-The level of rural medical and health services in our county can meet the basic health care and medical needs of farmers. Recently, the Standing Committee of the County People's Congress set up an investigation team to investigate the rural medical and health situation in the county. After listening to the county government's report on the rural medical and health work in the county, the research team concentrated on hospitals and community medical and health service stations in Beidahu Town, Xiyang Town and Deng Chun Township, and conducted research on the level of primary health care enjoyed by farmers in the county, the basic medical needs of farmers and the construction of rural medical security system by holding symposiums and visiting farmers on the spot. Now report the investigation to the meeting of county people's congress directors: 1. Basic situation of rural medical and health care in the county * * There are 15 townships (districts) and 139 administrative villages in our county, with a total population of 404,400 people, including agricultural population of 3 1. 1.4 million people, per capita net income of farmers of 2,503 yuan and per capita health consumption. At present, there are 22 non-profit medical and health institutions organized by our county government, including county-level medical and health institutions 1 1 and township hospitals 1 1. * * * There are 58 social medical institutions and 244 urban and rural community health service stations. There are 1830 health technicians in the county, and the ratio of health technicians to service population is 1: 220, which is higher than the national average. The medical and health institutions in the county have a building area of 30,869 square meters, with 708 beds actually opened, and the ratio of beds to serving population is 1:57 1. In recent years, our county is committed to improving the health quality of rural residents, and regards it as a comprehensive construction of small

One of the goals of a healthy society is to establish a rural health service system and a preventive health care service system that meet the requirements of health development under the new situation, and form a strong medical and health care network at the county, township and village levels, which has played a positive role in safeguarding people's health and promoting county economic development and social progress. 1, improving the construction of medical and health infrastructure. First, strengthen the housing construction of medical and health institutions. In recent years, the county health administrative department has invested150,000 yuan, rebuilt or newly built county CDC, county maternal and child health hospital, county hospital, county second hospital, county hospital branch, central hospitals such as Beidahu Town, Wanchang Town and Shuanghe Town, and business rooms of general hospitals such as Dagangzi Township, Guanting Township, Yilaxi Town and Sanjiazi Township, with a total construction area of 20,000 square meters. Second, medical equipment has been added and updated. In recent years, county and township medical and health institutions have purchased a total of 70 sets of large-scale medical equipment/kloc-0, with a total investment of more than 2.5 million yuan/kloc-0. Among them, the county hospital invested 9 million yuan in four years and purchased 34 large-scale medical equipment such as spiral ct machine, automatic biochemical analyzer, color Doppler ultrasound, automatic blood cell counter and microwave therapeutic instrument. All township hospitals are equipped with X-ray machines, B-ultrasound machines, cardiac motors and biochemical inspection equipment with a capacity of over 100ma, which provides scientific basis for clinical detection and diagnosis. 2. A well-functioning rural health service system has been established. In order to meet the rural medical and health needs and further improve the rural health service system, in 200 1 year, the county government issued the Implementation Plan of Rural Community Health Service in Yongji County. Under the guidance of planning, our county has reformed the management system of township health institutions in accordance with the model of "two-level network and one-level office", set up community health service centers in township health centers to manage the daily management of rural community health service stations in this area, and reformed the original village health institutions into community medical and health service stations. After four years of construction, at present, there are 244 rural community health service stations in the county (including 8 urban community health service stations), with a coverage rate of 100% and a qualified rate of 80%. Over the years, the rural community medical and health service station in our county has combined paid service with voluntary service, integrating community medical treatment, prevention, health care, rehabilitation, health promotion, health education and planned immunization, providing farmers with positive, convenient, fast, high-quality and low-cost comprehensive services. 3. The prevention and treatment of infectious diseases and chronic diseases have been strengthened. In order to strengthen the management of planned immunization, in 2003, our county incorporated hepatitis B vaccination into the children's planned immunization program, and the county finance invested 40,000 yuan each year to vaccinate newborns for free. At the same time, the county health department went deep into six township investigation points to investigate the current situation of human parasitic diseases such as paragonimiasis, clonorchiasis and trichinosis, and investigated 4500 people, which provided a basis for the prevention and control of other diseases. In order to effectively prevent and control tuberculosis, the county tuberculosis control institute implemented the World Bank loan/British grant tuberculosis control project in July 2003, and treated tuberculosis patients found in our county with dots, strengthened the training of tuberculosis doctors and BCG vaccinators on tuberculosis prevention and control knowledge, and monitored tuberculin in 30,000 primary and secondary school students in the county. At present, the incidence of infectious diseases in our county is 254.23/65438+ ten thousand people, which is at a medium level in the whole region, and the vaccination rate of "four vaccines" remains above 98%. In order to prevent and treat AIDS, the whole region held a working conference on the comprehensive AIDS prevention and control demonstration zone in our county in the first half of this year, and introduced the construction of the comprehensive AIDS prevention and control demonstration community and the experience of AIDS prevention and control in our county. At the beginning of the year, our county completed the construction of the AIDS screening laboratory of the county CDC. In May, our county held a training course for AIDS prevention and treatment teachers, and trained more than 60 people, including the presidents of township hospitals, medical section chiefs, prevention and protection section chiefs and some community health service stations. At the same time, the results of prevention and control of endemic diseases in our county have been consolidated. Focusing on controlling iodine deficiency disorders, in the first half of this year, our county completed 60 samples of pregnant women's urine and pregnant women's household salt, and monitored 64 samples of household salt and inverted salt in 27 food wholesale departments in the county. 288 samples were tested, and the qualified rate was 100%. At present, the prevention and treatment of Kaschin-Beck disease, Keshan disease, brucellosis and iodine deficiency disease in our county have reached the national control standard.

Through computer programmed management, the total number of women of childbearing age, diseases affecting women's health and their sequence in the county were mastered in detail. Mastered the number of newlyweds, pregnant women, high-risk pregnancies, maternal deaths, etc., providing a reliable basis for better implementation of maternal and child health care management. On the platform of systematic management of pregnant women, focusing on screening high-risk pregnancy, we will improve management measures, so that the systematic management rate of pregnant women will reach 90% and the health care coverage rate of pregnant women will reach 95%. The delivery rate in hospital reached 75%, which reached the goal set by the original health care plan. In order to further improve the service function of obstetrics, since 2003, our county has strengthened the construction of obstetrics and gynecology in county and township medical institutions by sending technicians to study and purchasing necessary equipment, and further improved the service level of obstetrics and gynecology in hospitals, so that general hospitals can undertake physiological obstetrics and general gynecological operations, and medical units above central hospitals have the level of pathological obstetrics and difficult gynecological operations. At present, the medical units above the county center health center have carried out the construction of baby-friendly hospitals, and all the work indicators have reached the standards required by the initial insurance, and will pass the municipal acceptance at the end of 2004. The coverage rate of children's health care in the county reached 100%. The incidence of neonatal tetanus is zero. The incidence of neonatal asphyxia and intracranial hemorrhage decreased significantly. The mortality rate of newborns and children under five years old decreased by 20% compared with the previous five years, and the popularization rate of scientific feeding and health care knowledge of infants and young children reached over 65%, which reduced the incidence of malnutrition diseases in children. 5. Law enforcement in the health industry has intensified. In order to meet the needs of the new situation of health industry management, our county has established a new health supervision and disease prevention and control system, abolished the former Yongji County Public Health Supervision Office and Yongji County Health and Epidemic Prevention Station, and re-established Yongji County Health Supervision Office and Yongji County Disease Prevention and Control Center. In terms of health supervision, social health anti-counterfeiting activities are carried out throughout the year and combined with daily health supervision. Regularly carry out special rectification of food hygiene and school hygiene industries, standardize the distribution and management of food hygiene "three certificates", improve the distribution procedures and management methods of "three certificates", formulate the accountability system, severely deal with illegal business households according to law, standardize the market economic order, and protect the health of the broad masses. In terms of law enforcement in the medical industry, the Medical Administration Department of the Health Bureau conducts law enforcement inspections on various medical institutions, beauty salons, pharmacies and morning markets all the year round. In the past two years, 36 cases of illegal medical practice have been cracked, 28 illegal medical institutions have been banned, 2 illegal medical beauty salons and 6 pharmacies have been cleaned up, and medical devices 10 have been confiscated, with a fine of 38,000 yuan, which has standardized the medical market and ensured the health and life safety of the people. 6. Strengthening the functions of the government in rural health construction and management. Adhere to the regular patriotic health campaign, improve environmental sanitation, and constantly improve the living environment of residents. Through the establishment of a permanent institution, the county government is responsible for the management and supervision of environmental sanitation. Every year, our county regards environmental sanitation as one of the goals and responsibilities of spiritual civilization construction in the county. Since last year, management has been strengthened. The county government has formulated the patriotic health target responsibility assessment plan, signed the target responsibility letter with the township government and relevant departments, and implemented the reward and punishment measures. Through civilized village activities, 1 township reached the municipal health township standard. By the first half of this year, six towns and villages had improved water in some towns and villages,162.7 million people benefited from tap water, and a total of 265,500 people benefited from water improvement. Toilets were improved in 8 townships, and 35,000 households built sanitary toilets, with a penetration rate of 34%. Second, the problems that need to be solved urgently in rural medical and health care in our county Although the medical and health care in our county has made certain achievements with the economic and social development of the county, according to the requirements of primary medical and health care, it can basically meet the needs of farmers, but there are still some problems, mainly reflected in the following aspects: 1, medical equipment and facilities are outdated. In this survey, we can see that there are some township hospitals in rural areas.

Hospitals and community medical and health service stations have dilapidated houses, simple facilities and damaged medical equipment, which can not be supplemented and improved, and it is difficult to achieve the goal of normal medical care. The houses of Deng Chun Township Health Center and Sanjiazi Village Community Health Service Station in Beidahu Town are in poor repair, and the old bungalows in the 1960s and 1970s are still in use, which are in urgent need of reconstruction. In the survey, we also found that the medical and health infrastructure of some township hospitals and community health service stations is weak, and quite a few rural community health service stations only have "old three samples", a stethoscope, a sphygmomanometer and a thermometer. The pace of medical and health reform is slow, and the development of health undertakings is lagging behind, which is incompatible with the people's demand for medical and health care. 2. Lack of medical and health personnel. Due to the backward material conditions in rural areas, most of the medical professional and technical personnel in our county are concentrated in cities and towns, resulting in a relatively low proportion of rural medical personnel, and the problem of difficulty in seeing a doctor is more prominent. There is only one township doctor in the community health service station of Soudenggou Village in Xiyang Town, but it serves the prevention and health care of nearly 1,000 people in the village. According to the survey of Peking University Lake Town Health Center and County CDC, the shortage of talents leads to the shortage of medical staff, and the phenomenon of "unable to get out and enter" seriously restricts the development of the cause. Measures to improve the training of existing medical personnel are not in place, and the shortage of medical and health personnel has not been improved. 3. Village medical and health institutions and rural doctors have a heavy burden. In Sanjiazi Village of Beidahu Town and Hongshi Village Community Health Service Station of Xiyang Town, it is known that the burden of village-level medical institutions in our county is heavier at present. Sanjiazi Village Health Service Station has to pay more than 7,000 yuan a year to the superior, including the annual inspection of the price department, the career development fund of the town health center every month, and the fees paid to the drug supervision, health and other departments and the Bureau of Quality and Technical Supervision every year, not counting the fees for various training courses and the certificates issued by relevant departments every year. Village-level health institutions have no investment in the village collective economy. Houses, medicines and facilities are all invested by rural doctors, and the salaries of personnel are paid as usual. However, governments at all levels do not subsidize rural doctors' public health and preventive health care, which affects their enthusiasm for preventive health care to some extent. 4. Illegal medical practice occurs from time to time. According to the survey, at present, illegal medical practice has been repeatedly banned in some rural areas, which seriously threatens the safety and health of farmers. These people use the brand of medical institutions or medical schools to sell medicines and defraud money under the guise. Illegal medical institutions have also established close ties with local village committees. According to a township doctor in Deng Chun township, in April this year, the county tuberculosis prevention and control institute went to a village in the township for a physical examination for farmers, but the village committee only convened 50 or 60 people. On the contrary, an illegal medical institution came to the village for a "free clinic" and was directly stationed at the home of a village cadre, who spared no effort to provide convenience for it. 5. The situation of farmers returning to poverty due to illness is serious. After investigation, in rural areas, some farmers are "disease-resistant" and die of illness; Some farmers have no money to see a doctor and are looking forward to it. Some of them borrowed money to see a doctor, but because the best treatment opportunity was delayed, the condition was not optimistic, and people and money were empty. At the symposium of rural doctors held in Deng Chun Township, I learned that a considerable part of farmers' visits to village community health service stations are on credit, and the general ledger is only counted after the end of the year. But every year, when rural doctors settle their accounts at the end of the year, there are always 8000 accounts that cannot be cashed. A farmer told the investigation team that he might be able to turn over after being flooded or his house burned for several years, but if he really got seriously ill, the final result was often ruin. Three. Suggestions on developing rural medical and health undertakings in our county The report of the 16th National Congress of the Communist Party of China pointed out that in China, it is necessary to establish health services and medical and health care systems, strive to improve rural medical and health conditions, and improve the medical and health level of urban and rural residents. Combined with the investigation, the following suggestions are put forward to do a good job in rural medical and health work in our county. 1, put rural medical and health undertakings in a more important position. Rural medical and health care is related to the life safety and health of farmers. Without the health of farmers, there is no well-off society in rural areas. Facing the new situation, it is necessary to put accelerating the development of rural medical and health undertakings into the focus of the county's national economic and social development, into the important work schedules of governments and departments at all levels, formulate long-,medium-and short-term development plans according to the new situation, and improve policies and measures. All towns and villages should ensure that relevant departments and part-time cadres are responsible for this work, put health education, patriotic health and other work into the government's work agenda, and make unremitting efforts to change the situation that the township government's "big health" work is unattended and unattended. Continue to carry out health education classes among primary and secondary school students in the county, publicize health knowledge among farmers, and further promote the improvement of self-care awareness of the whole people. 2. Promote the reform of the operating mechanism of township (town) health centers. Strive to explore a variety of business models of township (town) health centers, do not make a one-size-fits-all approach, and do not impose a business model. It is necessary to conscientiously sum up the reform experience of Dagangzi Township Health Center, further deepen the reform of operating mechanism and personnel system, actively implement the personnel employment system, pay attention to introducing talents and funds, improve medical conditions, improve medical standards, better meet the medical needs of farmers, and strive to achieve remarkable results within three years. 3. Establish a talent inflow mechanism and do a good job in employee training. It is necessary to speed up the reform of the personnel system within the health system, activate the employment mechanism, formulate a loose talent policy, actively create an environment conducive to the inflow of talents, and recruit technical talents. It is necessary to continue to strengthen the training of rural health personnel, train rural doctors in rotation once a year, and accelerate the pace of knowledge updating of rural doctors. Further improve the operation mechanism of medical groups, lower the medical technology by one level, implement technical cooperation and guidance, help local people improve their medical level, and further improve the overall quality of rural health teams in our county. 4. Strengthen the soft environment construction of medical and health undertakings. Supervision, price and other departments should strengthen the inspection of fees set up by relevant departments for village-level community health service stations, resolutely cancel unreasonable fees, resolutely cancel unreasonable parts of reasonable fees, re-establish standards, and reduce the burden on village-level medical and health institutions. At the same time, it is necessary to further increase the punishment for illegal medical practice, thoroughly purify the rural medical and health market, and let illegal medical practice have no soil for survival in rural areas. 5, actively create conditions to establish a medical insurance system for farmers as soon as possible. It is the general trend to fully implement the new cooperative medical system in rural areas. We should seize the opportunity of fully implementing the new cooperative medical system in our province in 2008 and make full preparations for the implementation of this system in our county. In the absence of this system for the time being, governments at all levels and relevant departments should combine poverty alleviation with solving the medical needs of the poor people in rural areas, take the people who are poor due to illness as the focus of poverty alleviation, and take various measures to effectively solve the problem of poor people's difficulty in seeing a doctor.