Implementing autonomy in public hospitals: An inevitable trend

(Baonghean) - Implementing autonomy in regular expenditure or all regular expenditure and investment in public hospitals has been and is an inevitable requirement and trend today. Only then will hospitals be "untied" to develop and patients will enjoy the best medical examination and treatment services at the facility...

Autonomy to develop

Coming to Vinh City General Hospital (grade II hospital) in the first days of the year, we have seen many positive changes in all aspects: The facilities are relatively complete, spacious, clean, and beautiful, the treatment rooms, waiting rooms, and examination areas are mostly equipped with air conditioners, automatic drinking water filtration systems, and free wifi... In the first days of this year, the hospital welcomes about 1,000 - 1,100 people every day for examination and treatment. There are many patients coming for examination but there is no situation of pushing, shoving, or pushing, but they wait their turn peacefully according to the automatic numbering and control system.

Ms. Nguyen Thi Hoa, a resident of Hung Nguyen district, said: “Although we had to wait a long time for our turn to be examined, we were satisfied with the service of the doctors and hospital staff. They were very gentle, thoughtful in guiding and examining us, making us feel like we were being served.”

Applying high technology in medical examination and treatment at the Provincial General Hospital. Photo courtesy

Although the hospital bed quota is 230 people, at the beginning of this year, the number of inpatients at Vinh City General Hospital has always been maintained at 500 people. With the efforts of the unit, currently there is no need to share beds in the hospital rooms; the sanitary facilities have been renovated, replaced cleanly and neatly. Many new techniques, specialized techniques from the upper level have been deployed at the hospital; the service style and attitude have been renewed towards patient satisfaction...

According to Dr. Nguyen Hong Truong - Director of Vinh City General Hospital: The recent developments, plus the large number of patients, are the necessary and sufficient conditions for the hospital to be autonomous. Entering autonomy, the Hospital is completely proactive in terms of targets and plans; organizing and implementing tasks; finances; and especially the right to proactively decide on personnel in accordance with the actual situation of workload, ensuring the best quality of service provision for customers, most satisfying. Thereby, the Hospital can attract experts and talented people to develop the unit...

Patients being treated at Nghe An Eye Hospital. Photo: Tu Thanh

Along with Vinh City General Hospital, Nghe An Rehabilitation Hospital is one of the units assigned autonomy and approved the Autonomy Plan, self-responsibility for performing tasks, organizing apparatus, personnel and finance for the period 2017 - 2019 according to Decree 16/2015/ND-CP on the autonomy mechanism of public service units and Decree 85/2012/ND-CP on the operating mechanism, financial mechanism for public health service units and prices of medical examination and treatment services of public medical examination and treatment facilities.

Ms. Thai Thi Xuan - Director of Nghe An Rehabilitation Hospital analyzed: "With the autonomous mechanism, the hospital has switched to operating under the mechanism of "profit and loss". Thus, if the hospital wants to survive and develop, it must develop all aspects from human resources, material resources to infrastructure, services and meet the needs of patients. Financial independence, the hospital's main source of revenue comes from health insurance and legitimate and legal public services. Doing well, many patients, high income and vice versa. To "live healthy", the hospital must save on expenses, promote creativity and clearly know what patients "need" to prioritize service. From there, patients will enjoy the best medical examination and treatment services right at the grassroots level".

Take it step by step

Pharmacist Hoang Van Hao - Deputy Director of Nghe An Department of Health said: The roadmap of the Ministry of Health is to calculate all salary costs, direct costs, management costs and asset depreciation by 2018. From there, the Ministry of Health and the Ministry of Finance will stipulate a common price for each type of medical service, applied to the system of all medical facilities nationwide. Therefore, the policy of giving autonomy to public hospitals is completely inevitable.

On December 24, 2015, the People's Committee of Nghe An province issued Plan No. 827/KH-UBND, implementing Decree No. 16/2015/ND-CP of the Government regulating the autonomy mechanism of public service units in Nghe An. Implementing this Decision, in 2017, the province is determined to bring 6 units to be eligible for autonomy, namely the Provincial General Hospital of Friendship, Nghe An Obstetrics and Pediatrics Hospital, Oncology Hospital, Endocrinology Hospital, Tay Bac General Hospital and Tay Nam General Hospital. These are the units that meet the conditions of facilities, technical equipment and services, have good service attitude, and have a large and stable number of patients.

With autonomy, the State will not have to provide operating expenses for the above 8 units of about 165 billion VND/year, nor pay salaries for about 2,744 workers. And on the patient side, these units are required to take the patient as the center. All professional techniques and services, infrastructure, revolve around the patient's needs to serve... In the long term, to implement the autonomy mechanism in all public hospitals, we must overcome current limitations and challenges such as: Prolonged subsidy thinking, limited knowledge of modern hospital management, so some hospitals do not easily support financial autonomy, especially district hospitals. Therefore, it is necessary to implement step by step according to the roadmap.

The autonomous mechanism has helped Vinh City General Hospital develop many new techniques. Photo: Thanh Son

According to pharmacist Hoang Van Hao, autonomy is "unleashing" the unit, but autonomy does not mean doing whatever it wants. Units are proactive in developing within the framework of specific plans approved by the Provincial People's Committee, as well as other current relevant State documents. Nghe An Department of Health will develop a plan for post-inspection, inspection, supervision, encouragement and motivation as well as correcting deviations and deviations, so that patients can enjoy the best medical examination and treatment services right at the grassroots level.

Thanh Son