In Beijing a few weeks ago, discussing alternative health reform models with Chinese government officials, I was struck by the fact that at about the time the NHS Plan was being formulated in 2000, China was embarking on a similar 10-year health plan.

And now as health minister Lord Darzi contemplates the next stage of NHS reform, his Chinese counterparts are doing the same.

While the differences are obvious, there are some interesting - if indirect - parallels as China struggles to raise public spending on healthcare, boost primary care in a system overly dominated by hospitals and take public health seriously.

Of course, the eyes of the world are on China. That much is guaranteed by the combination of the awful earthquake in Sichuan and the Olympic games in August.

Beijing is in the middle of major urban cosmetic surgery. Across the city half-grown trees are being airlifted in to dust-swept concrete-scapes and propped up with bamboo pegs. Traditional hutong communal housing is being bulldozed before your very eyes. And the old streets south of Tiananmen Square are being replaced with Disney-fied facades for tourists.

There can be little doubt China knows how to do grand projets. What is less clear is whether it can apply that same determination - and resource mobilisation - to health improvement.

China has been spending too little public money on healthcare. Surprising perhaps for an avowedly Communist regime, but like many middle-income countries, its healthcare system is far too reliant on patient charges and co-payments.

Over half of healthcare spending comes from patients' out-of-pocket payments when they get sick; under a fifth comes from government. Even in public hospitals, less than 10 per cent of revenue typically comes from the Chinese taxpayer.

The announcement by Chinese premier Wen Jiabao that the government will raise its healthcare spending by 25 per cent this year (to£5.8bn for 1.3 billion people) is therefore welcome. More will be needed because the lack of risk-pooled health spending graphically shows what happens when individual consumers lack a healthcare purchaser working on their behalf.

That families are exposed to devastating financial shocks as they try to cobble together the money to treat a loved one is obvious. But more than that, they lack an agent to counterbalance hospitals' pricing power, ensure minimum standards of quality and help safeguard against oversupply of inappropriate care as well as promote the use of timely primary and preventive care.

Because Chinese hospitals are financially overly dependent on mark-ups on the drugs they prescribe, patients are being prescribed expensive but unnecessary medicines on an industrial scale.

And because Chinese hospitals are trying to trade their way out of closure, there is something of a medical arms race under way.

Visiting a gleaming new cardiac hospital in Tianjin a few years ago, in the middle of a construction zone stretching as far as the eye could see, I was struck by the fact that it was stuffed full of the latest imaging and diagnostics equipment, with impressive cardiac catheterisation labs, operating theatres and wards. All it seemed to lack was patients.

This underlines what the Chinese government points out is one of the paradoxes of China's health sector: oversupply of inappropriate care existing side-by-side with the undersupply of needed care.

What then to do about it? China's newly published draft reform plan (phase one of its Darzi equivalent) talks of the need to expand publicly financed healthcare coverage, strengthen planning and funding functions and narrow the gap between rural and urban areas.

In seeking to "promote fair competition and mutual stimulation" between hospitals, it talks about payment reform and seeks to "reform the mechanism of propping up hospitals by selling medicines and cut off the benefits medical staff get from drug sales". And it seeks to introduce "comprehensive performance assessment focusing on workload and service quality" so as to "fully promote the enthusiasm of the medical staff". (Good luck!)

However, the biggest area of controversy concerns the place of hospitals relative to primary care. Some Chinese reformers would like to see marginally viable hospitals shut down or sold off. But as one analyst recently reported, "it is likely China has decided it cannot do much to reform its hospitals directly - the hospitals are too powerful politically within the Communist hierarchy". Instead it seems the new plan will mostly sidestep the question of surplus hospital capacity and will instead build up a parallel primary care infrastructure based on - you guessed it - polyclinics.

Yet underpinning all this, of course, are even more fundamental questions about how China will tackle the main drivers of its future disease burden, as its population industrialises, urbanises and ages on a larger, faster scale than any society in human history.

My wife and I are expecting our second baby in a few weeks, which set me thinking about China's one-child policy, demonstrating as it does that this is a society that draws the boundary between the individual and the collective in a radically differently way from ours.

However, when it comes to public health policy, China has to date been less interventionist than us, be it on the growing scourge of road traffic accidents, the rising prevalence of chronic disease, or smoking. How it tackles these issues will have a bigger impact on its future success than anything else in its new health reform plan. Hence its rallying cry that it is time to "unfold the patriotic public health campaign deeply"!

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