China’s hospital finances are coming under strain as shrinking revenues and tighter funding expose deeper pressures across the healthcare system
BEIJING: Medical workers across several parts of China are facing mounting financial pressure as hospitals cut basic salaries, reduce or eliminate performance bonuses and struggle to pay wages on time. Reports from different provinces indicate that some healthcare employees are receiving monthly base salaries of less than 2,000 yuan, while a number of hospitals are grappling with unpaid debts, shortages of medicines and, in some cases, suspension of operations.
The worsening financial situation is adding to concerns among hospital employees as public medical institutions confront declining revenues and tighter government finances. Reports indicate that salary reductions have affected nurses and other medical personnel, while delayed payments have left some workers waiting for several months to receive their wages and social security contributions.
In Hangzhou, Zhejiang Province, a public hospital reportedly reduced nurses’ monthly base salaries from 2,750 yuan to 2,200 yuan in August, representing a 20 percent cut. The reduction has added to broader concerns over declining incomes among healthcare workers as hospitals attempt to contain operating costs.
In Suzhou, Jiangsu Province, a nurse at a public hospital reportedly saw her monthly base salary fall from around 3,700 yuan before the COVID-19 pandemic to approximately 1,700 yuan. The hospital has also stopped paying performance bonuses, leaving employees with substantially lower overall incomes than in previous years.
The financial strain has also resulted in disputes over unpaid wages and protests by medical workers. In November 2025, employees at Suihua People’s Hospital in Heilongjiang Province reportedly staged a protest over delayed salaries.
Reports at the time indicated that some employees had gone five or six months without receiving their wages, even as they continued working on the front line and sought payment of outstanding salaries and social security contributions.
Similar tensions emerged in Shandong Province. Videos circulated online in April showed medical workers at Hedong Hospital in Linyi demanding payment of unpaid wages. Reports indicated that the protest occurred on April 8 and April 9, highlighting the growing tensions surrounding wage arrears in the healthcare sector.
Other hospitals have faced demands for the repayment of money that workers had already received. A public hospital in Beijing reportedly required employees to return six months of performance bonuses that had previously been paid, adding another layer of financial pressure on medical staff.
The difficulties have also extended to the survival of some medical institutions. Tianhu Hospital in Leping, Jiangxi Province, reportedly encountered serious financial problems following changes to health insurance policies. The hospital accumulated wage arrears before eventually dismissing its entire workforce, according to reports citing Chinese state media.
In Shandong, Luxinan Hospital entered bankruptcy liquidation proceedings in 2024 after reportedly owing more than 600 employees eight months of wages. The cases demonstrate the varying forms of financial stress affecting hospitals, from salary reductions and unpaid bonuses to wage arrears, workforce dismissals and bankruptcy proceedings.
Financial difficulties are also affecting the way hospitals generate income. Reports indicate that public hospitals receiving only partial government funding can face significant funding gaps when fiscal allocations decline. Under China’s differential appropriation system, hospitals may have to rely more heavily on revenue generated from patients to compensate for reductions in government funding.
However, declining household purchasing power is making that strategy increasingly difficult. Hospitals in some areas are reportedly seeing fewer patients as ordinary families become more reluctant or unable to afford medical treatment. Lower patient numbers can translate into reduced hospital revenue, further widening financial deficits and making it harder for institutions to maintain salaries, bonuses and other operating expenses.
Hospitals in Jiangsu have also faced complaints over medical charges, with some institutions reportedly penalised by authorities. After certain hospitals were required to restore earlier fee schedules, their revenues declined further, intensifying existing financial difficulties.
The emerging pattern points to a wider financial squeeze affecting sections of China’s healthcare system. Salary reductions, disappearing performance bonuses, delayed wages, unpaid social security contributions, medicine shortages and institutional closures are being reported alongside declining hospital revenues.
While the circumstances differ between hospitals and provinces, the cases collectively highlight the pressure facing medical institutions as government funding, household spending and hospital revenues come under strain. For healthcare workers, the consequences are increasingly visible through lower salaries, delayed payments and reduced employment security.
