Bạch Mai Hospital in Hà Nội. — VNA/VNS Photo

HÀ NỘI — Efforts to restructure the hospital system must ensure efficiency and stability while avoiding unnecessary disruption, lawmakers and healthcare experts have cautioned.

The warning comes as Standing Deputy Prime Minister Nguyễn Hòa Bình has approved a programme to restructure public service units, State-owned enterprises and organisations within the administrative system. The restructuring will cover sectors like healthcare and education, with the guiding principle that changes must not undermine the quality of essential public services provided to citizens.

Under the plan, a number of hospitals currently under the Ministry of Health will be transferred to provincial management. The ministry will retain responsibility for top-tier, specialised hospitals tasked with providing professional direction, training highly skilled staff, conducting research, transferring technology and coordinating national responses to epidemics and public health emergencies.

Provinces are expected to maintain their existing hospitals, expand socialisation where possible and ensure that each locality has at least one specialised hospital, alongside geriatric facilities.

Maintaining specialised hospitals

National Assembly deputy Phạm Văn Hòa of Đồng Tháp Province said restructuring was necessary amid administrative reforms, but he stressed the importance of preserving specialised hospitals managed by the ministry.

He cited Chợ Rẫy Hospital in HCM City and Bạch Mai Hospital in Hà Nội as leading facilities that must continue to operate under central management due to their advanced capacity.

Specialised hospitals in oncology, ophthalmology and other disciplines should also remain directly managed by the ministry, he added, because they are equipped with the most modern technology and expertise needed when provincial hospitals cannot meet patient demand.

“Transferring ordinary hospitals to local management is appropriate,” Hòa told the Voice of Vietnam.

"But provincial hospitals must be equipped with adequate facilities and staffed by well-trained doctors. While they may not match national hospitals, they must be strong enough to treat patients effectively, reducing pressure on central facilities and saving people the cost and burden of travelling long distances.”

Professor Nguyễn Công Hoàng, director of Thái Nguyên Central Hospital, said the plan would help streamline the healthcare system, but he warned that central hospitals have a crucial training role that must be preserved.

He explained that national and regional hospitals play a key role in training provincial hospitals, which then continue the process with grassroots facilities. Without the presence of central hospitals, he noted, this training chain would be disrupted.

Thái Nguyên Central Hospital, for example, currently trains medical staff for 12 northern midland and mountainous provinces. Specialised hospitals also provide professional guidance for entire fields nationwide, such as ear, nose and throat care or oncology.

“These hospitals are the backbone of the system,” Hoàng said. “During the COVID-19 pandemic, their importance was proven when provincial hospitals were overwhelmed, and central-level doctors had to step in and provide support. Only hospitals of national standing have the capacity to carry out such large-scale tasks.”

Restructuring without waste

Hoàng also noted that each province could realistically develop a specialised general hospital if resources were focused on meeting necessary criteria such as equipment, infrastructure and staffing.

However, he said that transferring some central units to local authorities should be carefully assessed. Many public hospitals have already achieved a level of financial autonomy, at least in covering recurrent expenditures. In such cases, mergers may not generate significant savings but could, in fact, weaken operational capacity.

“Restructuring can even lead to unnecessary expenses, from changing signs and seals to rebuilding established partnerships. These disruptions create waste, while the benefits remain uncertain,” he said.

Hoàng added that the restructuring process must be designed with precision.

“The key is to ensure effective management while avoiding unintended problems. The goal should be a more efficient, capable and resilient healthcare system.” — VNS