Financial autonomy is designed tohelp reduce State expenditures so that funds can be diverted to preventivemedicine and targeted to community-care programmes. Reduced State spending willalso allow the State to pay for more health insurance cards for the poor,including those near the poverty line and welfare recipients.
Although hospitals are expectedto become a high-quality service industry and will no longer be overloaded ifthey have more funding, some hospitals worry about financial shortages if themodel is widely applied.
The newly built Cu Chi Hospitalin Cu Chi district on HCM City’s outskirts has a capacity of 300 beds butattracts far fewer patients due to a lack of high-skilled doctors thatreduces confidence in the quality of care, according to hospital director Ho HaiTruong Giang. The hospital chiefly provides healthcare services for socialwelfare beneficiaries and families rendering great services to the revolution.
Giang said due to the lack ofpatients, the hospital’s total revenues are low. If autonomy is applied, thehospital’s State budget will be cut, preventing it from training staff anddeveloping services and specialties to attract more patients, Giangwarned. He also suggested that autonomy should be applied gradually toensure a smooth transition from State funding to a market mechanism.
Other small district-levelhospitals, such as hospitals in Can Gio and Nha Be districts, face the sameproblem.
Deputy Director of the HCM CityDepartment of Health Tang Chi Thuong admitted that hospitals will initiallyface difficulties because they rely solely on the State budget.
Director of District 2 HospitalTran Van Khanh said some hospitals of lower quality and prestige that do notattract enough patients will face many difficulties when they implement fullfinancial autonomy, making it harder for them to improve. He advisedhospitals to balance their spending and collection and carefully calculatecosts to ensure efficiency and avoid unnecessary spending.
The District 2 Hospital is among10 public hospitals chosen to pilot the autonomy mechanism from 2016. Thehospital invested in improving infrastructure and purchasing equipment as wellas in developing more specialty departments and using complex techniquesto attract patients, according to Khanh. Additionally, to satisfypatients, the hospital has also focused on administrative reform and improvingmedical workers’ attitudes towards patients, he said.
Sharing the same view, deputydirector of the municipal health department Thuong said medical staff need toconsider patients as customers to provide the best service in order to bring inmoney. “If hospitals do not treat patients well, they will not come back,”he said.
The health department willstrictly supervise public hospitals after implementing autonomy, he said.
Eighty two hospitals have beengranted autonomy since the city began implementing this policy in 2006, hesaid. Ten managed to mobilise all the revenues they need to operate while theremaining are able to fund themselves in part.-VNA