'Opening the way' for socialization and financial autonomy of public hospitals

(Baonghean) - In order to improve the quality of medical examination and treatment in the context of medical service prices gradually moving towards accuracy and sufficiency and health insurance being fully integrated, Nghe An Health sector is building a new direction of socialization to increase the number of hospital beds and financial autonomy in public hospitals.

Socialization "solve" the problem of overload

From the practical shortcomings, on January 13, 2016, the People's Committee of Nghe An province had a meeting and agreed to expand the scale of hospital beds by 2020 for Nghe An General Hospital of Friendship to 1,600 beds, of which 1,000 are public beds and 600 are socialized beds; Nghe An Obstetrics and Pediatrics Hospital to 1,000 beds, of which 800 are public beds and 200 are socialized beds.

Provincial leaders inspect the overload situation at the Northwest Regional General Hospital.

For Nghe An Obstetrics and Pediatrics Hospital, it has long been in a state of constant overload in terms of both the number of patients and the workload of doctors and nurses. Since 2009, Nghe An Obstetrics and Pediatrics Hospital has also built and put into operation an on-demand medical examination and treatment area with a scale of 50 beds, contributing to reducing the situation of sharing beds and increasing the number of medical staff serving.

Since its inception, the on-demand medical examination and treatment area has been operating well. However, the addition of 50 beds is still far from the actual demand. As of 2015, Nghe An Obstetrics and Pediatrics Hospital had a capacity of 600 beds, but the actual number of beds was 913, with a bed occupancy rate of 193.8%; by June 2016, the actual number of beds was 1,002. The on-demand medical examination and treatment area is always full.

The Provincial General Hospital of Friendship is also in a similar situation. This hospital receives a large number of patients every day, and the volume is increasing. The hospital put into use a new facility in September 2014, with 900 beds, but the actual number of beds is up to 1,557, with a bed occupancy rate of 151%.

Implementing the policy of expanding the Provincial General Hospital, on March 13, 2016, Nghe An province held a groundbreaking ceremony for the construction project of phase 2 of this hospital. Accordingly, phase 2 is implemented according to the combined public-private socialization model, with a total estimated investment of 1,300 billion VND, including a credit support package of more than 1,000 billion VND from BIDV. It is expected that by the second quarter of 2018, the 600-bed hospital will officially come into operation, combined with Nghe An General Hospital - phase 1 to create a complex with 1,600 beds.

Nghe An Maternity and Pediatrics Hospital is always overloaded.

Nghe An Obstetrics and Pediatrics Hospital is also gradually implementing this policy. Doctor Tran Van Cuong - Deputy Director of Obstetrics and Pediatrics Hospital said: "The hospital has been gradually completing the construction of the hospital on an area of ​​17,400m2, with the commencement of construction of a 7-storey building with a total area of ​​10,000m2 for the Obstetrics and Gynecology block; building a 7-storey voluntary treatment area with self-contributed capital from staff and civil servants to reasonably increase the number of beds in the current hospital campus".

Reality also shows that not only the two leading provincial hospitals mentioned above are overloaded and need to increase the number of hospital beds in the form of socialization. Recently, Nghe An Department of Health held a meeting to count the demand, units to build private hospital models in public hospitals. Initially, nearly 20 units have registered to build medical examination and treatment facilities on demand within the campus with nearly 1,000 beds.

The autonomous "revolution"

Financial autonomy is a mandatory requirement for public hospitals in the coming time, in the context of overspending on the policy of reducing regular expenditures. After studying Decree No. 16/2015/ND-CP dated February 14, 2015 regulating the autonomy mechanism of public service units, Nghe An Health Department is developing a pilot project for autonomy in a number of hospitals. Nghe An Health Department has decided to choose Vinh City General Hospital as the first pilot unit according to level 2 "Financial autonomy for units that ensure regular expenditures".

Financial autonomy helps Vinh City General Hospital put into use many new techniques such as cerebral angiography with reconstruction.

Currently, Vinh City General Hospital has a scale of 280 beds, 450 beds, 270 medical staff and doctors. The hospital constantly innovates, improves the quality of examination and treatment, has implemented many advanced techniques of the provincial and central levels, along with many modern machines and equipment... Since implementing the health insurance connection, the number of patients coming to the hospital has continuously increased; the number of patients examined and treated is about 500 - 900 patients/day.

In 2016, Vinh City General Hospital received 14 billion VND from the budget to pay salaries and allowances. When implementing financial autonomy at level 2, this amount will no longer be allocated, but the hospital will balance its own revenue and expenditure.

According to level 2 of Decree No. 16/2015/ND-CP regulating the autonomy mechanism of public service units, Vinh City General Hospital will have the right to decide on its organizational structure, human resources and finances, be subject to state management and still receive partial budget investment in infrastructure facilities.

Doctor Nguyen Hong Truong - Director of Vinh City General Hospital said: "The hospital determined that implementing autonomy is a major breakthrough to improve quality in all aspects, ensuring the rights of the people. The hospital has also made certain preparations such as sending staff for training to improve their expertise and skills, learning to change the way of serving patients and working style...".

After calculating revenue and expenditure sources and investment levels, there are currently 4 units that have registered to implement autonomy, namely Vinh City General Hospital, Northwest Regional General Hospital, Dien Chau District General Hospital and Nghi Loc District General Hospital.

Thanh Son