Management of non-public medical and pharmaceutical practice in Nghe An and issues arising when the Law on Medical Examination and Treatment comes into effect

Regarding the management of medical practice and innovations in this field when the Law on Medical Examination and Treatment No. 15/2023/QH15 has come into effect, Nghe An Newspaper had an interview with Mr. Nguyen Huu Le - Deputy Director of the Department of Health.

PV: Could you tell us about the current situation of non-public medical and pharmaceutical practice in Nghe An province?

Mr. Nguyen Huu Le:As of November 30, 2023, the whole province has 714 medical practice establishments (15 hospitals, 35 general clinics and 664 specialized clinics, medical services) and 2,931 pharmaceutical practice establishments (92 companies and branches; 689 pharmacies; 2,150 drugstores) licensed to operate.

Before 2018, in Nghe An, there were many unlicensed medical and pharmaceutical establishments. The total number of unlicensed medical and pharmaceutical establishments inspected by districts, cities and towns was 685. In order to improve the quality of medical and pharmaceutical practice, the Provincial People's Committee issued Directive No. 03/CT-UBND on continuing to strengthen the management of non-public medical and pharmaceutical practice in Nghe An province; Decision No. 1491/QD-UBND dated April 20, 2018 promulgating the Regulation on coordination in the management of non-public medical and pharmaceutical practice in the province between the Department of Health, relevant sectors and the District People's Committees.

Implementing the directives and decisions, Nghe An has increased the dissemination, guidance and training on laws related to medical practice for medical establishments operating in the management area; established inspection teams to handle violations; performed well the appraisal and approval of applications for certificates of medical practice; appraised the conditions for granting licenses for medical examination and treatment; and revoked establishments requesting to stop practicing in accordance with the provisions of law.

Prominent in this work are the police force, market management and People's Committees of districts, towns and cities. In particular, the Provincial Police issued Plan No. 224/KH-CAT-PA83 dated March 19, 2018 to implement Directive 03 on continuing to strengthen the management of non-public medical and pharmaceutical practice activities in Nghe An; At the same time, directing the police of units and localities to disseminate the contents of Directive 03 and Plan 224 to relevant departments and officers for serious and effective implementation; directing the police of units and localities to proactively coordinate with the Department of Health, District People's Committees, medical units and related sectors to participate in regular and surprise inspection and examination delegations.

With the active advice of the health department, the People's Committees of districts, towns and cities have issued many directive documents: Directives, plans and decisions to establish inspection teams, implementing Directive 03 on non-public medical and pharmaceutical practice in the management area. Every year, training on laws related to medical and pharmaceutical practice is organized for establishments operating in the management area. Periodically 1-2 times/year, surprise inspections of private medical and pharmaceutical practice activities in the area are conducted.

Thanks to that, the situation of practicing without a license has been reduced. At present, the whole province still has 29 medical establishments operating without being granted a license to practice according to regulations.

Currently, medical and pharmaceutical practice is receiving more and more attention and guidance from all levels, sectors and support from the people. In particular, the system of legal documents in medical practice is increasingly improved.

Recently, the National Assembly issued the Law on Medical Examination and Treatment No. 15/2023/QH15 (amended) to specify the guidelines and policies of the Party and State; contribute to enhancing the effectiveness, efficiency, order, discipline and discipline of state management of medical examination and treatment activities; overcome limitations and inadequacies, resolve newly arising issues to develop and improve the quality of medical services for the people.

PV:The Law on Medical Examination and Treatment (amended) was passed by the 15th National Assembly at the 2nd Extraordinary Session, effective from January 1, 2024. What are the basic new points in the Law on the field of medical practice, sir?

Mr. Nguyen Huu Le:The Law on Medical Examination and Treatment No. 15/2023/QH15 consists of 12 chapters and 121 articles and has some basic new points. In particular, the law stipulates the expansion of the scope of practice - changing from granting practice certificates to practice licenses based on professional qualifications.

The law has improved and standardized the skills of practitioners. Specifically, the law stipulates that professional capacity must be assessed and evaluated according to the roadmap: Establishing a National Medical Council to carry out the task of assessing and evaluating the capacity to practice medical examination and treatment according to the following regulations: From January 1, 2027 for the title of doctor; From January 1, 2028 for the titles of physician, nurse, midwife; From January 1, 2029 for the titles of medical technician, clinical nutritionist, outpatient emergency worker and clinical psychologist.

The law stipulates that a practice license is valid for 5 years and that updating medical knowledge is one of the conditions for renewing a practice license. It stipulates that foreigners practicing long-term in Vietnam and examining and treating Vietnamese people must use Vietnamese fluently in medical examination and treatment, except in some cases of cooperation in exchanging experts, transferring techniques, and training.

Regulations on the application of electronic prescriptions, electronic medical records and this information must be connected to the Information System on the management of medical examination and treatment activities to control and monitor the quality of service provision of practitioners and to connect medical examination and treatment results between medical examination and treatment facilities. Along with that, the law also has regulations on improving the quality of service provision of medical examination and treatment facilities, increasing people's access to medical examination and treatment services.

Regarding improving the quality of medical examination and treatment services: Supplementing regulations requiring facilities to self-assess the quality of medical examination and treatment according to the basic quality standards issued by the Ministry of Health periodically every year and to update the self-assessment results to the information system on medical examination and treatment management. Supplementing regulations requiring medical examination and treatment facilities to apply information technology with the aim of gradually connecting medical examination and treatment results between medical examination and treatment facilities; creating convenience for patients, and at the same time, it is also a solution to manage the practice activities of organizations and individuals.

PV: Could you please tell us about the new regulations on granting medical practice licenses from January 1, 2024?

Mr. Nguyen Huu Le:According to the provisions of the Law on Medical Examination and Treatment 2023, professional titles that must have a license to practice medical examination and treatment include: Doctor; Physician; Nurse; Midwife; Medical Technician; Clinical Nutritionist; Outpatient First Aider; Clinical Psychologist; Traditional Physician; Person with traditional medicine or traditional treatment method;...

According to Article 27 of the Law on Medical Examination and Treatment 2023, each practitioner is only granted 1 practice license valid nationwide, the practice license is valid for 5 years. The content of the practice license includes basic information: Full name; date of birth; personal identification number for Vietnamese practitioners; passport number and nationality for foreign practitioners; professional title; scope of practice; duration of the practice license.

According to Article 20 of the Law on Medical Examination and Treatment 2023, individuals are prohibited from practicing medical examination and treatment, including: Being prosecuted for criminal liability; serving a suspended sentence or a non-custodial reform sentence; being on probation for those sentenced to imprisonment but released early on conditional terms... for violations of the law related to technical expertise.

People who are serving a prison sentence or are being subject to administrative measures of being sent to a compulsory education facility or compulsory drug rehabilitation facility; are being banned from practicing medicine according to a legally effective criminal judgment of a court or are restricted from practicing medicine according to a decision of a competent authority; have lost civil act capacity or have difficulty in cognition, behavior control or have limited civil act capacity... are also banned from practicing medicine.

The issuance of new practice licenses is applied to cases where a person requests a practice license for the first time; a practitioner changes the professional title recorded on the practice license; a person whose practice license is revoked in cases where a new license is issued according to Government regulations and other cases according to Government regulations.

PV: How will Nghe An implement the Law on Medical Examination and Treatment (amended) in particular and strengthen the management of medical practice in the coming time?

Mr. Nguyen Huu Le:The Government has just issued a Decree guiding the Law on Medical Examination and Treatment 2023/QH15 and the Government, ministries, departments and branches are researching to soon issue a Decree "Regulations on specialized training in the health sector" guiding specialized training from 6 months or more and to implement the issuance of licenses to practice medical examination and treatment in specialized fields according to regulations...

Currently, the Ministry of Health is drafting a Decision on promulgating newly issued administrative procedures; replaced and abolished under the management scope of the Ministry of Health as prescribed in the Law on Medical Examination and Treatment No. 15/2023/QH15 dated January 9, 2023 and Decree No. 96/2023/ND-CP dated December 30, 2023 of the Government detailing a number of articles of the Law on Medical Examination and Treatment. At the same time, it will deploy instructions on the Decree for units nationwide for implementation.

Nghe An Health Department has proactively researched laws, decrees and circulars widely in all medical examination and treatment facilities. After receiving specific instructions from the Ministry of Health, Nghe An Health Department will coordinate with relevant sectors to advise the Provincial Public Administration Service Center to submit to the Provincial People's Committee to issue a set of administrative procedures to implement the Law on Medical Examination and Treatment 2023 and focus on propaganda, training and dissemination of the Law on Medical Examination and Treatment 2023/QH15 to medical examination and treatment facilities operating in the management area.

To improve the management of medical practice, Nghe An continues to promote propaganda, raise awareness for cadres, party members and people about the role, position and importance of medical practice in the area, creating favorable conditions for people to choose health care and protection services. Party committees and local authorities strengthen the work of reviewing, inspecting, monitoring and thoroughly handling all unlicensed practice establishments in the area. Departments, branches and local authorities continue to enhance their roles and responsibilities in the management of medical practice; attach responsibility to the heads of Party committees, authorities and units in the management of medical practice in the area.

Mr. Nguyen Huu Le - Deputy Director of Nghe An Department of Health

Nghe An Department of Health will continue to organize the issuance of practice licenses and operating licenses for medical examination and treatment facilities in accordance with the provisions of law. Strengthen coordination in inspection and examination of compliance with legal provisions on medical practice in the province; strictly handle establishments that violate the law.

The Department will strengthen the review of conditions to ensure the granting of operating licenses to practice establishments and individual practice licenses; direct establishments to develop dossiers declaring sufficient conditions for practice to grant licenses. The Department of Health will also continue to promote the application of information technology and digital transformation from management agencies to practice establishments. Accordingly, practice establishments are required to connect to the Information System on management of medical examination and treatment activities, continuously update data (especially human resources) to control and monitor the quality of service provision of practitioners and connect medical examination and treatment results between medical examination and treatment establishments.

In 2024, the Department of Health will advise the Provincial People's Committee's Personnel Committee, submit to the Provincial Party Committee Standing Committee to issue a Directive on strengthening the leadership of Party committees in the management of non-public medical and pharmaceutical practice in Nghe An province (expected in June 2024); advise the Provincial People's Committee to issue amendments to the Coordination Regulations (Decision No. /QD-UBND dated April 20, 2018) in the management of non-public medical and pharmaceutical practice in Nghe An province, after receiving the Directive of the Provincial Party Committee Standing Committee (expected in July 2024).

PV:Thank you for the conversation!