Health

Concerns surrounding the proposal to increase medical allowances

Thanh Chung DNUM_BEZBAZCACE 11:55

The Ministry of Health proposes to increase surgery and procedure allowances, on-duty allowances, and meal allowances for medical staff in accordance with the current inflation index and consumer prices.

Change the level of treatment

At this time, the Ministry of Health is developing a preferential allowance regime according to profession, proposing to replace Decree No. 56/2011/ND-CP dated July 4, 2011; developing amendments and supplements to Decision No. 73/2011/QD-TTg on the regulation of a number of special allowance regimes for civil servants, public employees, and workers in establishments.medicalpublic and anti-epidemic allowance regime.

Cấp cứu cho bệnh nhân nguy kịch. Ảnh Thành Chung
Emergency care for critically ill patients. Photo: Thanh Chung

Specifically, the Ministry of Health proposes: Increasing surgery and procedure allowances; increasing on-call and meal allowances for medical staff in line with the current inflation index and consumer prices; applying regulations on working hours, overtime and overtime payment for 24/7 on-call time of civil servants and employees according to the Labor Code; applying special allowances for labor contract subjects whose salaries have been classified according to Decree No. 204/2004/ND-CP dated December 14, 2004 (including security guards, drivers, nurses, and professional contracts while waiting for civil servant recruitment exams).

Currently, the on-call allowance for doctors and medical staff is being implemented according to Clause 3, Article 2 of Decision 73/2011/QD-TTg. Accordingly, employees on duty 24/24 hours are entitled to an allowance of 115,000 VND/person/on-call for grade 1 and special hospitals; 90,000 VND/person/on-call for grade 2 hospitals; 65,000 VND/person/on-call for other hospitals and other equivalent facilities; 25,000 VND/person/on-call for commune health stations, military-civilian health stations, and military-civilian infirmaries.

Workers on duty for 12/24 hours are entitled to a rate equal to 0.5 times the 24/24 hour on-call allowance. Workers on duty for 16/24 hours are entitled to a rate equal to 0.75 times the 24/24 hour on-call allowance... If on duty in the emergency resuscitation area or special care area, the on-call allowance is calculated at 1.5 times the above prescribed rate; if on duty on a weekly day off, the on-call allowance is calculated at 1.3 times the above prescribed rate; if on duty on holidays or Tet, the on-call allowance is calculated at 1.8 times the above prescribed rate.

Điều trị cho bệnh nhân bị đột quỵ não ở Bệnh viện Hữu Nghị Đa khoa Nghệ An. Ảnh Thanh Sơn
Treating a stroke patient at Nghe An General Hospital. Photo: Thanh Chung

In addition, doctors and staffmedicalAlso enjoy the following benefits: Workers on duty 24/24 hours are supported with a meal allowance of 15,000 VND/person/shift. Workers on duty 24/24 hours on weekdays and weekly holidays are given 1 day off in compensation; on holidays and Tet holidays are given 2 days off in compensation; workers on duty 12/24 hours or 16/24 hours are given at least the next 12 hours off.

In case a medical examination and treatment facility mobilizes employees to work during the above break time, it must pay overtime wages according to the provisions of the law on labor. In case a medical examination and treatment facility mobilizes employees to work overtime, it must pay overtime wages to employees according to the provisions of the law on labor. Employees working on the night shift are paid wages for working at night according to the provisions of the law on labor.

“Although the training time for medical and medical staff is longer than other professions, not to mention the time for specialized training, practice, and continuous learning, the salary and benefits are not much. In addition, the current salary and allowance regime for medical staff is not suitable for the current market mechanism. The salary regime for medical staff is very low and was established many years ago, and is no longer suitable today.”

Minister of Health Dao Hong Lan

Decision No. 73/2011 stipulates the allowance level (VND/person/surgery) for subjects participating in surgery:

Object
Special type
Type I
Type II
Type III
Chief surgeon, anesthesiologist or chief sedative
280,000
125,000
65,000
50,000
Surgical assistant, anesthesia assistant or acupuncture assistant
200,000
90,000
50,000
30,000
Surgical assistant
120,000
70,000
30,000
15,000

Still have many concerns

Môi trường làm việc, sự đồng cảm của bệnh nhân đang là một yếu tố để cán bộ, viên chức y tế vững chân công tác. Ảnh Thành Chung
The working environment and patient empathy are factors that help medical staff and civil servants to stay strong in their work. Photo: Thanh Chung

Although the Ministry of Health has not yet clearly stated how much the increase will be, the above proposed information has made many medical staff and employees excited, especially those at district-level medical centers (managed and budgeted by the District People's Committee).

Mr. Pham Ngoc Luan - Director of Thanh Chuong District Medical Center stated: In early 2012, when Decision 73/2011 took effect, the basic salary was 830,000 VND/month. Over the past 12 years, the basic salary has been adjusted 8 times, currently at 2,340,000 VND/month, but the above allowances for surgery, procedures; on-duty pay; and meals have not been adjusted accordingly. The Ministry of Health's proposal to increase the preferential allowances according to the profession is very correct and appropriate. This proposed increase should also increase according to the increase in the basic salary, up to about 3 times compared to the old level.

However, for many medical examination and treatment units (especially financially autonomous units of groups 3, 2, 1), the attitude of receiving this information is "neither sad nor happy". In Nghe An today, there are 46 medical career units, of which 1 is financially autonomous unit of group 1; 18 are financially autonomous units of group 2; 18 are financially autonomous units of group 3 and 9 units are guaranteed regular expenditure by the State.

It is known that the implementation of financial autonomy at medical units in the province is facing many difficulties. From July 1, 2024, the basic salary will be increased from 1.8 million VND/month to 2,340,000 VND/month. However, at this time, up to 7 financially autonomous units at the district level have not been able to pay the new salary to medical staff.

Nữ điều dưỡng bám trụ hàng tháng trời nơi cơ sở y tế thực hiện điều trị cho bệnh nhân Covid-19. Ảnh Thành Cường
Female nurse stays for months at medical facility treating Covid-19 patients. Photo: Thanh Cuong

Mr. Tang Viet Ha - Director of the Northwest Regional General Hospital stated: Increasing preferential treatment and benefits is inevitable and very good for medical staff. However, I also think that after increasing the allowance, the price of medical examination and treatment services must also increase; it is necessary to structure this increase into the price of medical examination and treatment services. Otherwise, increasing is the same as not increasing.

In self-financed units with regular expenditures, if the price of medical examination and treatment services is not increased, the increase in allowances will not change the total income of employees. The reason is that the hospital's revenue is entirely dependent on hospital fees. When the price of medical examination and treatment services has not changed, and all constituent elements have not been calculated correctly and fully, the total revenue remains unchanged. Thus, the salary increase and preferential treatment of medical staff and employees means that the additional income must be reduced.

Currently, the price of medical examination and treatment services is being implemented according to Circular No. 21/2023/TT-BYT and Circular No. 22/2023/TT-BYT dated November 17, 2023, in which the price includes 2 factors: Direct costs (electricity, water, maintenance, repair of houses, equipment, etc.) and labor (salary according to the basic salary); not including management costs and depreciation of fixed assets. Meanwhile, management costs and depreciation of fixed assets are also regular expenses to maintain normal operations of medical facilities.

Not including all cost factors in prices affects the revenue of hospitals. Specifically, not including depreciation costs in prices leads to medical facilities not having a career development fund to reinvest, purchase additional equipment, and develop techniques; not including management costs in prices leads to medical facilities not having resources to spend on activities to innovate management methods, invest in information technology applications, and train to improve skills. Thus, this also directly affects the rights of patients... Increasing preferential treatment and benefits for medical staff is very necessary. However, calculating correctly and fully the price of medical examination and treatment services needs to be done soon.

Mr. Nguyen Hong Truong - Director of Vinh City General Hospital

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