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    Muddled System Denies Compensation to Village Doctor’s Widower

    Woman’s death officially designated a ‘work injury,’ but it’s unclear who her employer was.

    Village doctors are crucial for providing health care to China’s 600 million rural citizens, but a widower’s lawsuit has highlighted that the country’s health care system gives them little support.

    Over the past five years, Luo Ruqi has repeatedly sought compensation for the death of his wife, a village doctor. She died from a heart attack while working at her village clinic in China’s southwestern Guizhou province. But his efforts have been stymied by the question of whom she actually worked for.

    Luo’s wife, Chen Shengqin, worked in Jinsha County for 19 years until her death on March 2, 2012. The same month, the local department of human resources and social security officially designated her death a “work injury,” meaning her family is entitled to compensation from her employer. Luo argued that his wife’s employer was the county hospital, which paid her, but the local health department disagreed.

    A court ruled in Luo’s favor, but because Chen, like most of China’s 1.2 million village doctors, had never signed a contract, the county government had grounds to deny compensation to her husband. The money Chen received from the hospital wasn’t a salary, but rather a subsidy, it argued — and so Chen never technically worked for the hospital.

    But Luo counters that his wife’s clinic is affiliated with the county hospital, and that she should be seen as one of its medical staff. “She spent lots of work hours on public health care administration,” Luo told Sixth Tone. Apart from providing medical treatment, Chen also provided public health services such as vaccinations, blood pressure checks, and care for the mentally ill.

    “Government subsidies made up a large part of her income,” Luo said. “She was required to buy medication from the county hospital, and she had to report the public health care records to the county hospital, too. I don’t understand how she’s not considered a staff member who worked for them.”

    Luo told Sixth Tone he was entitled to around 500,000 yuan ($72,500) in compensation. However, after five years, he had spent almost 400,000 yuan on lawsuits and petitions, and he’s currently awaiting the result of a petition he filed with the provincial health bureau, who told him to seek media exposure to increase his chances of getting a compensation.

    Village doctors have been an integral part of China’s health care system since the 1950s, when the country gave rural residents basic medical training so they could become so-called barefoot doctors who treated common illnesses and assumed other public health responsibilities, such as administering vaccines.

    In the 1980s, village doctors were officially separated from the public hospital system, which put them in an ambiguous position since they continued to hold public health care roles in their rural communities and still reported to their local health departments. Though they are practicing doctors, they are officially classified as farmers — and unlike public hospital employees, they do not receive salaries, social security, health insurance, or pensions.

    Village doctors are walking away from the profession due to a lack of benefits, high pressure, and low incomes. Very few young medical students take up rural posts, and most village doctors are over the age of 40.

    “Village doctors have done a lot for the country’s public health care [system],” said Luo’s lawyer, Yang Shiwei. “But there is no clear way to tell who these village doctors actually work for.”

    Editor: Kevin Schoenmakers.

    (Header image: A village doctor carries a medical kit in Henan province, Jan. 20, 2015. VCG)