The problem is that the visa process is very different for those FT's who have to return
home to get the visa.

You are correct. The initial post by the OP was referred to him being outside China. For any school to send him an invitation letter for a 'z' visa, they will need this health screen certificate completed. No ifs, no buts. If they don't ask for it then they are not providing an invitation letter for a 'z' visa. Simple as that.

I am sorry to learn you are having to wait it out in Hong Kong. Depending on your previous circumstances, if your new employer has not asked you for this document, then they have either used the previous health check (assuming its less than 6 months old) or generated one themselves as a stop gap.

Agreed! The chinese have complicated everything to the point of madness.How do I know? I am
currently in contact with a uni in Guangdong, and they have just told me that per the
Chinese visa regulations, EVERYTHING must be completed in the UK.

I can't comment for Guangdong but what I can say is that a new China wide application system has been introduced for online applications for work visas. Whilst initially at provincial level, it is then fed into one database. This was in fact changed on the 7th September. To begin the process we have to upload copies of everything, this includes a criminal background check, degree etc etc with different variations on the theme for transfers, renewals cancellations and the like. Before we can continue with anything we have to wait for approval. Once that stage is approved then we can move forward.

Only last week I was completing an application for a new foreign teacher and upon inputting the details I received a warning saying that he had an existing application in another province and I could not continue. This is new and never happened previously. When I challenged the new teacher about this he rather sheepishly admitted he had several applications on the go as a failsafe. This will not work any longer but in one way I am glad as as I mentioned before the headache to us a a school who only has a licence for three foreign teachers and who does everything by the book is that this may cut down on the inevitable 'no shows' that we have to contend with. Just for the record the cost to use as as school to obtain the invitation letter for a 'z' visa so far this semester is averaging out at just over 14,000rmb per teacher including all the travelling expenses and everything else.

The time I have to spend as an FAO on dealing with all this is now double what it was a year ago. Trying to remain neutral here but some of the things I read on here and other boards quite frankly piss me off. When I have to deal with people saying 'well I have heard this or I have read that' I can only say well in China things are never set in stone. We do our best to follow the rules, we do not make them.

I hope you manage to get your issues sorted out.