and maternity insurance related work on the implementation of merger. Research to improve worker health insurance personal accounts. (human resources social security, health and family planning commission, ministry of finance is responsible for)

(2) promote the integration of urban and rural residents basic medical insurance system. According to the national overall arrangement, the end of June 2016, the provinces (autonomous regions and municipalities) to complete the plan as a whole to promote the overall deployment of integration of urban and rural residents health care system work. Each year as a whole the area to a concrete implementation plan and organize their implementation. Straighten out the management system of encourage conditional area. Orgnaization of innovation management, improve the efficiency of management and service level. Support has the qualification of the commercial insurance institutions and other social forces to participate in local orgnaization of basic health care services. (reform of the state council office, human resources, social security, health and family planning commission, the provinces (autonomous regions and municipalities) people's government is responsible for, respectively, circ),

(3) strengthen improve the system of the urban and rural residents a serious illness insurance and medical treatment. Realizing a complete coverage of a serious illness insurance, let more burden on patients with serious illness. A serious illness insurance policy, including inputting, five guarantees tent card's poor and low object, such as urban and rural poverty population has skewed pay policy, expand benefited range, improve the level of benefits. Encourage the provinces, autonomous regions and municipalities directly under the scope of reasonable compliance with the actual medical expenses, further easing the burden on patients with serious illness, conditional region with a serious illness insurance provincial plan as a whole. Standardize the orgnaization of business of a serious illness insurance, strengthen the supervision and inspection and examination evaluation, implement to undertake the responsibility. The central government allocated 16 billion yuan for urban and rural medical treatment subsidy funds. Overall shift and disease medical treatment, and actively guide social forces to participate in medical treatment. Improve the basic medical insurance, serious illness insurance, medical treatment, disease, emergency rescue, commercial health insurance policy effective connection and charity relief. Improve disease emergency rescue system, guide the local standard to carry out their work. Perfecting the insurance of worker complement medical treatment measures. Organization to carry out multi-level, many forms of mutual aid activities of worker medical treatment. (reform of the state council office, human resources, social security, health and family planning commission, the ministry of civil affairs, insurance regulatory commission, the ministry of finance is responsible for respectively, the national federation of trade unions, the China disabled persons' federation to participate in)

(4) to further deepen the reform of the medical insurance payment. To formulate policy measures to deepen the reform of the medical insurance payment, accelerate reform of the mode of payment, control the medical expense unreasonable growth. Promoting local successful experience, promote the capitation payment system, pay according to macro-reforms, according to a bed day, or total in advance, and other methods of combining the compound payment reform. Step by step to extend health supervision of medical institutions services to the regulation of medical staff medical services. Support the operation in the daytime, and so on. (human resources, social security, health and family planning commission, ministry of finance shall be responsible for the bureau of traditional Chinese medicine)

(5) promote the development of commercial health insurance. To guide the insurance industry to strengthen product innovation, rich health insurance products, improve service levels. To carry out the health insurance of personal income tax preferential policies, perfecting the pilot plan optimization. Changes to the measures for the administration of health insurance, a sound system of health insurance related regulation, standardize the order of the commercial health insurance market. (circ, human resources, social security, ministry of finance, health and family planning commission is responsible for)

Fourth, improve the drug supply security mechanism

(a) strengthen improve the system of basic drugs. Study basic drugs directory, production, marking, price, distribution, equipped with using unified work, carrying out a policy to encourage local leading to carry out the exploration. Study children basic drugs appropriate dosage forms, specifications, strengthen basic clinical drug application and prescription set training, intensify assistance to poor areas pharmacy practice. Promote the quality of generic drugs and curative effect evaluation consistency, to do a good job of basic drugs all varieties to sample. Continue to strengthen the adverse drug reactions monitoring of national essential drug varieties, drug safety information to the community in a timely manner. To conduct special inspection, flight check, and other forms of supervision and inspection, existing in the process of drug production, management, violation behavior, to initiate an investigation. Increase HIV/AIDS and other special drug supply free of charge. Proceed with the safeguard basic drugs in the elderly. (health and family planning commission, ministry of finance, national development and reform commission, ministry of science and technology, ministry of industry and information technology, food and drug supervision bureau, bureau of traditional Chinese medicine, respectively responsible for)

(2) promoting public hospital drug centralized purchasing. Continue to implement the state council general office on perfecting public hospital drug centralized procurement guidelines "(countries do hair [2015] no. 7), a classification of procurement, dosage form for each drug purchase, in principle, shall not exceed 3 kinds, each corresponding specifications in principle no more than two kinds of dosage forms. Promote local experience, to encourage and guide the provincial cross-regional joint procurement, in the comprehensive reform pilot provinces can encourage certain regional belt joint procurement. Optimization of drug distribution order, compression of circulation, comprehensive reform pilot provinces throughout the province to carry out "two votes" (production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice) of medical institutions, actively encourage public hospital comprehensive reform pilot cities to implement the "two votes", encourage hospital and pharmaceutical production enterprise direct settlement drugs and drug production and distribution enterprise settlement distribution costs, the compression of the intermediate links, reduce prices artificially high. Review of our efforts to evaluate national drug price negotiations, and gradually increase the number of drug varieties, reasonable price reduce the patent drugs and exclusive rights to produce drugs. To sum up the experiences of places and perfect policies and measures to further promote high value medical consumables centralized purchasing, online trading, etc. Comprehensive reform pilot provinces to choose area to develop high value medical consumables centralized purchasing, the first breakthrough. To further improve the national drug supply security integrated management information platform and the provincial drug centralized purchasing platform standardization construction, improve the drug purchase data sharing mechanism. (health and family planning commission, the food and drug supervision administration and national development and reform commission, ministry of industry and information technology, human resources, social security, the ministry of commerce, comprehensive reform pilot province people's government shall be responsible for)

(3) improve the drug price formation mechanism. We will further improve the drug price formation mechanism. Strengthen drug price behavior oversight, improve the drug price monitoring system, investigate price fraud and monopoly behavior in accordance with the law, to safeguard pharmaceuticals market price order. According to the relevant national policy requirements, to carry out the basic pay medicare drug formulation of the standard. Take many forms to promote medical separate, ban hospital limit prescription outflows, patients can choose in hospital outpatient pharmacy or on prescription to retail pharmacy to buy medicine. , health and family planning commission (national development and reform commission, human resources, social security, respectively responsible for)

(4) to build the new order for producing and distributing medicines. Further improve drug production quality management rules and drug management quality management standard system such as policy, and strictly supervise the implementation. Pharmaceutical trading enterprises access strictly, standardize the order of drug circulation. To crack down on drug distribution in violation behavior, prevent and contain drugs, medical devices and consumable purchase the abuses and corruption. For retail pharmacies classification grading management, encourage the development of chain pharmacies, organization of medical institutions and drug prescribing information, health care and settlement information retail sales information sharing, promote medicine apart. (respectively responsible for the food and drug supervision bureau, the ministry of commerce, human resources and social security, health and family planning commission, the ministry of industry and information technology)

(5) improve the ability of drug supply security. Strengthen the drug supply security and shortage of early warning, set up many departments in consultation with the linkage mechanism, by provinces, autonomous regions and municipalities directly under the unit selection for a number of hospitals and shortage of grassroots medical institutions as drug monitoring, improve the shortage of drug information submitted to the system. Established, with emphasis on the basic drugs, the synthetic evaluation system of clinical medication. Promote the establishment of normal shortage pharmaceutical reserve system. Four varieties of fixed-point production has been completed, organize public medical institutions in accordance with the provisions from the designated production enterprise procurement, supply situation of the bidding enterprise production monitoring, timely solve the problems. Expanding the scope of the pilot varieties designated production, about five new varieties. Support the construction of small variety production base. Strengthen scientific and technological innovation, the implementation guidance to promote the development of medical equipment and medical industry in China policy. Accelerate the independent innovation and industrialization of major new drugs, accelerate the localization and the brand development of medical equipment. We will deepen reform of the drug review of medical equipment examination and approval system. Further open children, the elderly and other special groups the preparation and rare diseases, clinical need drug approval review of the specialized channels, speed up the registration review progress. Build system of production and distribution enterprises interview, focus on improving rural and remote areas and drug distribution management level, improve the shortage of drug distribution management. (health and family planning commission, the ministry of industry and information technology, food and drug supervision administration and national development and reform commission, ministry of science and technology is responsible for)

(6) set up a special working group, the research designed to deepen the reform of the drug approval for examination and approval system, perfect the pharmaceutical production, circulation, use policy file, focus on solving the problem of drug should standardize the order of production and circulation. To strengthen the department cooperation, support to establish perfect information system, strengthen the different information systems. To strengthen the drug quality supervision, establish the ex-factory price of start information traceability system, related price information to offer price, health, family planning, industry and information technology, health care management, and other departments. Promote the establishment of pharmaceutical factory price information traceability system, "two votes" and medical staff incentive mechanism between the linkage mechanism, such as comprehensive ShiCe lower drug prices artificially high. , promote the circulation of pharmaceutical production enterprise integration, standardize the order of drug circulation. (food and drug supervision bureau, the ministry of industry and information technology, national development and reform commission, ministry of finance, the ministry of commerce, health, family planning, administration of traditional Chinese medicine)

(7) for deepening the reform of the medicine circulation field. (health and family planning commission, the ministry of commerce, food and drug supervision administration is responsible for)

Five, establish and improve the comprehensive regulatory system

(a) improve the medical supervision legal system. Positive change of government functions, further improve the comprehensive supervision mechanism. Strengthen the regulation of things afterwards, organize regular supervision inspection. Strengthen the supervision of medical quality and strengthen the medical service charges and the price supervision and inspection. (health and family planning commission, the legislative affairs office, food and drug supervision administration and national development and reform commission, the administration of traditional Chinese medicine)

(2) to establish medical institutions of medical expenses and other information disclosure mechanism. Strengthen health the industry regulatory region, all medical institutions into the local family planning administrative department of public health of unified planning, unified regulation. (responsible for health and family planning commission, bureau of traditional Chinese medicine)

(3) strengthen the health care industry supervision and law enforcement and severely crack down on all forms of illegal practice medicine, investigate violation behavior, promote credit system construction of medical industry, to promote all kinds of medical institutions in accordance with the practice. (health and family planning commission, food and drug supervision administration, administration of traditional Chinese medicine)

Sixth, strengthen the construction of health personnel

(a) continued to strengthen, with emphasis on the general practitioner, grassroots health personnel training. Perfect rural order directional free medical students' employment, performance management, and other related policy. We will continue to do a free medical undergraduate enrollment training, plans to recruit 5000 free medical undergraduates. (health and family planning commission, the ministry of education, ministry of finance, administration of traditional Chinese medicine, human resources and social security ministry participation)

(2) the comprehensive implementation resident standardization training. New standardized training of resident doctors, 70000, 190000 people in total. To strengthen the connotation of resident standardization training base construction and dynamic management, further in the third party assessment, strict enforcement of exit mechanism. Pilot training specialist standardization system. (health and family planning commission, ministry of finance, national development and reform commission, Chinese medicine administration, human resources and social security ministry participation)

(3) support conditional medical colleges to strengthen the pediatric, mental medicine, midwifery, shortage of professional personnel training, etc. To promote pediatric medical personnel training, colleges and universities recruit students properly to the pediatric resident standardization training professional tilt and some theory guilds for a county to pediatricians job-transfer training, increase the gp pediatric professional skills training and other measures, to strengthen the construction of pediatric medical staff team. According to the number of graduates and post demand, 5000 pediatric resident standardization training. Geriatric medicine, rehabilitation and health management specialized talents training, etc. High-level medical talent training mechanism innovation. (health and family planning commission, the ministry of education, ministry of finance, bureau of traditional Chinese medicine, China disabled persons' federation are responsible for)

(4) the provinces (autonomous regions and municipalities) shall establish perfect health professional and technical personnel titles at the grass-roots level review of the detailed rules for the implementation. (the provinces (autonomous regions and municipalities) people's government, responsible for human resources social security, health and family planning commission)

(5) to continue to carry out the gp AD hoc positions and pilot. To carry out the construction of rural doctors major policy measures in the implementation of the supervision and inspection, promoting policy implementation. Start the pilot village general examination of assistant practicing doctors' qualifications. To strengthen the hospital's professional training. We will continue to inheritance and innovation of traditional Chinese medicine talent project. (health and family planning commission, human resources, social security, ministry of finance, bureau of traditional Chinese medicine, a pilot region people's government shall be responsible for)

Seven, solid improve the system of equal basic public health services

(a) basic public health services spending per capita fiscal subsidy standard up to 45 yuan. To optimize the existing services, expand service coverage. (ministry of finance, health and family planning commission, the administration of traditional Chinese medicine)

(2) perfect collaboration mechanism, the implementation of major public health institutions of grassroots medical institutions to implement the management of the basic public health services and guidance. Strengthen the project performance evaluation, perfecting examination methods, to strengthen the county district inspection, implementation of the assessment results and funds disbursed. Strengthen project progress monitoring and evaluation work, improve the project management and payment of funds, according to the service quantity and quality of transferring funds. For basic public health services in the integrated supervision evaluation for the project implementation. (responsible for health and family planning commission, ministry of finance, bureau of traditional Chinese medicine)

(3) strengthen the health promotion work, develop to strengthen health promotion and education work of the guidance document. We will continue to implement the important public health service projects, such as maternal and child health action plan. To further strengthen the comprehensive prevention and treatment of birth defects, we will continue to implement the national free pregnancy eugenics health check program. Start the implementation of the floating population health promotion action plan, promoting the floating population basic public health work to ensure equal access to family planning services. Provide from check-ups, pregnancy check to cover such as maternal health care, child care bears the whole process of basic health care services. (health and family planning commission, bureau of traditional Chinese medicine, China disabled persons' federation are responsible for)

(4) promote the family planning service integration with women's and children's institutions. (health and family planning commission, the public sector is responsible for)

Eight, to promote health informatization construction

(a) to plan as a whole to promote national, provincial, city and county population health information platform construction, speed up the construction of public health, family planning, health services, health care, medicine, management, integrated management and other business application information system and realize the connectivity. Promote the implementation of electronic health records and electronic medical records continuous recording as well as between different levels, different categories of medical institution authorized the use of information. (traditional Chinese medicine health and family planning commission, national development and reform commission, ministry of finance, administration, ministry of industry and information technology, network communication office, bureau of statistics)

(2) of the selected areas and areas with appropriate conditions leading to promote health care pilot big data applications. Integration of health management and health information resources, and promote diagnosis and treatment, online payment, online booking and follow-up inspection results online query service, actively develop the remote medical treatment, disease management, pharmacy practice and other business applications. Strengthening clinical data application development work. (traditional Chinese medicine health and family planning commission, national development and reform commission, ministry of finance, administration, ministry of industry and information technology, network communication office, bureau of statistics)

(3) choose part of the province (city) to carry out the medical institutions and physicians, nurses, electronic certification pilot work. (health and family planning commission, bureau of traditional Chinese medicine, the pilot provinces (city) people's government shall be responsible for)

Nine, speed up the development of health services

(a) pays special attention to the social medical policy implementation, to carry out "issued by the general office of the state council on promoting social do medical several policies and measures to speed up the development of notice (countries do hair [2015] no. 45) to carry out the situation of supervision. (national development and reform commission, responsible for health and family planning commission, ministry of commerce, bureau of traditional Chinese medicine)

(2) practitioners more steady progress and specification, to speed up the transformation government function, to broaden the conditions, simplify procedures, optimize the environment of physicians more practice policies, play the "catfish effect", activating mechanism of choose and employ persons. Encourage physicians to grass-roots, and other remote areas, medical resources are scarce area needs more practice of medical institutions, promoting form a pattern of hierarchical diagnosis and treatment. Practitioners and first place in medical institutions, on the basis of consensus, sign a contract of employment (labor), clear personnel (labor) relations and the rights and obligations, and attend social insurance in accordance with the relevant provisions of the state. The first site medical institutions shall support practicing doctors more practice and improve the internal management. Pilot open public hospital serving or retired more than attending physician practice or to basic medical and health institution to open studio. (traditional Chinese medicine health and family planning commission, administration, human resources and social security ministry participation)

(3) the implementation of the state council concerning the strategic plan for development of Chinese medicine (2016-2030) of circular (guo fa [2016] no. 15) and issued by the state council general office on traditional Chinese medicine health service development plan (2015-2020) notice (countries do hair [2015] no. 32), the positive development of traditional Chinese medicine and the folk medicines of ethnic minorities to develop the traditional Chinese medicine health services. (bureau of traditional Chinese medicine, health and family planning commission, national development and reform commission is responsible for)

(4) the implementation of the "state council on forwarding health and family planning commission and other departments of promoting health and pension service combined guidance notice (countries do hair [2015] no. 84), establish and improve the medical and health institutions and pension institutions cooperation mechanism, promote the traditional Chinese medicine combined with pension services. Encourage a combined with institutions run by social forces and geriatric rehabilitation, aged care and other professional medical institutions. Promote health service extending to the community, and family. (health and family planning commission, the ministry of civil affairs, national development and reform commission, ministry of finance, human resources, social security, traditional Chinese medicine administration, the ministry of commerce)

(5) perfect the policies and measures to actively promote the development of medical tourism. (responsible for health and family planning commission, bureau of traditional Chinese medicine)

Ten, strengthen to organize the implementation

(a) to establish and perfect the powerful health organization leadership system and working mechanism is advanced. Deepening health reform is a complicated system engineering, the current reform into the deep water area and GongJianQi, all localities and departments must set up the general situation consciousness, actively participate in and support the reform, comprehensive ShiCe, forming resultant force overcome difficult. To further strengthen organization and leadership, give full play to the leading group for reform of overall coordination function, support and encourage the establishment of medical, health care, medicine, unified management system. Implement the leadership responsibility, security responsibilities of government, management responsibility, supervision and responsibility. Establishing health reform should be brought into the evaluation of local government requirements such as constraint mechanism. Stick to the reform target, detailed work plan, strengthen the policy implementation, local governments at various levels, various departments responsibility clearly, timetable and roadmap, and tasks to carry out the reform policy. Intensify urged guidance, for lack of work or slow progress, strengthen the supervision and accountability. (health and family planning commission, the local people's governments at various levels is responsible for)

(2) further summarize the experiences of promoting comprehensive reform pilot provinces. Summary of perfect practice and experience of sanming city, fujian province reform in comprehensive reform pilot provinces such as anhui, fujian. Added a number of comprehensive reform pilot provinces, region linkage to promote comprehensive reform, further enhance reform integrity, systematic and collaborative. (health and family planning commission, ministry of finance, comprehensive reform pilot province people's government shall be responsible for)

(3) strengthen the health propaganda work and so on. Insist the right public opinion direction, intensify reform policy interpretation and positive publicity, timely questions, respond to social concerns, guide the populace to rational expectations and behavior. Timely summary to promote grassroots mature experience. The provinces (autonomous regions and municipalities) to combined with the actual, strengthen the experience summary, trying to extract can copy promotion of the reform of the mode. Strengthen the three major policy issues such as medical and public health linkage studies. Propulsion with medical science and technology, to further improve the national center for clinical medical research and major disease collaborative research network layout, strengthen the health science and technology support. (health and family planning commission, the central propaganda department, ministry of science and technology, the provinces (autonomous regions and municipalities) people's government shall be responsible for)

Attachment: some key task division of labor and schedule

The attachment

Some key task division of labor and schedule

The serial number

Work task

Lead the department

schedule

1

"Much starker choices-and graver consequences-in" health reform plans

Reform of the state council office

Completed by the end of June 2016

2

Start expanding public hospital comprehensive reform pilot cities and new provincial comprehensive reform pilot

Reform of the state council office

In 2016, completed before the end of may

3

Develop a guiding document for modern hospital management system

Health and family planning commission

Completed before the end of September 2016

4

To formulate policy measures to deepen the reform of the medical insurance payment

Human resources and social security, health and family planning commission, the ministry of finance

Completed by the end of June 2016

5

The revised measures for the administration of health insurance

circ

Completed before the end of October 2016

6

To make sound family doctor contract signing and management policy document

Reform of the state council office

Completed before the end of October 2016

7

Improve and standardize the city and county in medical policies and measures for the construction of a consortium

Health and family planning commission

Completed before the end of September 2016

8

Study designed to deepen the reform of the drug approval for examination and approval system as the key point, improve the pharmaceutical production, circulation, use policy documents

The food and drug supervision administration and national development and reform commission, ministry of industry and information technology, health and family planning commission, the ministry of commerce

Completed before the end of December 2016

9

To formulate policy measures to improve the drug supply security mechanism

Health and family planning commission

Completed before the end of October 2016