Nguyễn Thị Kim Tiến, Minister of Health, speaks to Lao động Cuối tuần (Labour Weekend) about measures to improve health examination and treatment quality at hospitals in 2019.

In 2018, the Ministry of Health focused on improving health treatment quality at grassroots clinics, especially the 26 communal clinics operating by the principles of family medicine.  Please tell us the results of such an effort and your plan to increase the number of clinics working by those principles?

Since the beginning of 2018, the healthcare sector had taken concrete actions to make sure grassroots healthcare becomes the foundation and the backbone of the country’s healthcare system, including making major, practical changes in the mechanisms and methods of operation of healthcare services at the communal level.

Over the past year, apart from providing the 26 communal clinics with training courses on family medicine and healthcare facility management, health departments in different localities had also succeeded in supplying and rotating medical personnel among them. The clinics had their functions redefined, their facilities upgraded, and more medical equipment installed. Many of them established patient management databases. Some 9,655 communal clinics across the country had a separate database of epilepsy patients.

By the end of the first quarter of 2019, we aim to provide enough medical personnel for the 26 communal clinics and for other clinics and major provinces and cities that are the targets of development projects sponsored by the World Bank, Asian Development Bank, and European Union. We also aim to get 70 per cent of the clinics in the country well-equipped and operate by the principles of family medicine by 2025, and to have all the remaining ones follow suit by 2030.

Public hospitals becoming financially independent is an issue that has remained at the centre of public attention. What measures do you have regarding this method of operation to ensure health centres and patients will benefit from it?

Giving public hospitals financial autonomy has its advantages and disadvantages. The health ministry has come up with the following measures to make sure hospitals can thrive with different levels of autonomy:

First, to classify public hospitals into four categories: those who are able to cover their own regular expenses and investments, those who are able to cover only their regular expenses, those who are able to cover only part of their regular expenses, and those who rely on the State’s budget to cover their regular expenses.

Second, to establish regulations that hold hospitals’ directors responsible for the management and use of their personnel, assets and financial resources.

Third, to give the hospitals the degrees of operational autonomy in accordance with their ability to become financially independent.

Fourth, to reinforce leadership power of the hospitals’ Party Committees’ and supervisory power of their labour unions over their operational activities.

Fifth, to provide highly capable managing personnel with thorough training on the socialist-oriented market economy.

Sixth, to establish and apply a service pricing mechanism based on evaluations of the hospitals’ healthcare quality.

The Government has assigned the Ministry of Health to reduce patient overload at hospitals at the central level by 2020. What have you done and how has it helped to solve the problem?

Reducing patient overload has been a mission of the healthcare sector for many years. To fulfill this mission we have carried out several schemes to establish satellite hospitals, improve the medical examination process, train family doctors, and so on. An online survey we conducted on 1 million patients shows several hospitals had 80-90 per cent of patients satisfied with their services. The percentage of patients having to share a bed with other patients dropped from 58 per cent in 2012 to 16.7 per cent in 2018 at central hospitals, and from 47 per cent to 11.4 per cent at provincial hospitals.

The 17 satellite hospitals have helped reduce the number of patients having to transfer from local to central hospitals by 98.5 per cent for cardiology and surgical departments, 97 per cent for cancer departments, 99 per cent for obstetric departments, and 73 per cent for pediatric departments.

Patient overload still persists at major hospitals in Hà Nội and HCM City. The Việt Đức and Bạch Mai hospitals (in Hà Nội) are going to have their second facility open in the near future, which will be a major help in reducing patients in other hospitals.

What results did you get from medicine quality monitoring and confiscation of substandard medicines in 2018? What is your plan for better medicine quality control in 2019?

The medicine supervising and monitoring activities in 2018 helped to reduce the percentage of substandard medicines in the market. From 2013 to 2017, substandard medicines in Việt Nam accounted for 2.54, 2.38, 2.00, 1.98 and 1.59 per cent of the total number of medicines in each year, respectively. And based on preliminary data, in 2018 they accounted for 1.6 per cent.

For better medicine quality control, we will continue to apply the measures we used in 2018. We will utilise software that manages and connects databases of pharmacies nationwide. We will also establish a database within the pharmaceutical industry to monitor the origin, quality and prices of medicines sold at pharmacies. — VNS