北京公立医院试点权力运行分工制衡 Beijing public hospital pilot power operation and division of labor

　　理事会管决策，院长管执行 Council tube decision，Dean tube execution

　　医院管理局派驻监事负责监督 The hospital authority stationed supervisors responsible for supervision

　　【阅读提示】：在医院法人治理结构中，决策、执行、监督分工制衡：

【Reading tips】：In the hospital corporate governance structure，decision、execution、Supervision division of labor and：

　　理事会作为决策层，由社区居民、专家学者、法律界人士、新闻界人士等外部理事和医院内部理事组成，是医院最高权力机构；

The council as a decision-making，The community residents、Experts and scholars、Legal professionals、The press people external directors and hospital internal directors composition，Hospital is the highest authority；

　　执行院长由市医院管理局党委提出建议人选，并向医院理事会推荐，重在执行理事会的决策，主要研究考虑理事会决策的执行落实问题；

Executive director of the hospital authority by the municipal party committee for Suggestions，And to the hospital board recommended，The decision on executive board，The main research consider council decision execution implementation problems；

　　监事会将以派驻监事组的方式入驻医院，加强对医院决策层、执行层履职情况的检查，加大对医院规范运行的监督。

The board of supervisors will be accredited supervisors group way in hospital，To strengthen hospital management team、Directors resumption of the inspection，Strengthen the hospital standard operation of the supervision。

　　医院里谁说了算？以前是院长说了算，现在是理事会来决策。

The hospital who have the final say？Before the President have the final say，Now is the council to decision making。

　　这一变化缘于北京试点建立的以理事会为核心的医院法人治理结构。北京友谊医院、北京朝阳医院先行试点成立理事会。

This change resulting from Beijing to pilot the establishment of board of directors is the core of the hospital corporate governance structure。Beijing friendship hospital、Beijing chaoyang hospital first pilot establish council。

　　8月22日，在试点工作媒体通气会上，北京市医院管理局局长方来英说，这一改革试点举措是政府开放办医的探索尝试，主要是通过医院领导体制、管理模式、运行机制的变革，更好地实现政府办医为民的公益性目标。

August 22，In the trial work media ventilation meeting，Beijing hospital authority chief party to the said，The pilot reform measures is the government KaiFangBan medical exploration attempt，Mainly through the hospital leadership system、Management mode、Of the operation mechanism of transformation，Better achieve the goals of medical government public welfare。

　　

改变“院长一支笔”模式 change“Dean a pen”mode

　　

理事会成为核心决策层 The council become the core management team

　　封国生，北京朝阳医院原院长，他现在的身份是理事长，而理事会聘任的负责执行院长是陈勇。医院法人治理运行机制改革试点，将医院的决策、执行、监督权力分割，分工制衡，彻底改变以往“院长一支笔”的医院运行模式。

Seal countries born，Beijing chaoyang hospital of the former director，Now he is the identity of chairman，And the executive director of the council is responsible for employment is Chen yong。Hospital corporate governance mechanism reform pilot，Will the hospital decision、execution、Supervisory authority division，Division of labor and，Thoroughly change in the past“Dean a pen”Hospital operation mode。

　　我国公立医院长期采取事业单位管理体制，用人编制均由财政核定，对内管理权高度集中于院长，被称为“一支笔”决策；对外在公共服务和经营业绩之间，医院往往更偏重经营业绩，自身发展目标优于社会服务。

Our country public hospitals to take long-term business unit management system，Employing prepare all by financial verification，Internal management heavily focused on the dean，called“A pen”decision；Foreign in public service and business performance between，Hospital tend to be more emphasis on business performance，Their own development goal is better than that of social services。

　　而推行法人结构治理之后，权力的行使者——理事会、执行院长、监事会都有明确的职责分工。其中，作为决策层，理事会是主体，是核心，是医院最高权力机构；而与传统院长负责制下集决策和执行于一身的院长不同，执行院长重在执行理事会的决策，主要研究理事会决策的执行落实问题；监事会将以派驻监事组的方式入驻医院，加强对医院决策层、执行层履职情况的检查，加大对医院规范运行的监督。

And the implementation of the legal person governance structure after，The exercise of power, the board of directors、Executive director of、The board of supervisors has a clear division of responsibilities。the，As a management team，Council is subject，Is the core，Hospital is the highest authority；And with the traditional part of responsibility system in the decision-making and implementation of a different，Executive director of the council's decision on execution，The main research council decision execution implementation problems；The board of supervisors will be accredited supervisors group way in hospital，To strengthen hospital management team、Directors resumption of the inspection，Strengthen the hospital standard operation of the supervision。

　　据介绍，传统院长负责制下院长的考核任用，均由市医院管理局直接进行。执行院长的任用，则是由市医院管理局党委提出建议人选，并向医院理事会推荐，由理事会按照有关规定聘任和解聘。执行院长也实行任期目标责任制，由理事会与执行院长签订任期目标责任书。理事会受市医管局委托，对执行院长实行年度和任期绩效考核，考核结果作为执行院长工作评价、薪酬确定和职务任免的重要依据。

According to introducing，The President responsibility system under the traditional long assessment employment，All the municipal hospital authority directly。The executive director of employment，The hospital authority is the municipal party committee for Suggestions，And to the hospital board recommended，By the council in accordance with the relevant regulations, appointment and dismissal。Executive director also implement term target responsibility system，By the council and executive director of a term target responsibility。The council entrusted by the city formed，To the executive director of the annual performance appraisal and term，The assessment results as executive director of job evaluation、The appointment and removal of the position and salary to determine the important basis。

　　方来英表示，理事会、执行院长、监事会都有明确的职责分工，在这个基础上各司其职，各负其责，避免了职责不清、分工不明而导致的混乱和效率低下。三方权力又是相互制衡密切结合在一起的，相互协调、相互配合。

Party to the said，council、Executive director of、The board of supervisors has a clear division of responsibilities，On this basis, each doing his own job，individual，To avoid the responsibility is not clear、Division of labor is unknown and cause confusion and low efficiency。Three party power checks and balances is closely together，coordination、And cooperate with each other。

　　

公众参与医院治理 Public participation in hospital management

　　

关门决策变公开决策 Close the door decision variable public decision-making

　　今年7月，51岁的朝阳区社区居民邢平芳成为北京首家试点法人治理医院——北京朝阳医院的外部理事。通过暗访，他在医院的首次理事会会议上提出，社区老人反映抽血化验要等很长时间，院方需改善就医环境。这一提案获医院理事会表决通过，决议增设采血化验室。

July，At the age of 51 chaoyang district community residents XingPingFang become Beijing first pilot corporate governance hospital - Beijing chaoyang hospital external directors。Through the investigations，In the hospital he first council came up at the meeting，Community elderly reflect exsanguinate assay to wait a long time，The hospital should be improved medical environment。The proposal was hospital council vote through，Resolution add draw blood laboratory。

　　截至目前，北京朝阳医院、北京友谊医院理事会已正式履职，北京儿童医院也将试点组建理事会。邢平芳表示，外部理事作为群众代言人参与医院决策并予以监督。自己代表近10万北京呼家楼地区居民诉求，通过暗访、居民沟通等形式提出建议。

So far，Beijing chaoyang hospital、Beijing friendship hospital council has officially resumption，Beijing children's hospital will pilot a council。XingPingFang said，External directors as the spokesperson to participate in decision-making and hospital shall be supervised。His representative nearly 100000 Beijing residents in HuGuLou appeal，Through the investigations、Residents communication put forward the proposal form。

　　以组建后的北京朝阳医院理事会为例，7名理事中有4名来自医院外。北京友谊医院的9名理事中，有4名社区居民、病患代表担任外部理事，参与医院决策。两家医院的外部理事包括社区居民、专家学者、法律人士以及新闻界人士，均采取零薪酬任职。

To set up after the Beijing chaoyang hospital council as an example，The seven directors four from outside the hospital。Beijing friendship hospital nine among the directors，Four community residents、On behalf of the patients as external directors，Participate in hospital decision。Two hospitals external directors including community residents、Experts and scholars、Legal experts and journalists，All adopts zero salary office。

　　封国生说，医院理事会外部和内部理事的结构设置，兼顾了公立医院的公益性和医院发展的可持续性。外部理事参与医院决策，使医院决策对社会公众更具透明性。医院重大事件的决策从单纯医院内部人员参加的“关门决策”转变为社会各界人员参加的“公开决策”。

Seal countries student said，Hospital director of council of the structure of the internal and external Settings，Taking account of the public hospital public welfare and the sustainable development of the hospital。External directors participate in hospital decision，Make the hospital decision of social public more transparency。Hospital important events from the simple decision of hospital internal personnel to participate in“Closed decision”Into the social from all walks of life of persons to attend“Public decision”。

　　北京市友谊医院理事长刘建说：“理事会的决策职能，把‘行政导向’和‘专业导向’有机结合起来，能够代表社会各方利益。同时，通过各方利益代表的沟通，促进各种横向协作，进而形成医务人员、政府管理部门、广大患者和社会各界对医院建设的合力。”

Beijing friendship hospital director liu said：“The council's decision function，the‘Administrative guidance’and‘Professional guide’Organic combine，To represent the interests of society。At the same time，Through the interests of all parties represent communication，Promote all sorts of transverse cooperation，Then forms the medical staff、The government management departments、The majority of patients and the social from all walks of life to hospital construction force。”

　　方来英表示，成立理事会将带来决策立场的转变，综合考虑政府、群众、医院等各方利益，更为突出公益。据悉，社区居民理事通过医院和周边社区协商产生，并由医管局任命。

Party to the said，Establish council will bring the change of position decision，Comprehensive consideration of the government、masses、Hospital interests of all parties, etc，Is more outstanding public。It is reported，Community residents directors through the hospital and surrounding community consensus，And the hospital authority appointed。

　　

用约束机制保公益 Use restraint mechanism of the public welfare

　　

抑制过度经营冲动 Inhibiting excessive business impulse

　　法人治理结构能否抑制公立医院盲目做大做强的冲动，让老百姓看病更便利、更便宜？

Legal person governance structure can inhibit public hospital blind bigger and stronger impulse，Let people see a doctor more convenient、cheaper？

　　复旦大学经济学院教授张晖明认为，公益医院实施法人治理，最大的意义在于政府对所办医院建立评价体系、约束机制，通过法人行为规范保证公益性。医院本身可兼具公益和市场特征，但问题在于：现有公益职能存在巨大缺口的同时，市场发育却非常成熟，甚至过度膨胀。

Fudan university school of economics professor ZhangHuiMing think，Implementation of public hospital corporate governance，The biggest significance lies in the government work to hospital to establish evaluation system、Constraint mechanism，Through the legal person code of conduct ensure public welfare。The hospital itself can be both public and market characteristics，But the problem is that：There is a huge gap existing public functions at the same time，Market development is very mature，Even excessive expansion。

　　为加强对所办医院的运营规范，北京市已出台了考核办法。在北京“市属医院年度绩效考核办法”中，患者满意度、人次(例)均费用、抗菌药物使用、医疗纠纷情况等已被纳为关键指标。连续两年不合格，医院院长和党委书记将被免职。

In order to strengthen the work of hospital operation specification，Beijing has already issued a assessment method。In Beijing“Using annual performance evaluation way to hospital”in，Patient satisfaction、people(An example)All expenses、Antibacterial drug use、The medical dispute case etc have been accept as the key indicators。Two consecutive years not qualified，The hospital deans and secretary of the party committee will be removed。

　　北京市医院管理局副局长毛羽表示，公立医院绩效考核的重心在于保证公益性。从下月起，北京市医院管理局将陆续向试点医院派驻监事。监事将从具有医院管理经验的专家中产生，同样不从医院领取薪酬，并将定期在不同公立医院轮换任职，担负监督职责。

Beijing hospital authority deputy director hairiness said，Public hospital performance evaluation of the center of gravity is to ensure public welfare。From next month，Beijing hospital authority will have to pilot the hospital accredited supervisors。Supervisors will have from hospital management experience from experts，Also don't get salaries from the hospital，And will regularly in different public hospital in rotation，Supervision and responsibility for。

　　北京市医院管理局本着公开透明的原则，多渠道多角度完善公立医院监督机制，还将建立总会计师制度，向医院委派总会计师；根据需要委托中介机构审计医院年度财务报告，维护政府出资人和患者合法权益；完善信息公开制度，主动接受社会监督，确保医院的发展运行更加规范有效。(王君平 杜 放)

Beijing hospital authority in line with the principle of transparency，Multi-channel public hospital from perfect supervision mechanism，Will also establish the chief accountant system，To the hospital appointed by the chief accountant；According to the need to entrust intermediary auditing hospital annual financial report，Maintain the government contributor and patient legal rights；Perfect the information disclosure system，Active accept social supervision，Ensure the development of hospital operation more standardized and effective。(WangJunPing du put)