Strengthening management of non-public medical and pharmaceutical practice

Reduce unlicensed establishments

Following the interdisciplinary delegations chaired by the Nghe An Department of Health to inspect and examine non-public medical and pharmaceutical practices in the province in recent times, many establishments have been found to have violated legal regulations. Common violations include: Incomplete posting of the scope of practice and prices of medical examination and treatment services; failure to ensure operating conditions; providing services without a license or exceeding the scope of expertise; practitioners who have not been granted a practice certificate or exceed the scope of expertise; advertising special products, goods and services without the content being confirmed by a competent State agency before advertising according to regulations...

Directly conducting inspections and examinations, 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. Implementing the Directive, from 2018 to August 2023, the Department of Health established 81 inspection and examination teams and 2 teams to monitor the implementation of Directive No. 03. Thereby, inspections and examinations were organized at 709 medical and pharmaceutical practice establishments (688 establishments were granted operating licenses and 21 establishments were not granted operating licenses); Of which, administrative violations were handled for 163 establishments with violations; the amount of administrative fines was more than 2 billion VND.

In addition, the Department of Health also decided to revoke 1 medical examination and treatment license for a general clinic; revoke the right to use the pharmacy practice certificate and the certificate of eligibility for drug business for a period of time for 7 drug retail establishments; suspend the operation of 6 medical examination and treatment establishments for a period of time; revoke the right to use the medical examination and treatment license for a period of time for 1 medical examination and treatment establishment; revoke the right to use the medical examination and treatment practice certificate for a period of time for 3 individuals; suspend the operation of 2 cosmetic service establishments for a period of time; force the removal of advertisements for medical examination and treatment on Facebook pages for 2 medical examination and treatment establishments... Through inspections and supervisions, the Department of Health has discovered 197 unlicensed establishments and has notified the People's Committees of the districts to handle them according to the decentralization regulations.

Along with the Department of Health, relevant levels and sectors such as the Provincial Police, the Market Management Department, the People's Committees of districts, cities and towns have also stepped up inspection, examination and handling of violations. Along with inspection and examination, training activities, dissemination of legal documents; licensing of medical and pharmaceutical practice; and information and communication have been promoted. Thanks to that, Directive 03/CT-UBND has gradually come into life, contributing to the health of non-public medical and pharmaceutical practice in the area.

Mr. Le Hong Linh - Head of the Department of Private Medical and Pharmaceutical Practice Management, Department of Health said: As of August 30, 2023, Nghe An province had 3,597 licensed establishments (an increase of 952 establishments compared to 2018). Of which, there were 703 medical establishments (15 hospitals, 34 general clinics and 654 specialized clinics and medical services); 2,894 pharmaceutical establishments (94 companies and branches; 648 pharmacies and 2,152 drug stores)... The total number of unlicensed establishments reviewed and reported by districts, cities and towns before issuing Directive No. 03/CT-UBND was 685 establishments; After implementing Directive 03, by August 30, 2023, there are still 29 unlicensed establishments operating (mainly dental, maxillofacial and traditional medicine establishments).

Strengthen inspection, control and supervision

The reality shows that unlicensed medical establishments still exist and have not been completely eliminated; there are other unlicensed medical establishments that are still operating secretly, and have not been discovered, counted, or reported by localities. Many unlicensed medical and pharmaceutical establishments have been administratively sanctioned and suspended by inspection teams, but have since resumed operations.

The reason for this situation is that the state management work of some localities has not been implemented well. The work of reviewing and reporting on unlicensed establishments has not received due attention. There are not many inspections, the handling is not strict, drastic and not deterrent enough. There are not many and not strong communication and propaganda work to make people aware of choosing services... The number of medical examination and treatment establishments is large, spread throughout the province, but many human resources doing state management work on medical and pharmaceutical practice are limited. Unlicensed establishments cooperate with each other, notify each other whenever there is an inspection team, check to proactively respond and temporarily close.

Mr. Pham Xuan Sanh - Vice Chairman of Dien Chau District People's Committee shared: Dien Chau District currently has 38 private medical facilities (1 general hospital, 5 general clinics, 5 vaccination rooms, 27 specialized clinics). In the past time, Dien Chau District People's Committee has implemented many solutions to strengthen the management of private medical facilities. However, the organization of inspection of facilities is still limited compared to the number of facilities operating in the area. Therefore, the district still has a situation where facilities operate without operating licenses (8 facilities do not have licenses).

The management of non-public medical and pharmaceutical establishments in Dien Chau district still faces many difficulties, due to incomplete legal regulations, especially regulations related to standards for granting operating licenses for traditional medicine clinics. The management force is thin, unable to regularly inspect and check. When inspected, the establishments are not operating, so they cannot be handled. In addition, it is also difficult to punish non-public medical and pharmaceutical establishments, especially for small clinics with high fines and the inability to pay the fines. Many clinics operate before applying for a license, but the licensing process is stuck in the signing of a waste treatment contract... therefore, the situation of illegal practice still occurs.

Reality also shows that unlicensed medical and pharmaceutical establishments are scattered, small-scale, in families, without signs. To detect and handle 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 promote propaganda work, raise awareness for cadres, party members and people about the role, position and importance of non-public medical and pharmaceutical practice in the area, create all favorable conditions for people in choosing health care and protection services; strengthen the work of reviewing, inspecting and thoroughly handling all unlicensed medical and pharmaceutical establishments in districts, cities and towns; do not allow unlicensed medical and pharmaceutical practice in the management area. Attaching responsibility to the heads of Party committees, authorities, and units in the management of medical and pharmaceutical practice in the area.

In particular, it is necessary to encourage people to participate in monitoring and detecting violations of non-public medical and pharmaceutical facilities, in order to have information to handle promptly, in accordance with the law, contributing to the good performance of the task of caring for and protecting people's health.

At the district level, it is necessary to arrange health department staff or health monitoring staff reasonably; further strengthen the management, inspection and examination 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 promote 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.