Nearly 1,300 health sector leaders must resign

Minister of Health Nguyen Thi Kim Tien said that in 2018, the health sector will continue to innovate and reorganize the health system in the direction of streamlining the apparatus on the basis of merging medical centers (TTYT) performing preventive medicine tasks without hospital beds at the provincial level into provincial disease control centers (CDC).

Merge into one hub

According to Mr. Pham Van Tac, Director of the Department of Organization and Personnel - Ministry of Health, implementing Joint Circular 51/2015/TTLT-BNV-BYT between the Ministry of Health and the Ministry of Home Affairs, the Ministry of Health has been and is continuing to guide localities to re-merge health centers with the same function of preventive medicine into CDC as mentioned above. According to the arrangement plan, each province will reduce an average of 5 units and gradually reduce 315 units in 63 provinces and cities. Up to now, about 40 provinces and cities have carried out this merger.

At the same time, the hospital and the district health center will be merged into a dual-function district health center, directly managing the health station to reduce 450 positions, equivalent to reducing about 1,800 leadership positions (1 head, 3 deputy heads). Currently, 202/450 facilities have been merged.

Merging primary health care will help improve the quality of medical examination and treatment.

According to Mr. Tac, the difficulty that localities face is the problem of re-arranging personnel after rearranging medical facilities according to the CDC model, including the allocation of leadership positions.

Currently, most provinces have many health centers with the same function of managing preventive medicine, such as preventive health centers, medical quarantine centers, HIV/AIDS prevention centers, reproductive health centers, health education and communication centers, testing centers, social disease prevention centers, etc.

On average, each province and city has 6 centers (some places have up to 9, 12 centers), corresponding to 6 directors and 18 deputy directors. After rearrangement according to the CDC model, there is only 1 director, 5 redundant directors and 15 deputy directors. In total, the whole country has nearly 1,300 redundant directors, deputy directors and 12,000 administrative staff.

Up to now, Hanoi has reorganized 9 units in the preventive health system in the direction of merging into a single focal point according to the CDC model; 17 other provinces and cities are continuing to implement. The total number of streamlined staff is 2,140 cases.

Save billions every year

According to Minister Nguyen Thi Kim Tien, the merger not only saves the budget by cutting down on the already cumbersome indirect staff, but also adds resources to invest in preventive medicine and primary health care. The 1,300 leadership positions mentioned above alone have saved the state budget about VND93.6 billion/year (an average of VND6 million/month per person).

The number of employees determined based on job positions (according to the Law on Civil Servants) is expected to decrease by about 2,140 people (mainly doing administrative work such as drivers, cashiers, clerks, accountants, etc.), saving about 154 billion VND/year.

For local health facilities, after the reorganization, it is expected that about 35,000 cases will not have to pay salaries from the state budget, saving about 2,520 billion VND/year. In addition, at the district level, if 420 district health centers and 420 district general hospitals are merged, the state budget for leaders alone will decrease by 121 billion VND/year. At the same time, thanks to the reduction of 10,899 administrative staff, the budget will not have to spend about 784 billion VND/year.

The leaders of the Ministry of Health believe that in the context of such a major change in personnel, the proposed solution is that those who are good at their profession will move to do professional work, and those who are good at management will continue to hold leadership positions. In addition, the rotation of staff will be maintained to find leaders who are truly good at management.

For the administrative, security, and personnel teams, the solution is to transfer jobs or streamline the payroll, ensuring that only 18%-20% of the staff are in administrative work, while 80%-82% are in professional work. The ultimate goal is to streamline the leadership team, reduce administration, and enhance professional service.

According to the roadmap, the merger must be completed before 2020.