改革政府对公立医院的管理体制是公立医院改革的唯一出路

Reforming government management system for public hospitals,the only way out for the reform of public hospitals

公立医院改革作为医改一项重点工作已经进行了数年,实事求是地讲实际效果不尽人意,究其原因是改革未切中要害。笔者认为公立医院改革的关键是改革政府的管理体制。笔者从人、财、物三个方面具体解析了目前政府对公立医院管理体制中存在的问题,提出加快公立医院人事制度改革,政府将人事权下放给医院、改革职称评价体系;政府应当实事求是、客观地正视目前公立医院的现状与困境,根据地方经济发展状况、医院的类别、主要服务对象等因素施行不同的财政补贴政策;改革现行的药品、耗材的招标采购体制,减少中间流通环节;鼓励社会资本进入公立医院,用于基本建设、大型仪器设备更新等硬件设施的建设等具体改革建议。在借鉴经济体制改革成功经验的基础上,明确提出与经济体制改革一样,公立医院改革不是经济问题,而是政治问题,公立医院改革的突破口是改革政府对公立医院的管理体制,简政放权是公立医院改革的唯一出路。

The reform of public hospitals has been carried out as a key work of medical reform for several years. The reason is that reform has not hit the point.The author thinks that the key of public hospital reform is to reform the management system of the government.The author analyzed the problems existing in the current management system of public hospitals from three aspects:human,financial and material.The reform of the personnel system of public hospitals was put forward.The government delegated the personnel power to hospitals and reformed the professional title evaluation system.Government should be practical and realistic,objective to face up to the present situation of public hospital and dilemma,according to local economic development conditions,the category of the hospital,such factors as the main service object of different finance subsidy policy,and reform the current bidding and purchasing system for pharmaceuticals and consumables,reduce the intermediate circulation.We should encourage social capital to enter public hospitals for specific reform proposals,such as infrastructure construction,upgrading of large equipment and other hardware facilities.In the use of the economic system reform,on the basis of clearly put forward as well as the economic system reform,reform of public hospitals is not economic problems,political, the breach of the public hospital reform is to reform the government for public hospital management system,reduce the decentralization is the only way out of the reform of public hospitals.