Interpretation of the Nine Guidelines on Integrity for Healthcare Professionals
- Date：2023-09-02
- Click：470Times
I. Background of the formulation of the Nine Guidelines
In December 2013, the former National Health and Family Planning Commission (NHFPC) and the State Administration of Traditional Chinese Medicine (SATCM) jointly issued the Circular on the Issuance of the ‘Nine No-No's’ on Strengthening the Construction of Healthcare Ethics (hereinafter referred to as the Nine No's), which plays a positive guiding role in strengthening the construction of the style of the healthcare industry and resolutely correcting behaviours detrimental to the interests of the public in healthcare. (hereinafter referred to as the ‘Nine Disallowances’), which has played a positive guiding role in strengthening the style of construction of the medical and health care industry, seriously improving the discipline of the industry, and resolutely correcting the behaviours of medical and health care that are detrimental to the interests of the public. In recent years, the CPC Central Committee and the State Council have put forward a series of new requirements for strengthening the construction of style in the medical and healthcare industry. In order to further enhance the sense of responsibility, mission and honour of the staff of medical institutions, regulate the practice of law, promote the professionalism of medical and health personnel in the new era, guide the formation of a clean and upright industrial environment, and guarantee the high-quality development of medical and health care undertakings, the National Healthcare Commission, in conjunction with the National Health Security Bureau and the State Administration of Traditional Chinese Medicine, has addressed the current outstanding problems in the field of healthcare that have been strongly reflected by the public, in the ‘Nine No's’. On the basis of the ‘Nine No-No's’, the State Healthcare Commission, together with the State Medical Security Bureau and the State Administration of Traditional Chinese Medicine, jointly formulated and issued the ‘Nine Guidelines on Integrity in the Practice of Medical Institutions’ (hereinafter referred to as the ‘Nine Guidelines’).
II. Scope of Application of the Nine Guidelines
The Nine Guidelines are applicable to the staff of medical institutions, including but not limited to health professionals and technicians, management personnel, logistic personnel, and other social practitioners who provide services in medical institutions and accept the management of medical institutions.
Main contents of the Nine Guidelines
The Nine Guidelines adhere to the positive advocacy, negative warning in parallel, is the basic normative documents for all staff in the medical institutions of clean practice, is the industry ethics, practice standards, the masses of the concrete presentation of the demands, reflecting the ‘whoever is in charge of who is responsible for’ ‘management of the industry must be in charge of the style of practice It embodies the requirement of ‘whoever is in charge is responsible’ and ‘to control the industry must control the practice style’, and draws the bottom line of basic behaviour for the majority of medical staff.
Each guideline in the Nine Guidelines first sets out the requirements for promotion and then lists the prohibited behaviours. Specifically: to be paid legally for their work and not to accept commercial commission. Strictly abide by the principle of honesty, not to participate in fraudulent insurance. Practise medicine according to the norms, do not carry out excessive diagnosis and treatment. Comply with work procedures, do not accept donations in violation of the law. Abide by the principle of confidentiality, and do not disclose patients' privacy. Obey the need for treatment, not profit-making referral of patients. Maintain the order of medical treatment, not to undermine the fairness of medical treatment. Build a harmonious relationship, do not accept ‘red packets’ from patients. Abide by the bottom line of communication, do not accept corporate kickbacks.
The Nine Guidelines take whether the behaviour of medical institution staff is for personal gain as the evaluation and judgement standard, and explain the specific performance and connotation of the prohibited behaviours. The Nine Guidelines emphasise the main responsibility of medical and healthcare institutions for the management of ethical practices, as well as the supervisory responsibility of healthcare departments at all levels for the management of ethical practices. In particular, it emphasises the accountability of administrative departments and heads of healthcare institutions that fail to implement the Nine Guidelines, reflecting the convergence of regulations, discipline and law, and enhancing the effectiveness of the policy.
The Nine Guidelines are an upgrade of the Nine No-Nos.
After the publication and implementation of the Nine Guidelines, the ‘Nine Prohibitions’ were abolished at the same time. Nine Guidelines’ is in the “nine prohibited” from the strict governance of the kernel on the basis of the upgrading of the content to the form of improvement, specifically expressed as follows:
(a) Covering all the requirements of the ‘Nine No-Nos’. The ‘nine prohibitions’ of ‘no personal income of medical and health personnel linked to income from medicines and medical examinations’ and ‘no illegal fees’ have been incorporated into the ‘nine prohibitions’ of ‘no excessive diagnosis and treatment’ and ‘no illegal fees’. No over-diagnosis and treatment’; “No billing for commission”, “No prescription for commercial purposes”, “No participation in sales activities and illegal release of medical advertisements”, “No illegal release of medical advertisements”, “No illegal release of medical advertisements”, “No personal income of medical and health personnel linked to income from medicines and medical examinations”. ‘No illegal private procurement and use of medical products’ was incorporated into “no acceptance of commercial commission”. The ‘nine prohibitions’ of ‘no acceptance of patients’ red packets’, “no acceptance of kickbacks, no illegal acceptance of social donations” and so on, the “Nine Guidelines” adopted in its entirety, emphasised, and the scope of application is made clear. The scope of application has been clarified.
(ii) Supplementing and expanding the content. Supplementary prohibitions have been made on new issues and new situations and new manifestations of old problems. New contents such as ‘not to carry out over-diagnosis and treatment’, ‘not to participate in fraud and insurance fraud’ and ‘not to profitably refer patients’ have been added; as well as ‘old problems’ such as the recommendation of out-of-hospital purchase of medicines, the promotion of non-medical commodities, and Internet medical care, have been added. As for the new manifestations of ‘old problems’ such as recommendation of out-of-hospital purchases of medicines, promotion of non-medical goods, Internet medicine, etc., the Nine Guidelines have made comprehensive requirements with ‘no acceptance of commercial commissions’, covering all kinds of commissions to the maximum extent possible.
(iii) Clearly define the corresponding punitive measures. In accordance with existing laws and regulations, Party rules and departmental regulations, the reference basis for penalties for violating the Nine Guidelines has been increased. If the personnel concerned violates party discipline or political discipline, they will be transferred to the disciplinary and supervisory organs to be given party disciplinary and political punishment; if they are suspected of committing a crime, they will be transferred to the judicial organs to pursue criminal responsibility. For violations of the ‘nine guidelines’ behaviour more or cause bad social impact and other serious consequences of medical institutions in charge, in accordance with the relevant provisions, be accountable.
(d) Provide for specific ways of implementation. Learning and training, supervision and implementation, investigation and notification, constraints and assessment as a means of four measures to carry out the implementation of the Nine Guidelines, to ensure that the policy requirements are implemented in detail.
In December 2013, the former National Health and Family Planning Commission (NHFPC) and the State Administration of Traditional Chinese Medicine (SATCM) jointly issued the Circular on the Issuance of the ‘Nine No-No's’ on Strengthening the Construction of Healthcare Ethics (hereinafter referred to as the Nine No's), which plays a positive guiding role in strengthening the construction of the style of the healthcare industry and resolutely correcting behaviours detrimental to the interests of the public in healthcare. (hereinafter referred to as the ‘Nine Disallowances’), which has played a positive guiding role in strengthening the style of construction of the medical and health care industry, seriously improving the discipline of the industry, and resolutely correcting the behaviours of medical and health care that are detrimental to the interests of the public. In recent years, the CPC Central Committee and the State Council have put forward a series of new requirements for strengthening the construction of style in the medical and healthcare industry. In order to further enhance the sense of responsibility, mission and honour of the staff of medical institutions, regulate the practice of law, promote the professionalism of medical and health personnel in the new era, guide the formation of a clean and upright industrial environment, and guarantee the high-quality development of medical and health care undertakings, the National Healthcare Commission, in conjunction with the National Health Security Bureau and the State Administration of Traditional Chinese Medicine, has addressed the current outstanding problems in the field of healthcare that have been strongly reflected by the public, in the ‘Nine No's’. On the basis of the ‘Nine No-No's’, the State Healthcare Commission, together with the State Medical Security Bureau and the State Administration of Traditional Chinese Medicine, jointly formulated and issued the ‘Nine Guidelines on Integrity in the Practice of Medical Institutions’ (hereinafter referred to as the ‘Nine Guidelines’).
II. Scope of Application of the Nine Guidelines
The Nine Guidelines are applicable to the staff of medical institutions, including but not limited to health professionals and technicians, management personnel, logistic personnel, and other social practitioners who provide services in medical institutions and accept the management of medical institutions.
Main contents of the Nine Guidelines
The Nine Guidelines adhere to the positive advocacy, negative warning in parallel, is the basic normative documents for all staff in the medical institutions of clean practice, is the industry ethics, practice standards, the masses of the concrete presentation of the demands, reflecting the ‘whoever is in charge of who is responsible for’ ‘management of the industry must be in charge of the style of practice It embodies the requirement of ‘whoever is in charge is responsible’ and ‘to control the industry must control the practice style’, and draws the bottom line of basic behaviour for the majority of medical staff.
Each guideline in the Nine Guidelines first sets out the requirements for promotion and then lists the prohibited behaviours. Specifically: to be paid legally for their work and not to accept commercial commission. Strictly abide by the principle of honesty, not to participate in fraudulent insurance. Practise medicine according to the norms, do not carry out excessive diagnosis and treatment. Comply with work procedures, do not accept donations in violation of the law. Abide by the principle of confidentiality, and do not disclose patients' privacy. Obey the need for treatment, not profit-making referral of patients. Maintain the order of medical treatment, not to undermine the fairness of medical treatment. Build a harmonious relationship, do not accept ‘red packets’ from patients. Abide by the bottom line of communication, do not accept corporate kickbacks.
The Nine Guidelines take whether the behaviour of medical institution staff is for personal gain as the evaluation and judgement standard, and explain the specific performance and connotation of the prohibited behaviours. The Nine Guidelines emphasise the main responsibility of medical and healthcare institutions for the management of ethical practices, as well as the supervisory responsibility of healthcare departments at all levels for the management of ethical practices. In particular, it emphasises the accountability of administrative departments and heads of healthcare institutions that fail to implement the Nine Guidelines, reflecting the convergence of regulations, discipline and law, and enhancing the effectiveness of the policy.
The Nine Guidelines are an upgrade of the Nine No-Nos.
After the publication and implementation of the Nine Guidelines, the ‘Nine Prohibitions’ were abolished at the same time. Nine Guidelines’ is in the “nine prohibited” from the strict governance of the kernel on the basis of the upgrading of the content to the form of improvement, specifically expressed as follows:
(a) Covering all the requirements of the ‘Nine No-Nos’. The ‘nine prohibitions’ of ‘no personal income of medical and health personnel linked to income from medicines and medical examinations’ and ‘no illegal fees’ have been incorporated into the ‘nine prohibitions’ of ‘no excessive diagnosis and treatment’ and ‘no illegal fees’. No over-diagnosis and treatment’; “No billing for commission”, “No prescription for commercial purposes”, “No participation in sales activities and illegal release of medical advertisements”, “No illegal release of medical advertisements”, “No illegal release of medical advertisements”, “No personal income of medical and health personnel linked to income from medicines and medical examinations”. ‘No illegal private procurement and use of medical products’ was incorporated into “no acceptance of commercial commission”. The ‘nine prohibitions’ of ‘no acceptance of patients’ red packets’, “no acceptance of kickbacks, no illegal acceptance of social donations” and so on, the “Nine Guidelines” adopted in its entirety, emphasised, and the scope of application is made clear. The scope of application has been clarified.
(ii) Supplementing and expanding the content. Supplementary prohibitions have been made on new issues and new situations and new manifestations of old problems. New contents such as ‘not to carry out over-diagnosis and treatment’, ‘not to participate in fraud and insurance fraud’ and ‘not to profitably refer patients’ have been added; as well as ‘old problems’ such as the recommendation of out-of-hospital purchase of medicines, the promotion of non-medical commodities, and Internet medical care, have been added. As for the new manifestations of ‘old problems’ such as recommendation of out-of-hospital purchases of medicines, promotion of non-medical goods, Internet medicine, etc., the Nine Guidelines have made comprehensive requirements with ‘no acceptance of commercial commissions’, covering all kinds of commissions to the maximum extent possible.
(iii) Clearly define the corresponding punitive measures. In accordance with existing laws and regulations, Party rules and departmental regulations, the reference basis for penalties for violating the Nine Guidelines has been increased. If the personnel concerned violates party discipline or political discipline, they will be transferred to the disciplinary and supervisory organs to be given party disciplinary and political punishment; if they are suspected of committing a crime, they will be transferred to the judicial organs to pursue criminal responsibility. For violations of the ‘nine guidelines’ behaviour more or cause bad social impact and other serious consequences of medical institutions in charge, in accordance with the relevant provisions, be accountable.
(d) Provide for specific ways of implementation. Learning and training, supervision and implementation, investigation and notification, constraints and assessment as a means of four measures to carry out the implementation of the Nine Guidelines, to ensure that the policy requirements are implemented in detail.
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