无锡市实行的托管制改革已经运行4年多,取得了一些成功经验,但是托管制不可能解决卫生事业发展中的所有问题,尤其是体制上的深层次问题.在此背景下,无锡市从卫生行政管理体制着手,以管办分离为核心,从强化政府责任、转变政府职能、调整组织结构、界定管理权限等方面就创新卫生管理体制进行了探索.本文从改革的总体思路、改革后的体制架构、事权划分、初步成效等方面,剖析了无锡市实行管办分离模式改革后政府部门与事业单位的关系、政府部门与各类中介组织的关系、政府在公共卫生服务中的主体地位和主导作用等,并就实现政事分开、政资分开、政企分开的有效途径进行了理性的思考.%In Wuxi City,the trusteeship reform has been in practice for four years with success to some extent.This reform,however,cannot be expected to remove all roadblocks in the development of the health system,especially in-depth structural problems.Against this background,Wuxi initiated the reform starting from the health administration system.Centering on the separation of hospital regulation from its management,the city made worthy experiments in innovating the health management system,by way of intensifying government responsibility,converting government functionality,adjusting organizational structure,and distinguishing management powers.This paper analyzed this separation model in Wuxi health system from such aspects of the overall reform concepts,reformed structure,inter-governmental decision-making division,and initial outcomes.The author also analyzed the relationship between government departments and institutions following the reform,and that between such departments and individual intermediary organizations,as well as the dominant and leading role of the government in public health service delivery.Furthermore,the paper probed into effective practices of separating the functions of government from those of institutions,separating the government role as state-owned assets owner from that of administrators,and separating government functions from enterprises.
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