HA NOI — The quality of healthcare services does not differ across patients regardless of payment exchange, normally in the form of offering cash to health workers, a survey says.
This is part of the findings of a qualitative study conducted from August 2010 to February 2011 by Towards Transparency – the official national contact of Transparency International in Viet Nam and the Research and Training Centre for Community Development.
According to the findings, most of the surveyed healthcare workers said that they did not ask for such unofficial payments, but that the payment could change their attitude to patients, for example treating them in a more friendly manner.
Low salary is blamed for the bribe acceptance as it helps healthcare workers supplement their income. It is a factor driving them to stay in public hospitals as bribery is less common in private ones.
Moreover, giving envelopes with cash inside has become a "normal" practice in society when users of any public services pay bribes for better quality service.
Meanwhile, patients – the service users – usually expect better examinations, treatment and more care when giving bribes.
The move makes them feel secure, especially when people are told about the indifference and neglect allegedly caused by the absence of this informal payment.
The study also finds that offering cash directly and in envelopes are the most common ways of making informal payments in the healthcare services.
Other forms include gifts and "opportunities" in other services [applications for housing, education, goods purchasing] offered by patients/their relatives.
Values of the payments range from VND50,000 (US$2.5) to VND5 million ($250) or even up to several thousand US dollars, depending on levels and location of the hospitals.
Since corruption in health services was a widespread phenomenon in Viet Nam which deteriorated people's trust in the quality and equity of the public health systems, existing measures to control and handle the problem seemed to be nominal and not effective, said Towards Transparency's executive director Nguyen Thi Kieu Vien.
President of the Viet Nam's Paediatric Association Nguyen Thu Nhan said that "envelope culture" in the sector would not stop unless there was a proper salary for healthcare staff.
Meanwhile, President of the Viet Nam Obstetric Association Nguyen Duc Vy said: "In the anti-corruption fight, high determination of hospital leadership and stricter punishments are crucial."
He added that violators should be dismissed.
He said that this was time the healthcare sector and policy makers should seek more engagement from doctors, satisfy their requirements including income or medical equipment.
"When they don't have to worry about living conditions, they can concentrate and contribute to their profession morally," he said.
According to a recent report of World Bank, 65-85 per cent of Vietnamese people see corruption in the healthcare sector at both central and local levels. — VNS