公共卫生服务考核不透明 诊疗补助费用不到位 The public health service assessment opaque medical assistance cost does not reach the designated position

收入骤减 一些村医无奈改行 Income fell sharply some village doctor, but switching

　　一个多月来，村医汪洋为了讨要其所在的哈尔滨市阿城区新富村卫生所今年上半年的2826元一般诊疗费，在距离卫生所10里的蜚克图镇卫生院和距离70里的阿城区新型农村合作医疗管理办公室(以下简称“区农合办”)来回奔波。得到的答复却是“相关人不在”，或者是“正在走程序”等等。

More than a month,Wang Yang village doctor in order to beg for its place of Harbin city, new FuCun health clinic in the first half of this year the 2826 yuan general fee,In the distance health clinic in 10 abrod g diagram township health centers and distance in 70 the city, the new rural cooperative medical management office(Hereinafter referred to as"Area agriculture joint")rides.Get answer is"Related out of",or"Is go program", etc.

　　“我们干着同样的活儿，为什么其他村医能拿到钱，而我们一毛钱都拿不着？”汪洋每次在蜚克图镇卫生院都这样问院长。

"We do the same work,Why other village doctor can get money,And we can all take a dime?"Each time the ocean abrod g diagram township health centers are asking President.

　　与汪洋相比，阿城区和绥化市等地的其他村医也有抱怨，“像汪洋这样还算不错了，至少还拿到了公共卫生服务费。我们什么都没拿到。”

Compared with ocean,O city and suihua of other village doctor also have complain,"Like ocean so also is very good,At least also got the public health service charge.What we haven't got."

　　在全国普遍实施“乡村一体化”管理和基本药物制度背景下，中国青年报记者近日对黑龙江部分地区进行调查时发现，因为该项制度实施中存在各种难以预料的因素，部分村医收入较之前大幅度减少。由于各种补助费用没有及时到位，不少村医已无奈改行。一些留在岗位的村医在“观望”之际也时有怨言，为了维持收支平衡，一些地区造假、虚报等现象时有发生。

In the national common implementation"Rural integration"Management and essential drugs system background,The China youth daily reporter recently in heilongjiang parts of survey found,Because the system existing in the implementation of various uncertain factors,Part of the village doctor before income is greatly reduced.As a result of all sorts of subsidy costs not timely in place,A lot has changed but the village doctor.Some stay at jobs in village doctor"wait-and-see"It is often the complaints,In order to maintain balance,Some areas misconducts/The phenomenon such as false happen from time to tome.

村医之“惑” The village doctor"confused"

　　今年3月黑龙江省落实国家新医改政策，启动了“村级医改”工作。这项工作开始实施后，村级卫生所实行了基本药物制度，村医原本靠药品差价赚钱的利润空间不存在了，来自上级卫生部门的补助成为他们的主要收入来源。但政策执行中的一些纰漏让部分村医困惑：与补助费相挂钩的村医考核到底是啥标准？完成了相应服务，为何迟迟看不到包括一般诊疗费和公共卫生服务费在内的两项补助费下拨？按照政策要求垫款改建卫生所后，为何得不到补助，还要倒贴？

In march this year heilongjiang implement national new medical reform policy,launched"Village-level medical"work.The work began after implementation,Village-level health clinic practice the essential drugs system,Village doctor originally by drug spread the profits space does not exist,From the superior department of health subsidies as their main source of income.But some of the policy implementation bloomer make part of the village doctor confused:With the aid of the village doctor linked assessment what is standard?Completed the corresponding services,Why can see includes general fee and public health service charge, ropriating into two subsidy?In accordance with the policy requirements make advance reconstruction after clinic,Why not subsidies,Also DaoTie?

困惑一：怎么考核？ Confused a:How to assessment?

　　8月15日，蜚克图镇卫生院院长李某在会上宣布，该镇7个卫生所的一般诊疗费已经到位，还宣布了各卫生所的补助金额。这让汪洋等人欣慰，她至今依旧清楚地记得自己所在卫生所该得2826元。

August 15,,Abrod g diagram of township health centers at the meeting li mou announced,The town seven clinic general fee already in place,Also announced the selected the subsidy amount.It makes WangYangDeng people gratified,She still clearly remember their own health clinic this in 2826 yuan.

　　然而，她的兴奋并没有延续几天。发放补助那天，汪洋所在的新富村被告知，因为绩效考核不到60分，补助不予拨付。

however,Her excitement and didn't last for a few days.Issue subsidies that day,Wang Yang in the new FuCun was told,Because the performance appraisal less than 60 points,Subsidies will not be allocated.

　　“我们和其他几个所一样都是按照要求做的，为什么偏偏我们考核不及格？不及格是否就代表没干工作，就应不予拨付补助？”新富村和同样考核未及格的光明村的村医们满心疑问。

"We and several other is as that in accordance with the requirements,Why are we failed the examination?Don't pass the exam whether representative didn't work,You should not appropriate subsidies?"The new FuCun and also not passing the examination GuangMingCun village doctor with the question.

　　为了搞清楚上级是怎么考核的，汪洋与几名村医开始不断地去找镇卫生院和区农合办负责人。而每次得到的都是“要开会”、“在开会”、“电脑坏了，查询不了”这样的回复。

In order to make clear the superior is how assessment,Wang Yang and several village doctor began to constantly find township health centers and area agriculture joint person in charge.And every time get is"Will have a meeting"/"In a meeting"/"Computer crashed,Inquires the not"Such a reply.

　　汪洋一直在“讨说法”，希望得到一个透明的考核标准和明白的解释。到目前为止，汪洋只从区农合办要到一份字号为“哈阿合管发[2012]3号”的文件。该文件名为《关于印发2012年新农合门诊总额付费及一般诊疗费补偿方案》。文件规定：“按参合人口每人10元计算一般诊疗费总额，乡镇卫生院由区合管办对其实施基本药物、门诊统筹情况进行绩效考核；村卫生所由乡镇卫生院进行考核，并将考核结果上报区合管办，抽查认定后按比例下拨费用，即：考核分数100分者一般诊疗费100%拨付，每降低1分扣1%，考核分数低于60分不予拨付。”

Ocean has been"For saying",Hope to get a transparent assessment standards and understand explanation.So far,Ocean only from area agriculture joint to a name for"O ha close tube is sent [2012] no. 3"files.The file name[About print and distribute in 2012 new farming combined total outpatient service fees and general fee compensation scheme].documents:"According to the population of ginseng adds up to 10 yuan per person generally calculate the total fee,Township health center by the district joint tube to do the implementation of essential drugs/Outpatient service of overall performance evaluation;The village health clinic by township health center to examine,And will assess result report to area joint tube to do,Selective examination after that in proportion to stir cost,namely:Assessment score 100 points is generally allocated 100% fee,Each 1 minute button to reduce 1%,Assessment score less than 60 points will not be appropriate."

　　一次偶然的机会，汪洋跟同样是村医的同学孟阿娜谈起此事。孟阿娜所在的阿城区阿什河乡也同样有这份“文件”。但文件中关于相关内容的规定是：“分数100分者一般诊疗费100%拨付，每降低1分扣1%。”文件并没有“考核分数低于60分不予拨付”的相应表述。

A pure chance,With the same ocean is the village doctor students o meng's talk about this matter.Meng's o o in urban ASHLEY river township also have this"file".But in the documents about the provisions of the relevant content is:"Score 100 points is generally allocated 100% fee,Each 1 minute button to reduce 1%."File and no"Assessment score less than 60 points will not be appropriate"Corresponding expression.

　　中国青年报记者看到，两份文件都没有盖公章，只是汪洋的是“红头”，而孟阿娜手上的是文件复印件。区农合办一位负责人在电话里告诉记者，汪洋手上的文件才是真的。而孟阿娜手上的文件，在阿什河乡几乎所有的村医人手一份。村医们回忆说：“文件在乡里某次会议上宣读了。”

The China youth daily reporter saw,Two documents are not official seal,But the ocean is"red",And her hands, o meng is documents.Area agriculture jointly organized a person in charge told reporters on the phone,Wang Yang hand files is really.But o meng's hand files,In ASHLEY river township almost all the village doctor a hand.The village doctor recalls:"Files in a village meeting read out."

　　抛开考核未达60分应否得到补助不谈，汪洋还一直对自己为什么第一季度考核只得56分耿耿于怀。汪洋说，自己再三追问，镇卫生院表示再算算。

Despite assessment is not up to 60 points should get subsidies don't talk,Wang Yang had been telling yourself why the first quarter examination had to 56 points ourselves.Wang Yang said,Himself repeatedly ask,Township health centers to calculate said.

　　到底怎么考核的？汪洋如今也没得到明确答复，但第三季度镇卫生院告诉她得了94分。

What examination?Ocean now also didn't get a definite reply,But the third quarter township health centers tell she got 94 points.