District health care lacks everything.
Bac Lieu Provincial Department of Health acknowledged that with the many years of imbalanced deficits of some units, if not or delayed in consideration and timely support, they will continue to face difficulties in regular expenditures, especially salary payments and debt repayment for medicine and medical supplies.
According to the Bac Lieu Department of Health, after the COVID-19 pandemic, medical examination and treatment facilities in Bac Lieu have seriously degraded, especially the units that were requisitioned to establish COVID-19 treatment hospitals. Currently, there are 4 district-level medical centers that are being repaired and renovated from the capital for economic recovery and development after the pandemic.
When the units entered financial autonomy, most of the equipment was degraded and damaged, not ensuring medical examination and treatment, few patients, low bed occupancy, causing service fee revenue to decrease sharply.
At Gia Rai town medical center, the capacity utilization in 2022 was 73.7%, in 2023 it was only 74.5%, in the first 6 months of 2024 it was only 64.6%. Similarly, at Phuoc Long district medical center in 2022 it was 74.4%, in 2023 it was only 82.5%, in the first 6 months of 2024 it reached 84.4%.
The outstanding debts to suppliers of medicine and medical supplies for many years, but the payment source has not been balanced for a long time due to low revenue, amounting to more than 32 billion VND (of which Phuoc Long District Medical Center is more than 20 billion VND, Gia Rai Town Medical Center is more than 12 billion VND).
Paying the bills
Implement Decree No. 24/2023/ND-CP dated May 14, 2023 of the Government on stipulating the basic salary from VND 1,490,000 to VND 1,800,000, based on the salary needs of the reserve block, commune health stations, and administrative block from retained revenue according to regulations.
However, this is the source of salary reform for the treatment sector, while the medical centers do not have the resources to pay according to the new salary level. Therefore, when implementing the new salary policy, it is used to pay salaries for the reserve sector, commune health stations, and administrative sector.
When the basic salary increases from VND 1,800,000 to VND 2,340,000 from July 1, 2023, units will continue to face difficulties because the price of health insurance medical examination and treatment services will not be applied until November 17, 2023 at the new price.
To have money to pay, the units borrowed the budget allocated from the reserve block, the administrative block, and the commune health station to pay salaries in advance with an amount of more than 6.8 billion VND. Many units also borrowed the state budget allocated to the reserve block and health station to pay salaries for the treatment block with an amount of 8 billion VND. According to the Department of Health, this borrowing was wrong, but currently the units do not have the money to pay back the budget.
The situation of medical examination and treatment exceeding the total health insurance payment of Bac Lieu province in 2019, 2020, 2022 is very large, but it is slow to be considered, accepted, and transferred to pay with a total amount exceeding 115,170 billion (of which: 2019 is 64,850 billion; 2020 is 43,587 billion; 2022 is 6,732 billion). In 2023, 8 billion was paid, in 2024, 85.5 billion VND was accepted for payment. Currently, 21.5 billion VND has not been transferred for payment. The amount exceeding the estimate in 2023 is 24 billion VND - currently, Vietnam Social Security is still considering and has no comments.
