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"school is about to start, and i found that i can't even afford the children's tuition. i have to borrow money from my parents. my emotions exploded at this time."

written by yan xiaoliu, guo xuemei

after the collective wage-demanding movement of medical staff at qingfeng first hospital in henan province attracted widespread media attention, the local county party committee and government have set up a "qingfeng first hospital problem investigation team" to enter the hospital and released a preliminary statement: the hospital is a private hospital. the investigation team will urge the hospital to actively deal with the situation reported by netizens and strive to safeguard the legitimate rights and interests of employees.

"there are several working groups in the hospital now. some are communicating with employees, mostly about salary issues, and others are discussing the hospital's future survival path." on september 2, liu cheng (anonymous), the hospital's chief physician in surgery, told "medical world".

liu cheng has worked at qingfeng first hospital for more than 20 years. he said that around 2022, the hospital began to default on medical staff salaries.

the leadership message board of "people's daily" has relevant records. in april and september 2023, qingfeng first hospital was repeatedly complained about for a long time in arrears of performance wages, etc. "qingfeng county party committee" and "county party committee and county government supervision bureau" responded to this successively.

liu cheng has also seen people sending messages to the mayor to "demand wages." "the superiors responded by urging the hospital to resolve the arrears as soon as possible." he told "medical world" that the hospital did make some efforts to pay the medical staff, including taking out loans from banks.

tian fang (anonymous), a pediatrician at the hospital, said that the hospital had also "raised funds" from department heads and senior doctors to pay their salaries, with interest rates slightly higher than banks. "it was not forced, and everyone participated voluntarily."

but liu cheng felt that the situation was getting worse.

tian fang told "medical world" that the hospital has not issued any performance bonuses since january this year, and the salary paid is very low. "i have been working for more than 20 years, and my salary is only more than 300 yuan." the same is true for liu cheng's income situation.

some medical staff also told the media that in order to stabilize the emotions of employees, the hospital only paid 1,000 yuan around august 25. liu cheng told "medical world" that this was true.

as for the reasons why the hospital is short of money, tian fang believes there are many reasons, "but it is not caused by just one reason."

for example, liu cheng, tian fang and others have felt that the number of patients seen has decreased significantly in recent years. also, after the implementation of the reform of the medical insurance payment method, hospitals and departments did not fully understand and master the rules, and were punished by the superior medical insurance department many times, which had a great impact.

in february this year, the hospital was ordered by the qingfeng county medical security bureau to return the medical insurance funds and was fined a total of more than 1.58 million yuan. in 2022, the hospital caused losses to the medical insurance funds due to split charges and over-restricted drug use, and the amount of illegal funds returned alone exceeded 4 million yuan.

"i think the biggest problem that has led the hospital to this point is that its operations and management have not kept up after the restructuring," said liu cheng.

on may 28, 2016, qingfeng county people's hospital held a ceremony to unveil the new hospital. hu chuanping, chairman of beijing dongjun hospital investment company, and zhou yu, vice chairman, attended the ceremony. image source: qingfeng.com

according to the official website, qingfeng first hospital was formerly qingfeng county people's hospital, which has 800 open beds, more than 300,000 outpatient visits per year, and more than 30,000 discharges per year. in may 1997, the hospital successfully established a "national grade ii class a general hospital", which was the only grade ii class a general hospital at the county level in puyang, henan at that time.

in 2014, the hospital was restructured from a public hospital to a private hospital. the social capital that took over promised to build a "star-level garden-style" tertiary hospital for qingfeng.

during the same period, the hospital purchased medical equipment such as gem ct, high-field mri, and digital subtraction angiography (dsa), and created many firsts: it was the first to use medical technologies such as interventional treatment and minimally invasive treatment, and it was the first among all county-level hospitals in the city to open an air emergency channel with henan provincial people's hospital.

in 2019, the hospital celebrated its 70th anniversary. puyang daily reported that the hospital's business had grown substantially, with social and employee satisfaction rates both above 98%. by then, the hospital had trained nine doctoral and master's degree students, becoming the hospital with the most graduate students in the county.

a former internal medicine doctor from the hospital told medical world that in the first few years after the reform, the hospital developed very well, and the monthly performance salary was 4,000 to 5,000 yuan, which was much higher than other medical institutions in the county. medical world found that the per capita disposable income of urban residents in qingfeng county was 17,172 yuan that year.

liu cheng also said that in those years, employees from other units in the county all wanted to work at qingfeng first hospital, and the original establishment could be abandoned.

but the good times did not last long, and qingfeng first hospital began to decline.

"first financial daily" quoted a health administration expert as saying that qingfeng first hospital will be responsible for its own profits and losses after being restructured into a private hospital. many private hospitals are designated medical insurance units, and medical insurance funds account for a large proportion of hospital income. in recent years, the use of medical insurance funds has been strictly regulated. if they are not used in a standardized manner, they will be decertified as medical insurance units or their use of medical insurance will be stopped, which will directly affect hospital income.

a more fatal blow may come from capital. according to a 2020 article in "county health", after social capital invested part of the funds, the capital chain broke, the original promise fell through, and the nearly 200 million yuan of construction funds for the new campus were transferred to the hospital. then, the social capital boss who took over the hospital got into trouble and criminal measures were taken, and the hospital was involved in the controversy. drug dealers and builders sued one after another, and their accounts were blocked... at the same time, because of the social medical status after the reform, the project funds within the system basically did not fall to the hospital.

in july this year, the secretary of the qingfeng county party committee of puyang city, henan province, responded to the "salary complaint" again on the "leaders' message board" of people's daily online and frankly stated that the original investor did not contribute enough money when the hospital was restructured, which caused the hospital to be heavily in debt, and business operations were difficult, making it difficult to carry out normal business...

"the key is management. it still has the operational thinking of a public hospital. the career status of many employees has not changed, and the institution has no efficiency advantage." liu cheng heard that the entire process and details of the hospital reform were complicated, the superiors lacked supervision of the investors, and the hospital employees did not participate in the supervision. all aspects of the fund operation were in chaos.

"many employees, especially those whose families have two people working in the hospital, are indeed living in difficulty. now that school is about to start, they find that they can't even afford their children's tuition and have to borrow money from their parents. their emotions explode at this time," said liu cheng.

on august 28, employees of qingfeng first hospital took to the streets to demand their wages. on the same day, the hospital issued an announcement stating that the hospital leaders had reported the current situation of the hospital to the qingfeng county party committee, the county government and the investors many times. the county government and the county health commission had interviewed the investors and sent letters to urge them to fulfill their promises as soon as possible. when the funds were insufficient to pay one month's performance bonus, the hospital leaders squeezed out some funds to pay 1,000 yuan to each employee (including leaders) to solve the urgent needs of the employees. the hospital is currently actively raising funds, and will pay the performance salary for january 2024 according to the new performance accounting method before the mid-autumn festival.

despite the difficulties, tian fang is still full of pride when talking about the hospital. "our hospital is still the largest in the county. whether it is the staff technology, environment, or comprehensive strength and quality, no other hospital in the county can compare with us."

this, too, may become a thing of the past.

according to qingfeng county's "2024 government work report", the county invested 503 million yuan to build a new county people's hospital to fill the gap in the county's public comprehensive hospital. a total of 280 million yuan has been allocated so far, and the main structure of the project has been "erupted".

"it is currently the largest livelihood project in our county." in january this year, zhao dan, deputy secretary of the county party committee and county magistrate, said when presiding over a project construction promotion meeting.