China lays out bold plan to improve healthcareBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1877 (Published 09 April 2015) Cite this as: BMJ 2015;350:h1877
China’s State Council has laid out its five year plan for the healthcare system, with the aim of improving the ratio of healthcare workers to the population, expanding the private sector’s involvement in healthcare provision, and making greater use of technology to improve healthcare services.
The 2015 to 2020 plan, announced on 30 March, aims to increase China’s number of hospitals, so that there will be six hospital beds for every 1000 people, up from 4.55 beds per 1000 people in 2013. The plan also focuses on increasing the workforce, aiming for two primary care doctors and 3.14 nurses per 10 000 people, compared with the 2013 figures of 1.07 GPs and 2.05 nurses per 10 000 people. The current 1:1 ratio of doctors to nurses will be adjusted to 1:1.25, said a statement by the State Council.1
At the same time as expanding the healthcare sector, the State Council’s plan seeks to shift the government’s main role from health service provision (almost 90% of China’s hospitals are public) to “policy-making, overall planning and supervising, to make sure the medical system benefits the public, while the market will decide the distribution of medical resources,” the statement said. The plan states that 1.5 in every two beds per 1000 people should be provided by the private sector by 2020.
China’s healthcare market is estimated to grow to $1 trillion by 2020, up from $350bn (£230bn; €320bn) in 2011, said a 2012 report by the consulting firm McKinsey & Co.2 Furthermore, restrictions on foreign players’ involvement in China’s healthcare market will be scaled back, said the State Council, but it is unclear how the private sector will be encouraged to cater to the rural market. The new five year plan includes a commitment to improve the currently woeful provision of healthcare services in rural areas. Li Bin, head of the National Health and Family Planning Commission, told China’s official news agency Xinhua that, despite annual investment of ¥1bn (£109m; €149m; $161m) in training rural healthcare workers, the quality was still low.3
The plan for the coming five years also promotes greater use of information and communication technology, such as wearable devices to collect large volumes of data, mobile health services, and electronic medical records.
Cite this as: BMJ 2015;350:h1877
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