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

(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.

Working session scene. Photo: Thanh Le

Discussing at the working session, 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 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...

Regarding human autonomy, according to Mr. Phan Van Tu - Director of the Obstetrics and Pediatrics Hospital, proposed: "If the State grants financial autonomy, it must also 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. This leads to patient overload and work frequency of the unit's employees."

The autonomous mechanism has helped Vinh City General Hospital develop many new techniques. Photo: Document

"By implementing autonomy, units have saved nearly 290 billion VND/year from regular expenditure sources 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the province needs to adjust Decision 125 on hospital fee collection of the Provincial People's Committee because it is outdated" - said Mr.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 the concerns of the units in the health sector and members of the Supervisory Team, the representative of the Department of Finance emphasized that the health sector is 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, the representative of the Department of Home Affairs said: The head of the unit has the right to decide 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 Provincial People's Council's Legal Committee 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 health 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 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 a change in awareness and action for units in the sector.

Thanh Le