'Companions' ease pain of China's bustling, bamboozling hospitals
At a bustling Beijing hospital, Tian Yigui hands over some of his elderly wife's paperwork to Meng Jia, a "patient companion" hired to help navigate China's stretched and bureaucratic healthcare system.
Yawning funding gaps and patchy medical coverage have long funnelled many Chinese people towards better resourced city hospitals for much-needed care.
Sprawling, overcrowded and noisy, the facilities can be exhausting for patients and their families, especially the elderly.
The problem has fuelled the rise of patient companions, or "peizhenshi", a lucrative and unofficial service in the country's growing gig economy.
Tian, 83, said most Beijing hospitals were "overwhelmingly confusing".
"We have to go up and down all the floors, wait for elevators, wait in lines... it's really troublesome," he told AFP.
Elsewhere at the People's Liberation Army General Hospital in the Chinese capital, patients faced long queues, myriad check-ins and a whirl of digital payment codes.
Hospital aides wearing bright red sashes rattled off directions into headsets as hundreds of patients filed through the colossal lobby.
Armed with a sheaf of papers at a traditional Chinese medicine ward, Meng breezed through check-in before joining Tian and wife Gao Yingmin in a consultation room.
Leaving Gao to rest in a waiting area, Meng then brought Tian to a payment counter before explaining to the couple how to pick up prescribed medications.
For a four-hour service, patient companions like Meng charge around 300 yuan ($40).
It is worth every penny for Gao, 78, who is undergoing treatment for complications from throat surgery.
The helpers are "convenient, practical and (give us) peace of mind", she said, straining against a breathing tube.
"We no longer have to worry... they do all the work for us."
- 'Real need' -
Hundreds of advertisements for patient companions have sprung up on Chinese social media in recent years.
Authorities appear to allow the companions in hospitals because they are broadly in line with the government's promotion of health services for seniors.
Meng, 39, had no medical background before enrolling in a weeklong training programme run by Chengyi Health, an online platform that connects patients and companions.
Founder Li Gang, a former anaesthesiologist, said "there's a big knowledge gap when it comes to medical care".
Large Chinese hospitals can have over 50 clinical departments, each with numerous sub-specialities.
That means many people "don't know how to go to the doctor", Li said.
While some young people -- such as expectant mothers -- hire companions, some two-thirds of Chengyi's clients are aged 60 or older.
Trainee Tao Yuan, 24, said he left his job at an internet company to pursue a vocation "more valuable than money".
A generation born under China's now-abolished one-child policy are approaching middle age and caring for their elderly parents alone.
Increasing work and family pressure had left them with a "real need" for help, Tao said.
- Ageing nation -
China's healthcare system has long struggled to tackle deep-seated regional funding gaps and inconsistent access to equipment and medical staff.
Limited treatment options, especially in rural areas, push many patients into municipal hospitals for comparatively minor ailments.
"It's a perennial structure problem," said Wang Feng, an expert on Chinese demographics at the University of California, Irvine.
Working adults have no time to take elderly parents to hospital, while technology cannot yet replace human caregivers, he said.
China "will have a larger... demand for personal assistance" as the elderly account for an ever bigger proportion of the population, Wang said.
Authorities are betting big on the "silver economy" -- products and services for older people, which totalled seven trillion yuan ($970 billion) last year, according to the nonprofit China Association of Social Welfare and Senior Service.
The figures are a bright spot in an economy struggling to maintain strong growth and robust youth employment.
Xiao Shu, who asked to be identified by a nickname for privacy, told AFP he made around 10,000 yuan ($1,400) per month –- a tidy wage in China's competitive capital.
But the former dentistry worker said there were limits to the service.
The 36-year-old once refused to take a client's nearly 90-year-old father to a post-surgery check-up.
"If something happened to him, who would be responsible for it?" he said.
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News.com.au
11 hours ago
- News.com.au
Emergency help, healthcare and fitness in infrastructure spotlight
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Critical communications and electrical areas are being fitted out, while the facade of the new ambulance station is nearly complete and internal works continue.' The new headquarters will house more than 338 personnel, including Triple Zero (000) call takers and dispatchers and clinical staff. 'It will also serve as the new home for the State Health Co-ordination Centre, enhancing our ability to coordinate patient care across the state,' Elliott says. 'We anticipate practical completion of the new HQ and Adelaide ambulance station in the coming months, with plans to commence operations at the new site in December this year.' The operational move to the new building will take a staged approach to ensure critical Triple Zero (000) call services remain uninterrupted, safeguarding the ambulance service's capacity to respond to emergencies without compromise during the relocation process. 'Ensuring no impact on patient safety, uninterrupted Triple Zero (000) services, and robust support for relocating teams are our top priorities during this operational transition,' Elliott says. 'These commitments are vital to maintaining emergency care to the people of South Australia.' The soon-to-be completed headquarters complements the construction, upgrade and rebuild of 24 ambulance stations throughout Adelaide and regional SA. Stations have been completed and are now open at Norwood, Woodville, Edwardstown, Port Augusta, Mount Barker, Victor Harbor, Birdwood and Strathalbyn, with construction nearly complete on a new Gawler station. Rebuilding work on the Campbelltown centre is also under way. Construction of Whyalla, Marion and Two Wells stations is also scheduled to commence this year. 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And we're not stopping yet – we're striving to improve even more.' A new team of 20 ambulance officers has been recruited to better transfer patients out of hospitals – getting them home sooner and freeing up beds for others – while SAAS is also introducing an electronic patient care record (ePCR) system to improve patient safety in the field, while expanding the clinical telephone assessment telehealth service and establishing a mental health focused role 24/7. 'That's an absolute innovation here in South Australia,' Elliott says. 'We partnered with the Hospital Research Foundation to trial having a dedicated mental health focused service. 'The trial was really successful, offering patient safety and some really good outcomes, so with the recent investment we are turning that into a 24/7 service, another first for paramedicine.' New health era for SA families South Australian families will be the key beneficiaries of the new Women's and Children's Hospital, on the edges of Adelaide's north-west parklands. Being built to replace the ageing North Adelaide hospital, the contemporary facilities at the former SA Police Barracks site at Thebarton will have more beds, theatres and greater emergency capacity – and increased scope for future expansion. Slated for completion in 2031, it is planned to provide capacity for 414 overnight beds – 56 more than the existing hospital – with plans for an onsite helipad. An integrated four-bed Intensive Care Unit will enable women requiring critical care to remain on site rather than be transferred to the Royal Adelaide Hospital. 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'In addition to this, the new hospital is proposed to include a Centralised Family Accommodation Unit, which will cater for a short-term stay of an additional parent or carer of a baby.' Formston says the family-first focus is just one of the benefits of building a brand-new hospital, with the opportunity to design a facility to deliver a more innovative 'patient experience' right from the start. Construction on the 5.7-ha site began in April 2024, when the first sod was turned on what had been the long-standing police base. The first stage included the construction of a car park and precinct works. A second team – including a consortium of architecture firms Billard Leece Partnership, Bates-Smart, Grieve Gillett and Taylor Cullity Lethlean – was appointed this month to lead the design of the main clinical building and remaining precinct works. Formston says during its construction peak there is likely to be a 2100-strong workforce at the site, which will be dominated by up to seven tower cranes. 'We've done a lot of work with the clinicians and the hospital staff around what they need for a new hospital,' she says. 'We've fed that through to the design team, who will now look at how to best deliver it.' Easy patient flow throughout the hospital is key. 'We want to make sure that the flows are set up so the minute you're entering the hospital, the wayfinding's right,' Formston says. 'Do people actually need to wait in the waiting room or can you now do a digital set-up so you can actually go and wait down in the park or the playgrounds? We need to work out how we can actually enable that patient experience when they come into the hospital.' Formston says with the buildings at the current North Adelaide hospital on average almost 70 years of age, upgrading – and building out – to meet modern standards is virtually impossible. 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A floor at the new Acute Services Building will be dedicated to ophthalmology, and include two operating theatres and, for the first time at FMC, a separate paediatric ophthalmology area. The top two floors of the new building will each house 32 beds for adult inpatients. Most will be single rooms to improve progression-of-care and reduce cross-infection risks. 'We're also provisioning for fold-out beds for a support person,' Mahon says. 'We do have regional and remote people come in, so that will be available when needed. 'There will be quiet rooms and lounge areas where families can visit if they don't need to stay. It will be a beautiful facility, with lovely western views out toward the sea.' The Acute Services Building will have four new operating theatres and related recovery spaces. On completion, FMC will then have 16 operating theatres. 'This will certainly give us more capacity to move through our elective surgery waiting lists,' Mahon says. The new building will become the main entrance with improved access, including a drop-off zone covered against the weather. Ready to make a splash The new Adelaide Aquatic Centre is taking shape, with expectations that water-lovers will be able to make a splash this summer. The concrete structures for the pools at the North Adelaide complex – which replaces the former centre in Pardipardinyilla/Denise Norton Park – have progressively been completed, with testing to ensure their integrity ongoing as the main structure is being built. The new $135 million centre will boast a host of family-friendly features, from a 50m pool, a 25m outdoor pool and dedicated learn-to-swim and warm water rehabilitation pools through to an outdoor lagoon and 'splash pad' and water slides, as well as extensive gym and fitness facilities. Department for Infrastructure and Transport executive director, Infrastructure Delivery, Simon Morony says progress is continuing 'really well'. 'We've planned the construction phase from a long time out, including the demolition of the former centre,' he says. 'Construction's been under way for around 18 months – and it's really taking shape on site. 'The timber frames and pool structures are all complete and we've been busy testing those to make sure the pools are all watertight. 'And then in the coming months, there'll be a lot more progress on the internal fit-out. And there'll be external elements such as the water slides being installed as well. 'We're on track for opening this summer and looking forward to achieving that – as we get a bit closer to completion we'll be able to confirm an opening date.' The design intent – which is being constructed by contractor Sarah Constructions – is centred around the creation of high-quality spaces that use warm and natural tones to reflect the local landscape. There is also a strong focus on ensuring the spaces are welcoming for people of all ages, cultures and abilities. 'The previous centre had come to the end of its lifespan, but we know it was an important facility for the community and the new centre will serve many generations to come,' Morony says. The 'carefully considered' design takes in a number of environmentally sustainable features, while the centre's smaller footprint ensures more than 1000sqm is returned to Park Lands. 'It's an all-electric centre, powered by 100 per cent renewable energy,' he says. 'The building itself has been designed to be airtight, which gives you an improved indoor air quality and importantly enhances the operational energy efficiency. 'The ultra-fine pool filtration systems also provide operational benefits – and then there's other components to the facility, such as solar panels, EV charging stations, sun shading on the facade – and a water-sensitive urban design car park as well.' Site enabling works started in late 2023, with the main construction starting in 2024. The building phase has offered plenty of employment opportunities, which will flow through to the centre once it's open to the public under the management of experienced operators YMCA Aquatic. 'More than 1500 jobs are being supported over the life of the construction phase and that's from builders and engineers to plumbers and painters,' Morony says. 'We obviously needed a whole raft of different skill sets to build what is a state-of-the-art centre. 'Sarah Constructions has inducted more than 1300 people to the construction site. And those 1300 people so far have completed more than 230,000 hours worth of work. 'In terms of the operations, up to 300 jobs will be created to staff the new aquatic centre – that's lifeguards, instructors, administration staff and so on.' Staff who worked at the former Aquatic Centre will be given the first opportunity to express their interest at filling the roles with YMCA Aquatic, a non-profit community organisation that also operates the SA Aquatic and Leisure Centre at Oaklands Park. Morony is confident the new swimming centre will more than meet community expectations. 'I think it's going to give people a fantastic new place to come and swim for fitness or for fun,' he says. 'So if you're a serious swimmer you can get out there and really utilise the place but others might just come to it to improve or maintain their fitness. 'It really will offer a range of uses for everyone who wants to visit.' Elbie set for the life aquatic Little Elbie won't be able to stop himself from taking the plunge when the new Adelaide Aquatic Centre opens, his mum Rachael Neumann reckons. 'He will be jumping in from the side with enthusiasm, that's for sure,' she says of her water-baby son, who has been a regular participant of learn-to-swim classes since he was only six months of age. 'And even before we started taking him to swimming lessons, he's always enjoyed the water and swimming pools whenever we've been on holidays – and he just loves the beach.' When the North Adelaide centre closed for the construction of the new facility, Rachael and husband Brandon, of Bowden, elected to continue Elbie's learn-to-swim lessons in Unley. 'The whole (replacement swim centre) process has been really smooth and helpful, but we're looking forward to coming back to North Adelaide because it's much closer to home,' she says. The completed centre will include a host of features including a dedicated learn-to-swim pool, a lagoon outdoor pool, an outdoor 'splash pad' and extensive gym and fitness facilities. 'We're just really excited to see the new centre,' Rachael says. 'It will be great to have something to do while we tag team and watch Elbie swim. I'll be able to go and swim laps myself and if there's a good gym in the same centre, then that might be useful as well.'
ABC News
a day ago
- ABC News
Woman feels abandoned by WA health system amid year-long chronic pain battle
Jayde Guest spends most evenings in extreme pain. For almost a year, the mother of two from Esperance, 700 kilometres south-east of Perth, has barely been able to work or socialise. She feels as though her life has been stripped of all its best parts. "I'm at the end of my tether right now. "Day-to-day life is a real challenge." While she has turned to Western Australia's health system numerous times for help, she said the process had only compounded her suffering. The pain, which "feels like her chest wall is caving in", arrived out of the blue on a normal winter's morning. It has returned each day since, intensifying the more active she is and often becoming unbearable by night. Her doctor's first suspicion was cancer, as she had been in remission from an aggressive form called osteosarcoma for about 20 years. But the medical system was at a loss when tests ruled out cancer. She made the journey to Perth, seeing five different specialists on separate occasions, none of whom could produce the answers she sought. Ms Guest said she was then twice rejected from the WA Health Department's central referral service — designed to triage and allocate cases — and the hospital stopped calling her back. "I [was] in the too-hard basket," she said. Ms Guest said she turned to support groups on social media and sought out experts in London, America, Melbourne and Sydney. Finally, she found someone who might have an answer to her pain. During her previous bone cancer battle, she had five ribs removed and replaced with a Gore-Tex mesh. A doctor in Sydney believes the 20-year-old mesh is now shrinking and pulling against her chest wall. The doctor, who specialises in mesh removal, told Ms Guest they were confident of being able to remove hers but is still working out how to rebuild her chest wall. Ms Guest is relieved to have a way forward, but the wait continues as they work on a solution. She said the uncertainty of her experience felt harder than the 16 rounds of chemotherapy she endured in her 20s. "The lack of communication from the medical system has been really disappointing," she said. "And I think that's what makes people feel really alone. Clare Mullen, executive director at WA's Health Consumers Council, said experiences like Ms Guest's happened "too often". But Ms Mullen said cases involving regional patients and chronic pain could be particularly difficult. She said this was due to the disconnect between country GPs and metropolitan health professionals and the scepticism that could follow chronic pain. "Unfortunately, it's one of the areas where we see a lot of people having to convince the clinicians … that their pain is real." Ms Mullen said anyone feeling like their case was not progressing or who had been rejected from the service should contact the GP who made their first referral. "It's not ideal, particularly in a case like this [where] someone is living with chronic pain," she said. "It's a time-consuming process." Ms Mullen said if they still had no luck, they should contact the Health Consumers Council. Monika Boogs, chief executive of Pain Australia, said the number of Australians suffering chronic pain was about 3.7 million and growing. But Ms Boogs said there were only about 200 pain specialists in the country, with access proving particularly difficult for regional residents. She said a national action plan for pain management was done six years ago, but many programs were still unfunded. "Pain is like mental health was 20 years ago. It's something that's growing. It's impacting so many people," she said. WA Health Minister Meredith Hammat said the health system aimed to provide world-class care to all West Australians. "We will never stop working to advance the care our health system provides," she said. A WA Health spokesperson said initiatives were in progress to improve access to public specialist outpatient services. To help others, Ms Guest started blogging about her experience. She said she was a big believer in documenting experiences and helping others to advocate within the medical system. "By me sharing it, I've had people open up to me and hopefully I've helped them to see that they're not alone. "And Facebook groups, as much as they can be a little bit negative sometimes, I've found some great people and great friends going through similar things to me. "And that's definitely helped." Ms Guest said it also kept her sane, as the wait for a cure continued. "I think it's hard for people to understand because I look kind of normal, I don't walk around going, 'Oh, my gosh, I'm in so much pain.' "I just have to carry on."
ABC News
a day ago
- ABC News
Concerns upcoming NDIS price changes could force providers to stop out of office services
When physiotherapist Kate Caldow was asked how she's feeling about the future, her eyes welled up with tears. "We're all feeling a bit down, a bit deflated, a bit under-valued," Ms Caldow said. "And we're having to make really tough decisions." Ms Caldow is one of a number therapy support providers in Canberra struggling to make sense of the National Disability Insurance Agency (NDIA's) latest annual pricing review. From July 1, the fee for physiotherapy services will be capped at $183.99 per hour, marking a $10 reduction. Dietitian and podiatry appointments will be capped at $187.99 per hour, marking a $5 reduction. And travel subsidies for allied health professionals will be cut in half. Ms Caldow opened Country Children's Physiotherapy in Belconnen almost a decade ago with the goal of ensuring children living in regional towns surrounding the ACT had access to good quality care. Hayden Traynor fits that exact bill. The six-year-old, who lives in Booroowa, was diagnosed with cerebral palsy after having a stroke at just three months old. Regular physiotherapy has been key to helping Hayden overcome those challenges and has helped him to learn to walk, dress himself and make his own breakfast. Once a week, a physiotherapist or allied health assistant from Ms Caldow's team visits Hayden at home or at school. His speech pathologist also travels to Booroowa for appointments, and he sees an occupational therapist in Canberra. "I think he'd be completely [incapacitated] without all of the intervention we've done," Ms Moorby said. "We were lucky enough to get streamlined on to the National Disability Insurance Scheme (NDIS) early." Hayden's physiotherapy visits are now seriously in doubt, with Ms Caldow grappling with the prospect of scaling back her team's travel on account of the looming pricing changes. NDIS participants currently make up around 75 per cent of her clinic's clients. "We travel to Booroowa, Gunning, Gundaroo, Harden, Collector — all the areas around Canberra," she said. "For some parents, especially those with children with high needs, it's so hard to come and see us and there are no providers in these areas. "Now, we have to make a decision whether we continue to see children by travelling and put our business at huge financial risk or whether we say, 'No sorry, we can't see these clients'. "That's an awful decision to be making. It's heartbreaking, gut-wrenching." The risk for Hayden, if he were to go without regular physiotherapy, is significant. "If there's no intervention, he's likely to end up in a ball due to tightening muscles," Ms Caldow said. "That will impact his ability to function, his ability to walk and his ability to use his arm." Ms Moorby will do whatever it takes to prevent her son from missing out — including making the three-hour round trip to Canberra — but admitted the constant battle for adequate support was exhausting. "I'd do anything for my children, but it's been an uphill battle from the beginning with Hayden so to find out we have another challenge in front of us, it's just really hard," she said. "It's honestly devastating, a real kick in the guts. "And it's like it's targeted at us. We already miss out on so much living in a country town and now they're taking this away from us as well." In a statement to the ABC, a spokesperson for the NDIA described the caps to hourly rates as "modest". "It's important that NDIS participants are paying prices that are fair and in line with industry standards," the spokesperson said. "In some cases, NDIS price limits exceeded the market rate by up to 68 per cent." The spokesperson also said the changes to travel claims were in direct response to feedback from NDIS participants. "The updated travel therapy claiming rules encourage more efficient scheduling by providers and provide clear cost expectations for participants to help them get better value from their funding." Like most five year olds, Jon Beit loves Bluey, trains and playing in playgrounds. But unlike most other children his age, Jon requires an array of equipment to do the things he loves. He also relies on equipment to move, eat, sleep and shower. "Jon lives with a genetic condition called spinal muscular atrophy," his mother Megan Beit said. It's occupational therapist Kat Senger who has been there every step of the way — picking the appropriate equipment and ensuring it's correctly fitted at home and school. Her Canberra clinic, Little Hands OT, is focused on children with high, complex needs, with NDIS participants accounting for 95 per cent of her client base. The latest NDIA pricing review delivered her an unwelcome blow. "Before these changes, I would say we were surviving, not thriving," Ms Senger said. Although occupational therapy won't see a reduction in pricing caps, it will endure a seventh year without a pricing increase from $193.99. Visits to a client's home, school or work as well as experiences in the community, such as supermarkets and on public transport, are foundational for occupational therapy. Given that, the cut to travel claims will also put additional pressure on Ms Senger's business. "Ultimately, occupational therapy is about life skills, so we practice those in our clinic but if we don't go into the environment, there's no way of knowing if those skills are transferring," Ms Senger said. "And for some of our families, they just can't come here — they're financially strapped or they're single parents with four children who all require care — so we go to them." Ms Senger is now considering introducing a gap fee to cover travel costs. "We wouldn't change anything in terms of the hourly rate," Ms Senger said. "For us, the gap fee would be the 50 per cent travel that the NDIS has taken away. "Anything more, we will do our hardest to avoid." It's a price Jon's mother, Megan, is not confident her family can afford to pay. "Or something else gets missed in order to pay for it — maybe that's takeaway one night or a night out at the movies. "I think it's really heartbreaking that you have to make those choices." Ms Senger and Ms Caldow are still considering workforce changes, but both have made the decision to let go of their therapy assistants, who are typically university students. "I was really hopeful this time around that with all the cost of living increases, wage increases, superannuation increases, the NDIA would see the numbers weren't adding up," Ms Senger said. "I can't believe that's not been recognised and instead we're being portrayed as money hungry, price-gouging, fraudulent allied health professionals because of a few bad eggs, which are in every profession. "All I want is to provide the best care for my kids and these new changes really stop us from being able to do that." In Australia, more than 65 per cent of NDIS participants have their funds managed by a financial intermediary or plan manager. Jess Harper, the chief executive of Disability Intermediaries Australia, said those working in that sector are also reeling. "It's a pretty big kick in the guts," he said. "It will now be seven years of systemic price freezes. "And on top of that, the NDIA has also made the decision to pretty significantly cut the amount and the type of service plan managers can claim for." From July 1, a one-off establishment fee of $232 will be scrapped and some loading charges will also be removed, with a nationally consistent price introduced. "In the last 12 months, we've seen more than 600 providers close their doors because they just can't keep the lights on and we expect that number will be significantly more this year," Mr Harper said. "In the ACT, we've had 22 providers close their doors in the past 12 months, and we've had a further four give notice that they'll be closing come July 1. "Ultimately, what we're seeing is a race to the bottom on quality and so for participants, that means they're getting less — less choice, less access, less availability." Mr Harper said introducing an independent pricing approach was vital. "The sector has been calling for this for years," he said. "It is beyond belief that a government agency that is ultimately the payer gets to set the prices." It's a view shared by Michael Perusco, the chief executive of National Disability Services, an organisation that advocates for disability service organisations. "Like aged care, like health, we think it makes a lot of sense for pricing in the NDIS to be independent," Mr Perusco said. He said he was "deeply concerned" that providers of therapy support were going to leave the market. "Organisations are looking at their finances and are going to make very difficult decisions about what they can continue and what they can't," Mr Perusco said. "For some of those organisations, it means they won't continue at all. "If that occurs, participants suffer and particularly those with the most complex needs who need the NDIS the most."
