Solution to the problem of attracting doctors to primary health care in Nghe An
(Baonghean.vn) - Currently, the annual recruitment of medical staff does not meet the approved plan, especially the team of doctors working at commune health stations in lowland, delta, urban areas and at dual-function medical centers.
Favorable in highlands, difficult in plains and cities
In recent years, Nghe An’s health sector has grown strongly in both quantity and quality. However, this development is still not balanced and even among all levels. High-quality human resources are concentrated mainly at the provincial level, while the grassroots health sector still faces many difficulties.
From 2020 to now, the entire Nghe An health sector has recruited 3,231 people. Of which, the district level recruited 781 people (214 doctors) and the commune level recruited 53 people (12 doctors)... The annual recruitment is not enough compared to the approved plan, especially the team of doctors at commune health stations and dual-function health centers.
To overcome the above situation, Nghe An Health sector has implemented many solutions to improve the quality of human resources at the grassroots level, such as increasing recruitment as well as training. Over the past 3 years, the recruitment of high-quality human resources in the health sector, specifically doctors, has seen a new trend, completely opposite to before, that is: In previous years, recruiting doctors to work at commune health stations, health centers, and district hospitals in mountainous areas was very difficult, but now, the recruitment is quite favorable.
From 2021 to now, Ky Son district has recruited 6 doctors to work at the medical center. Up to now, 21/21 commune and town health stations of the district have 22 doctors working.
Over the past 3 years, Que Phong district has recruited 9 doctors. Currently, 13 commune and town health stations have 15 doctors working sustainably and long-term.
Similarly, in the past 3 years, Tuong Duong District Medical Center and Quy Chau District Medical Center recruited 5 doctors... The recruitment of many doctors has helped mountainous district medical centers to conveniently arrange high-quality human resources at their units and commune health stations; gradually improve the quality of medical examination and treatment as well as do a good job of prevention.
On the contrary, in mountainous areas, recruiting and attracting doctors to work at commune health stations and medical centers in favorable areas, plains and urban areas is extremely difficult and problematic.
From 2021 to now, the unit has only recruited 2 reserve doctors. Local children who graduated from general medicine have not returned despite being invited and encouraged.
In the past 3 years, Vinh City Medical Center has recruited 3 doctors, of which 1 person works at the medical station. Currently, the Center is still recruiting but there are no doctors applying. After increasing the number of doctors from the medical center and Vinh City General Hospital, there are still nearly 10 medical stations in wards and communes without doctors.
From 2021 to now, the unit has not been able to recruit any doctors to work. Regarding the center, the commune health station only has basic salary so they do not return. It is expected that by 2027, 10/19 commune and town health stations will lack doctors because the doctors currently working will retire.
The solution to the attraction problem?
The reason why mountainous district health centers easily recruit doctors is because all aspects of life, including the quality of education in this area, are increasingly improved. Many children in mountainous areas pass the entrance exams to medical universities. District health centers focus on recruiting doctors who are all children in this area.
As for favorable areas, newly graduated doctors do not want to work there because the working environment at health centers and commune health stations is stressful and unattractive (few patients make it difficult to improve skills and low income). Along with that, salaries and allowances for health workers in the public health system are low (especially at preventive health facilities and primary health care facilities), not enough for newly graduated doctors to cover their living expenses... Meanwhile, almost all localities do not have strong attraction policies.
Along with that, currently, the system of private hospitals and private clinics is increasingly developing, the favorable working environment has a need to recruit doctors, nurses, medical technicians, especially highly qualified and specialized medical staff. Private medical facilities are willing to offer high income to attract medical staff, while public medical facilities do not have a mechanism to retain and promote medical staff with good professional qualifications.
Information from Nghe An Department of Health: Nghe An Department of Health has been implementing policies to attract and support training according to Resolution 157/2014/NQ-HDND dated December 12, 2014 on a number of specific policies to support the development of public health human resources in Nghe An province, Decision No. 01/2015/QD-UBND dated January 6, 2015 of the Provincial People's Committee stipulating a number of specific policies to support the development of public health human resources in the province.
The total budget for implementation according to these documents from 2020 to present is over 28.1 billion VND for 762 people. Of which, support for attracting 165 people, with a budget of nearly 5.7 billion VND; support for training high-quality human resources for 458 people, with a budget of over 20 billion VND; support for training from medical assistant to doctor for 126 people, with a budget of nearly 1.9 billion VND; support for contracts for 13 retired doctors at commune, ward and town health stations, with a budget of nearly 512 million VND.
According to Decision No. 01/2015/QD-UBND of Nghe An Provincial People's Committee: University and postgraduate doctors and pharmacists are initially supported with money when they are first recruited to work at medical centers, hospitals, commune and town health stations in mountainous areas (mountainous areas include: communes, wards, towns in mountainous districts, towns and mountainous communes in plain districts); Tuberculosis and Lung Hospital, Mental Hospital, Forensic Examination Center, Forensic Psychiatric Examination Center and have a commitment to work at the unit for 5 years or more, receiving a maximum of 30-100 million VND.
It can be said that Resolution 157 and Decision No. 01 have helped Nghe An's health sector attract and train many doctors; improve the quality of health care and protection for the people of the province. However, compared to other provinces and cities in the country, Nghe An's attraction policy is not much. For example, for comparison: The amount of money that Quang Ninh province supports doctors to work is from 200-750 million VND; doctors who commit to working at public facilities in Binh Thuan province for 10 years will receive from 600-800 million VND; doctors who commit to working at public facilities in Thanh Hoa province for 10 years will receive from 216-1,335 million VND.
According to the representative of Nghe An Department of Health: The Department will continue to propose to all levels and sectors to consider and soon promulgate amendments and apply the system of salary scales, tables and preferential policies, attracting enough to encourage medical staff to work, especially at the grassroots level, the prevention system; propose the Provincial People's Council and People's Committee to issue stronger policies to attract and support training to develop human resources in the health sector in a sustainable manner, especially at the grassroots level...
The Department of Health will also continue to pay attention to and fully implement salary and allowance policies for health workers; mobilize other social resources to provide material support for health workers to reduce difficulties; invest in improving the working environment and conditions for health workers; and increase the organization of job introduction sessions to connect supply and demand between students and human resource recruitment facilities./.
