Underpaid doctors trapped in chain of medical corruption

After finally seeing his last patient, Zhang Wei still had no intention of going home, although it was already 6:30 pm. He wanted to recheck the X-rays of a patient due for surgery the next day. But something else had kept this energetic doctor occupied all day, as it had all doctors in the city.

What troubled Zhang was a shocking piece of news exposed by media nationwide in late July. According to an investigation by the local Commission for Discipline Inspection (CDI) of the Communist Party of China (CPC) during the first half of the year, 90 percent of medical staff at all 73 hospitals in the city of Zhangzhou, Fujian Province were found to be involved in medical corruption.

With 57 medical representatives initially arrested, 1,088 medical staff and 133 administrative staff members were eventually implicated with 20.49 million yuan ($3.34 million) in bribes having been returned so far.

A recent scandal involving British drug giant GlaxoSmithKline (GSK) has already shaken China. The Chinese healthcare sector is facing another body blow in the shape of this brewing corruption case.

But this is far from the first time that authorities have cracked down on medical corruption in public hospitals in China. In 2010, all nine pharmacy chiefs at nine major public hospitals in Zhuhai, Guangdong Province were charged with bribery and sentenced to life imprisonment.

The incident rocked the local government and a series of measures was taken across Zhuhai to stop the same thing from happening again. But across the nation, the problem persists.

Although medical corruption is no longer news in China, the scale and level of complicity in Zhangzhou still surprised many. Some questions linger: is this just another case or is the healthcare system in China is rotten to the core?

Doctors' confessions

"To be frank, I was a little surprised but not angry when I first saw this story online," Zhang Wei told the Global Times.

Zhang has been a surgeon at a major hospital in Zhangzhou for more than 20 years. Besides heavy daily outpatient work, he carries out regular surgeries every week as well as teaching medical students.

"When you wear a doctor's coat, you should take on the full responsibility of this job. And I believed most doctors were good and were willing to cure their patients from the bottom of their hearts," Zhang said.

According to Zhang, the hospital he works for was only designed for 1,500 patients but now it handles 3,000 since demand is so high. Doctors often need to work until 1:30 pm without rest when morning working hours are supposed to be over at 11:30. Operation rooms are always full. Even after the scandal was exposed, crowds of patients have kept on flocking to hospitals.

"But in return for all this work, doctors might only be paid some 2,000 yuan per month," Zhang said.

"It's true that there is corruption in hospitals just like the report. Although I don't agree with some doctors who think it is acceptable to take bribes due to the low salary they get for the hours they put in, I think there should be a system to balance the gap. After all, not all doctors adhere to noble medical ethics," Zhang said.

In Zhang's eyes, writing out prescriptions should be based on safety, efficiency and maintaining prices as low as possible. However, a profit-seeking mentality has twisted the simple ideology which every doctor should follow.

When doctors are always working under high pressure, it is not hard to understand why they will look for some other ways to make ends meet.

One main way to earn money for doctors is to use their right to write out prescriptions. Under the current medical system for public hospitals in China, doctors' salaries are linked with the prescriptions they give. The more medicine they give to patients, the more money they earn. Such a business model has been denounced by experts as a way "to cover hospital expenses through medical revenue" and which has become a hotbed of corruption.