Doctors take urine samples at Hanoi's Bach Mai Hospital, one of the first financially independent public medical facilities in Vietnam. (Photo: VNA)Hanoi (VNS/VNA) - Alack of clear and transparent regulations relating to autonomy for publichospitals is hindering the efficiency of their operation, a senior expert said.
Doan Xuan Tien, Deputy AuditorGeneral of the State Audit of Vietnam, made the statement at a workshopentitled Autonomy mechanism to publichospitals and the role of the State Audit of Vietnam (SAV) held recentlyin Hanoi.
He said the dearth of regulationsmeant hospitals still relied on the State budget and could not cover theirexpenses or find funds to invest in equipment and other facilities to improvehealth care services.
According to Nguyen Nam Lien, Directorof the Planning and Finance Department under the Ministry of Health (MoH), asmany as 160 public hospitals independently controlled their regularexpenditures by the end of last year.
Another 1,364 hospitals withpartial financial autonomy could control between 80 and 90 percent of theirregular expenditures.
Nguyen Truong Son, DeputyMinister of Health, said positive results had been recorded in providingautonomy to a number of health facilities.
Autonomy helps reduce Statespending, while the quality of health care services is improved, meetingpatients’ demand, according to the official. Most public hospitals have beenproactive in mobilising private investment to upgrade their medical equipment.
Statistics from the ministryshowed that State expenditure for the health sector decreased over the pastthree years. The State budget allocation for hospitals in 2018 was 3.9 trillionVND (137 million USD) lower than in the previous year.
While applauding the increasingnumber of hospitals with budget autonomy, Lien also pointed out shortcomingswhich need to be solved.
In accordance with the Law on themanagement and use of State Assets and Government Decree No 151, if publichospitals want to purchase medical equipment or facilities, they have to joinwith investors and undertake procedures like a business. This was notappropriate, he said, adding that many health facilities seek upgrades toimprove care, not to increase revenue.
Regarding the results of SAVinspections at public hospitals, Chief Auditor from the SAV Le Dinh Thang saidthere was a pattern of hospitals collecting more than the allowed amount ofmoney and abusing high-tech medical services and medicine. These incidentsworsen the financial burden on poor patients and uninsured people and reducetheir access to care.
According to Thang, a number ofcentrally run hospitals are expanding in-demand health care services to collectmore fees. Many of the services could and should be conducted at the provincialor district level to improve funding for these lower level hospitals.
Nguyen Trong Khoa, Deputy Directorof the Medical Examination and Treatment Department under the MoH, said anumber of problems had been revealed during the Vietnam Social Insurance andthe MoH’s joint examination of health insurance and treatment.
A number of health facilities hadintentionally prolonged patients’ treatment and unnecessarily prescribed expensivemedicines, he said.
“We saw some doctors made five orsix diagnoses in a medical record during an inspection at a hospital,” he wasquoted by Kinh te & Do thi (Economicand Urban Affairs) newspaper as saying.
Khoa emphasised the need toimprove the management capacity of hospitals to minimise problems relating toprofessional skills and financing.
To solve difficulties forautonomous hospitals, participants at the workshop agreed it was necessary toallow them to make independent decisions on buying equipment and medicineaccording to their demand to ensure efficiency. The building of regulations toavoid abusing treatments and medicines as well as assure reasonable prices wasalso a must.
Pham Dinh Cuong, an economicexpert, said hospitals should be clear on what they could do and what theycould not do while exercising their right to autonomy.
Bui Sy Loi, Deputy Chairman ofthe National Assembly Committee for Social Affairs, suggested the Governmentcomplete mechanisms on financial autonomy for public hospitals to preventnegative effects on health care when the market economy is applied athospitals.
He also called for increasedState spending for health care to ensure sufficient investment in preventivecare and health care at a grass-roots level.-VNS/VNA
Doan Xuan Tien, Deputy AuditorGeneral of the State Audit of Vietnam, made the statement at a workshopentitled Autonomy mechanism to publichospitals and the role of the State Audit of Vietnam (SAV) held recentlyin Hanoi.
He said the dearth of regulationsmeant hospitals still relied on the State budget and could not cover theirexpenses or find funds to invest in equipment and other facilities to improvehealth care services.
According to Nguyen Nam Lien, Directorof the Planning and Finance Department under the Ministry of Health (MoH), asmany as 160 public hospitals independently controlled their regularexpenditures by the end of last year.
Another 1,364 hospitals withpartial financial autonomy could control between 80 and 90 percent of theirregular expenditures.
Nguyen Truong Son, DeputyMinister of Health, said positive results had been recorded in providingautonomy to a number of health facilities.
Autonomy helps reduce Statespending, while the quality of health care services is improved, meetingpatients’ demand, according to the official. Most public hospitals have beenproactive in mobilising private investment to upgrade their medical equipment.
Statistics from the ministryshowed that State expenditure for the health sector decreased over the pastthree years. The State budget allocation for hospitals in 2018 was 3.9 trillionVND (137 million USD) lower than in the previous year.
While applauding the increasingnumber of hospitals with budget autonomy, Lien also pointed out shortcomingswhich need to be solved.
In accordance with the Law on themanagement and use of State Assets and Government Decree No 151, if publichospitals want to purchase medical equipment or facilities, they have to joinwith investors and undertake procedures like a business. This was notappropriate, he said, adding that many health facilities seek upgrades toimprove care, not to increase revenue.
Regarding the results of SAVinspections at public hospitals, Chief Auditor from the SAV Le Dinh Thang saidthere was a pattern of hospitals collecting more than the allowed amount ofmoney and abusing high-tech medical services and medicine. These incidentsworsen the financial burden on poor patients and uninsured people and reducetheir access to care.
According to Thang, a number ofcentrally run hospitals are expanding in-demand health care services to collectmore fees. Many of the services could and should be conducted at the provincialor district level to improve funding for these lower level hospitals.
Nguyen Trong Khoa, Deputy Directorof the Medical Examination and Treatment Department under the MoH, said anumber of problems had been revealed during the Vietnam Social Insurance andthe MoH’s joint examination of health insurance and treatment.
A number of health facilities hadintentionally prolonged patients’ treatment and unnecessarily prescribed expensivemedicines, he said.
“We saw some doctors made five orsix diagnoses in a medical record during an inspection at a hospital,” he wasquoted by Kinh te & Do thi (Economicand Urban Affairs) newspaper as saying.
Khoa emphasised the need toimprove the management capacity of hospitals to minimise problems relating toprofessional skills and financing.
To solve difficulties forautonomous hospitals, participants at the workshop agreed it was necessary toallow them to make independent decisions on buying equipment and medicineaccording to their demand to ensure efficiency. The building of regulations toavoid abusing treatments and medicines as well as assure reasonable prices wasalso a must.
Pham Dinh Cuong, an economicexpert, said hospitals should be clear on what they could do and what theycould not do while exercising their right to autonomy.
Bui Sy Loi, Deputy Chairman ofthe National Assembly Committee for Social Affairs, suggested the Governmentcomplete mechanisms on financial autonomy for public hospitals to preventnegative effects on health care when the market economy is applied athospitals.
He also called for increasedState spending for health care to ensure sufficient investment in preventivecare and health care at a grass-roots level.-VNS/VNA
VNA
