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 inspection force.

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

The health inspection force is 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 "blooming" situation, 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. In the remaining 61 provinces and cities, each health department has on average only 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 each department has 4 inspectors in the medical and pharmaceutical fields, 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 intensive and active inspections, 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 a number of areas such as handling complaints and denunciations; preventing and combating corruption, health insurance... The awareness of law compliance of many inspection subjects is not good, deliberately circumventing and violating the law for the purpose of profit.

It is from this reality that every inspection is accompanied by violations. According to the report of the Ministry of Health Inspectorate, 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 violations were discovered, of which 168 establishments were fined, 71 establishments were suspended, and administrative violations were fined 2,799,350,000 VND.

According to the Director of the Department of Medical Examination and Treatment Management (Ministry of Health) Luong Ngoc Khue, inspections have shown that some medical examination and treatment facilities practice beyond the scope of their permitted professional activities, abusing paraclinical practices 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 their permitted professional activities, do not list prices or list prices but charge higher than the listed prices.

Increase the force

To further improve the health inspection work, the Ministry of Health Inspectorate has made many recommendations to the 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, it is recommended to establish and organize a specialized inspection and management system at the commune level. At the same time, there should be measures to increase the staffing for the Inspectorate of 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 skills 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 and prescribe appropriate policies and regimes for inspection officials, ensuring that inspection officials 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