The Information Office of Shanghai Municipality held a press conference today (July 24). Vice Mayor Weng Tiehui introduced the latest development of the “Opinions on Promoting the Quality Development of Health Service Industry and Accelerating the Construction of a First-Class Medical Center City”.

Director of the Shanghai Municipal Health & Family Planning Commission Wu Jinglei, vice director of the Shanghai Urban Planning and Land Resources Bureau Cen Fukang, Shanghai Food and Drug Administration vice director Chen Yaoshui, vice director of China Insurance Regulatory Commission Shanghai Bureau Wang Xiaodong, chief economist of Shanghai Development and Reform Commission Qin Liping, deputy director of the medical insurance department at the Shanghai Municipal Human Resources and Social Security Bureau Zhang Chao attended the conference and answered questions from the press.

"The 50 guidelines to promote healthcare services in Shanghai" is an implementation strategy following chairman Xi Jinping's blueprint of the "Healthy China 2030" as well as the decree released in 2013 regarding the "Several Opinions of the State Council on Promoting the Development of the Health Service Industry", and the circular that was put forward in 2017 to encourage the development of diverse private healthcare services.

It's also an important step for Shanghai to become a global financial center, a global economic center, a global trade center, a global shipping center and a global scientific and innovation center, as well as to promote Shanghai's position and reputation as a leader in shopping, service, manufacturing and cultural activities.

To formulate the 50 guidelines, Shanghai strives to further optimize the business environment by deepening the reform of administrative measures and loosen restrictions on new business applications, and to strengthen policy guidance and support to build a health service industry system with coordinated development of multiple entities to meet the various medical demands of consumers.

At the same time, efforts will be made to promote the industry integration, specialization and high-quality development of the health service industry, thereby accelerating the construction of Shanghai as an Asian medical center and further improving the development level and core competitiveness of Shanghai's health service.

According to the arrangements of the China Communist Party Shanghai Committee and the municipal government, the city started the drafting of the "50 guidelines to promote healthcare services in Shanghai " at the end of last year.

For more than half a year, the city has been adhering to problem-oriented, demand-oriented, and effect-oriented principles and has conducted in-depth research at the grassroots level, and has listened to opinions extensively from medical institutions, relevant enterprises, experts and scholars, representatives of the public, and relevant departments.

By focusing on the major concerns of industry players in the field of “big health” industry, the study proposed a series of substantive preferential policies and formulated specific measures to further deepen reform measures and simplified administration, decentralization and optimization of services.

After more than half a year of hard work, the 50 guidelines to promote healthcare services in Shanghai were finally formed, which have been submitted to the municipal party committee and the municipal government for review and approval, and will be announced and implemented shortly. This is also the first provincial health service industry development policy since China entered a new era of social and economic development.

The Opinions abbreviated as “50 guidelines of health service industry”, mainly involve four parts: general requirements, key areas, market system and policy support. Part one, on general requirements, the city has specified the guideline on formulating the Opinions, the development objective and the future industry structure, emphasized on the establishment of the innovation system of health science and technology, with talents being the core, institutions being the main body and market being the guide, as well as integration with production, research and medical treatment. Shanghai will encourage the setup of a number of high-standard and distinctive private hospitals and the construction of a high-quality health care service industry matching the city’s positioning of an“excellent global city” and has proposed a three-phase goal and task by 2035. Part two, on key areas, the city will focus on health care, health service and health insurance and specify the development orientations and supporting measures of the health industry. Part three, on market system, the city will establish an open and fair market system with strong support and strict supervision for health service industry, boost the construction of high-standard service platform, improve the supporting system of health science and technology, facilitate innovation of financial insurance service, promote rational consumption on health, deepen reforms on delegating, supervising and supporting. Part four, on policy support, the city will specify the safeguard mechanism for promoting the development of health service industry, reduce tax burden for institutions and enterprises with financial revenue, ensure the construction land for health service industry, promote the informational development of health service industry and enhance the advantage in talents.

During the drafting process of the“50 guidelines of health service industry,”based on Shanghai’s resources and strategic advantages and with an aim to promote the development and core competitiveness of the city’s health service industry, we have focused on several key areas to deepen the reform and innovation as well as to improve the supporting system.

I Focus on key areas and specify the new development orientation

Health service industry covers numerous supporting industries such as pharmaceutical, medical instruments, health products, fitness products and health insurance. Shanghai will focus on three key areas of health care, health service and health insurance to offer policy support.

As for health care, we will encourage the establishment of a number of international high-standard private medical institutions with characteristics, mainly guided by the market demand and based on the establishment of health care service cluster. For example, we will encourage social forces to set up branded specialty hospitals, support the development of distinctive clinics with doctors boasting brilliant medical skills. We will support the development of high-end, international and collective third party professional organizations specialized in medical examination, pathologic diagnosis and medical imaging. In particular, we will support the interactive development of public and private medical institutions, allow public hospitals to establish new non-profit medical organizations with social forces on the basis of planning and market demand. We will encourage the cooperation of the two parties in talents, management and technologies. We will encourage social forces to provide multilevel and diversified medical services to meet the public’s high-standard demand. We will encourage private medical institutions to participate in the establishment of joint medical system. We will encourage high-end private medical institutions to turn themselves into medical colleges and universities’ teaching bases and standardized training centers for resident doctors and diplomates.

As for health service, we will promote integrated development between health and Internet, tourism and senior care, as well as high-quality health management and services based on the development of information technology and covering the whole life cycle. For instance, with modern medical and information technologies, we should promote early screening to detect diseases, conduct basic assessment of health conditions among local residents, launch accurate prevention and control of tumor and communicable and infectious diseases; develop human assisted reproductive technology, reduce birth defect through the use of genetic detection technology and promote early screening to detect heraditary diseases for the newborns; boost the development of smart health services, promote the implementation of big data and artificial intelligence in a variety of fields including medical imaging, pathological analysis and computer aided diagnosis; and foster the development of a batch of renowned TCM health companies or chains boasting both mature technologies and good reputation as far as strict management on TCM-based health services remains in place.

As for health insurance, we will bring the resource integration function of commercial health insurance in the whole health service chain into full play, make health insurance a basic demand for people seeking medical and health services and promote an improved health service chain. For instance, we should encourage data exchange and sharing between commercial insurance companies and medical organizations, realize direct insurance claim of medical expense by the residents; encourage commercial health insurance to serve as brokerages for social medical insurance and play an active role in the control of medical insurance bills; develop health insurance products qualifying for preferential individual income tax (IIT) treatment, raise its public awareness and improve its coverage; continuously promote the purchase of commercial health insurance products through individual accounts and encourage development of supplementary commercial long term care insurance products.

With focuses on three major fields, efforts will be made in two specific areas:

First of all, a series of functional platforms and key projects will be established to serve as the carriers. For instance, focusing on the industry layout and combining regional resources and future positioning, we will promote the “5+X” master plan for health service industry parks (5 refer to Shanghai International Medical Zone, New Hongqiao International Medical Center, Jiading Accurate Medical and Health Service Zone, Putuo Taopu International Health Innovation Industry Park and Xuhui Fenglin Life and Health Industry Park; X refers to a couple of health and medical service clusters in Yangpu, Fengxian, Jinshan, Chongming, Songjiang, etc), and establish a batch of modern health service parks and bases with upgraded functions and distinguished characteristics. Focusing on health technologies, we will build six types of functional platforms including labs for key industry technologies, public service platforms for pharmaceutical and medical products, functional platforms for R&D and transformation for medical artificial intelligence, and open-for-sharing clinic test platforms, as well as establish the Yangtze River Delta regional rare disease diagnosis center, in an aim to build a government-backed, market-driven and profit-sharing operation model. Focusing on health insurance, we will actively prepare for the establishment of Shanghai Health Insurance Trading Center with the support of Shanghai Insurance Exchange, and create platforms designated for insurance product innovation, insurance claim services, etc, to further boost integrated development of commercial insurance, medical services and health management with a target to upgrade the city’s health and medical security, service and managment systems.

Second, Shanghai will further enhance its technology and set up a new batch of key clinical specialties. Shanghai is an important medical service highland in China. As a mega city with a total of 24.18 million permanent residents, high-quality health service development must be supported by high-level medical technologies. Last week, the National Health Commission held a press conference in Shanghai to introduce China's medical technology capabilities and medical quality improvement. The commission highly affirmed and publicized the city's heart, nerve, blood, pediatric and other top clinical specialties. Based on the situation above, Shanghai aims to become a world-leading city in the field of clinical specialties and further improve its level of medical service and core competitiveness. The city will invest 1.29 billion yuan during the three-year period from 2018 to 2020, and implement a new round of key specialties development through the Tengfei Plan. Leading specialties such as general surgery, neurology, urology, orthopedics, endocrinology and other specialties are expected to reach the world-leading level. Department of cardiology, obstetrics and gynecology, ophthalmology, oncology and other domestic specialties will maintain their positions as first-class specialties and further enhance international influence. The city will focus on sub-specialties such as spine surgery, hand surgery, birth defects, organ transplantation, the minimally invasive surgery and emerging and cross-specialties of clinical pharmacy. These sub-specialties are expected to be further developed to achieve steady growth. After a new round of development, Shanghai’s medical service level will be further enhanced. Shanghai’s key clinical specialties will be further improved across the country and worldwide.

II Adhere to policy guidance and improve the health service industry to support the new system

In order to promote the high-quality and sustainable development of the health service sector, Shanghai will further deepen the reform to establish a more open and transparent market access mechanism and an efficient and convenient service system. The city will take practical measures and seek practical results to meet the needs of all parties. A series of practical measures will be implemented to solve the difficulties of institutions and enterprises, meet the urgent needs of the society and further optimize the development environment of the health service sector. To be more specific:

On one hand, Shanghai will continue to deepen reform and innovation. The city will actively strive for the support of the National Health Commission and other ministries and commissions. The city will take the initiative of self-revolution and propose a series of breakthrough reform measures. For example, (1) Ease the planning restrictions. The city will first ease restrictions of 100 beds and above for those high-level social medical institutions, general clinics and Chinese medicine clinics; (2) Ease requirements. The city will improve the medical technology filing system, ease the hierarchy requirement of medical institutions and focus on reviewing the qualifications of doctors; (3) Relax the restrictions on employment. The city will support the registration of general practitioners to set up clinics and implement the filing system; (4) Relax the subject setting requirement. The city will expand the subject from one to four; (5) Promote the management model. Shanghai will promote the management model of large-scale medical equipment of Class B medical institutions in the China (Shanghai) Pilot Free Trade Zone to the entire city. (6) Simplify the approval process. Shanghai will further optimize the approval process for Sino-foreign joint ventures and cooperative medical institutions. All of the measures above will become leading practices in the country.

On the other hand, Shanghai should create effective policy focuses. On people’s concerns on finance, land and medical insurance, the city should introduce targeted policies for practical results. For example, on taxes, certified healthcare enterprises can enjoy policy support for high-tech companies with a corporate tax rate at 15 percent (compared with 25 percent for others); for the actual spending on employees’ educational training which is less than 8 percent of their salary, it can be exempted for taxation. On medical insurance, patients covered by social insurance can have fees of basic medical services charged by private medical institutions settled on the same standard with those of public hospitals, while the non-basic medical services should be covered by patients themselves. On human resources, the city will try to allow doctors to work in multiple sites, creating shared interests and standardizing their professional practices to usher doctors’ productivity and provide diversified medical services for the public, which is an all-win result. On land policies, commercial medical institutions can apply for land through signing agreements in accordance with the national rules; for existing land plots, they can be used for healthcare service industry through transformation development, transfer of surplus land and storage by the government.

Besides, the city will change the services mode to construct a complete and efficient medical system for closer interaction between the government and medical services providers. It can play a better role in offering support for medical organizations in areas including providing professional services, solutions to address actual problems and targeted trainings.

III Strict Supervision for a new mechanism of safety and order

The healthcare services industry is s very special and important sector related to life and health of the public. We have to innovate on supervision that adopts the strictest standards. The master plan is to achieve it through the approach of “policy + technology” for an all-around supervision system based on digital technology to maintain the market order of healthcare services.

Shanghai has a good foundation in the construction of a new-type supervision system, especially that for medical services. For example, the city is pushing forward CA (Certificate Authority) certificate for medical professionals. With digital identity verification, dynamic supervision for medical professionals during key practices can be realized. At the moment, Shanghai has chosen one district and five medical institutions for pilot operation, and it will be expanded across the city later. Also, Shanghai has established an information platform to answer people’s inquiries on medical services. It offers reliable information, helping to lift transparency and lead the public to reasonable decisions for medical services. The platform started a trial operation in April, and it has covered information of certificates and punishment of more than 4,000 medical institutions in the city.

On the exiting basis, Shanghai will make efforts in the following three aspects and make them priorities in the next step of works to further improve post-registration supervision system. First, the city will make efforts on strengthening joint supervision. With digital technology, Shanghai will establish a 5-in-1 supervision system integrating credit management, classified supervision, risk control, joint punishment and social supervision, to encourage information sharing among different government departments and create a joint supervision mechanism under the partnership of supervisors of health, medical insurance, industry and commerce, civil affairs, food and drug, quality and public security. Second, the city will make efforts on punishment in accordance with laws. It will improve the management of credit-based blacklist for unqualified medical institutions and doctors, while formulate an exit mechanism. For serious violation, medical institutions should be clamped down. Third, the city will make efforts on nurturing more professionals. By 2020, the city’s medical supervisors should reach 0.75 for every 10,000 permanent residents, and they should be equipped with supervision vehicles accordingly. Also, the training should be more professional. The city will take medical supervisors into the reform of public service classification, and focus on the nurturing of their sense of responsibility and professional skills to improve supervision and create a good environment for healthy development of the health services industry.