Many difficulties in implementing autonomy mechanism in hospitals
(Baonghean.vn) - On the afternoon of August 13, the Provincial People's Committee worked with sectors and medical units in the province to listen to and give opinions on the results of implementing the plan for autonomy and self-responsibility for performing tasks, organizing apparatus, personnel, and finance of public medical examination and treatment facilities. Many concerns were raised during the working session.
 |
| The meeting was attended by 15 autonomous hospitals in the province. Photo: Thanh Chung |
According to the report, at the beginning of 2017, there were 82 public health service units. In April 2017, 10 medical centers and 10 grade III general hospitals at the district level were merged into district health centers to perform two functions of disease prevention and medical examination and treatment. After the merger, there were 72 public health service units.
At the provincial level, there are 15 self-funded public service units in group II, 10 public service units in group III that partially fund their own regular expenditures, and 26 public service units whose regular expenditures are funded by the state budget in group IV.
 |
| Implementing autonomy has improved the service attitude at Vinh City General Hospital. Photo: Thanh Chung |
By implementing the autonomous mechanism, health service units have raised awareness and responsibility of leaders as well as civil servants; proactively implemented activities of the units from the stage of planning and developing strategies for the unit, organizing and implementing, restructuring the organizational structure to suit the reality of the unit, proactively attracting, recruiting, allocating, organizing, and using resources reasonably and effectively.
However, up to now, there has been no detailed Circular guiding the autonomy mechanism of public service units, so in the implementation process, there are still some contents that directly affect the financial activities of the units.
 |
| Using high technology to examine patients at Nghe An Oncology Hospital. Photo: Thanh Chung |
Group II autonomous units have high bed capacity but have not yet had solutions to increase bed capacity or invest in infrastructure such as the Provincial General Hospital, Obstetrics and Pediatrics, Oncology, Northwest Regional General Hospital, Vinh City General Hospital... Some departments have been established with many employees holding multiple positions. Some autonomous units have not yet developed a job position plan; the units have not fully utilized the assigned staff and number of employees.
At the meeting, representatives of the units reported on the implementation status, shortcomings, difficulties and obstacles in the process of implementing the autonomy mechanism. The delegates requested competent authorities to issue a synchronous system of policies on socialization, taxes and service prices in healthcare to determine a clear legal corridor for healthcare facilities to operate autonomously; it is necessary to innovate the financial mechanism in the direction of calculating correctly and fully the costs so that a portion is accumulated in healthcare service prices.
 |
| Associate Professor, Dr. Nguyen Van Huong - Director of Nghe An General Friendship Hospital proposed to increase the estimated cost of health insurance examination and treatment in 2018. Photo: Thanh Chung |
Associate Professor, Dr. Nguyen Van Huong - Director of the Provincial General Hospital proposed that regarding the implementation of the budget for health insurance examination and treatment costs in 2018, it is necessary to assign additional budgets to increase the budget for health insurance examination and treatment costs in 2018 so that the hospital can proactively organize health insurance examination and treatment to ensure the rights of patients; in case the budget has been used up, the hospital should be allowed to pay directly to health insurance patients and issue invoices for health insurance patients to pay directly to the Social Insurance agency.
Propose that the Department of Health and the Provincial People's Committee have a mechanism to allow the General Friendship Hospital in particular and public medical facilities in general to open more types of medical examination and treatment services upon request, voluntary medical examination and treatment to meet the medical examination and treatment needs of the people and contribute to reducing medical examination and treatment costs from the province's health insurance fund...
Concluding the meeting, comrade Le Minh Thong - Vice Chairman of the Provincial People's Committee affirmed: After 1 and a half years of implementing the autonomy mechanism at hospitals, very positive and clear results have been shown, such as better management and operation; more attention has been paid to medical ethics; financial work has been carried out more strictly in the direction of saving costs to improve medical examination and treatment facilities, and increase income for staff.
 |
| Comrade Le Minh Thong recommended that units build a high-quality medical examination and treatment mechanism according to demand. Photo: Thanh Chung |
Comrade Le Minh Thong acknowledged and highly appreciated the issues and suggestions that were close to the actual situation of the hospitals. For issues under the authority of the Provincial People's Committee, the provincial People's Committee will direct departments and branches to pay attention to resolving them on a suitable basis, in accordance with the provisions of law.
The Vice Chairman of the Provincial People's Committee said: Units that want to increase revenue without depending on health insurance funds need to build a high-quality medical examination and treatment mechanism according to requirements; strictly manage investment sources from the State budget; continue to assign annual health insurance budget estimates to medical examination and treatment units.
In particular, the construction of hospital bed plans and actual hospital bed allocations must be consistent with the actual treatment. The ultimate goal is to ensure both hospital operations and the rights of patients in general and health insurance participants in particular./.