Private hospitals begin to nurse big ambitions

Medical profession engaged in healthy debate over nature of care

While job-hopping is quite common, few medical professionals make the switch from a public hospital to a private one. A position in a public hospital has traditionally been regarded as an "iron bowl", offering long-term employment.

Yang Jie is one of the exceptions. While working in a public hospital in the 1990s she was chosen by the Beijing Health Bureau to go to Singapore to study nursing. After two years in Singapore she decided to work at a private hospital when she returned to Beijing.

"My colleagues said I was crazy," the 41-year-old nurse says. "Even my parents spent several weeks trying to persuade me not to go to a private hospital. They said a private hospital could close at any time."

There were only a few private hospitals in China at that time, mostly treating venereal diseases, and many had bad reputations.

Yang, who now works at Beijing United Family Hospital, a private general hospital in Beijing, which is a joint venture between US-headquartered healthcare provider Chindex International and the Chinese Academy of Medical Sciences, says it was her experience in Singapore that made her decide to change to a private hospital.

"I had never fed patients or cleaned a bedpan before in my five years working in Beijing," she says. "Two years in Singapore changed my attitude toward nursing and I really wanted to promote such patient and family oriented services in my country."

Yang says that in Singapore hospitals, about a dozen of patients are cared for by two staff nurses, who do daily medical checks and give status reports on the patients' condition to the doctors. Two assistant nurses are in charge of tasks such as giving injections. The cleaning work is done by another group called house attendants.

"In China, nurses have to do all these and there is such a high number of patients that there is no time to give them the attention they need," Yang says.

Even though she has now been working in the Beijing United Family Hospital for 15 years, Yang says that many of her friends in public hospitals don't want to make the change because they still have concerns about working at a private hospital.

Better service, higher cost

However, more and more Chinese patients are now using private hospitals and clinics, as private healthcare providers have developed a reputation for having a better service than public hospitals for those that can afford to use them.

Sharon Liu, 34, who lives in Canada but wants to deliver her baby in Beijing so she has the support of her family, says her experience of a public hospital was so unpleasant that she burst into tears as soon as she got outside.

In order to make an appointment with one of the top doctors, Liu says that she got up at 6 am. "But there were still 20 or more patients waiting, and less than 10 seats were available for those waiting."

Liu only needed to do a regular health check on that day and the doctor only saw her for 10 minutes. "But in Canada, even for a regular checkup, doctors will spend at least 20 minutes with a patient and they will provide very detailed information to patients."

The public maternity and children's hospital Liu attended receives more than 5,000 patients a day, and there is a line stretching back 200 meters from the window where patients have their blood tested every morning. A one-hour wait to have a blood test is normal.

According to the Ministry of Health, there are 1.5 times more public hospitals than private ones, however, waiting times at public hospitals are 30 times longer than private hospitals.

Although many patients believe private hospitals provide more efficient service and have more experienced doctors they are too expensive and thus, out of reach for patients. Only six of the 1,000 private hospitals in Beijing are covered by the medical insurance system, and although private hospitals account for one-third of the hospitals in Beijing, they only cater to 12 percent of patients.