Kickbacks given to medical staff by drugs and medical equipment companies were officially defined as commercial bribery in a November 21 ruling by the Supreme People's Court (SPC) and the Supreme People's Procuratorate. But the move left the status of patient gifts to doctors unclear.

Commercial bribes need not be in the form of cash. Paying for holidays, house decoration, club and gym memberships are also included.

Undefined sentencing standard

Although China set out regulations to outlaw commercial bribery in the medical field back in 2006, lack of a clear legal basis meant little progress was made. "I think medical staff will be bound by the new legal tie. But I don't understand why the new rules don't include accepting money from patients as bribe-taking", said a senior manager of a medical supplies company.

He said that from a legal perspective, receiving money from pharmaceutical companies and patients should both be seen as bribery.

That the new judicial interpretation does not define any to take as reference contributes to uncertainty to make sentencing.

In addition there are worries that hospital directors will find it easier to accept bribes since the new ruling focuses on doctors who prescribe medicine.

"If hospital directors take bribes, they will be covered by legislation covering their positions as public servants," said Zhang Peihong, deputy director of the Criminal Law Committee of Shanghai Lawyer Association.

Medical staff debate ruling

Many doctors feel it is unfair to make them liable to bribery prosecutions. "No one would risk a bribery conviction if they were paid decent salaries," said a doctor at a Beijing hospital.

Including subsidies and bonus, the average monthly income of a Beijing doctor with 20 years experience is just 9,000 yuan (US$1,300), and in other cities pay rates are much lower, according to the doctor.

For young doctors, especially recent graduates, monthly wages as low as 700 yuan ($103) are simply not enough to live on. Many doubt the new judicial interpretation will make any real difference.

This single policy won't solve the problems in the health sector, said the doctor. The government, patients and doctors all have their own ideas of what needs to be done and there is no agreement on the way forward.

(China.org.cn by Wu Huanshu, November 27, 2008)