On September 4th, the Shenzhen Nanshan District Maternal and Child Health Hospital held a ceremony to unveil its "Grade A" designation. With this, the total number of Grade A hospitals in Shenzhen reached 33, approaching the levels of Taiyuan, Jinan, and Chongqing; since the "Fourteenth Five-Year Plan," an additional 15 have been added, making it one of the cities with the most new Grade A hospitals in the country during the same period.
At the same time, Shenzhen has vigorously increased the number of basic education school places, implementing the "Million School Places Initiative," which has added nearly 650,000 basic education places in the past four years, equivalent to the basic education scale of a city with a population of about 3 million.
As a metropolis with top-tier economic strength and population size in China, Shenzhen's basic medical and educational supply levels have long been criticized. The main manifestation is the severe mismatch between the number of Grade A hospitals and the city's size, and the long-term shortage of basic education places, making it difficult for the public to seek medical care and education.
To address these two major shortcomings in people's livelihoods, Shenzhen has made multifaceted efforts, especially in terms of financial investment, which can be described as a significant commitment. For instance, in 2023, the city's nine major categories of livelihood expenditures totaled 331 billion yuan, with education spending at 101.5 billion yuan and health and wellness spending at 61.91 billion yuan, accounting for nearly half of the total livelihood expenditures.
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Currently, these efforts have achieved significant results. Shenzhen's medical and educational capabilities have been continuously strengthened, service capabilities have been continuously improved, and the gap with other mega and super cities has been narrowing. This undoubtedly benefits Shenzhen in enhancing its city image, optimizing the business environment, and increasing talent attraction.
The number of Grade A hospitals has tripled in 9 years.
At the end of 2015, Shenzhen's permanent population reached 11.38 million, with only 10 Grade A hospitals. This level was not only far behind other cities with a population of over 10 million but also lagged behind many prefecture-level cities with a population of millions.
The direct cause of this situation was that the pace of urban supporting resource planning and construction could not keep up with the expansion of the economy and population size. The deeper reasons are related to Shenzhen's relatively low urban administrative level and the small number of registered residents. In China, these two factors are the main considerations for the planning and construction of public hospitals.
Currently, Shenzhen is a sub-provincial city, with four municipalities and ten sub-provincial provincial capitals ahead of it. In 2015, Shenzhen's registered population was 3.55 million, accounting for only 31.2% of the permanent population. After years of effort, by the end of last year, this proportion had only increased to 34.1% (permanent population of 17.7901 million, registered population of 6.0614 million).
However, due to the pressure of the situation, Shenzhen must enhance its medical and health capabilities at an extraordinary speed and rapidly increase the number of various medical institutions.The 2021 Shenzhen City Health and Wellness Work Conference materials indicate that during the "13th Five-Year Plan" period (2016-2020), the Shenzhen government consistently increased its investment in health and wellness, with a cumulative investment exceeding 150 billion yuan, which is 2.51 times that of the "12th Five-Year Plan" period. There were 23 new tertiary hospitals and 125 community health institutions added. By the end of 2020, the city had 5,298 medical and health institutions, 62,900 hospital beds, and 42,600 licensed physicians, representing increases of 50%, 65%, and 47% respectively compared to the end of the "12th Five-Year Plan" period. In that year, Shenzhen's health and wellness expenditure reached 44.05 billion yuan, a 31.3% increase, and the number of tertiary A-level hospitals increased to 18.
The aforementioned conference proposed that Shenzhen will continue to increase its investment in health and wellness, aiming to reach a total of 82,900 hospital beds, 55,000 physicians, 60 tertiary hospitals, with more than 26 being tertiary A-level hospitals, and over 900 community health institutions by 2025. The city aims to establish 2 leading national centers for the prevention and treatment of major diseases, strive for 3 hospitals to enter the top 100 in the country, and preliminarily build itself into a nationally important medical center city and a globally influential healthy city.
In the last three years, Shenzhen has further accelerated its efforts to "catch up" in medical and health investment. Last year, Shenzhen started the construction of 13 new hospital projects and completed 10; it added 5,500 hospital beds, bringing the total number of beds in the city to 70,000; it added 45 community health institutions, 1,629 new general practitioners, and the total number of general practitioners exceeded 10,000. Along with the expansion in quantity, the quality has also improved—in the 2023 national performance assessment of tertiary public hospitals, Peking University Shenzhen Hospital jumped to 38th place in the country, with 9 hospitals entering the national top 100 and 4 specialized hospitals entering the top 10 of their category. For Shenzhen, this is a significant advancement.
After years of rapid strengthening and expansion, as of now, Shenzhen has established 56 tertiary hospitals and 926 community health centers, with 15 new tertiary A-level hospitals added since the "14th Five-Year Plan," preliminarily establishing a new pattern of a "top-notch and comprehensive" medical service system. According to the plan, this year Shenzhen will complete the first phase of the renovation and expansion of the Longhua Branch of the Municipal People's Hospital, the Municipal Proton Tumor Treatment Center, and other projects, promote at least 7 completed projects to be put into use as soon as possible, add more than 8,000 hospital beds, and add 35 community health institutions and more than 500 general practitioners.
However, Shenzhen's overall medical and health strength still has a gap compared to the expectations of its citizens. For example, the number of tertiary A-level hospitals per million people is lower than that of many mega and super-large cities, and there are not many high-level hospitals. In the authoritative "Fudan National Hospital Top 100 List (2022)," Shenzhen only has the Municipal People's Hospital ranked 98th in the country and the Third People's Hospital ranked 100th. According to First Financial Daily reporters, in the second half of the "14th Five-Year Plan," Shenzhen will optimize and improve its health and wellness development strategy, shifting from "building foundations and ensuring supply" to "building highlands and improving quality."
Implementation of the "Million School Places Initiative"
Before the start of the new school term this fall, Shenzhen welcomed a batch of newly renovated and expanded schools to be delivered and put into use, adding 90,000 new basic education places, with a total of 170,000 new places to be added throughout the year. This is one of the "livelihood big gifts" that the Shenzhen government has been giving to its citizens in recent years, originating from an "educational super project" known as the "Million School Places Initiative."
For Shenzhen, for a long time, the urgency of expanding basic education places is, to some extent, stronger than that of increasing the number of tertiary A-level hospitals. The Shenzhen government's efforts in education are not to be underestimated. Official data show that from the 18th National Congress to 2020, Shenzhen added a cumulative total of 641,000 new public basic education places, ranking first in the country in terms of the number of new places; the city's cumulative investment in basic education from the fiscal funds was nearly 240 billion yuan, with an average annual growth of nearly 21%. However, in the face of the continuous high growth in population inflow, the new places have always been difficult to meet the demand, and the citizens' voices are strong.
Faced with the huge pressure of school places, in December 2020, the Shenzhen Municipal Party Committee and the Municipal Government issued the "Implementation Opinions on Accelerating the Construction of School Places and Promoting the High-quality Development of Basic Education" (hereinafter referred to as the "Implementation Opinions"), proposing the "Million School Places Initiative" - by 2025, the city will add 740,000 new public compulsory education places, 145,000 new kindergarten places, plus the 97,000 new public general high school places that were under construction at the time, with a total of nearly one million new basic education places. After the completion of the plan, the total scale of public compulsory education in the city will nearly double. Among them, the new public compulsory education stage places will reach three times that of the "13th Five-Year Plan" period.
Shenzhen has a strong financial strength, and it should not be difficult to build more schools, but why has the construction speed long failed to keep up with demand? This is greatly related to the tight land resources in Shenzhen. Shenzhen is the smallest among the national cities with a population of ten million, about 1/4 of Guangzhou, less than 1/3 of Shanghai, and 1/8 of Beijing. The higher the population density, the more prominent the contradiction between educational land and land resources. At the same time, there are many urban villages in Shenzhen, and the preparation of many educational land is difficult and costly. These two reasons have led to the slow progress of new and expanded school construction.The "Implementation Opinions" call for the concerted efforts of the entire city to advance this grand plan, specifying tasks such as the formulation of a special plan for basic education facilities (2021-2035) and the improvement of mechanisms to ensure the construction of school places in residential areas. The "Implementation Opinions" emphasize the establishment of a joint review system for school place construction, requiring that supporting educational facilities must be planned, constructed, and independently accepted in conjunction with residential projects, and then handed over to the government without compensation.
The "Implementation Opinions" also propose the "three nos": residential projects that cannot meet the layout requirements of educational facilities determined by the regulatory detailed plan will not be processed for planning permission; residential areas where the planned educational facility land has not reached the construction conditions will not be supplied with land for residential projects; and residential projects within an area will not pass the joint acceptance if the planned educational facilities for the area have not been completed and put into use.
The year 2021 marked the beginning of the "Million School Places Initiative," and by the fall semester, Shenzhen had completed the construction and operation of 130 newly built, renovated, and expanded schools (kindergartens), adding approximately 120,000 new basic education places, once again leading the country in the number of new places added. In 2022, the effort was further intensified, with 182 new, renovated, and expanded primary and secondary schools (kindergartens), adding 206,000 new basic education places. The performance in 2023 was comparable to that of 2022.
This year, Shenzhen plans to renovate and expand more than 130 primary and secondary schools (kindergartens), adding 170,000 new basic education places. According to official statistics, as of the first half of this year, more than half of the "Million School Places Initiative" has been completed, with 644,000 new basic education places added, setting a "Shenzhen speed" for the expansion of basic education places. At the current pace, there is little doubt about completing the entire plan on schedule.
It is worth mentioning that Shenzhen's plan for new school places is formulated based on a comprehensive calculation of population change trends and takes into account future changes in population structure and the decline in population growth. After 2025, according to the changes in the population of school-age children entering each stage of education, Shenzhen will issue guidelines for adjusting the basic education stages, allowing some primary and secondary schools (kindergartens) to adjust their educational stages in a timely manner to avoid unbalanced regional school place supply.
While expanding the quantity of basic education, Shenzhen also focuses on improving the quality of education. One approach is to promote high-quality and balanced development of education through the advancement of group-based operation of basic education. By 2025, Shenzhen will establish 80 high-quality basic education groups, achieving full coverage of group-based operation in public compulsory education schools across the city. At the same time, Shenzhen will prioritize the placement of high-quality schools in university areas where educational quality is relatively weak and incorporate weak schools in the university areas into the group-based operation of high-quality schools. In addition, efforts will be made to promote 1 to 2 districts to create national high-quality balanced development areas for compulsory education.
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