Autonomy in health and higher education (according to Decree 60/2021/ND-CP) is one of the policies of the Party and State to innovate management mechanisms, in accordance with the context of market economy development.
The goal is to reform public finance methods in the direction of promoting autonomy, improving efficiency in using the state budget and exploiting all capabilities of public non-business units in providing high-quality public services.
However, an alarming reality is that recently, many schools and hospitals across the country are falling into a state of "debt-taking" after a period of being granted financial autonomy.
Most recently, Quang Ngai Vietnam - Korea College. Dozens of lecturers of the school were owed more than 8.5 billion VND in salaries, allowances and overtime teaching fees by the governing agency - many of which have lasted for 10 years without being paid.
Only when Lao Dong Newspaper intervened did the school leaders manage to pay part of the salary to lecturers.
A similar incident occurred in Hue, in the field of healthcare. More than 100 medical staff of A Luoi Health Center had their December 2025 salaries delayed and were owed 2/3 of their December 2024 salaries. The situation of debt and salary delays also occurred at Phu Loc, Phu Xuan, Thuan Hoa Health Centers... with debts of up to billions of VND for each unit.
There are many reasons for wage arrears, but the core is still the financial autonomy mechanism.
In the field of education, take the example of Vietnam - Korea Quang Ngai College. When the 100% financial autonomy mechanism was applied from 2023, the school's revenue almost only depended on tuition fees, in the context of increasingly difficult enrollment. If revenue is not enough to cover expenses, debts for salaries, allowances, teaching hours... are inevitable.
Similarly in the field of healthcare, the fact that the City People's Committee assigned the health sector to self-pay salaries for 1,448 job positions from career income is not appropriate, exceeding the actual capacity.
Currently, the infrastructure and equipment of local health centers have not been synchronously invested; the quality of medical examination and treatment cannot compete with central and private hospitals.
Reality for many years shows that many public health facilities have very few patients coming for examination. Without patients, there is no source of income, without sources of income, there is no money to pay salaries, without money to pay salaries, debt is inevitable.
It is worth mentioning that this debt situation is not just a single story of a few localities such as Quang Ngai or Hue, but is a common problem in many places across the country.
It is time for localities to reconsider the allocation of autonomy to medical facilities and schools in a flexible direction, suitable to the capacity and actual conditions of each unit, instead of being egalitarian and uniform as at present.
Education and healthcare are two core, essential and closely related fields to all people, playing a pillar role for national development.
Therefore, financial autonomy is only truly meaningful when accompanied by the responsibility to ensure minimum resources for those who are directly maintaining the quality of education and community health care, and cannot push financial risks to lecturers and doctors as it is now.
