**解读:卫计委规范医疗机构科室管理及医疗技术临床应用管理精神

2016-05-04 MedSci MedSci原创

今天上午国家卫计委医政医管局召开规范医疗机构科室管理及医疗技术临床应用管理视频会议。全国31个省市(自治区、直辖市)等卫生厅局处,省市县级医院负责人参加了会议。 会议内容大体汇报如下: 1,卫生行政部门要履行监管责任,规范依法执业,加强基层民营医疗机构管理力度,要尽快改进监管作风,做好卫生机构特别是民营医疗机构的监管,规范医疗机构的科室管理,特别是公立医疗机构的违规,坚决杜绝违规违法现

5月4日上午国家卫计委医政医管局召开规范医疗机构科室管理及医疗技术临床应用管理视频会议。全国31个省市(自治区、直辖市)等卫生厅局处,省市县级医院负责人参加了会议

会议内容大体汇报如下(会议内容由医讯网友记录,并不完全,详细信息还有待官方公布),以下是梅斯医学对目前流传出来的会议内容的解读,仅供大家参考:

1,卫生行政部门要履行监管责任,规范依法执业,加强基层民营医疗机构管理力度,要尽快改进监管作风,做好卫生机构特别是民营医疗机构的监管,规范医疗机构的科室管理,特别是公立医疗机构的违规,坚决杜绝违规违法现象发生。


解读:民营机构监管要更严格了,以后开私立医院,民营医院更困难。医生集团,私人诊所,恐怕没这么容易放开。

大家一直报怨开诊所这么难,其实原因在于政府不敢放开,怕乱!如果满天下都是蚂蚁军团的混乱,根本无法监管,到头到天天都是事。

2:要求各医疗机构不得追求医院效益的最大化,采取各种违规违法手段,损害百姓利益,尤其是出租科室的公立机构,各医疗机构要严格监管检查,必须出重拳打击。

解读:与科室合作,出租等变相谋利行为,或借用第三类医疗技术进行合作收费,会变得困难。实际上,出租科室在非部队的公立医院已极少见了。这次管理意见事先明确,如果仍然合作的话,后续将迎来严重的惩罚可能。因为以前规矩也有,但并不特别明确,现在明确意义了,主动退出,可能以后不究,如果仍然暗箱操作的,就会......

3.出租科室的公立医疗机构进行严肃处理,根据国家相关规定进行彻底的清理与检查,各医疗机构立即停止合作。

解读:同上。当停则停!

4.严格加强医疗技术和设备的监管力度,对医疗机构进行分级分类管理,二类和三类技术实行第三方审核管理,任何医疗机构不得未经允许开展临床应用,严格医疗技术审批,加量临床质量过程的审批与监管。

解读:第三类医疗技术上临床会受到严格监管,意味着,没核心技术,或没有确实疗效的,很难真正进行下去。表面是禁令,实际上是提高门槛,把一些违规的,没有技术能力的第三方筛选掉,对行业整体发展应该是有益的。

未来免疫细胞治疗公司,在全国,最好只有几家大型的巨头,而不是遍地开花!从监管角度来看,遍地开花,也不利于监管,出问题是迟早的事情。如果国内也能出现Juno这样的公司,自然是政府乐见其成的!政府不希望再出现数千家制药公司这样的场景。

对于资本层面,也应该推动行业整合,哪怕现在投资了大量公司,未来也是推动整合和并购,监管巨头总比监管蚂蚁军团容易,而且企业做大了,违法成本就提高了;同时,巨头也能集中研发,能单点突破。分散经营,优点在于个别医院违规,即使受到处车主卡,也不会影响整体,但这种经营方式不合适政府监管。因此,从政府层面希望能建立支配市场地位的几家公司,以稳定市场秩序,规范市场行为,以促进市场良性发展。

从这种角度上看,此时更是资本介入的良机,风口上介入成本太高,在严格监管下介入,反而容易脱颖而出。

5.基层医疗机构不得未经授权开展第三类医疗技术开展临床,未经审批开展的三类医疗技术,严令禁止。各医疗机构开展的所谓合作开发,未准入审批的医疗技术,不得进入临床应用。

解读:这一条十分重要,强调“基层医疗机构”!意味着大型医疗机构,尤其是有临床试验资质的机构,仍然是允许的,这一点给专业的机构开了个口子。以后大家做CAR-T,TCR应该是自已做,或与一些高水平机构合作,只是合作的模式和机制可能要调整了。如果完全按新药临床试验的模式,那可以大投入了,没有几个亿下不来的。因此,需要创新的合作模式介入。

有关叫停,不必担心的,是金子就会发光的。免疫细胞治疗是国际大趋势。类似的案例也发生在基因测序方面。2014年2月,CFDA和卫计委一纸通知叫停了当时同样颇受争议的临床基因测序,原因是相关产品和技术并没有通过审批。未经审批就做诊疗,算是非法行医,属于严重违法行为。但此后,在不少院士、专家的不断呼吁之下,仅仅过了4个月,2014年6月30日,CFDA就批准了二代基因测序产品上市,6个月后,2015年初国家卫计委发布《关于产前诊断机构开展高通量基因测序产前筛查与诊断临床应用试点工作的通知》,二代基因测序获得迅速发展。

这个案例告诉大家,如何合理解读政策?叫停是提高门槛,实际上是给规范的公司创造机会,让忽悠的公司退出市场。如果你有技术,很规范,此时此刻,打好内功,练好真功夫,保护好知识产权,加强研发投入,等政策春风一下去,首先得益的就是你!

中国人做事风格往往都是这样,一脚油门,一脚刹车,往往矫枉过正。原因很简单,新事物不知道如何预先监管(政策往往落后市场一大步),而且国人中有一小摄人不守规矩,喜欢乱来,搅乱市场,于是监管层只好踩刹车了。但是,真金不怕火炼,踩踩刹车,降降温,方能气静神明!

6.各卫生行政部门对医疗广告的管理要依法进行查处,需要审批的必须严格规范,卫生行政部门严格审批审查后可发布。加大医疗广告的监督力度,违规违法的立即停止。

解读:百度的事情,现在还有一个法律障碍,虽然提出已8年之久,国家工商总局现在还无法认定百度推广属于不属于广告。估计近期会出来司法解释,予以定性。将百度竞价排名字为信息服务,还是广告服务,最终决定走向。二者在监管层面有本质性区别。

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu May 05 20:26:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84319, encodeId=95f984319ff, content=免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:19:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84318, encodeId=d17c84318b0, content=希望不是矫枉过正,毕竟免疫疗法是大势所趋!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
    2016-05-09 jaysppr

    喂鸡尾就是个笑话

    0

  4. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu May 05 20:26:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84319, encodeId=95f984319ff, content=免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:19:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84318, encodeId=d17c84318b0, content=希望不是矫枉过正,毕竟免疫疗法是大势所趋!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
    2016-05-06 gyczyxy

    之前为什么视而不见?

    0

  5. 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createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
  6. 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createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
  7. 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createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1835620, encodeId=1c3618356201c, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Jun 03 01:27:00 CST 2016, time=2016-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1957926, encodeId=96b1195e92635, content=<a href='/topic/show?id=9556e492586' target=_blank style='color:#2F92EE;'>#科室管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74925, encryptionId=9556e492586, topicName=科室管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, 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createdBy=d0921674448, createdName=gyczyxy, createdTime=Fri May 06 08:32:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1298328, encodeId=73091298328f4, content=<a href='/topic/show?id=ac55350442f' target=_blank style='color:#2F92EE;'>#医疗机构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35044, encryptionId=ac55350442f, topicName=医疗机构)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=63a4277, createdName=cy0324, createdTime=Fri May 06 07:27:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1354033, encodeId=dbf6135403341, content=<a href='/topic/show?id=4d723669096' target=_blank style='color:#2F92EE;'>#卫计委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36690, encryptionId=4d723669096, topicName=卫计委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 06 07:27:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542003, encodeId=331c1542003d1, content=<a href='/topic/show?id=c639349683a' target=_blank style='color:#2F92EE;'>#医疗技术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34968, encryptionId=c639349683a, topicName=医疗技术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0e513335524, createdName=ms5822920152752585, createdTime=Fri May 06 07:27:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84321, encodeId=3fe78432140, content=这是个过渡期, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu May 05 20:26:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84319, encodeId=95f984319ff, content=免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:19:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84318, encodeId=d17c84318b0, content=希望不是矫枉过正,毕竟免疫疗法是大势所趋!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
    2016-05-05 明崖

    这是个过渡期

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu May 05 20:26:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84319, encodeId=95f984319ff, content=免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:19:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84318, encodeId=d17c84318b0, content=希望不是矫枉过正,毕竟免疫疗法是大势所趋!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
    2016-05-05 1dea03edm93(暂无匿称)

    免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床

    0

  10. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu May 05 20:26:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84319, encodeId=95f984319ff, content=免疫疗法是人类对抗疾病的原子弹,希望加大这方面的正规研究和临床, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:19:00 CST 2016, time=2016-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84318, encodeId=d17c84318b0, content=希望不是矫枉过正,毕竟免疫疗法是大势所趋!, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e1671710360, createdName=1dea03edm93(暂无匿称), createdTime=Thu May 05 20:18:00 CST 2016, time=2016-05-05, status=1, ipAttribution=)]
    2016-05-05 1dea03edm93(暂无匿称)

    希望不是矫枉过正,毕竟免疫疗法是大势所趋!

    0

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