context: A pilot work plan for expanding the opening of the wholly foreign-owned hospitals sector was releseased by the National Health Commission and three other departments on 29 November. It permits the establishment of wholly foreign-owned hospitals (excluding traditional Chinese medicine and public hospital acquisitions) in Beijing, Tianjin, Shanghai, Nanjing, Suzhou, Fuzhou, Guangzhou, Shenzhen and Hainan Island. This plan builds on a previous notice in September that encourages international hospitals to operate in PRC.
The workplan imposes strict restrictions on activities involving human genetic resources at wholly foreign-owned hospitals, including
- prohibiting the establishment of haematology hospitals or registering haematology departments
- banning procedures with high ethical risks, such as organ transplantation, assisted reproductive technology, prenatal screening and prenatal diagnosis
Wholly foreign-owned hospitals are prohibited from establishing psychiatric, infectious disease, traditional Chinese medicine, integrative Chinese-Western medicine or ethnic medicine hospitals.
Wholly foreign-owned hospitals complement existing healthcare services by providing differentiated roles and service models, said Cai Jiangnan 蔡江南 Shanghai Chip Academy executive director. They cater to expatriates and attract domestic high-income patients who might otherwise seek advanced treatment abroad, he added.
Some experts argue that this ‘complementary relationship’ should focus on introducing new technologies, therapies, and medical devices. Gao Jiechun 高解春 Fudan University's Hospital Management Research Institute director, notes that
- transitioning from joint ventures to wholly-owned facilities can foster productivity and higher-quality development by integrating advanced international technologies
- innovation must be balanced with safety
- better to prioritising internationally proven and widely applied technologies for approval rather than conducting clinical trials within the PRC
Zhao Dahai 赵大海 Shanghai Jiaotong University professor suggests evaluating this complementary role based on the hospital's global reputation
- prestigious brands like Mayo Clinic or Massachusetts General Hospital could meet international standards and attract high-income patients
- lesser-known brands should face equivalent regulatory oversight upon entering the PRC
Regarding the issue of including international hospital treatments in the PRC’s medical insurance system, experts note that
- there are precedents from joint venture hospitals being included
- while this may help attract patients, high fees for registration and services at foreign-owned hospitals mean out-of-pocket costs remain significant even with partial insurance coverage
- some industry insiders suggest evaluating eligibility based on the pilot cities' insurance funding levels