Gradually restructuring the public service unit system
From 2017 to present, the Ministry of Health has implemented the restructuring of the public service unit system according to Resolution 18. The Ministry has transferred 3 affiliated hospitals to localities, merged 4 focal points, merged two magazines into the Journal of Medicine and Pharmacy, and established Viet Duc Medical and Equipment College on the basis of merging with Viet Duc Friendship Hospital.
Currently, the Ministry of Health is directly managing 90 units, including 35 hospitals, 11 prevention units, 12 training facilities and testing, pharmaceutical - vaccine and forensic hospitals.
According to the new plan, the Ministry of Health proposed to transfer 13 units to localities, reorganize 11 units, and at the same time retain leading hospitals such as: Bach Mai, Viet Duc, K, Nhi Trung Trung, Trung Obstetrics and Gynecology, Cho Ray, Thong Nhat... to ensure the leading role in treatment, training and research.
Of the 39 affiliated hospitals, 25 will continue to belong to the Ministry of Health. Notably, Bach Mai Hospital is expected to form a chain of leading hospitals when receiving the merger of E Hospital. Some specialized hospitals will be merged into the central general hospital or larger facilities, while other hospitals will be handed over to local authorities to increase proactiveness in management.
The Ministry also proposed to convert some hospitals into practice facilities for medical universities. In the reserve block, the Ministry is oriented to form a Central CDC on the basis of merging sanitation, nutrition, parasitic, occupational health and environmental hospitals. With the training block, the network of medical universities and colleges will be streamlined, increasing connectivity, ensuring inheritance, avoiding disruption and improving the quality of service to the people.
Completing institutions before implementation
According to the proposal, E Hospital will become a facility under Bach Mai Hospital, aiming at a leading hospital chain model with a unified management system, in accordance with the spirit of Resolution 18. This proposal has received attention, especially the issue of whether insurance benefits are guaranteed when implementing hospital mergers.
Ms. Le Thi Men (75 years old, Hanoi) shared: "I have been treated at Hospital E for many years, the doctor knows my condition. Hopefully, if there are changes, it will not affect patients." Mr. Tran Van Quang (70 years old, retired teacher) expressed: "The important thing is to ensure the quality of medical examination and treatment and avoid putting more pressure on the already overloaded system".
The Ministry of Health has not yet announced a specific roadmap, but affirmed that every arrangement step will be implemented with a plan, complying with the transitional regulations in Decree 188/ND-CP, ensuring the rights of patients and uninterrupted medical examination and treatment activities.
Dr. Nguyen Huy Quang - former Director of the Legal Department (Ministry of Health) - commented that the merger of hospitals needs to have a complete and clear legal basis to avoid risks in management and operation.
He analyzed: If E Hospital merges into Bach Mai and forms a chain of hospitals, this model is similar to a medical group with many member units. However, the current law does not have specific regulations for this type".
According to Dr. Nguyen Huy Quang - Hospital E is a Grade I hospital, while Bach Mai is a Special Grade hospital. "If merged, will Hospital E be upgraded or not? If there are, the price of medical services will have to be adjusted accordingly. If not, what will be the difference between the two hospitals?" - he asked.
Another notable point is personnel. Currently, Bach Mai Hospital is completing its second facility in Ninh Binh and needs to recruit more human resources. If the merger is done, will Bach Mai have the right to transfer the personnel of Hospital E to facility 2? At that time, who is responsible for paying salaries and managing them? The recruitment mechanism between the two sides is different, does it need to be unified again?" - Dr. Quang stated.
According to Dr. Nguyen Huy Quang, the appointment of leaders needs to be clearly regulated: Previously, hospital directors were appointed by the Ministry of Health. But if we switch to a chain model, when the director of Hospital E expires, who has the authority to appoint him? Will the standards change?".
Dr. Quang assessed the merger policy as correct, aiming to reduce the number of hospitals under the Ministry of Health so that the ministry can focus on the role of policy making and state management. The important thing is to perfect mechanisms, policies and legal frameworks to ensure unity, effectiveness and efficiency in health sector governance, while helping new models operate smoothly, without causing disruption.
Caring for patients is still the number one task
Regarding the proposal to merge hospitals under the Ministry of Health operating in Ho Chi Minh City, there is a list of plans to have the Ho Chi Minh City Orthopedic - Rehabilitation Hospital merged into Thong Nhat Hospital; the Ho Chi Minh City Institute of Malaria - Parasitology - insect reptiles and the Ho Chi Minh City Institute of Public Health will be merged into the Ho Chi Minh City Pasteur Institute...
In response to this information, the hospitals in the merger plan also have additional concerns and proposals to facilitate the merger process, optimize the quality of treatment and medical examination of each unit before and after the merger.
For example, at the Orthopedic - Rehabilitation Hospital (Hospital 1A) under the Ministry of Health in Ho Chi Minh City, MSc. Dr. Ngo Anh Tuan - Director of the Orthopedic - Rehabilitation Hospital (HCMC) - affirmed: "Whether merged or not, patient care is still a top priority".
Doctor Tuan Anh added that the draft to merge the Ho Chi Minh City Orthopedic and Rehabilitation Hospital into Thong Nhat Hospital had been previously announced, currently the unit has about 300 staff and nearly 400 beds in practice.
In response to staff's concerns about whether there will be changes in professional orientation after the data merger, Dr. Tuan affirmed: "The core values of orthopedics and rehabilitation will certainly continue to be maintained and developed. This is also a trend that the city's health sector really needs. The Hospital's medical staff hope to keep their duties, positions and the policies they are receiving will continue to be maintained so that medical staff can work with peace of mind in the newly merged environment".
Regarding this issue, Associate Professor, Dr. Le Dinh Thanh - Director of Thong Nhat Hospital - said: "Currently, it is only the plan of the Ministry of Health, so we have not been able to share much. However, the hospital currently has many plans and strategies for Thong Nhat Hospital to develop into a comprehensive geriatric Hospital. This is also to do a good job of taking care of the health of cadres and people".
Reorganizing public health in Da Nang, without interruption in medical examination and treatment
The Da Nang Health Sector is gradually reviewing and adjusting the structure of public service units, ensuring unified professional direction, without interrupting medical examination and treatment activities for people.
Speaking to Lao Dong Newspaper, Ms. Tran Thanh Thuy - Director of the Department of Health of Da Nang City - said: "Currently, the city's health sector is still implementing the policies of the Ministry of Health. Wherever the Ministry has instructions, we will follow them. The arrangement of Food Safety Boards, Testing Centers, health stations... is still continuing to be implemented according to the roadmap".
According to Ms. Thuy, Da Nang is carefully reviewing focal points and affiliated units to ensure stable professional operations, without affecting medical examination and treatment services. The arrangement was carried out carefully, step by step, on the basis of stabilizing the medical team and the rights of the people.
Also according to the general policy, some specialized hospitals are proposed to be handed over to localities in order to decentralize more strongly in managing and exploiting facilities. Including the plan to transfer Quang Nam Central General Hospital to Da Nang for management.
The Ministry of Health also proposed that some hospitals be transferred to practice hospitals for medical universities. In Da Nang, there is a Da Nang Orthopedic - Rehabilitation Hospital proposed to be converted to practice hospitals under the Da Nang University of Medicine and Pharmacy.
Some other specialized hospitals in the system are proposed to be merged into large general hospitals or central-level hospitals to form a chain linkage, in order to reduce small independent units, increase scale and efficiency. Da Nang also continues to perfect the model of organizing the Food Safety Committee and Testing Center in the direction of streamlining, inter-sectoral coordination and meeting management requirements in the new period.
The implementation of the arrangement of public health units in Da Nang will be carried out publicly, transparently, in accordance with the authority and instructions of the Ministry of Health, ensuring uninterrupted health care for people and in line with the development orientation of the urban government model of Da Nang.
Tran Thi
