Yuexiu District Procuratorate 25,000 words research report perspective medical supplies duty crime, medical intervention equipment rebate 15% to 20%
Release date: 2017-02-27
Medical intervention equipment rebates 15% to 20%, each medical film rebate 1.5 yuan ... Recently, Guangdong has investigated a number of cases of illegal profits from medical equipment and supplies.
Guangzhou Daily reporter recently learned that the Guangzhou Yuexiu District Procuratorate visited seven top three hospitals in Guangzhou within two months, issued 500 questionnaires and wrote a 25,000-word investigation report. The report looked at the problem of medical consumables crime.
Trend: the replacement of drugs in the field of equipment has become the hardest hit
In the case of job-related crimes in the medical and health field handled by the People's Procuratorate of Yuexiu District, before 2010, it mainly occurred in the purchase and sale of drugs. According to statistics, from 2006 to 2010, the hospital handled 13 cases of job-related crimes in the medical and health fields, 14 of which were 13 in the drug purchase and sales. Since 2013, the links involved have shifted, and the trend of job-related crimes in the medical and health fields has changed from the drug link to the medical consumables, especially in 2016.
Famous medical experts, academic leaders
In recent years, medical corruption has shown that the medical corruption personnel involved in the case have changed from the general to the “three highsâ€, that is, the administrative level is higher, the education is higher, and the professional influence is higher. The "three high" personnel generally have a relatively large social resources, and they are less constrained. They face greater temptation than ordinary people.
The conspiracy bribery crimes investigated by the People's Procuratorate of Yuexiu District are mainly concentrated in the cardiovascular department. The doctors involved are often engaged in administrative management, medical care, education and scientific research.
For the sake of mutual disclosure, "husband" corruption
The case shows that in recent years, individual corruption in the medical and health field has been decreasing year by year, and it has been replaced by collective corruption. For example, Zhang, a director of a hospital's cardiology department, together with the subordinates of the department, accepts the consumables rebate: First, Zhang and the consumables agent negotiate the rebate ratio, and then the deputy director is responsible for regularly contacting the other party to collect the rebate. The other two departments The attending physician participates in the division. In order to play the role of mutual supervision and mutual disclosure, Bian and the two attending physicians drove to the place of payment agreed with the briber and participated in the specific collection process. The whole department became a corrupt community.
Reason: The rebate rules come from huge profits? "Do not take white, don't take it"
The report believes that profiteering is the root cause of corruption. Hospitals, like patients, are also victims of the high price of medical consumables, opaque ex-factory prices, and multi-layered agent sales models. It is precisely because of the huge profit margins of medical consumables that medical consumables agents have enough money to bribe relevant medical personnel.
Many doctors have learned that even if they do not take the agent's rebate, the price of medical consumables will not be reduced, and the middle profits will all be monopolized by the agents, resulting in a mentality of "do not take white and not take". For a long time, the treatment of doctors and the unequal pay of labor have made many doctors unable to refuse when they face “kickbacksâ€.
Subject leader has too much power to supervise
Excessive power and too little supervision are important causes of crime. In the case investigated by the Yuexiu District Procuratorate, the bribery link is not an admission entry that is generally considered to be a crime, but a daily use. The doctor involved is also the chief administrative officer of the department and the chief doctor. He is generally the academic leader of the hospital in this field. In the same operation, he has the right to talk about which manufacturer and which type of consumables to use. Due to the strong professionalism of consumables, the director of the hospital trust department, other doctors within the department generally respect the director's opinion, and it is difficult for the supervisory department to intervene in the use management of consumables.
The gray area of ​​academic exchanges
According to the analysis of the research report, due to the low degree of commercialization of medical science activities, the doctor's academic activities have no formal and sufficient financial support, which has led to the strange exchange of academic funds support through private exchanges with agents. On the other hand, doctors participating in academic conferences often generate tuition and travel expenses. For doctors who have just stepped out of school at the age of 28, there is also a lot of pressure from individuals.
Low crime costs make agents have no fear
The research report also compiled the judgment of the briber. Since 2010, Guangzhou Yuexiu District People's Procuratorate has investigated 58 cases of 58 cases of job-related crimes in the medical and health field, including 31 cases of bribery, of which 9 of the 15 cases of bribery have been sentenced. Lightly not prosecuted, 5 5 people were sentenced to probation, and only 1 person was sentenced to substantive punishment. Generally speaking, in the case of duty crimes, the handling of bribers is relatively light. For many agents, the cost of illegal crimes is low, and it is also an important reason for them to arbitrarily and bribe and seek interest space.
"Pharmaceutical side": strengthen the occupational protection of doctors, and compress the malformed profits of medical consumables
In response to the complicated causes of medical consumables duty crimes, the research report issued a “pharmaceutical prescription†of 8,500 words, calling for strengthening doctors' occupational protection and establishing a salary system that reflects the value of doctors. At the same time, scientifically constructing a medical consumable price mechanism, compressing deformed profits, and strengthening procurement and Supervision of the use process.
The report suggests that a salary system should be established based on the characteristics of doctors' education time, training time, labor time, labor intensity, occupational risk, and technical content, so that the salary is decoupled from the income of hospitals and doctors. At the same time, the price of technical services will be increased, and the charges for medical consumables will be reduced, so that “medical treatment with medicine†and “medical treatment with consumables†will be transformed into “medical trainingâ€, so that the hospital can return from the commercial operation mode to the public welfare operation mode. .
In terms of consumables, the report proposes to reduce the intermediate agent link, disclose the price information of medical consumables, and strengthen the supervision of sales prices. At the same time, online procurement, unified procurement, and monitoring continue to the use of consumables. The report emphasizes that the selection of consumables should be carried out by multiple departments and personnel in the hospital, reducing the leadership of the hospital and the director of the department. By setting the specific technical parameters of the consumables, the “tailor-made†bidding for the bribers The tendency to bid for the phenomenon.
Source: Guangzhou Daily
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