Strong GP network vital for healthy China

Cutting-edge healthcare system possible A nurse measures body temperature of patients at a medical center in Hangzhou, Zhejiang province. LONG WEI / FOR CHINA DAILY

When I first arrived in China, I was worried for my Chinese friends whenever they said they were sick and "going to the hospital". Where I'm from, going to the hospital is serious－usually involving a serious or life-threatening emergency or a pre-booked specialist service like surgery. Generally people prefer to see a local doctor.

The National Health Conference is taking place this weekend to discuss the next steps for a "Healthy China". China's healthcare reform aims to provide basic medical services to the entire population and reduce impoverishment caused by healthcare costs. At the heart of this project is the creation of a tiered healthcare system-based on general practitioners or GPs and community health centers as the first point of contact with the healthcare system.

As China's healthcare challenges increasing rates of cancer and cardiovascular diseases－continue to mount, with an aging population, so too will the demands on its healthcare system, along with the costs. And a healthcare system that relies on hospitals cannot meet these challenges. Of course, hospitals are needed－to provide medical care for the seriously ill, and for specialized services like surgery and radiotherapy. But hospitals are expensive to run, and not especially pleasant or convenient for patients.

Since online and telephone booking systems are not always reliable, the sick (or their family members) must queue up at the hospital either the night before or early in the morning to secure an appointment (gua hao), then sit in awaiting room until their name is called. When the doctor is finally ready to see the patient, the consultation is likely to last only a few minutes-a symptom of the enormous patient load and pressure which doctors in China face every day. But this is not how things should be in a well-functioning healthcare system.

Globally, healthcare systems in which community medical services are rendered by well trained GPs and primary care professionals in neighborhoods is the most effective and efficient way to provide quality healthcare for the people. In this model, people develop a sort of bond with GPs, who get to know their patients and their medical needs better. In the majority of cases the care people need can be provided in the community clinic. If not, the staff can refer patients for the specialist care they need.

China is already taking steps in this direction and the signs are encouraging. However, such a massive transformation will not take place overnight. GPs and nurses must be given special training and decent salaries for that. And people have to stop going to the hospital when their medical needs can be taken care of by a GP.

Premier Li Keqiang has said health is at the root of happiness. Similarly, the GP is at the root of aw ell-functioning healthcare system. During her recent visit to Beijing, World Health Organization Director-General Margaret Chan discussed her "Chinese dream" with President Xi Jinping: when she retires back to China, she will have close to her home a well-trained GP who will help her to manage her health, look after her medical needs, and, only if it is needed, navigate her way through hospital care.

Realizing the vision of a "Healthy China"－where all people in need can access healthcare services close to home－and at an affordable cost－will not be easy. But with the same pragmatism and determination with which China has faced so many health challenges in the past, it is possible. And it will set China on a path to a healthier and more prosperous future.

The author is WHO representative in China.