Public interest litigation: How procurators help protect consumer rights in a profound way

How to deal with medical overtreatment if available administrative penalties, like warnings or regular fines, fail to sufficiently deter any hospital habitually involved in health-care fraud?

In other words, does society or an individual have a more effective remedy to right the wrongs in a case of hospital fraud, where applicable measures of administrative punishment have proved less biting than expected?

A crucial case revealed last week shows how public interest litigation brought by the country's procurators could go a long way toward categorically curbing hospital fraud and protecting patients' rights.

The landmark public interest lawsuit, filed by local procurators against a hospital in Huangshi City, central China's Hubei Province, is the first of its kind in China concerning overtreatment. It was among the 10 major cases of public interest litigation jointly selected and released by the Supreme People's Procuratorate and the China Consumers Association on March 12, ahead of the annual World Consumer Rights Day that falls on March 15.

In a succinct preface, both organizations explained that the 10 classic cases were selected as a guide to the country's procuratorates and consumer associations at different levels in their efforts to ensure reasonable consumer rights and improve the consumption landscape.

Unjustified surgeries

A closer look at Huangshi's case reveals that procurators can help protect consumer rights in a profound way.

The story in Huangshi City goes back to 2022, when local health authorities discovered through random checks that a for-profit hospital had overtreated many of its patients. To be specific, the hospital was found to have performed unnecessary or otherwise unjustified surgeries in 113 out of 125 examined cases, causing clinical chaos as well as extra burden on patients.

Local health authorities also found the hospital in question had received administrative punishment every year since 2020 for medical bill overcharges.

In April 2023, the city's procuratorate received reports from the local health commission, which suggested that all available administrative measures would not be enough to punish the hospital concerned for its past frauds or prevent it from contriving new scams in the future. As such, the commission expressed the hope that procurators could lend support to the city's crackdown on and prevention of medical overtreatment.

What local procurators did immediately was to conduct field interviews or investigations with a wide range of organizations, including tax authorities, banks and the hospital in question. The procurators even reviewed relevant records of past administrative punishment handed down to the hospital.

And by July 2023, the city's medical association, comprising professional physicians and medical scientists, was able to present a new and final expert verdict on the hospital's overtreatment.

Based on extensive examination and experts' opinion, local procurators filed a public interest lawsuit in a major local court in October 2023, requiring the defendant hospital to pay punitive damages. In May 2024, the local court supported the procurators' claim by ordering the hospital to pay damages in three installments, the last installment to be paid before May 27, 2025.

The case did not end here, though. In July 2024, the procuratorate and the court jointly sent the hospital a notice, asking it to strictly abide by law and ensure patients' legal rights. In follow-up reviews, local procurators and judges found the hospital had duly adjusted its shareholder structure, changed its management team and standardized its clinical procedures. These efforts on the part of the hospital were eventually endorsed by local health and wellness law enforcement staff.

Compared with a case filed by an individual or a group of individuals, a public interest litigation initiated or supported by procurators often can proceed more efficiently, given procurators' innate deterrent power and professional expertise. That partly explains why public interest litigation involving procurators has become an ever more important source of legal protection for individual and collective interests alike over the past 10 years.

China began to explore public interest litigation involving procurators in 2014, and a year later, the practice was implemented on an experimental basis. In 2017, it was written into law. In some other countries, public interest lawsuits are often filed by individuals (especially those with direct injury), organizations or judges. In China, mainly procurators and certain qualified organizations take on such a task.

The benefit of involving procurators in such cases is at least two-fold: On one hand, procurators often can have more resources than an individual plaintiff or a group of plaintiffs; on the other hand, procurators do not pass final judgment – only court judges do. It's about reasonable checks and balances of power.

Cosmetic changes

In another classic case of public interest litigation, also released last week, procurators not only sought to have unlicensed beauty salons duly disciplined for having wantonly performed cosmetic surgeries like removing eye bags (blepharoplasty) or reshaping noses (rhinoplasty), but also sued the local health commission for failing to duly fulfil its responsibility as a supervisor.

It all began in 2022, when procurators in Changyuan City, Henan Province, found through special investigations that quite a few beauty salons had performed cosmetic surgeries on customers without medical license. Procurators then notified the local health commission, asking it to supervise and rectify the situation.

In a timely written response, the local health commission claimed the case had been duly handled. But in follow-up investigations, local procurators found certain unlicensed medical aesthetic companies had not been duly disciplined. Urged by the procurators, the health commission then moved to fine those unlicensed companies on top of confiscating their illegal income. However, local procurators discovered later that one of the unlicensed companies continued to provide medical aesthetic service despite having been fined.

In October 2023, local procurators filed a public interest lawsuit against the local health commission, demanding it fulfil its responsibility as a supervisor of the medical aesthetic industry. During court hearings, procurators proved that the amount of previously confiscated illegal income was far smaller than the actual figures.

In 2024, the court ruled in favor of the procurators. As a result, the health commission reinvestigated relevant companies and came up with heavier punishment.

Procuratorial network

The above two cases are mainly about consumer rights protection, but procurators' public interest litigation has covered far more aspects in the past decade, including environmental protection, food and drug safety, and the proper use of state-owned land.

The Supreme People's Procuratorate published a latest white paper on public interest litigation on March 9, saying the country's procurators had handled more than 1.1 million such cases since 2017, when the practice was fully implemented nationwide.

Public interest litigation led or aided by procurators indeed helps better protect consumer rights and many other collective interests. And as an individual, you can always dial 12309 or log onto www.12309.gov.cn to submit your clues that may eventually help lead to procurators' litigation for public interest – certainly including your own.