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解讀《普洱市人民政府辦公室關于印發普洱市進一步加強鄉村醫生隊伍建設實施細則的通知》
索引號: 1001-/2019-0107002 公開目錄: 政策解讀 發布日期: 2019年01月02日
主題詞: 發布機構: 市政府辦公室 文    號: 普政辦發〔2018〕152號
 

 

 

  一、事項由來

為貫徹落實中央、省關于深化醫藥衛生體制改革的一系列重要決定以及《國務院辦公廳關于進一步加強鄉村醫生隊伍建設的實施意見》(國辦發〔2015〕13號)和《云南省人民政府辦公廳關于進一步加強鄉村醫生隊伍建設的實施意見》(云政辦發〔2015〕54號)精神,出臺了《普洱市進一步加強鄉村醫生隊伍建設的實施細則》(以下簡稱《實施細則》)。

    二、主要內容

   《實施細則》共10章24條,包括鄉村醫生配置、準入、退出、考核、培養培訓、補助、養老、轉變服務模式、改善執業環境等方面政策進行了詳細規定。

   (一)健全鄉村醫生準入及退出機制

    1.準入機制。各縣(區)可按照“退一進一”的原則,根據空缺崗位每年面向社會招考一定數量的品學兼優、中專以上全日制大中專學校畢業生到村衛生室工作。在崗的鄉村醫生和新進入的人員必須取得中等醫學專業以上學歷或執業(助理)醫師以上資格,否則不得使用或錄用。

    2.退出機制。鄉村醫生男年滿60周歲、女年滿55周歲必須辦理退出手續。對確有一技之長的老鄉村醫生,在辦理退出手續后,在雙方自愿的前提下可返聘使用,但不再享受在崗鄉村醫生的財政補助。對在崗的不具備資質的鄉村醫生(未取得執業醫師資格、執業助理醫師資格、護士資格、鄉村醫生資格其中之一的人員)可限定期限參加醫學教育取得中等醫學專業以上學歷,在5年期限內未達到者逐步予以清退(對邊遠山區、民族地區及條件艱苦地區鄉村醫生給予適當延長清退期限

    (二)健全鄉村醫生考核補助制度。一是對年度考核為優秀鄉村醫生,由市、縣(區)財政給予每人800元補助。二是對新考取專科及以上學歷的鄉村醫生,由市、縣(區)級財政一次性給予每人10000元補助。三是對考取執業助理醫師資格的鄉村醫生,市、縣(區)級財政一次性給予每人10000元補助;對考取執業醫師資格的鄉村醫生,市、縣(區)級財政一次性給予每人20000元補助。

    (三)加強鄉村醫生培養培訓。2011年來,省級每年安排我市約19萬元培訓經費用于對縣(區)衛生計生行政部門對在村衛生室執業的鄉村醫生每年不少于2次的免費培訓,累計培訓時間不少于2周,遠遠不能滿足開展鄉村醫生各種培訓、進修、學歷教育所需的實際經費。市、縣(區)兩級每年對所有鄉村醫生進行輪訓15天,其中,集中理論培訓5天和臨床跟班培訓10天。市、縣(區)級財政按照每人每年1500元進行補助。

(四)保障鄉村醫生收入。目前我市在崗鄉村醫生收入主要由四部分組成:一是村衛生室實施國家基本藥物制度中央補助。二是基本藥物制度定額補助,每人每月500元補助(省財政300元/人、市財政50元/人、縣財政150元/人)。三是一般診療費收費和補助。四是基本公共衛生服務補助,即居民健康檔案建檔費、計劃免疫接種費、健康教育宣教費等。按照村衛生室服務人口數人均5元的80%,經過縣級考核后進行劃撥。離崗后待遇依靠各縣(區)積極引導鄉村醫生參加社會養老保險為主,無其他待遇保障。針對鄉村醫生待遇低,隊伍不穩定等現狀,一是制定退養鄉村醫生補助政策,對在本細則出臺后,按年齡政策規定辦理退出手續的鄉村醫生按月發放退養補助。連續工齡在30年及以上的按不低于200元/月發放;連續工齡在20—29年的按不低于150元/月發放;連續工齡在5—19年的按不低于100元/月發放。二是建立離崗鄉村醫生一次性退出補助政策。對在本細則出臺前已退出、目前仍健在且連續工齡在5年以上的;在崗連續工齡不足10年,但已達到退出年齡的;因學歷不達標、條件不具備(未取得執業醫師資格、執業助理醫師資格、護士資格、鄉村醫生資格其中之一的人員)而被清退但連續工齡滿5年以上(含5年)的鄉村醫生。三類人員給予一次性退出補助;市、縣(區)財政給予不低于500元/年工齡/人的一次性退出補助,按實際工齡數計算(截止到退出時間)。已享受過離崗補助,但未達到以上補助標準的上述人員,按照填平補齊的原則予以補足。因個人原因自動脫離鄉村醫生崗位的、或因紀律處分開除的、或因連續三年考核不合格等原因辭退的人員不得享受退養補助或離崗補助。

    (五)制定鄉村醫生養老政策。為切實解決在崗鄉村醫生的養老保障問題,支持和引導鄉村醫生按照《普洱市人民政府關于印發普洱市城鄉居民基本養老保險實施細則的通知》(普政發〔2014〕76號)要求參加城鄉居民基本養老保險,參保人員可根據本人收入狀況和經濟承受能力自行選擇繳費檔次對參加養老保險的鄉村醫生,每年每人補助500元保費。 

(六)建立鄉村醫生執業風險化解機制。建立適合鄉村醫生特點的醫療風險分擔機制,市、縣(區)級財政每年對每個村衛生室補助1000元,每個村衛生室自籌1000元。

 

 

 

 

 

 

 
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