Democracy in China (Part 2) The Cancer Specialist

See a video of this article here: https://youtu.be/-pFSQOF8G64

In 1949, the People’s Republic of China inherited a broken, almost non-existent medical system from the Republic of China, still virtually bankrupt from an invasion by Japan, a civil war, rampant Republican corruption and, of course, faced with insurmountable western sanctions, Mao instituted a medical system for rural populations which became known as “Barefoot doctors”. It was a great system that increased people’s health and covered the entire nation’s rural regions with low-cost, but well-trained and trusted local medics servicing the needs of their communities. When people think of Mao’s legacy they often forget how many great things he did for China, this is just one example.

In 1985, after about 20 years of service the Barefoot Doctors got an upgrade and they became Community Health Workers, but their legacy lives on as the model is being used in other developing nations expanding their own medical needs.

China’s medical system hasn’t stopped improving. Healthcare is generally cheap although, of course, there are some aspects of it that are expensive but even those are being negotiated and prices improved, for example, several international brand pharma companies including Novo Nordisk, Sanofi and Eli Lilly, were recently encouraged to reduce prices to as low as $2.81 per vial. What they lose in profit they say, they make up in volume; this probably tells people in the West far more about their pharmaceutical providers than I can tell them.

On a beautiful sunny day in Guangzhou, I met with a team from Xinhua at the Lung Cancer Institute of Guangdong Province People’s Hospital, (there’s that word again, People’s Hospital) we were there to meet with a cancer specialist Dr Zhou, who is also a delegate to the Chinese People’s Political Consultative Conference CPPCC.

Her first task was a conference call with a rural doctor — this was something I didn’t expect. One of her roles in the CPPCC has been to advise on medical care in rural regions. It’s now possible for a patient of hers to consult with a local clinic and be treated for cancer without her actually meeting the patient. It’s a modern-day progression from the “barefoot doctor”.

This rural doctor doesn’t need to send the patient on a costly journey to the city, computerised medical records can be shared, consultations happen online and medication is dispensed and delivered to the patient. The patients get state of the art treatment, the rural doctors gain invaluable experience and the specialist has time to help more patients than they did in the past. Of course, it won’t work for all patients, some need to come for treatment on specialised equipment or operations that the local hospital can’t perform but improvements are constant.

The hospital we were in is one of the top cancer hospitals in the world and was recently selected as the best in Asia. And, while online medical care has become a normal and accepted part of getting hospital treatment in China (global consultancy firm Deloitte has written a great article about this where it describes how China has transited from a “medical security provider” to a “healthcare services supplier”) the Doctor we were visiting was instrumental in suggesting this and pushing her own, her colleagues and even her patient’s ideas through the CPPCC and into general practice around China.

Medical care for the people, as Mao recognised, is an important part of governance. Mao created a situation which ensured the best care available must be provided for peasants and workers as well as the soldiers who came from those groups. For this reason, many doctors, including the one we visited, are not members of the Communist Party, but are members of the Peasants and Workers Democratic Party, which was recently congratulated for their work in the medical services, population and ecological environment fields.

Clearly, this is a people centered system where ideas and improvements developed out of the people’s needs have created a system where healthcare not only meets their needs, it’s constantly improved by suggestions to the CPPCC from people who recognise those needs, including patients.

This is a great example of how People form policy that meets their own needs. If that isn’t democratic, I don’t know what is!

Next, we’re going to meet a migrant worker whose work has improved the lives of millions of people, stay tuned…