China wants to train 500,000 new GPs by 2030

Doug Hendrie

2/11/2018 1:06:51 PM

China is looking to GPs and primary care to take the strain off its healthcare system.

China currently has around 210,000 GPs for its population of 1.3 billion.
China currently has around 210,000 GPs for its population of 1.3 billion.

China plans to train 500,000 new GPs within 12 years as part of a sweeping push to decentralise its health system and shift patients away from overcrowded hospitals.
The move comes as China deals with a huge ageing population, which will bring with it more issues related to multimorbidity and chronic diseases.
At last year’s National Party Conference, Chinese President Xi Jinping said that a key aspect of improving the nation’s health was to ‘strengthen the construction of grassroots medical and health service systems and the establishment of general practitioner teams’.
The nation of 1.3 billion currently has around 210,000 GPs.
The planned expansion would be more than 10 times the number of all of Australia’s GPs, and would ideally boost availability to five GPs per 10,000 residents, up from 1.5 at present. 
But the ambitious target may be a challenge.
GPs in China are traditionally not well remunerated and have limited career progression. Though China’s ‘barefoot doctors’ famously tended to the rural poor during the 20th century, many Chinese citizens bypass their family doctors and go directly to large hospitals. The long queues are the stuff of legend.
‘One of the most prominent problems is that GP jobs aren’t attractive,’ Zeng Yixin, deputy head of the National Health and Family Planning Commission, told Yicai Global. ‘By making the job more appealing, more young people will be willing to pursue it as a career.’
In April this year, a delegation of Chinese doctors and hospital administrators visited the RACGP to hear about the strengths of Australia’s community-based primary healthcare system.
RACGP Education Strategy Senior Advisor Dr Ronald McCoy told the 22 delegates from Zhejiang province who visited the RACGP that community-based GPs act as a constant in many Australians’ lives.
‘We can treat disease earlier and stop people having to go to hospital. It’s considerably cheaper to treat people in the community than in hospital, so if a patient is worried about money, they’re likely to seek treatment much earlier,’ he told the delegation.
‘Countries with well-developed primary care systems have lower overall health costs and better health outcomes. [The system] reduces hospitalisations and improves other health outcomes through early primary care management of health problems.’
Dr Hui Yang, China programs manager for Monash University’s Institute for Health and Clinical Education, told newsGP that the delegation was hoping to learn about further developing a primary care system.
‘In China, the primary care discipline has been identified as a key priority of healthcare system reform,’ he said. ‘[Primary care] is more efficient and cost-effective for the health system and has a better outcome for people’s health.’

The British Medical Journal (BMJ) reports that public hospitals in China still get around two-thirds of total Government health funding, with only a third of the workforce in primary care. Specialists greatly outnumber GPs, who made up only 6.2% of doctors in China in 2015.
China has public and private healthcare, with around 95% of people having at least basic medical insurance after a massive boost for people in rural areas began in 2003. A key issue, however, is that insurance only covers an average of half of a person’s healthcare costs.

Earlier this year, the Chinese Government unveiled a plan to produce enough qualified GPs by extending general medical education to all medical students, recruiting more college students, and increasing incomes.

China GP training primary care

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