Several alternative medicine clinics run by foreign nationals, mainly Chinese, were discovered recently to be offering substandard services and employing unqualified or unregistered practitioners. Viet Nam News reporters Thanh Hai and Thu Trang talk to health experts and a lawyer about managing the clinics.
Many violations have been found in health clinics, especially those offering traditional and alternative medicines, run by foreign nationals, mainly Chinese, in Ha Noi and HCM City. What is the reason for this situation?
Nguyen Hoang Son, deputy director of the Ministry of Health's Traditional Medicine Department:
The Ministry of Health has asked all health departments nation-wide to strengthen inspections and management of health clinics run by foreign nationals, especially traditional medicine clinics. We are summing up the reports of provinces and cities.
|Nguyen Hoang Son
Results of a recent inspection by the HCM City Health Department turned up violations in 7-8 clinics run by foreign nationals.
The main violations were unlicensed practitioners, false advertising, offering treatment beyond the skills of a practitioner, using unregistered medicines, prescriptions not in Vietnamese language and using unqualified interpreters.
The problem came to light when clinics were discovered employing foreign staff who did not obey Health Ministry regulations. Foreigners wanting to work in Viet Nam must have a work permit. Practitioners in the medical examination and treatment field need a work permit from the health sector.
In addition, the department admits that supervision and inspections haven't been effective. Inspection teams could not search whole clinics for reasons of privacy.
Inspecting clinics required undercover measures such as agents posing as patients.
What do you say about responsibilities of the Health Ministry and provincial health departments in managing clinics run by foreign nationals?
Son: Management of professional techniques and skills in State and private medical clinics, especially those run by foreign nationals, is the responsibility of the Ministry of Health and provincial and local health departments.
The Health Ministry is continually asking and instructing provinces to tighten management of clinics providing medical examinations and treatment, including those run by foreign nationals.
In Ha Noi and HCM City, the Health Ministry asked health departments to have monthly meetings with clinic managers, foreign practitioners and interpreters to review activities and to require violating clinics to follow legal regulations. In the first six months of this year, we inspected medical clinics in Dak Lak and Hai Phong provinces and Ha Noi.
The number of patients visiting traditional medicine clinics run by foreign nationals has reduced over recent years, so there is a trend of traditional medicine clinics transforming to general clinics.
There are currently 41 foreign practitioners licensed to work in traditional medicines (compared to 67 in 2010). They operate at 29 clinics in 16 provinces and cities, including 7 in Ha Noi and 11 in HCM City.
What measures will be taken by the ministry to bring the situation under control?
Son: Implementing the law on examinations and treatment and the Government's Decree 87 and other circulars, the ministry will authorise work certificates for foreign medical staff and operation licences for clinics run by foreign nationals. In the past this was done by the health departments. The Health Ministry will provide a database with information on traditional medicine clinics run by foreign nationals and foreign practitioners and staff licensed to work in Viet Nam.
Authorities found violations in most clinics they inspected. Why has no clinic been suspended or closed, despite continual violations found at many clinics in Ha Noi and HCM City?
Son: The Ministry of Health will strictly deal with violations following Government Decree 96/2011 on violations in health clinic examinations and treatment.
In the recent inspection campaign in HCM City, fines were imposed and in addition the health department suspended four clinics for 12 months; fined and considered withdrawing work certificates of practitioners for using unqualified interpreters; foreign practitioners without working certificates at three clinics were asked to stop working; unregistered medicine was seized for destruction at three clinics. Two clinics which were suspected of making false claims in advertising were referred to investigation authorities.
HCM City has taken drastic measures in the current inspection campaign. In Ha Noi, the city health department has invited violating clinics run by foreign nationals to work with us to meet the regulations. Provincial health departments will tighten their inspections and supervision and strictly handle violations.
What has the health sector in Ha Noi done to manage the clinics? What are the clinics' violations?
Ha Noi Department of Health's chief inspector Nguyen Viet Cuong:
Ha Noi now has 13 clinics with foreign practitioners. So far this year the department has joined hand with the city police to check all 13 clinics, and nine were found to be breaking the rules. The violations included supplying services which were beyond a practitioner's capacity and qualification, using unregistered foreign practitioners, making false claims in advertising, overcharging and using medicines of unclear origin. The nine clinics were fined a total of VND103.5 million (US$4,930).
The department plans to co-ordinate with municipal Market Watch and the Ministry of Health's inspectors to continue checking the clinics run by foreign nationals. Their breaches will be publicised so residents can avoid them. If a clinic repeats its violations it will be closed down.
Lawyer Nguyen Van Khoa, a member of the Hai Phong Bar Association:
Violators will not only have to pay fines and face suspension or closure, they will also have to compensate their patients. If they cause serious injury or death, the clinic owners and practitioners may be prosecuted under civil law. The penalty could be 1-4 years in jail.
How can the capital tighten its management of clinics?
Cuong: The should increase the frequency of inspection, maybe to four times a year. At present the clinics are checked twice a year so many of them repeat their violations. To check the clinics more regularly, the city needs more inspectors. Besides, not only Ha Noi but other cities and provinces should have a regulation that every foreign practitioner working in the country should speak Vietnamese. I heard that a patient sued a clinic for its practitioner's wrong diagnosis but investigation showed the interpreter was at fault because he did not understand some of the technical words.
Khoa: Decree 96 about fines for clinics with foreign practitioners is quite strict, regulating that inspectors can withdraw close clinics down permanently.
However, stronger punishments will improve management of the clinics. For instance, a practitioner can be punished for being an illegal resident and lacking proper qualifications. I know that some Chinese practitioners come to Viet Nam as tourist and then stay on to open clinics.
Each department of health should have a committee verify the records of foreign practitioners who want to work in the country before issuing them with work permits.
What measures should residents take to protect themselves?
Cuong: Residents should go to State hospitals for their health check to get benefits from their health insurance. If they go to private clinics, they should consider their services and price list carefully. If a resident discovers a violation, they can call the department's hotline 37333071, not only to protect their rights but also to help the department correct the clinics' procedures.
Khoa: Residents should go to Vietnamese traditional clinics for their health check and treatment. I believe that Vietnamese traditional medicines are prominent.
Moreover, Chinese practitioners cannot know Vietnamese patients' diseases as well as Vietnamese practitioners, because China has a temperate climate while Viet Nam has a tropical climate. Diseases in the two countries will be different.
Vietnamese people tend to prefer everything related to foreign services and foreign products. They flocked into foreign clinics partially because of advertisement in the mass media. Communications offices should research the clinics' quality carefully before broadcasting their advertisements. — VNS