Delegating autonomy over the number of employees to units in the health sector

DNUM_CJZADZCABH 12:45

(Baonghean.vn) - Financial autonomy needs to go hand in hand with autonomy in the number of employees - that is the recommendation of the Health sector to the Supervisory Delegation of the Provincial People's Council's Legal Committee.

Nghe An Department of Health has 60 public service units (of which 38 are at the district level, including 17 general hospitals and 21 medical centers, and 22 are at the provincial level, including 12 hospitals and 10 medical centers). Implementing the autonomous mechanism, in the whole sector, there are 17 service units that partially cover regular operating costs; 5 units have 100% of regular costs covered by the budget.

Quang cảnh buổi làm việc. Ảnh Thanh Lê
Working session scene. Photo: Thanh Le

Discussing at the meeting, leaders of the Department of Health and units of the sector reflected on the shortcomings and difficulties in implementing the autonomy mechanism. These include the general situation of a serious shortage of human resources; shortcomings in revenue sources according to the price of health insurance services and hospital fees according to Decision 125 of the Provincial People's Committee; initial funding support for units implementing autonomy to ensure regular operating expenses...

On the morning of March 29, the Supervisory Delegation of the Legal Department of the Provincial People's Council, led by Ms. Thai Thi An Chung - Deputy Head of the Legal Department, had a working session with the Department of Health on the implementation of the autonomy mechanism in public service units.

Regarding human autonomy, according to Mr. Phan Van Tu - Director of the Obstetrics and Pediatrics Hospital, "If the State grants financial autonomy, it must grant autonomy in the number of employees to the units. Because, currently, the human resources assigned to the units are still seriously lacking, inconsistent with the number of employees/number of assigned hospital beds; hospital beds go first, human resources do not follow. For example, at the Obstetrics and Pediatrics Hospital, the number of assigned hospital beds is 670 but the actual number of beds is 1,200. Meanwhile, the payroll is 400 people. Leading to patient overload and work frequency of the unit's employees".

Cơ chế tự chủ đã giúp Bệnh viện Đa khoa thành phố Vinh phát triển nhiều kỹ thuật mới. Ảnh tư liệu
The autonomous mechanism has helped Vinh City General Hospital develop many new techniques. Photo: Archive

"Implementing autonomy, units have saved nearly 290 billion VND/year from regular expenditures and the Department proposed that this saved amount should be invested in facilities and equipment. At the same time, the province needs to adjust Decision 125 on hospital fees of the Provincial People's Committee because it is outdated" - said Mr. Nguyen Sy Can - Deputy Head of the Finance - Planning Department of the Department of Health.

Clarifying concerns of units in the health sector and members of the Supervisory Team, the representative of the Department of Finance emphasized that the health sector was the unit that implemented the autonomy mechanism the earliest. However, many units have overlapping tasks, the sector needs to re-plan the network and complete the autonomy plan to submit to the approval levels for the units to implement.

Regarding the proposal to support initial funding for autonomous units, the representative of the Department of Finance said that according to Decree 43, there is no provision for initial support.

Explaining the use of the fund saved from regular spending, the representative of the Department of Finance said that this source was accumulated from the state budget allocated from previous years. Therefore, to use it for investment in facilities, it is necessary to ask for the province's policy. The Department of Finance will have a plan to propose to the Provincial People's Committee, when medical units implement autonomy, the fund saved from salary reform will be transferred to some urgent tasks.

Clarifying the autonomy of the number of employees, the representative of the Department of Home Affairs emphasized: After implementing the autonomy mechanism, the units will increase the number of employees in the units. They are civil servants receiving salaries from the unit's revenue, not from the state budget.

Responding to concerns of health units about employee autonomy, a representative of the Department of Home Affairs said: The head of the unit has the right to decide on the number of employees on the Job Position Project and the autonomy plan of the units under construction, but it must be within the "maximum, minimum" framework prescribed by the Provincial People's Committee to avoid massive recruitment.

Concluding the meeting, Comrade Thai Thi An Chung - Deputy Head of the Legal Committee of the Provincial People's Council highly appreciated the implementation of autonomy of units under the Health sector. She suggested that in the coming time, the Department should proactively advise the Provincial People's Committee to issue public services, re-plan the health network, and pay attention to the implementation of autonomy of district-level units and preventive medicine centers.

At the same time, the Department needs to direct the review of the plan assigned by the Provincial People's Committee on the Job Position Project, review the assets of public service units, strengthen the inspection of service providers and professional implementation units, avoid abuse in medical examination and treatment through health insurance services, and study the policy of merging units in the health sector system. Along with that, it is necessary to continue to propagate the implementation of autonomy to create changes in awareness and action for units in the sector.

At the end of 2016, the health sector implemented the autonomous mechanism according to Decree 16/2015/ND-CP dated February 14, 2015 of the Government on implementing the autonomous mechanism in public service units. 8 service units self-guaranteed regular operating expenses for the period 2017-2019 including: Provincial General Hospital; Obstetrics and Pediatrics Hospital, Oncology Hospital, Endocrinology Hospital, Rehabilitation Hospital, Tay Bac General Hospital, Tay Nam General Hospital and Vinh City General Hospital. Currently, Vinh City General Hospital has a Decision of the Provincial People's Committee to grant autonomy, the remaining units are being submitted by the Department of Health to the Provincial People's Committee.

Thanh Le

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Delegating autonomy over the number of employees to units in the health sector
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