The health authority of Xiangxiang, Hunan province, has ordered all medical institutions in the city not to refuse treatment to patients if they are unable to pay at the time.

The order came after an emergency medical center delayed the transfer of an ailing baby boy to Changsha until his parents had paid upfront. The baby later died.

According to a report in Sanxiang City Express on Monday, a woman surnamed Tan brought her 1-year-old son to Xiangxiang People's Hospital on Dec 23. The hospital decided that the boy should be immediately transferred to a better-equipped hospital in Changsha, which is more than 100 km away.

But a staff worker in the hospital's emergency center insisted that Tan pay 800 yuan ($132) for the transfer first.

Tan, who didn't have enough money with her, had to ask other people in the hospital for help, which took a while. Her son died after arriving in Changsha.

The hospital later compensated the family 9,800 yuan.

Li Mingjun, an official at the city's health bureau, confirmed the incident on Wednesday.

Li said the transfer was delayed for more than 20 minutes as a result of the dispatcher's actions, refuting earlier reports that the transfer was postponed by more than an hour. But he did not say whether the boy's death was caused by the delay.

Earlier media reports also quoted Zeng Wei, another official of the city's health bureau, saying the hospital's emergency center also erred as it did not charge in line with standards.

According to the provincial standard on emergency aid, a patient using an ambulance should pay 10 yuan for a ride of 3 km, and 2 yuan for every kilometer after that. Emergency treatment provided on the way costs extra.

A staff worker in the hospital who declined to be identified told China Daily the hospital has traditionally charged patients 800 yuan for transfers.

An emergency-aid expert in Beijing who declined to be identified said the ambulance fee system in Beijing is similar.

"In Beijing, we charge 5 yuan per kilometer for a high-end ambulance, and 3 yuan a kilometer for an ordinary one. We also charge extra for the treatment we offer on the way," she said.

She suspected that the emergency center in the Xiangxiang hospital insisted on an upfront payment because it feared it might not be able to obtain the money later.

"In Beijing we offer emergency treatment first and then we charge," she said. "Yet a lot of patients, such as those who are intoxicated or are mentally ill, don't pay after the emergency treatment.

"However, the main principle in emergency treatment, as already stated by the National Health and Family Planning Commission, is that life comes first," she said.

On Dec 19, the commission issued a regulation stipulating that emergency aid centers must not refuse or delay emergency treatment "due to the problem of payment".

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