Strengthening the management of non-public medical and pharmaceutical practices.
(Baonghean.vn) - During the 5 years of implementing Directive No. 03/CT-UBND, the operations of non-public medical and pharmaceutical establishments in Nghe An province have been rectified and improved.
Reduce the number of unlicensed practice establishments.
Following the inspections conducted by inter-agency teams led by the Nghe An Department of Health on the operation of non-public medical and pharmaceutical practices in the province over the past period, many establishments have been found to be violating legal regulations. Common violations include: Incomplete listing of the scope of practice and prices of medical examination and treatment services; failure to meet operating conditions; providing services without an operating license or exceeding the scope of expertise; practitioners without a professional practice certificate or exceeding the scope of professional practice; advertising special products, goods, and services without prior approval of the content by the competent state agency as required by law...
Speaking directly about the inspections, Mr. Tran Nguyen Truyen, Chief Inspector of the Department of Health, said: On January 29, 2018, the People's Committee of Nghe An province issued Directive No. 03/CT-UBND on continuing to strengthen the management of non-public medical and pharmaceutical practice activities in Nghe An province. In implementing the directive, from 2018 to August 2023, the Department of Health established 81 inspection teams and 2 monitoring teams to oversee the implementation of Directive No. 03. Through these efforts, inspections were conducted at 709 medical and pharmaceutical practice establishments (688 establishments with operating licenses and 21 establishments without operating licenses); of which, administrative violations were handled against 163 establishments with violations; the total amount of administrative fines was over 2 billion VND.
In addition, the Department of Health also decided to revoke one multi-specialty clinic's operating license; temporarily suspend the pharmaceutical practice certificate and drug business license of seven retail pharmacies; temporarily suspend the operation of six medical examination and treatment facilities; temporarily revoke the operating license of one medical examination and treatment facility; temporarily revoke the medical practice certificate of three individuals; temporarily suspend the operation of two cosmetic service establishments; and order the removal of medical examination and treatment advertisements from Facebook pages of two medical examination and treatment facilities... Through inspections and monitoring, the Department of Health discovered 197 instances of unlicensed medical facilities and notified the People's Committees of the districts to handle them according to the regulations on decentralization.
In parallel with the Department of Health, relevant agencies and departments such as the Provincial Police, the Market Management Department, and the People's Committees of districts, cities, and towns have also intensified inspection, examination, and handling of violations. Along with inspections and examinations, training, dissemination of legal documents; licensing of medical and pharmaceutical practices; and information and communication activities have been strengthened. As a result, Directive 03/CT-UBND has gradually been implemented, contributing to the healthy operation of non-public medical and pharmaceutical practices in the area.
According to Mr. Le Hong Linh, Head of the Private Medical and Pharmaceutical Practice Management Department of the Nghe An Department of Health: As of August 30, 2023, there were 3,597 licensed medical and pharmaceutical establishments in Nghe An province (an increase of 952 establishments compared to 2018). Of these, 703 were medical establishments (15 hospitals, 34 multi-specialty clinics, and 654 specialized clinics and medical services); 2,894 were pharmaceutical establishments (94 companies and branches; 648 pharmacies and 2,152 drug counters)... The total number of unlicensed establishments reviewed and reported by districts, cities, and towns before the issuance of Directive No. 03/CT-UBND was 685; after the implementation of Directive 03, as of August 30, 2023, there were still 29 unlicensed establishments operating (mainly dental, maxillofacial, and traditional medicine establishments).
Strengthen inspection, examination, and supervision.
The reality is that unlicensed medical and pharmaceutical establishments still exist and have not been completely eradicated; other unlicensed establishments continue to operate clandestinely, undetected, unrecorded, and unreported by local authorities. Many unlicensed medical and pharmaceutical establishments have been fined and suspended from operation by inspection teams, but have subsequently resumed operations.
The root cause of this situation is the inadequate state management in some localities. The review and reporting of unlicensed facilities have not received sufficient attention. Inspections have been infrequent, and penalties have not been strict, decisive, or sufficiently deterrent. Communication and public awareness campaigns have been insufficient to encourage people to choose services wisely. While the number of medical facilities is large and scattered throughout the province, the human resources for state management of medical and pharmaceutical practices are limited. Unlicensed facilities often collude, notifying each other whenever inspection teams arrive, proactively closing down to avoid detection.
Mr. Pham Xuan Sanh, Vice Chairman of the Dien Chau District People's Committee, shared: Dien Chau District currently has 38 private medical facilities (1 general hospital, 5 general clinics, 5 vaccination centers, and 27 specialized clinics). Over the past period, the Dien Chau District People's Committee has implemented many solutions to strengthen the management of private medical facilities. However, inspections of these facilities are still infrequent compared to the number of facilities operating in the area. Therefore, the district still has a situation where facilities are operating without licenses (there are 8 facilities without licenses).
Managing non-public medical and pharmaceutical facilities in Dien Chau district faces many difficulties due to incomplete legal regulations, especially those related to the standards for licensing traditional medicine clinics. The management force is small, making regular inspections impossible. When inspections are conducted, the facilities are often not operating, making enforcement difficult. Furthermore, penalizing non-public medical and pharmaceutical establishments is challenging, particularly for small clinics where the fines are high and they lack the ability to pay. Many clinics operate before applying for licenses, but the licensing process is hampered by issues related to waste disposal contracts… therefore, unlicensed practice continues.
In practice, it has also been observed that unlicensed medical and pharmaceutical establishments exist sporadically, often on a small scale in private homes, without proper signage. Detecting and addressing these unlicensed establishments requires the involvement of the People's Committees of communes, wards, and towns. Mr. Tran Minh Tue, Deputy Director of the Department of Health, stated: Local Party committees and authorities need to further strengthen propaganda efforts, raising awareness among officials, Party members, and the public about the role, position, and importance of non-public medical and pharmaceutical practices in their areas, creating favorable conditions for people to choose healthcare services; strengthening the review, inspection, and decisive handling of all unlicensed medical and pharmaceutical establishments in districts, cities, and towns; and preventing the operation of unlicensed medical and pharmaceutical practices within their jurisdiction. The responsibility of the heads of Party committees, authorities, and units in managing medical and pharmaceutical practices in their areas should be emphasized.
In particular, it is necessary to encourage the public to participate in monitoring and detecting violations by non-public medical and pharmaceutical facilities, so that information can be provided for timely and appropriate handling in accordance with the law, contributing to the effective fulfillment of the task of caring for and protecting the health of the people.
At the district level, it is necessary to allocate medical personnel or health monitoring officers appropriately; further strengthen the management, inspection, and supervision of medical and pharmaceutical practice activities annually according to regulations.... The Health sector will advise the Provincial Party Committee and the Provincial People's Committee to issue a new directive to replace Directive 03 to strengthen state management of non-public medical and pharmaceutical practice activities in Nghe An province in the new period, in accordance with the Law on Medical Examination and Treatment dated January 9, 2023, effective from January 1, 2024, and related decrees.
