中共中央、国务院关于卫生改革与发展的决定 DECISION OF THE CENTRAL COMMITTEE OF THE COMMUNIST PARTY OF CHINA AND THE STATE

rowth of medical cost.

　　Medical institutions and medical personnel who play an important role in doing a good job of medic are system reform for workers and staff members should actively participate in the reform， treat patients according to their ailments， conduct rational examinations， prescribe medicine rationally so as to curb waste. Meanwhile， the government should， in real earnest， solve the problem of compensation for medical institutions.

　　During the “Nineth Five-Year Plan” period， social medical insurance system for urban workers and staff members shall basically be set up on the basis of successful experiments and summing up experiences， and actively develop supplementary medical insurance in diverse forms.

　　（7）Reform public health management system. Departments of public health administration at all levels shall transform their functions and strengthen public health administration by applying laws and regulations， policies， plans and guidances， information services and economic means.

　　Rationally allocate and fully exploit existing public health resources to raise the rate of exploitation of public health resources. Regional public health planning is an important means of the government in the macro regulation and control of the development of the cause of public health. Its goal is to satisfy the requirements of all residents in a region in basic health service and it practises unified planning and rational allocation of such public health resources as the medical institutions， hospital beds， personnel， equipment and funds. Municipal（prefectural） governments shall， in accordance with the guiding principles and standards for public health resources allocation for regional public health planning formulated by the Central People's Government and the provincial people's governments， work out Regional public health plans of the localities and organize their implementation. Departments of public health administration shall， in accordance with the regional public health plans， conduct policy guidance， organize coordination and carry out supe

rvision and inspection with regard to the development of public health in their respective regions； adjustments should be made step by step with regard to existing public health resources， and new additions to public health resources shall be subjected to strict examination and approval and management.

　　Public health institutions of enterprises which are an important component part of public health resources， should actively explore and realize step by step socialization of public health institutions of enterprises in the light of the actual conditions in the process of deepening enterprise reform.

　　（8）Reform urban health service system， actively develop community health service and form step by step health service networks with rational functions and convenient for the masses. Grass-roots level public health institutions should target at the communities and families， carry out prevention of diseases， diagnosis and treatment of commonly encounted diseases and frequently encounted diseases， recovery of the injured and disabled， health education， planned parenthood technical service and health care for women， children， the elderly and the disabled. Community medical service should be integrated into medical insurance for workers and staff members and two-way diagnosis transfer system established. Medical personnel should be diverted in a planned way and medical personnel in society organized in setting up health service networks in residential areas which should be integrated into the community health service system.

　　Major urban hospitals shall mainly engage in the diagnosis and treatment of emergent and serious cases and suspected and difficult cases， carry out medical education and scientific research in combination with clinical practice， continuously raise the level of medical science and technology. They should also develop suitable techniques， provide guidance and training for grass-roots medical personnel.

　　Social groups and individuals shall practise self-operations in running medical institutions and be responsible for profits and losses. The government shall actively provide guidance and examine and approve such institutions according to law and carry out strict supervision and administration.

　　（9）Reform the operational mechanism of public health institutions. Public health institutions should establish an operational mechanism which is responsible and with incentives， restraints， competition and vitality by way of reform and strict management.

　　Public health institutions shall practise and perfect the responsibility system of the president of the hospital（director of the institute or station）。The independent operational and managerial powers of public health institutions shall be further enlarged. Continue to deepen the reform of the personnel system and distribution system， break egalitarianism by employing correct policy guidance， ideological education and economic means to mobilize the enthusiasm of the broad masses of public health workers.

　　Accelerate formulation of standards for the establishment of public health institutions and authorized size of personnel， standardize financial input for public health institutions， reform and perfect the price system of health service. Adjust the revenue structure of medical institutions， reduce the proportion of income accrued from medicine in the revenue of medical institutions， rationally control the range of growth of medical expenses and there shall be separate accounting and separate management of medical revenue and expenditure and medicinal revenue and expenditure.

　　Under the prerequisite of guaranteed completion of basic health service， medical institutions may engage in services related to their domain of profession， institutions of preventive health care may engage in suitable compensatory service to meet the social requirements of different tiers， and in the meantime， supervision and administ

ration should be reinforced.

　　III. STRENGTHEN PUBLIC HEALTH WORK IN THE RURAL AREAS FOR THE REALIZATION OF THE GOALS OF PRIMARY PUBLIC HEALTH AND HEALTH CARE PLAN

　　（10）Public health in the rural areas concerns the overall interests of the health of peasants and invigoration of rural economy to which Party committees and governments at all levels should pay close attention and take strong measures to strengthen it in good earnest.

　　Primary public health and health care plan has put forth the main tasks and goals for rural public health work indifferent regions by the year 2000. Implementation of the primary public health and health care plan is the key in doing a good job of rural public health work. Governments at all levels should integrate this work into the plan for national economic and social development and practise management by objectives to create necessary conditions for the building of well-to-do counties， xiangs（？） and villages.

　　（11）Actively， steadily and satisfactorily develop and perfect cooperative medical service. Cooperative medical service plays an important role in ensuring that peasants enjoy basic medical service， implementation of preventive health care tasks， and prevention of impoverishment caused by diseases. Establishment of cooperative medical service should abide by the principle of being run by local people with some state subsidies and voluntary participation. Individual input shall be the main source in fundraising with collective support and appropriate government support， raise peasants' awareness of self-health care and mutual assistance and mutual support and mobilize peasants to actively participate through propagation and education. The mode of cooperation， standards for fund-raising and percentage Of reimbursement shall be determined in the light of local conditions and insurance level raised step by step. Preventive health care compensatory system should continue as a form of cooperation. Scientific management and democratic supervision of cooperative medical service shall be enhanced to ensure that peasants reap actual benefits. Efforts should be made to establish cooperative medical service in various forms in most rural areas by the year 2000 and the extent of socialization increased step by step； where conditions are ripe， transition to social medical insurance can be effected step by step.

　　（12）Step up the building of rural public health organization and perfect the county-， xiang- and village-level health service networks. The scale and distribution of public health institutions shall be determined rationally and their structure and functions adjusted. County-level hospitals should be managed well in real earnest to upgrade their integrated services capabilities. Continue to step up the building of county-level epidemic prevention organs， maternal and infant health care institutions and rural and township health centers. Strive to realize in the main the goal of “one without and three matchings”， i.e.， without condemned houses and with matching houses， staff and equipment during the “Nineth Five-Year Plan” period. Rural and township health centers should do well preventive health care， make efforts to upgrade medical quality， and put the stress on strengthening the building of emergency and maternity wards. Village-level public health institutions shall mainly be run by collectives. Modes of operation and management of xiang and village public health institutions may be determined in the light of actual local conditions. Perfect channels of rural medical supplies to ensure safety and effectiveness of medicine.

　　（13）Consolidate and upgrade the ranks of rural basic health workers. Rationally solve the salary problem of r

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