Personnel reform in Chinese hospitals: policy interdependence and the challenge of coherent incrementalism

Abstract

Health care in China is plagued with problems, including barriers to access, maldistribution of resources, inefficiencies and uneven quality. The management of human resources in the health care system has a significant effect on what happens in the clinic and the ward. The management of staff appointments and the remuneration system are two critical areas that remain problematic although they have received government attention. We argue that new approaches to policy development and implementation are needed to achieve a high-performance health care system. In particular, we suggest a new focus on the challenges of policy interdependence across sectors and among levels of administration. We highlight the need for a clear vision for health care, which would provide direction for the entire reform process, and also for a restructuring of the system of accountability.