Many difficulties in managing private medical practice

There are only 290 health inspectors nationwide, while the number of private medical establishments nationwide is 157 private hospitals, more than 30,000 clinics and non-public medical establishments. Such a large number of private medical establishments is a challenge for the health inspectorate.

Many private medical facilities violate the law partly because the health inspection force is too thin. (Photo: vnexpress.net)

Health inspectors are too thin

According to the Ministry of Health, up to now, the country has 157 private hospitals, more than 30,000 clinics and non-public medical facilities (NCL). The total number of NCL medical practitioners is currently nearly 250,000 people.

In contrast to the above “bloom”, the entire health inspection force nationwide currently has only 290 people. Of which, the largest number is the Health Department Inspectorate of Ho Chi Minh City with 45 people, and the Health Department Inspectorate of Hanoi City with 14 people. The remaining 61 provinces and cities, on average, each health department only has from 2 to 4 inspectors. Moreover, the number of inspectors specializing in medicine and pharmacy is even rarer. Only the Health Department of Ho Chi Minh City and Hanoi City have inspectors specializing in medicine and pharmacy, while most provinces do not have any.

Mr. Dang Van Chinh - Chief Inspector of the Ministry of Health admitted that "the inspection force is still too thin compared to the actual large workload requirements". He gave an example: In Hanoi, the total number of health inspectors at the Hanoi Department of Health is 14 people, of which the medical and pharmaceutical inspectors each have 4 inspectors, having to manage 2,308 medical establishments and 2,827 non-public pharmaceutical establishments.

Mr. Bui Minh Trang, Chief Inspector of the Ho Chi Minh City Department of Health, said that with the current inspection team and inspection speed, some private medical facilities have to wait 2 years to be "touched". Mr. Trang cited that the Ho Chi Minh City Department of Health currently has 45 inspectors but the whole city has more than 13,000 private medical facilities. If we mobilize all forces and conduct inspections vigorously and actively, we can only inspect a maximum of 50% of those facilities each year. "Meanwhile, there are many violations at private medical facilities. In just 10 months, the department's inspectors have inspected and penalized 606 facilities," Mr. Trang said.

Mr. Dang Van Chinh also admitted that in addition to the small force, the qualifications of health inspectors are not uniform in some areas such as handling complaints and denunciations; preventing and combating corruption, health insurance... The awareness of law compliance of many inspectors is not good, deliberately circumventing the law, violating the law for the purpose of profit.

This reality leads to violations in every inspection. According to the report of the Inspectorate of the Ministry of Health, from the beginning of 2013 until now, the Inspection Team for State management of private medical practice has conducted inspections in Ho Chi Minh City, Hanoi, Hai Phong, Binh Phuoc... and discovered many violations. In Hanoi, in the first 9 months of 2013, 977 medical facilities were inspected and violations were fined with the amount of 2,872,750,000 VND. In Ho Chi Minh City, through inspection of 1,232 medical and traditional medicine establishments, 257 establishments were found to be in violation, of which 168 establishments were fined, 71 establishments were suspended, and administrative violations were fined 2,799,350,000 VND.

According to Luong Ngoc Khue, Director of the Department of Medical Examination and Treatment Management (Ministry of Health), inspections have shown that some medical examination and treatment facilities practice beyond the scope of permitted professional activities, abusing paraclinical procedures to gain high profits. Some private medical examination and treatment facilities place too much importance on profits, disregard the law, take advantage of people's trust by advertising their professional capabilities incorrectly or beyond the scope of permitted professional activities, do not list prices or list prices but charge higher than the listed prices.

Increase the force

To deepen the medical inspection work, the Ministry of Health Inspectorate has made many recommendations to functional units. Specifically, the Ministry Inspectorate proposed that the National Assembly soon promulgate the Law on Citizen Reception so that ministries, branches and localities can implement it in accordance with the requirements of the current situation.

The Health Inspectorate also recommended to the Government to allow the establishment and organization of a health inspection and examination system at the district level, and in the field of food safety and non-public medical and pharmaceutical practice, to establish and organize a specialized inspection and management system at the commune level. At the same time, measures should be taken to increase the staffing of the Inspectorate in provinces and cities to ensure at least 7-10 people; Ho Chi Minh City and Hanoi alone should have 50-70 people.

For the Government Inspectorate, it is recommended to promptly issue documents directing and guiding the work of receiving citizens, handling and resolving complaints and denunciations, and specialized inspection work. Strengthen training and fostering of professional skills in receiving citizens, handling and resolving complaints and denunciations, and specialized inspection for ministerial-level inspectors as well as those assigned to perform specialized inspection tasks at Departments and General Departments assigned to perform specialized inspection functions. Quickly build a system applying information technology to resolve complaints and denunciations for common use and report on inspection work. Have policies to ensure safety for people receiving citizens and have a reasonable remuneration regime to encourage officials receiving citizens to work with peace of mind. Quickly issue regulations on inspector uniforms, prescribe appropriate policies and regimes for inspection officials, ensuring that inspectors at all levels can work with peace of mind and stick with their profession.

Particularly in the field of private medical practice management, Mr. Dang Van Chinh proposed that the Ministry of Health issue a document guiding the recognition of Traditional Medicine qualifications for those who have been trained and educated in traditional medicine knowledge according to the provisions of the Law on Medical Examination and Treatment.

Recommend that the Department of Health of provinces and cities strengthen inspection and examination of compliance with legal regulations on private medical practice for private medical practice establishments in the area and strictly handle violations./.

According to the Communist Party of Vietnam