Medical attacks remain a problem

Police officers patrol outside Shandong Provincial Hospital, a major hospital in Shandong province, in June as part of an effort to prevent attacks against medical professionals and handle disputes between doctors and patients that might escalate into violence. Xu Suhui / Xinhua

Officials introduce measures aimed at preventing assaults on hospital staff

On June 7, a man rushed into a nurse station at the First Affiliated Hospital of Kunming Medical University, a top hospital in Yunnan province, with a kitchen knife, and stabbed a nurse.

The 30-year-old nurse, whose identity was not disclosed, suffered multiple injuries to her head and hands, and was nearly unconscious before police arrived and subdued the suspect.

After intensive care, the nurse was reported to be in stable condition a week after the attack. Police detained the suspect, surnamed Zhang, but disclosed no information about the case.

More than 10 attacks on medical workers were reported in China in the first three weeks of June, the Supreme People's Procuratorate said.

From December 2013 to December last year, prosecuting agencies filed charges against 347 people suspected of seriously assaulting medical workers and handed them over to courts.

Deng Liqiang, the Chinese Medical Doctor Association's legal affairs director, said more than 20 assaults on doctors resulting in injury occurred in China from the end of May to early July.

Violence against doctors has periodically drawn public attention in the past few years and remains a thorny issue despite policies and campaigns by several government departments.

More than 70 percent of doctors in China have suffered verbal abuse or physical violence, according to a white paper issued by the association in May.

More than 60 percent of doctors do not want their children to follow in their footsteps because of the excessively heavy workload and lack of a sense of security, according to the white paper.

The National Health and Family Planning Commission said in a statement, "Acts of violence at hospitals should be condemned by all of society."

Security introduced

In recent years, medical disputes escalating into violence at large public hospitals have sharply increased as have random attacks, said Sun Haibo, an official at the Ministry of Public Security's Security Management Department.

More than 70 percent of the hospital attack victims are doctors, and the others are nurses, the ministry said.

Most of the attackers are family members of patients who were dissatisfied with the medical treatment and services they received, but many patients also carried out attacks, the ministry said.

In one case that caught wide public attention, a man fatally stabbed a doctor and injured two others at a hospital in Wenling, Zhejiang province, after repeatedly filing complaints that the doctor failed to cure his disease with surgery in 2013. Lian Enqing, 35, was sentenced to death and executed in May.

A number of security measures stationing police officers in large hospitals have been introduced in major hospitals across the country in the past few years, the ministry said. Sun said that, generally, two or three police officers have been stationed at each major hospital to prevent fatal attacks and handle disputes that may lead to violence.

The police officers also offered mediation training to hospital security guards and helped them to recognize warning signs that a situation may become violent, enabling them to take immediate action.

"In serious situations, the police would apprehend and criminally detain suspects, and in some other less-serious situations they could help to defuse the dispute," Sun said.

Deng, from the Chinese Medical Doctor Association, said boosting security in hospitals has increased doctors' sense of safety, but security guards need more training to cope with various incidents.

"We have seen security guards just stand by and do nothing during violence directed at doctors," he said. "It is still a question of how to improve their ability to deal with violence."

Sun said some top public hospitals have improved their monitoring systems.

"They have invested millions of yuan to upgrade audio and video surveillance systems, especially at entrances and exits and at outpatient departments," he said.

"Once an emergency happens, the hospital will immediately rush security guards to the scene to control the situation and then report it to police to prevent fatal incidents."

Sun said the police should work closely with hospitals to establish a joint action system to deal with such crimes.

"We will increase the police presence in hospitals and severely punish the culprits. Hospital departments should do their part to strengthen security measures."

He proposed establishing security posts at the main gates in some pilot hospitals nationwide, and X-ray machines similar to those used in the subway to examine bags and luggage to prevent prohibited items such as guns and knives from entering these hospitals.

Disputes fall

According to the National Health and Family Planning Commission, violence against medical workers eased last year amid a joint campaign by several ministries. Medical institutions in China provided 7.6 billion treatments last year, an increase of 300 million year-on-year, while the number of legal violations involving medical workers fell by 10.6 percent and medical disputes by 18 percent, the commission said.

"The rule of law should be increased in improving the work environment for doctors, and it requires efforts from different sectors of society," the commission said.

Recently, a draft amendment to the Criminal Law was proposed, stating that those who commit violence against medical workers or disrupt hospitals could face up to seven years in prison.

The draft was reviewed in June by the National People's Congress Standing Committee, China's top legislature, and is now on its website to solicit public opinion until Aug 5.

If approved, "the law will definitely reduce violations against hospitals and medical staff," said Deng, of the Chinese Medical Doctor Association.

In recent years, the media have reported that patients or their relatives involved in disputes with doctors have tried to disrupt hospital business by blocking entrances or refusing to remove the bodies of deceased loved ones.

"In many cases, hospitals or police forces lack measures to deal with such incidents due to gaps in the law," Deng said.

"Including punishment for such activities in the Criminal Law, the most severe law in China, sends a message to all of society of the firm resolution to fight such activities," he said. "The law will also improve the sense of security for medical staff."

Personal care sees drop

Zhang Yanling, president of the Chinese Medical Doctor Association, said more humanitarian education is needed in China's medical education to ease tension in doctor-patient relationships.

"Hospitals are becoming bigger, and their medical equipment is becoming more advanced. The number of patients keeps growing, but in general, doctors have shown less care to patients," he said.

Deng said many doctors have failed to provide enough psychological care to their patients, which may cause tension and disputes. But having too many patients makes it difficult for doctors in big hospitals to care for each one individually.

"A doctor may see 60 or more patients in half a day. It's very difficult for them to have thorough exchanges with patients when they see so many others waiting in line," he said.

Most public hospitals rely on the fees they collect from patients as a major source of income, due to insufficient government investment.

Li Jia, an emergency room doctor at Peking University People's Hospital, said the keys to resolving tense doctor-patient relationships lie in continuing to reform the health system so that patients will not be excessively concentrated in several big hospitals, and to increase investments in public hospitals so that they will not focus on seeking profit.

Contact the writer at wangxiaodong@chinadaily.com.cn