Vietnam health service: firm steps forward

“The reduction of patient over-loading at hospitals, improvement of management, and upgrading of disease prevention and treatment are achievements of the health sector in recent years, marking a change in public health care quality,” Health Minister Nguyen Quoc Trieu affirmed in an interview with Vietnam Business Forum.

The Minister’s statement has been manifested in terms of indexes: 98 percent of communes with dispensaries, 100 percent of communes with physicians, 65 percent of communes attain national health standards, 85 percent of villages and hamlets with health workers and several co-workers. Those are encouraging achievements for the health service in implementing the policy of the Party and State on public health and ensuring human resources for national development and defence.

What are the most notable achievements of the health service in the past 35 years since the reunification of the country?

It is necessary to consider first the consolidation and development of the health care network from the central to the grass-roots level. After variations over the course of development, Vietnam currently supplies over 98 percent of communes with dispensaries, 100 percent of communes with physicians, nearly 14,000 health establishments including over 100 private hospitals, 230,000 beds and over 300,000 physicians. The number of beds and physicians continues to increase, ensuring better health service to the population.

Along with the expansion of health service, new and advanced technologies have been applied successfully in Vietnam. Some are of equal standard in the region such as artificial insemination, brain surgery by Gamma knife, heart surgery, separation of Siamese twins, especially internal surgery such as cutting off 95 percent of the pancreas and surgery on dislocation of the diaphragm.

The preventive medical system has been reinforced with forecast capacity and timely extermination of pandemic diseases, thus ensuring no major pandemic diseases over many consecutive years. Vietnam has been recognized by the world as one of the countries to control SARS with the shortest delay, and to control and exterminate in time Avian Flu (H5N1, H1N1) and other dangerous diseases. Besides, poor people and target groups have been given health care with financial support from the State. Together with the development of the health service, the professional skills of physicians have been improved with a high percentage of professors and PhDs compared to other services.

Among numerous achievements, I wish only to single out some of most difficult and time-consuming. Those achievements are the fruits of untiring effort from the whole health service and physicians over 35 years.

In light of population and economic growth, the health service seems unable to meet the demand, while private investments in the health service remain limited. How would you suggest addressing this problem?

I do not share the same view. Though the medical infrastructure fails to meet the demand of the people, the State in recent years has increased investments in health service through Government bonds. Development funds were around 10 percent of total expenses for health service, but they have increased since 2008 with Government bond programmes 47 and 930.

According to the Department of Health Service Management, since 2008, the number of private hospitals has increased significantly, reducing the over-load at public hospitals. There are currently 100 private hospitals, mostly in Ho Chi Minh city (30 hospitals) and Hanoi (12 hospitals). However, the size of private hospitals is still modest.

According to the Department of Foreign Investment (Ministry of Planning and Investment), so far Vietnam has FDI health service projects with registered capital of nearly US$1 billion. Though FDI capital in health service remains modest, I believe that in the coming years, private hospitals and FDI hospitals will develop, especially when encouragement policies are applied, restrictions lifted and preferential taxation treatments implemented.

Concerning policy and legal framework, besides improving the investment environment, Investment Law 2005 and Enterprise Law 2005 are big steps toward attracting local and foreign investors. The Vietnamese government has also adjusted many policies to encourage investments in health service. Accordingly, related businesses can benefit from an enterprise income tax rate of 10 percent throughout their operation, instead of 28 percent as in the past. Meanwhile, the Vietnam Development Bank can grant credits to investment projects of expanding and building new hospitals. In addition, with WTO commitments, Vietnam will ensure services to foreign investors establishing wholly foreign owned hospitals, joint ventures with Vietnam or by business cooperation agreements. Therefore, we can expect more foreign investments in health service.

To increase investments in health service, I think there must be improvement in policy and investment promotion, acceleration of administrative reform and enhancement of public-[VTC1] private partnership for development.

To reduce the bottleneck at central hospitals, people are advised to start with lower levels. However, patients are not convinced, with the shortage of physicians and equipment at lower levels. What is the Ministry’s solution?

The bottleneck is caused by a sharp increase of demand and diseases and due to the small number of hospital beds (18 beds for 10,000 people) and weak health service at lower levels.

To reduce the bottleneck at central hospitals, the Ministry has issued Directive 06/2007/CT-BYT on removing the bottleneck and improving health service, at the same time increasing the capacity of grass-roots levels with such projects as rotation of physicians from higher levels to lower levels (Project 1816) to improve medical treatment and technology transfer and meet the demand of distant, mountainous and poor regions. The Ministry has also implemented Project “Developing and upgrading general hospitals at district and regional levels with Government bonds and other legal sources in 2008-2010” in compliance of Decision 47/2008/QD-TTg of the Prime Minister.

With encouraging initial success, in the coming years, efforts will continue to reduce the bottleneck at higher levels and increase the capacity of lower levels. The Ministry will mobilize resources to improve and expand old establishments and build additional facilities at existing hospitals, especially those with serious bottlenecks. The Ministry will develop four intensive care medical centres in Hanoi, Ho Chi Minh City, Hue-Danang and Can Tho, serving as centres for science-technology and medical technology, promoting hi-tech medical service, technology transfer and development of the Vietnamese medical service.

The Ministry will also implement Projects 47 and 930 to upgrade equipment and capacity at the province and district levels, as well as Project 1816 to increase capacity and hospital beds, build new hospitals with private investments and diversification of medical service, raise the income of district level medical workers and issue policy on social responsibility regarding development of medical service in distant and difficult regions.

To you, what should Vietnamese hospital managers learn from annual seminars on Hospital Management in Asia (HMA)?

Annual HMA seminars are a useful forum for policy makers, medical and hospital managers in Asia. The Vietnamese hospital network has both public and private hospitals, with public hospitals making up over 90 percent in number of hospitals and beds. Many managers of public hospitals have medical expertise but lack management experience, especially in economic-financial management of medical service, hospital quality management and IT application. Therefore, through exchanges at HMA seminars, Vietnamese counterparts can learn precious experience in those fields. Meanwhile, managers of Vietnamese private hospitals can share experiences with private hospitals of other countries.

In addition to improving management of public hospitals, it also requires new concepts and expertise to improve efficiency in using resources and upgrading service quality. Therefore, the annual HMA seminar is most helpful for Vietnamese hospitals. It is a golden opportunity for Vietnamese hospital managers to improve the performance of their hospitals.

Thank you very much! – VCCI

Tags: Vietnam health services