Commercial Sector Expansion inside Taiwan's Hospitals
From as early as 2002, the Taiwan Healthcare Reform Foundation (THRF) has expressed our concern over the trend of continuous expansion of commercial quarters inside Taiwan's hospitals and medical centers. Using newly founded Show Chwan Memorial Hospital in Chang Bin as an example, Show Chwan has a lavish shopping alley, food plaza, a SPA, a movie theater, and a medical museum in its campus. The owner of the hospital proudly advertises Show Chwan as a "medical theme park" Observing this trend, we fear that the healthcare facilities are focusing overtly on the non-medical-related profit-making activities, and overlook the importance of healthcare qualities.
Show Chwan’s case is not an abnormity. All around the island, hospitals begin to invest more into their non-medical related commercial sectors to attract outside customers. And as the shopping zone continues to expand, many hospitals resemble more to a department store instead of a healthcare facility. It is reported that hospital’s commercial sector receives on average 10,000 ~ 30,000 visits per day.
The emergence of such phenomenon is partially cultural-oriented. Hospital cares in Taiwan have been relying heavily on patients' families beside the professional nurses. The family members would often stay with the patient in the hospital for an extensive period of time. In the beginning, these family members were the primary targets for the hospital's shopping districts, which also provide daily needs and some relaxation for the hospital employees.
The implementation of the global budget to the National Insurance system also fuels the excessive profit-seeking frenzies among hospitals. The global budget forces the hospital to find other ways to increase their incomes, which leads to the expansion of commercial sectors. The lavish commercial sectors help the medical facilities attract "tourists" with no medical needs along with them a significant amount of extra incomes. The fact that most of medical centers or hospitals in Taiwan are located at the busy commercial zone might also boost such phenomenon.
We have expressed the following concerns about the increasingly commercialized hospitals and medical centers:
1. Medical facilities are often congregations of various diseases and sickness. Even with the tight sanitary supervision, long period exposure in such environment would not be healthy to those who shop inside.
2. The increasing population traffic flow inside the hospital might increase the danger of pandemic disease outbreak such as flu or SARS. It also increases the danger of cross infections.
3. The existence of a public food plaza has potential to lure carriers of disease such as rats, flies and cockroaches to the hospital.
4. Several medical facilities have weak controls over traffics flow between the commercial quarters and the medical quarters. In some cases, patients were spotted dinning alongside with the outside population in the food plaza.
5. We concern that the focus of hospital management is divided between maintaining the quality of the healthcare, and attracting customers with commercial quarter. It brings alarm toward how much effort the management would put into healthcare quality.
6. Currently, there is no government branch willing to take responsibility to supervise the commercial sector within the medical facilities. The hospital commercial district is being treated as an grey area between healthcare and commercial activities.
In order to prevent the unchecked commercialization which degrades the safety of both patients and the public, we suggest the government, the hospitals and the public to cooperate and take the following precautions:
1. People without medical needs should refrain from paying unnecessary visits to the healthcare facilities or the commercial quarters inside those facilities. The hospital is the place to treat illness. Visiting the hospital under non-medical related purpose will only threaten the safety of both you and the hospital residents..
2. The commercial quarters inside the hospitals should set their priority in meeting the needs of the healthcare personnel and patients' families, instead of attracting outside consumptions unrelated to the healthcare.
3. The government needs to decide which administrative unit would be responsible in setting up standard and providing supervision to the commercial sectors and within the medical facilities.