Health of Beijingers on the Mend
Beijing issued the “Healthy Beijing 2030” Outline, putting forward a strategy for building a healthy Beijing over the next ten years and beyond.
On September 7, 2017, Beijing issued the “Healthy Beijing 2030” Outline (the Outline), putting forward a strategy for building a healthy Beijing over the next ten years and beyond. The Outline sets 28 major indicators to carry out a national health promotion campaign, optimise comprehensive health services, improve a national health insurance system, build a harmonious, liveable and healthy environment, diversify the health industry, and promote coordinated development of health in the Beijing-tianjin-hebei region. According to the Outline, the modern hygiene and health system fit for Beijing as a world- class harmonious and liveable city will be built by 2030. At that time, Beijing will become the healthiest area in China.
Promoting National Health
According to the Outline, the national health promotion campaign includes five parts, namely health literacy promotion action, national fitness popularisation action, mental health promotion action, smoke-free environment promotion action and major disease prevention and control action.
To promote health literacy, the Outline proposes to improve the national health education system, strengthen health education for adolescents and children, and popularise a healthy lifestyle. For improving the national health education system, Beijing will include the promotion of residents’ health literacy into long-term planning for national economic and social development, implement national health literacy promotion planning, establish municipal and district-level professional health education institutions, improve health education network, and strengthen standardised management. For strengthening the health education for adolescents and children, Beijing will include health education into the national education system, focus on primary and secondary schools, establish health education promotion mechanism at schools, include health education into teachers’ pre-service and on-the-job training, cultivate full-time and part-time health education teaching staff, strengthen health education organisation and management in schools, establish a home-school cooperation model for primary and secondary school students’ health management, and extend school health education to families. For popularising a healthy lifestyle, Beijing will implement the national nutrition planning, deepen the “three reduces and three healthy (reduce oil, salt and sugar; healthy weight, bones and mouth cavity)” action, establish and improve the nutrition monitoring system for residents, strengthen the training of health volunteers and give full play to them, and strengthen the guidance and intervention for healthy lifestyles of family and high-risk individuals. It is estimated that residents’ health literacy level will exceed 45 percent by 2030, and per capita daily intakes of salt and edible oil will continue to decline.
To popularise national fitness, Beijing will encourage and support utilising idle resources to transform and build national fitness facilities, implement the national fitness programme, vigorously carry out winter sports, and release guidelines for sports and fitness. The city will establish an exercise prescription library for different people, environments and physical conditions, to take advantage of national fitness in health promotion and the prevention and treatment of chronic diseases, and to promote the disease control and health service model integrating both sports and medicine.
To promote mental health , Beijing will guide the public to care about mental health, strengthen mass mental health promotion and mental disorders prevention awareness, strengthen early detection, diagnosis and treatment for common mental disorders and behaviors like depression, anxiety and child’s autism, and encourage social workers to participate in mental health services. It is estimated that by 2030, more than 85 percent of the medical institutions above Grade II will set up clinical psychotherapy departments; more than 70 percent of the patients with severe mental disorders will accept community rehabilitation services; and the treatment rate of schizophrenia will exceed 85 percent.
To build a smoke-free environment, Beijing will further strengthen the current smoke-free Beijing plan, raise public awareness of tobacco hazards and legal consciousness, set standardised smoking cessation clinics, and promote a smoking cessation system. It is estimated that by 2030, smoking cessation services with Beijing characteristics will form, which integrates professional smoking cessation clinic, smoking cessation hotline and simple clinically smoking cessation intervention, so that the adult smoking rate will be controlled within 17 percent.
To implement major disease prevention and control, the Outline proposes to implement comprehensive prevention and control of chronic diseases, strengthen prevention and treatment of infectious diseases, and strengthen the source treatment of major anthropozoonoses. It is estimated that by
2030, the risk factors for chronic diseases will be effectively controlled; the standardised treatment and management rate of hypertension and diabetes in communities will reach 85 percent; the five-year survival rate of cancer patients will increase by 15 percent; the premature death rate of major chronic diseases will be less than 9.9 percent; municipal immunisation planning will reach the level of developed countries; and major infectious diseases will be kept at a stable state.
Optimising Health Services
The Outline also proposes to implement a series of initiatives to optimise the health services for pregnant and lying-in women, infants, adolescents, youth, the middle-aged, the elderly and the disabled, while further optimising family planning services.
To this end, Beijing will improve the maternal and child health service system integrating basic health care institutions, maternal and child health care institutions, comprehensive medical institutions, specialised women and children hospitals and related research and teaching institutions, to promote the construction of baby friendly hospitals and communities. The city will strengthen pediatric and neonatal construction, build an orderly and efficient treatment network for severe illness of newborns, enhance the treatment capacity for severe illness, establish and improve the youth health service system, monitor the health of primary and secondary school students, strengthen the nutrition and health work at schools, and implement nutrition intervention. It will carry out regular physical examination, occupational health examination and occupational protection, build sports platforms for workers, and regularly carry out physical monitoring work. Beijing will also carry out mental health care services for the elderly, strengthen health guidance and comprehensive intervention for common diseases and chronic diseases, and advance health care for the elderly. As for optimising health services for the disabled, the city will develop a disability prevention plan, carry out comprehensive disability prevention, establish a social disability prevention and control system, improve reporting on child disabilities, and carry out early monitoring, treatment and intervention for children with disabilities.
Family planning is part of the national policy. The Outline proposes to reform family planning service management, build a family development policy framework with themes of fertility support, child care, youth development, elderly support and health care. At the same time, Beijing will continue to govern the newborn sex ratio, promote population structure and quality, and equalise family planning services for a transient population.
Perfecting the National Health Insurance System
According to the Outline, the Beijing Municipal Government will perfect the medical and health service system, medical insurance and security system and the pharmaceutical supply security system.
For perfecting the medical and health service system, the Beijing Municipal Government will build the medical service system in a rational layout, complete functions and a well- designed structure. The scale of beds in medical institutions in six urban districts will be controlled, and a high-level medical and health service system will be established in the urban sub- centre. Efforts will be made to enhance the supply- end structural reform of the medical and health service through setting up the hierarchical diagnosis and treatment, promoting the family doctor signing service, to form a reasonable medical service order featuring initial diagnosis at primary medical institution, two-way referral, linkage between low and high-level hospitals, and separate treatment of serious and minor diseases, as well as encourage social funds to provide related services. To raise the level and quality of medical service,
a group of regional medical centres and State-level key clinical specialised clusters will be built, and a citywide medical quality management and control information platform will be completed. Clinical pathways will be implemented, a prevention and settlement system of medical disputes will be improved, and humanistic care will be enhanced through medical service. To raise traditional Chinese medicine ( TCM) service, a municipal-level TCM medical centre, a specialised (special disease) diagnosis centre and a group consultation centre will be set up; the cooperation of the TCM and western medicine will be conducted to cope with major diseases.
For perfecting the medical insurance and security system, the Beijing Municipal Government will unify urban and rural residents’ basic medical insurance systems, set up a dynamic adjustment mechanism in which insurance contributions are linked to residents’ income, with the security level gradually raised, security coverage enlarged, and personal payment slowly reduced. Modes of insurance payment will be reformed, and the cross-region settlement of medical diagnosis and treatment will be promoted, involving migrant residents in Beijing and Beijing citizens working in other places considering the household registration system and the reform of residence permit policies. Enterprises and individuals will be encouraged to buy commercial health insurances and other supplementary insurances; commercial insurance companies will be supported to cooperate with medical, physical examination and nursing institutions to develop new health management organisations.
For perfecting pharmaceutical supply security system, drug and medical apparatus producers will be spurred on for more input in R&D to enhance product quality. These producers will be encouraged to extend their service upstream and downstream in the supply chain, innovate circulation modes, and reduce intermediate links of drug procurement. The government will use basic drugs in a wider range, give the priority to using basic drugs, enhance the pricing supervision over drugs with lower degree of marketing competition and high-value medical consumables, and perfect drug price monitoring and information disclosure system.
Building a Harmonious, Liveable and Healthy Environment
According to the Outline, building a harmonious, liveable and healthy environment mainly include carrying out a public health campaign, creating a green and liveable ecological environment, and building a safe and harmonious social environment.
In terms of conducting a public health campaign, the government will push forward urban-rural environmental sanitation, adopt grid-based management in sanitary areas, and enhance the environmental and health infrastructure in rural areas including sanitary toilets. A healthy city proper and villages / towns will be first built to implement a “healthy cell” programme and to shape a sound pattern integrating urban and rural areas. The government will perfect the comprehensive system of vector prevention and control, apply 100 percent of its grid-based management to the system, improve its vector supervision network, and regulate and develop the market-based service for vector prevention and control.
To create a green and liveable ecological environment, measures will be taken including comprehensive treatment of environmental pollution, guaranteeing safe water supply, constructing green landscape and leisure space, and improving city appearance and environment in urban-rural areas. It is expected in 2020 that the average content of atmospheric PM 2.5 (particulate matter that is 2.5 microns in diameter) falls to around 56 microns per cubic metre, and the ratio of days with AQI (air quality index) values no higher than 100 a year is 56 percent, with continuously improved air quality in 2030. By 2020, the safety sector of water supply in central Beijing and the urban subcentre will be 1.3 and then above 1.3 in 2030, with wastewater treatment efficiency reaching above 99 percent in 2020. The coverage rate of parks and greenbelts within a 500-metre radius in a built-up sanitary area will reach 85 percent in 2020, and in 2030, the per capita area of parks and greenbelts will be 16.8 square metres and the forest coverage rate will be no lower than 45 percent. The integrated collection and treatment of garbage in both rural and urban areas will be realised in 2030, with no differences in urban-rural environmental sanitation and the harmless treatment of domestic garbage being 99.8 percent.
In terms of building a safer social environment, efforts will be made to
improve urban food safety, and build a food logistics and distribution network in rational layout, which caters to people’s consumption demands and covers both urban and rural areas. The whole- course supervision and control of food production and processing, circulation and catering service will be enhanced. The GMT (Good Manufacturing Practice) and GSP (Good Supply Practice) will be rigidly implemented to enhance supervision over research and development, production, operation and use of drugs and medical apparatuses. A safety production mechanism coping with the capital’s socioeconomic development will be shaped to prevent and control occupational diseases and implement special treatment of occupational disease hazards. Road and traffic labels will be improved, road safety facilities will increase, traffic safety supervision and governance will be consolidated, and civilised travel will be advocated to reduce traffic accidents.
Diversifying the Health Industry
According to the Outline, diversifying the health industry contain supporting multiple forms of social running of medical institutions, giving impetus to innovative development of the health industry, and quickening integrated development of the health industry.
To support multiple forms of privately owned medical institutions, the government will support social funds to open nonprofit medical institutions, specialised medical institutions like obstetrics and paediatrics, and community-based health service institutions. Qualified individuals are encouraged to open clinics; privately funded medical institutions are supported to conduct medical research and continuing education projects. The government will also step up efforts to build a rehabilitation nursing service system, and spur social funds to build rehabilitation nursing institutions and to take part in transforming public hospitals into rehabilitation nursing institutions through trusteeship and cooperation.
To promote innovative development of the health industry, the government will lead physical examination organisations to run chain operation, support them to transform into health management institutions to promote physical examinations and health management service development. The State- and municipal level special scientific and technological projects will be used to support the R&D and industrialisation of innovative drugs, medical apparatuses and orthotics, as well as new biomedical materials. Efforts will be made to promote the high-end development of biomedicine, medical apparatuses and related industries, advance the construction and development of Zhongguancun Life Science Park, Daxing Biomedicine Industrial Base and Beijing Yizhuang Biomedical Park, in which medicine, teaching, research, provisional care for the elderly and rehabilitation are integrated, in a bid to create world-leading medical parks, the health industry with strong international competitiveness and demonstration zones for medical service.
To quicken integrated development of the health industry, the government will support the development of primary sports organisations, encourage them to host amateur sports competitions, and build a group of outdoor fitness and leisure bases with regional characteristics. The healthcare tourism industries will be integrated, with projects featuring healthy tourism. Support will be given to enlarge cooperation with overseas medical insurance institutions, develop the enterprises integrating health and culture to innovate health culture communication.
Promoting the Coordinated Development of Health
The coordinated development of the Beijing-tianjin-hebei region imposes new requirements for the construction of “Healthy Beijing.” According to the Outline, the government will optimise the layout of medical health resources for the region, strengthen public health cooperation, and link medical service with social security. A disease prevention and control integrated cooperation platform will be built, and a joint prevention and control mechanism for major epidemics and public health emergencies will be improved.
For optimising medical health resources for the region, Beijing-based medical institutions will work with peer institutions in Tianjin and Hebei to open branches, set up new medical institutions, cooperate among specialised departments, and build regional medical centres. Various exchanges in medical technologies, management and academic knowledge will be carried out to help foster advantageous departments in Tianjin and Hebei. To consolidate public health cooperation in the BeijingTianjin-hebei region, the three places will enhance the joint prevention and control of major diseases, cooperate in the public health and in maternal and child health care, for example, setting up a regional communication and cooperation platform of maternal and children health service organs, as well as build a health performance evaluation system. A referral system among the three places will be improved; the system of physicians’ multi-sited license and the mobility of medical talents will be advocated. The cooperative construction and pairingassistance will be enhanced, tele-medicine will be greatly promoted, the management measures for basic medical insurances will be perfected, and a regional liaison drug supply system will be set up. Besides, the three places will better the coordinated health security mechanism to enable the interconnection of the people’s health information platforms and share the big data on medical and health care. A Beijing-tianjinHebei medical research and technological innovation centre will be explored.
Today, “Healthy Beijing” is widely accepted by the public, with an improved development environment, hygiene and health security system perfected and health level of residents stably on the rise. In the future, Beijing will uphold its principals of “health first, governmental leadership, deepened reform and innovative development,” and pay equal attention to public welfare and fairness in health service, and maintain and guarantee people’s health.
Practising Tai Chi at the Temple of Heaven
A nurse tending to an infant