The Predicament And Countermeasure Of The Village Clinics

The village clinic is the most basic unit of the rural three-tier health networks.It undertakes the task of providing basic medical care and public health service, which plays an extremely important role in medical services in rural areas.Taking four village clinics at H town of Nantong city as case study and by means of field observation and semi-structured interview with rural doctors, villagers and the leaders of village clinics, the paper discusses the realization of the function of village clinics, structural-functionalism frame of reference, and tries to give some policy recommendations to help village clinics get out of predicament.The findings show that functions realization of the village clinics is inadequate.The village clinic plays an important role in the diagnosing and treating common diseases, and it can meet the demands of basic medical care of the villagers.But there are some deficiencies such as the poor medical equipment,high price and low levels of staff skills,which set up a great barrier to higher quality medical services for the villagers.Thus, the basic medical service function needs to be improved. Relatively, the public health service is even much weaker. It does not carry out properly, and it is poorly standardized. There are even some phenomenon of slacking and cheating.Most rural doctors focus on the medical care business, their initiative and enthusiasm on public health services is not high.There are two major factors that can affect the realization of expected functions of village clinics,which are the lack of resources and system integration.On one hand, the health resources of village clinics are seriously inadequate,which restricts the village clinics to carry out comprehensive and effective health services. On the other hand, from the system perspective, the management system is unreasonable.The village clinics are under the dual leadership of the township hospitals and public health centers, but there are conflicts in properties and objectives between the two. Out of the benefit, the public health service of village clinic is in a weak status. Besides, the incentive mechanism is inadequate. The rural doctors'salary is not directly proportional to their hard work. Thirdly, the lack of the control mechanism makes the service quality of the village clinics unstable. Fourthly, the related policies do not match well, the new rural cooperative medical system hasn't covered the village clinics, the essential medicine system has not been implemented and the evading risk mechanism has not been established.How can the village clinics get out of predicament? We should expedite the establishment of the village clinics based on the conception of coordinating urban-rural development, to achieve the goal that all people could enjoy public health service equally. Finally, the writer provides four suggestions.First, we must coordinate the medical and health care resources in urban and rural areas to increase resources in the village clinics.Improve the infrastructure of village clinics to create a good environment; establish talents training mechanism to improve the quality of rural doctors and increase the financial input into the village clinics, implement the essential medicine system as soon as possible.Secondly, reinforce the integration of system which is related to village clinics. We should nail down the public nature of village clinics. The village clinics and the township hospitals should be nationalized and the founds will be provided by the government, so that we can cut off the interest chain of the basic medical care. The new rural cooperative medical system should cover the village clinics into the system. And the risk evading mechanism should be established at appropriate time.Thirdly, creat and perfect the incentive mechanism for the rural doctors to promot their enthusiasm.Fourthly, establish the control mechanism to enhance the supervision to the village clinics.