Many public hospital nationwide have gradually wiped out fully-subsidised mechanisms and shifted to self-independent financial models.— Photo thanhnien.vn

HÀ NỘI — According to Minister of Health Nguyễn Thị Kim Tiến, many public hospital nationwide have gradually wiped out fully-subsidised mechanisms and shifted to self-independent financial models.

Starting this year, healthcare service charges also cover health care workers’ salaries.

Thanks to the mechanism, the number of health workers who are working in 18 hospitals under the management of the health ministry and paid by the State budget has been reduced by 20,599 persons. This equals nearly VNĐ1.681 trillion (US$74 million) a year. The number in HCM City was VNĐ1 trillion ($44 million). And in other provinces, the numbers were between VNĐ70 billion and VNĐ100 billion.

The savings are being used for preventive healthcare funds and financial support funds to buy health insurance cards for people.

Since 2016, the healthcare service charges have been adjusted to help hospitals have stable incomes.

“In the past, the State paid salaries to doctors and healthcare workers. But with the new mechanism, patients pay healthcare workers,” the minister told the Nông Thôn Ngày Nay (Countryside Today) newspaper.

“So, hospitals must improve their services to attract more patients. Doctors have to thank patients,” she said.

Commenting about financial self-dependence at public hospitals, Deputy Prime Minister Vương Đình Huệ said at present the number of public hospitals and clinics at local levels is too many. Especially, the preventive healthcare system is overlapping, and it needs measures to streamline the system.

The mechanism of financial independence at public hospitals has helped enhance high-technology application in healthcare services, which has benefitted patients. But this may cause a situation that patients only go to central-level hospitals and ignore local-levels hospitals and clinics, the deputy PM said.

Along with benefits of implementing the new financial mechanism, many public hospitals have faced difficulties.

Dr Trần Ngọc Lương, director of the National Hospital of Endocrinology, said the hospital had to borrow money to build new treatment buildings. Every month, the hospital has to pay VNĐ100 billion ($4.4 million) of loans and interest, while the total revenue is about VNĐ400-450 billion ($17.6 million-19.8 million) a month.

Despite operating with financial self-dependence, the hospital has been bound by some regulations on healthcare service charges or plans of building facilities fixed by health ministry.

“The hospital currently wants to build more in-patient wards and restaurants, but the project has not yet been approved after a long time of submitting,” Lương said.

Besides, public hospitals still lack the independence to recruit staff.

The deputy PM raised his opinion that self-dependence was practical. Staff recruitment should be decided by hospitals themselves if they ensure jobs, staff’s income and healthcare service.

Meanwhile, deputy chairman of National Assembly’s Social Affairs Committee, Bùi Sỹ Lợi expressed his concern that the new financial mechanism will increase healthcare service charges and overburden the medical insurance fund.

“In 2016, the over-expense was VNĐ5 trillion. At present, the medical insurance fund’s balance was VNĐ30 trillion. If the over-expense continues, the fund would be run out of in few years,” Lợi said.

If focussing on a self-dependent mechanism, it would create a gap in people’s healthcare tasks. — VNS