[Seeking Solutions for People's Livelihood]

　　This year's Government Work Report proposed to "focus on advancing tiered diagnosis and treatment, guide high-quality medical resources to sink to the grassroots, strengthen the coordinated linkage of county, township, and village medical services, and expand the variety of medications for chronic and common diseases available at primary-level medical and health institutions."

　　As the state increases its attention to and investment in primary-level healthcare, primary-level medical services are undergoing unprecedented changes: primary-level medical facilities have been greatly improved and service capacity significantly enhanced, bringing tangible benefits to the broad masses. How can we better advance the improvement of quality and efficiency of primary-level healthcare so that the people can enjoy high-quality medical services at their doorsteps? This publication specially interviewed deputies and members for analysis.

　　The Key Lies in People: Building a High-Quality Primary-Level Medical Workforce

　　Deputy Wei Xiaoli, a doctor at the community hospital of Qifang Town, Baisha Li Autonomous County, Hainan Province, is a village doctor who has worked at the grassroots for more than 20 years. "In the past, medical conditions in the village were backward, and when people got sick they put off treatment or simply endured it." Today, the village clinic where she works is fully equipped with medical devices such as oximeters, glucometers, and automated external defibrillators, and is able to handle most common diseases.

　　Although medical conditions have improved, primary-level healthcare still faces many specific problems, and the hardest to solve is the shortage of talent. Deputy Wei Xiaoli acknowledged frankly: "Because the working environment in rural areas is tough and pay is relatively low, it is very difficult to attract and retain outstanding medical talent."

　　Improving the career development channels for primary-level doctors is crucial. Deputy Wei Xiaoli suggested that measures such as providing promotion opportunities and raising remuneration be adopted to attract more outstanding talent to take root at the grassroots; and that primary-level doctors be given more technical support and learning and training opportunities to improve their diagnostic and treatment levels and service capacity, so as to better meet the health needs of the grassroots masses.

　　"To raise the level of primary-level healthcare, we must not only make great efforts on hardware but also pay attention to software issues—how to cultivate more high-level medical talent." Member Gan Huatian, discipline director of the Geriatrics Center and director of the Inflammatory Bowel Disease Center of West China Hospital of Sichuan University, believes that only by building a long-term and systematic training system for primary-level medical talent can the problem be solved at its root. He suggested that, based on grassroots realities, tiered training be implemented in medical education, while strengthening support training and online training from higher-level hospitals.

　　The Advantage Lies in Assistance: Building Close Medical Alliance Partnerships

　　"The characteristic of primary-level healthcare lies in its broad coverage and close community ties." Deputy Huang Yan, director of the Huidong County Center for Disease Control and Prevention in Huizhou City, Guangdong Province, believes that by building cooperation models such as medical alliances, high-quality medical resources can be channeled downward and shared, raising the diagnostic and treatment levels and service capacity of primary-level medical institutions.

　　In the construction of medical alliances, a support mechanism can be established between large hospitals and primary-level medical institutions, with experts regularly dispatched to see patients, demonstrate surgeries, and provide technical guidance. Member Gan Huatian introduced that in recent years West China Hospital has given full play to its advantages and provided paired support to primary-level county hospitals such as Zhenxiong County Hospital in Zhaotong City, Yunnan Province, and Dafang County Hospital in Bijie City, Guizhou Province, achieving good results.

　　"Using information technology to establish telemedicine platforms and realize remote sharing of medical resources is also an important direction in building medical alliances." Member Gan Huatian pointed out that through remote consultations, remote diagnosis, and other means, primary-level doctors can communicate in real time with experts at higher-level hospitals to jointly resolve difficult cases.

　　Recently, the National Health Commission and other departments issued guiding opinions to comprehensively advance the construction of tightly knit county-level medical and health communities. By having counties drive townships and townships drive villages, a tiered assistance and driving mechanism is formed, enabling the people to obtain higher-level medical and health services at their doorsteps.

　　"This is a major measure to coordinate and optimize the allocation of medical care." Deputy Huang Yan believes that advancing the construction of county-level medical communities is an institutional innovation in deepening the reform of the pharmaceutical and healthcare system, and is of great significance to optimizing the layout of medical resources, promoting the downward flow of high-quality medical resources, and enhancing primary-level medical service capacity.

　　The Focus Lies in Prevention: Strengthening Primary-Level Public Health Services

　　"The focus of primary-level healthcare lies in preventing and controlling the occurrence of disease." Deputy Wei Xiaoli pointed out that primary-level medical institutions should shoulder the important task of public health services, strengthen health education, and raise residents' health awareness and self-care capacity.

　　Deputy Huang Yan believes that at present the integration of medical care and prevention is not yet close enough, public health physicians are understaffed in primary-level medical institutions, and clinicians' awareness of disease prevention is weak. She suggested that relevant departments issue policies to put into practice the approach of "recruited by the county, managed by the county, and used by the township" and "recruited by the township, managed by the township, and used by the village." For example, staffing for county-level CDC personnel should be fully allocated and assigned to each township through the county-recruits-township-uses approach, serving as CDC supervisors responsible for coordinating local basic public health, infectious disease surveillance and response, and other work related to the integration of medical care and prevention.

　　Member Gan Huatian emphasized that attention should be paid to the role of family doctors as the "gatekeepers" of primary-level healthcare. The family doctor system is an important bond for the integration of medical care and prevention and a key means of promoting the shift from disease treatment to health management. In recent years, the scale of family doctors in China has continued to expand and the signing rate has kept rising. While recognizing the achievements, Member Gan Huatian pointed out that it should also be noted that the building of the family doctor workforce still lags behind demand, the problem of unbalanced development among regions is becoming increasingly prominent, and the habit of "rushing to big hospitals at the first sign of illness" has not yet been fundamentally changed. Enhancing the role of family doctors can enable many minor illnesses to be treated promptly at the grassroots, thereby easing the pressure on big hospitals. He suggested strengthening the education and training of general practitioners, guiding more medical graduates to join the family doctor workforce, and increasing support for western and rural areas, so as to raise the penetration rate of the family doctor system and public recognition of it, and help build a more robust and efficient primary-level public health service system.