The sentencing on 21 October of a teenager to life in prison for the murder of a medical intern and the stabbing of three other hospital workers in the north-eastern city of Harbin has once again highlighted the increasingly serious problem of assaults on medical workers by patients and other members of the public.

Most commentators, and even the defendant’s lawyer in this most recent case, have focused on the high costs, poor service and lack of accountability in China’s health system that drives so many patients to violence.

In this particular case, the defendant, Li Mengnan, told state broadcaster CCTV [2] that: “My grandpa and I have been travelling to the hospitals many times with a lot of money spent and efforts paid, but I felt the doctors were just deliberately making things difficult.” His lawyer added that he been misdiagnosed and this had only added to his frustration.

There is no doubt that trying to get decent and affordable medical help in China can be a very frustrating experience, especially for those like Li Mengnan from a poor family with limited resources. And clearly, much more needs to be done to prevent that frustration from building up to the point where it erupts into violence, but there are plenty of concrete measures hospitals and other medical facilities can introduce to better protect their staff straight away.

Firstly, hospitals need to get serious about this issue. A zero-tolerance policy for the physical and verbal abuse of staff would be a good start. Making it abundantly clear, through signs and literature placed throughout out the facility, that any violent act against staff will result in criminal prosecution would at least begin to create an atmosphere in which the rights of staff to work in a safe environment are protected.

It is important to note that the majority of hospital employees who do get assaulted are the poorest paid, most vulnerable employees, nurses, orderlies and support staff who are in direct contact with members of the public on a daily basis. Doctors do get attacked from time to time but they are generally insulated from the front line.

Secondly, employing well-trained, well paid, and vigilant security personnel with the ability and the authority to prevent and intervene in disputes between staff and patients would give hospital staff added assurance and a greater sense of security.

Thirdly, it is important to give all staff the training they need to protect themselves and to understand the measures they should adopt when confronted by an abusive or violent subject.

In the long-term however, fundamental changes to the health system and the health insurance system are absolutely necessary if the current mess is to be cleared up. The central government is now trying to expand health insurance coverage to as many people as possible, the problem is that these insurance policies only cover a very limited range of medical services, and often require patients to pay large sums of money out of their own pocket.

If people are promised a solution in the form of universal health insurance and then they discover that their insurance is next to useless when they actually try to use it that is only going to exacerbate tensions and frustrations.

The fundamental problem, as many commentators have noted, is the rampant commercialization of the health service. It will take a long time to fix all the problems that have emerged over the last few decades. But if there is one ray of light it is that just about everyone agrees that things do have to change.