HA NOI — Hospital overload, the quality of health services, human resources and food safety topped the list of issues raised by members of the public to health minister Nguyen Thi Kim Tien on Saturday during an on-line dialogue.
"Hospital overload is quite serious in Viet Nam and requires the efforts of ministries and their local branches, provinces and the people themselves to handle," Tien said.
The health sector had implemented many measures to minimise hospital overload, such as increasing the number of hospital beds and working hours, simplifying administrative procedures, adopting IT solutions, and encouraging private sector investment in the health sector, including the opening of private hospitals, she said. Project 1816 on rotating medical staff from the central level to support lower level hospitals also helped transfer technologies and reduced the number of patients who needed to travel to central hospitals for treatment.
Statistics from the Ministry of Health reveal that the growing problem of hospital overload is the result of a rising population without construction of new hospitals. The number of beds per 10,000 people remained modest, at 20.5/10,000 people by the end of 2011 in comparison with the World Health Organisation's recommendation of 33 per 10,000 people. The country's makeup of diseases has also changed to include more non-transmitted diseases like high-blood pressure, diabetes, cancers than it did in the past.
Tien said the ministry was drafting a plan to reduce hospital overload to submit to the Government for approval in the near future with a focus on increasing the number of hospitals and beds, strengthening the ability of medical units at district and local levels, reforming financial mechanisms and other technical measures.
Ha Noi residents Nguyen Xuan Cuong and Nguyen Ngoc Lam expressed worry that investment for building hospitals was currently very low compared with the increasing investment levels in commercial and economic projects by asking: "Are economic benefits being given more attention than people's health care?"
"It is difficult for people to access health care services when medical facilities funded by socialisation sources have to work for a profit. That's why Government investment is playing a major role in the education and health sectors," explained Tien.
According to the health minister, Party and Government policies had prioritised the health and education sectors. However, though investment in health had increased in recent years, it was still modest compared to demand.
Statistics from the Ministry of Natural Resources and Environment show that the land funds at the local level for the health and education sectors are modest due to the specific planning issues in each province and city. Private sector investment is encouraged in the health sector but companies have shown a greater interest in investing in housing over hospitals. Ha Noi recently set aside five areas of land to expand two hospitals.
Dao Duy Nguyen from HCM City asked for measures to handle food hygiene and safety at canteens in industrial and processing zones, and schools.
Director of the ministry's food administration Nguyen Cong Khan responded by saying that the leaders of factories and enterprises should be aware of the importance of food safety for their workers. It was regrettable that few leaders were aware of its importance, he said.
Most firms and factories in industrial zones had no group kitchens so meals were provided by outside firms or factories for modest prices ranging from VND8,000-12,000 ($40-60 cents) per set, said Khan.
"It is very difficult to control the quality of food sold by companies outside of industrial zones or schools," he said.
"The issue of food safety will be inspected and controlled in big provinces and cities. HCM City also has a plan to bring food processing facilities into factory and firm canteens.
"Food should be cooked in big kitchens within industrial zones or schools. This would play a key role in controlling food hygiene and safety, and nutrition, and help to reduce food poisoning in big industrial zone canteens," said Khan.
Le Thi Thuy from Vinh Chau Commune, Soc Trang Province expressed worry that the plan to increase treatment fees would have a significant impact on poor patients with serious diseases.
Tien said that Viet Nam was making progress in reaching the goal of ensuring health insurance for all by 2014. Under the plan, the poor would be 95 per cent covered with health insurance paid for by the Government. They would only be responsible for paying the remaining five per cent. Many serious health treatments such as heart surgery or dialysis were already paid for by the health insurance fund. Near poor people also qualify for coverage of up to 70 per cent of their health insurance fees while students receive 50 per cent support from the Government. These policies mean that the poor or near poor were not impacted by plan to increase health service fees, she said. Tien also said that one of four key tasks for the health sector was strengthening medical systems at the district level, especially the commune level. The health ministry had used ODA resources to help commune clinics develop their medical facilities. Priority was also given to training medical staff at the commune level in order to boost primary health care activities. New national standards on commune health clinics were issued recently. Commune health clinics would be strengthened along with the Government's programme for new rural development in the coming years, she said. — VNS