村卫生室建设中的政府责任研究

Study of government responsibility on village clinics construction

村卫生室作为农村三级医疗卫生网的"网底",是最贴近村民的医疗卫生机构。作者通过对北京市H区的实地研究,发现政府通过出台卫生政策开展村卫生室标准化建设、加强乡村医生从业管理、稳定乡村医生收入来源,落实对村卫生室的管理责任,使乡村医生更好承担村级公共卫生和常见病防治职能。然而,村卫生室所有制关系及乡村医生劳动关系不清晰、不同管理体制下的硬件配置差异与岗位职责趋同等问题,影响了政府对村卫生室管理责任的落实。政府需关注政策环境变化,适时进行村卫生室体制变革和机制并轨,建立县乡村贯通的职业发展机制,打破村卫生室建设瓶颈,实现农村居民"就近享有优质医疗卫生服务"的医改目标。

As the"bottom"of the rural three-level medical and health network,the village clinic is the closest medical and health institution to the villagers.Through field research on H District of Beijing,the author found that the government implemented the management responsibility of village clinics by issuing health policies to carry out the standardization construction,strengthened the practice management of village doctors,and stabilized the income source of rural doctors,so that village doctors could better assume the functions of village level public health and prevention and treatment of common diseases.However,the unclear ownership relationship of village clinics and the labor relationship of village doctors,the differences in hardware configuration and the convergence of post responsibilities under different management systems affected the government′s implementation of the management responsibility of village clinics.Therefore,it could be necessary to pay attention to the change of policy environment,timely reform and mechanism integration of village clinics,and establish a career development mechanism connecting counties and villages.The bottleneck in the construction of village clinics will be broken,and the goal of"quality medical and health services nearby"for rural residents will be realized.