PhD defence Ziyu Liu

China’s healthcare system has gone through a comprehensive reform since 1996. Great progress has been made while challenges remain. For instance, the effectiveness of the reform, the uneven healthcare distribution, and the weak involvement of primary healthcare, are all old questions but the answer to these question needs to be reinvestigated because of the changing context (i.e. the aging population, emergence of high-tech health services, and the growing burden of chronic diseases). Thus, this thesis is mainly built with an aim of developing proper strategies for balancing the protection of individual rights (e.g. satisfying patient needs) and the sustainability of healthcare resources in the context of Chinese healthcare system reforms.

In this thesis, I have made two major claims. The first one is that achieving an equitable and effective healthcare system by 2020 calls for a joint effort and commitment from all parties involved. In this thesis, special attention is given to drawing a fair ‘cut’ between personal responsibility and state accountability in order to make the reforms of the Chinese healthcare system more effective. The second claim is that reform strategies, such as encouraging the involvement of private sectors in healthcare delivery, the nationwide implementation of general practitioners, are unlikely to be succeed unless accompanied by efforts to improve and strengthen the regulatory sector of China’s healthcare system.