Many concerns surrounding the Decree on increasing preferential allowances for medical professions

Worth the effort

On February 15, 2023, based on the proposal of the Ministry of Health, the Government issued Decree 05/2023/ND-CP amending and supplementing a number of articles of Decree No. 56/2011/ND-CP dated July 4, 2011, regulating the regimepreferential allowancesby profession. Accordingly, the 100% allowance applies to regular and direct civil servants: Working in preventive medical profession (including border medical quarantine); working in medical profession at commune, ward, town health stations, regional polyclinics, district, town, city health centers and district, town, city hospitals.

Medical staff enter the epidemiological investigation area. Photo: Thanh Cuong

The Government's timely increase in allowances for grassroots health workers is a great encouragement and motivation for the health workers to stay committed and dedicate themselves to their profession. And the increase in allowances is completely worthy of the efforts of grassroots health workers - those who have to face many difficulties, hardships and sacrifices, especially in the work of preventing and fighting the Covid-19 epidemic, along with many other infectious diseases.

With Decree 05/2023/ND-CP, the allowance level for grassroots medical staff, working in preventive medicine has been significantly increased. For example, with a medical station chief with a salary coefficient of 4.06 exceeding the frame by 5% (coefficient 0.203), station chief position allowance of 0.2, preferential allowance of 40%, the old allowance is 2.66 million VND/month and the new allowance is 6.65 million VND/month. For a newly recruited medical staff at the medical station, with a university degree, the monthly increase is 2.092 million VND/month; with a college degree, the monthly increase is 1.877 million VND/month.

Dr. Nguyen Van Thuong - Deputy Director of the Department of HealthNghe Anshare: In recent years, the regime and policies for public health workers have been gradually improved, contributing to improving the lives of health workers. The State has issued many policies showing preferential treatment for the health sector such as attraction allowances, toxic and dangerous allowances, mobility allowances, professional responsibility allowances, professional specific allowances, professional preferential allowances...

Grassroots health workers cross the stream to enter the village to examine and treat people. Photo: Dinh Tuyen

However, many documents regulating allowances for medical staff were issued mainly in the years 2005-2007. After many years of implementation, these policies have revealed many limitations and inadequacies that are no longer suitable for the current situation and need to be adjusted and supplemented. Moreover, labor in the medical sector is a special type of labor with high intensity in most fields of operation, due to direct contact with patients and infectious diseases as well as toxic chemicals, radioactive substances, especially since the outbreak of Covid-19, the work intensity of medical staff is 2-3 times higher than normal.

Especially with the socio-economic development, there are many other professions with good and fair income, the prices of essential goods are increasing rapidly and more than salaries. Therefore, although there are certain incentives for medical staff, they are still low, not suitable for the contribution as well as the current life needs, especially for medical staff at the grassroots level. And the majority of medical staff believe that salaries, allowances and additional income at the unit only ensure a part of the family's life.

Many concerns… waiting for instructions

After Decree 05/2023/ND-CP was issued, in addition to the great consensus, there are still some concerns and questions from specialized units of preventive medicine and grassroots health. Specifically, Anh Son District Medical Center said: The task of epidemic prevention and control is a common task of the entire unit. During the epidemic, from doctors, nurses, administrative staff - accountants to security guards, drivers all participate in epidemic prevention and control work... To ensure fairness and peace of mind for civil servants and employees working indirectly at medical facilities, it is recommended that all levels supplement the occupational allowance regime for this team.

Preventive health workers take blood samples to test for malaria in highland residents. Photo: Thanh Hoa

Ky Son District Medical Center recommends: The implementation period of Decree 05/2023/ND-CP should be adjusted from January 1, 2020 to January 31, 2022 (instead of January 1, 2022 to December 31, 2023), because this is the peak period of the Covid-19 epidemic. There are a number of cadres who retired before the time of enjoying the regime, although they participated in the fight against the epidemic but did not enjoy it. Meanwhile, newly recruited cadres during or after the time of enjoying the regime will enjoy the regime from this Decree.

According to the Center for Disease Control & Center for Hematology and Blood Transfusion of Nghe An province: It is necessary to supplement the allowance level for subjects in the Department of Testing, Department of Pharmaceutical and Medical Supplies, General Clinic, Preventive System Treatment, Department of Reproductive Health, Planning Department, Health Education and Communication, Administrative Organization, Finance - Accounting, Technology - Information... because almost all of these human resources are mobilized to participate in anti-epidemic activities. In Decree 05 as well as Decree 56, only testing for patients or key surveillance is mentioned, it is proposed to supplement blood bag screening tests (including screening for HIV, hepatitis B, hepatitis C, syphilis).

Quynh Luu General Hospital and Dien Chau General Hospital jointly proposed: The Government should soon have specific instructions to implement the decree, in which, it is necessary to pay attention to the team working indirectly participating in the epidemic prevention and control tasks of medical facilities; after the application period from 2022-2023, the Government should then have a plan to increase preferential allowances according to Decree 05/2023/ND-CP...

Propaganda for disease prevention and control in Ky Son district. Photo: Thanh Chung

According to the units, the benefit period of only 2 years (2022, 2023) is too short to ensure attracting human resources for public hospitals. From 2024, implementing Decree 56, the preferential allowance level is not commensurate with the job position of medical staff, the difference is too much compared to the payment of private hospitals. For example, a doctor who has studied for 6 years and works at a public hospital will only have a salary of 4.6-5 million VND. Meanwhile, some private hospitals pay over 8 million VND.

In addition, medical units also have other concerns such as: How are benefits calculated for employees on maternity leave or going to school during this time? Are employees of Contract 68/2000/ND-CP entitled to 100% preferential treatment? Are population officers of health centers entitled to 100% preferential allowance?