To develop a healthy and strong non-public health system

Many bright spots

Over the years, the systemnon-public healthencouraged and facilitated by Nghe An province to develop. As of July 31, 2023, the province has 696 medical examination and treatment facilities with various organizational forms, including: 15 general and specialized hospitals; 35 general clinics; 646 specialized clinics and medical service facilities (with 31 non-public medical examination and treatment facilities signing health insurance contracts). In particular, non-public hospitals are distributed and concentrated mainly in Vinh city, Quynh Luu district, Hoang Mai town, Dien Chau district, Yen Thanh district, Tan Ky district; general and specialized clinics are concentrated in 21 districts, cities and towns in the province.

Human resources at non-public medical examination and treatment facilities in the province are increasingly developing, with 1,083 doctors, 1,245 nurses, 304 technicians, 109 midwives and other specialists. Along with the development of human resources, non-public medical examination and treatment facilities also have relatively synchronous and modern facilities and equipment, in accordance with the prescribed registration model. Many medical examination and treatment facilities have applied advanced techniques, providing people with quality health care services, the rate of patients coming for medical examination and treatment every year is increasing, contributing positively to reducing the overload of public medical facilities.

In general, non-public medical examination and treatment facilities ensure operating conditions and are assessed and licensed by competent authorities. The basic operation process fully complies with the provisions of the law on medical examination and treatment. The quality of medical examination and treatment is guaranteed, the service is convenient and fast. The spirit and service attitude of medical staff at private medical facilities are enthusiastic, thoughtful, satisfying patients... Thereby, it has created trust with the people, attracted a large number of patients to come for medical examination and treatment, contributing to reducing the burden on public hospitals.

From 2021 to June 2023, the total number of health insurance examinations and treatments at non-public medical facilities is 1,940,806 (of which, 973,840 are outpatients and 976,326 are inpatients). The total cost of social insurance payment is 1,757.9 billion VND.

Dr. Nguyen Thi Hong Hoa - Director of Nghe An Department of Health said: At present, Nghe An is the third locality in the country in developing the non-public health system. The system of non-public medical examination and treatment facilities has made an important contribution to improving the effectiveness of health care for the people. Nghe An will continue to expand the scale of the non-public health system, striving to reach 26 hospital beds/10,000 people by 2030.

DTemporary suspension of operations for some establishments that have committed serious violations

Besides the advantages and positive aspects, the non-public health system in Nghe An also has many shortcomings and limitations, which are: Firstly, in addition to thehospitalSome general clinics have been invested in with adequate scale and facilities, while the remaining medical facilities are small in scale and have limited investment in resources. The new facilities only basically meet the needs of routine medical examination and treatment, and do not yet have high-quality services.

Second, the number of unlicensed medical examination and treatment establishments still exists. According to district statistics, before the issuance of Directive No. 03/CT-UBND dated January 29, 2018, there were 685 unlicensed medical examination and treatment establishments and by February 28, 2023, there were 28 establishments (a further reduction of 657 establishments), mainly dental and traditional medicine establishments. The state management of some localities has not been well implemented in the issue of non-public medical practice activities, and there have not been strong and drastic measures.

Dr. Tran Nguyen Truyen - Chief Inspector of Nghe An Department of Health said: From January 1, 2021 to July 31, 2023, the Department of Health presided over and coordinated with relevant departments, branches, and sectors, Nghe An Provincial Police, to establish 26 inspection and examination teams according to plan and suddenly conduct inspections and examinations at 182 non-public medical examination and treatment facilities. Of which, 28 medical examination and treatment facilities committed violations. The Department of Health imposed administrative fines of VND 654 million, requiring medical examination and treatment facilities to remedy the consequences; at the same time, revoked the right to use medical examination and treatment operation licenses; and temporarily suspended operations for a number of facilities with serious violations.

Third, basically, all medical examination and treatment facilities in the area are licensed to operate in accordance with regulations. However, there are still hospitals whose quality of examination and treatment does not meet the requirements; inpatient admission is prescribed in some cases that are not really necessary and there is also a situation where the prescribed tests are not appropriate to the disease condition. Some hospitals have many violations in the settlement and settlement of medical examination and treatment under health insurance and life insurance, violating the law.

Also according to the Inspector of Nghe An Department of Health: Currently, in the field of spa, tattooing, and beauty, there is no regulation requiring the Department of Health to assess and grant a license before operating like other clinics and medical services. This is a field with a high risk of affecting people's health. In addition, the sanctions for violations in the field of spa, tattooing, beauty, and eyeglasses are still unclear and not strict, causing difficulties in application.

Enhance guidance and support

The practical requirement is to improve the operation of the non-public health system to promote the development of Nghe An's health sector. Therefore, in August 2023, the Provincial People's Council selected the field of non-public health activities for supervision. The Supervision Delegation of the Department of Culture and Society, Provincial People's Council conducted supervision at a number of non-public hospitals in Vinh city, Quynh Luu district and Dien Chau district.

Through this monitoring activity, the Monitoring Team discovered some more problems in the non-public health system. These include violations of the law and failure to pay insurance for employees in some facilities. Non-public health facilities are facing difficulties in purchasing medicines, chemicals, and consumables; lack of financial support from the State for the prevention and control of infectious diseases; lack of payment for medical examination and treatment under health insurance based on actual bed occupancy; difficulties in recruiting high-quality human resources; limited implementation of high-quality medical services and a list of new techniques due to too many procedures; difficulties in inviting good doctors and experts from central hospitals due to procedures.

The management of non-public medical facilities also faces many difficulties. According to Mr. Pham Xuan Sanh - Vice Chairman of Dien Chau District People's Committee: Management work faces many difficulties due to incomplete legal regulations, especially regulations related to standards for granting operating licenses for traditional medicine clinics. The management force is thin, unable to regularly inspect, and when inspecting, there are no customers performing procedures, so it cannot be handled. The application of penalty regulations is also difficult because many facilities are unable to pay fines. The issuance of operating licenses is also difficult due to problems in signing waste treatment contracts.

During the working session with the Nghe An Department of Health, the Monitoring Delegation of the Cultural - Social Committee, the Provincial People's Council requested the Department of Health to synthesize the problems to advise all levels and sectors to have solutions and support policies to help the non-public health system develop further. Regarding recommendations related to macro issues of non-public health facilities, localities, the Department of Health such as supplementing and amending Decree No. 117/2020/ND-CP, Decree 155/2018/ND-CP, Law on Medical Examination and Treatment; including criteria for evaluating state management of non-public medical examination and treatment practice in the annual emulation assessment... The monitoring delegation synthesizes and reports to the Standing Committee of the Provincial People's Council to propose competent authorities to resolve./.