Medical experts talk about the Ministry of Health's proposal to reorganize and merge hospitals

(Dan Tri) - According to experts, the Ministry of Health's policy of hospital arrangement and merger needs to ensure key conditions for success.

Regarding the Ministry of Health's proposal to reorganize and rearrange its affiliated public service units, recently the Ho Chi Minh City Orthopedic and Rehabilitation Hospital (1A) and Can Tho Orthopedic and Rehabilitation Hospital (2 facilities expected to be merged into other units) have spoken out.

Specifically, Hospital 1A proposed to continue being an independent unit under the Ministry of Health until 2027, then become a practice hospital under the University of Medicine and Pharmacy, Ho Chi Minh City. Meanwhile, Can Tho Orthopedic and Rehabilitation Hospital wants to have a roadmap to transfer the status quo to the locality in the period of 2028-2030.

In the Northern region, the Ministry of Health's proposal to transfer Hospital E to Bach Mai Hospital - forming a hospital chain model - also attracted much attention and expressed opinions from the medical community and public opinion.

Dan Tri reporter had a conversation with Associate Professor Do Van Dung, former Vice Principal and member of the Council of Ho Chi Minh City University of Medicine and Pharmacy, to gain more professional perspective on the above issue.

Associate Professor Do Van Dung, former Vice Principal, University of Medicine and Pharmacy, Ho Chi Minh City (Photo: BV).

Key conditions for successful mergers and acquisitions

Recently, the Ministry of Health has proposed a plan to reorganize its affiliated public service units, with different methods such as merging, becoming facilities under other units or transferring the status quo to the locality. What is your assessment of this?

- The policy of arranging and merging medical units is necessary, in line with the trend of streamlining the apparatus, improving the autonomy of public service units. From a management perspective, for the merger to be successful, it is necessary to ensure key conditions.

First, stabilizing and integrating human resources. This is the decisive factor for the success or failure of any merger.

Hospital reorganization or merger needs to pay attention to the issue of integrating organizational culture, through thoroughly handling cultural conflicts between old units (culture with patients, culture of applying medical advances). It is necessary to build a unified quality culture and focus on patients.

In addition, human resources must be arranged fairly, ensuring stability in terms of jobs, positions, and benefits for competent medical staff, avoiding dissatisfaction and brain drain.

Second, select the appropriate units to merge with to improve efficiency and professional quality.

Appropriate factors include: Optimal scale and reasonable functions (so that the new unit must achieve economic advantages, focus resources to develop in-depth expertise, but at the same time must avoid becoming a cumbersome, overloaded "super hospital");

Maximize resources (by integrating professional strengths, making the most of facilities and technological equipment, improving diagnostic and treatment efficiency).

Third, legal, governance and technological platforms.

Regulations on merging public service units need to be strictly implemented, including procedures for re-issuing or adjusting operating licenses. At the same time, it is necessary to build an effective and flexible management model and apply information technology (IT) to integrate management systems (HIS, EMR) of old hospitals. This helps control quality and operational efficiency in the new scale.

The Ministry of Health has proposed a merger plan for a number of specialized rehabilitation hospitals (Photo: Hoang Le).

According to the document on the plan to arrange and reorganize affiliated public service units, the Ministry of Health proposed that 25/39 hospitals continue to be under the Ministry.

Specifically, the frontline hospitals that continue to be under the Ministry of Health are Bach Mai Hospital, K Hospital, Viet Duc Hospital, National Children's Hospital, National Obstetrics Hospital, Cho Ray Hospital, Hanoi National Hospital of Odonto-Stomatology...

There are two hospitals proposed to be merged into other units, namely Can Tho Orthopedic - Rehabilitation Hospital (merged into Can Tho General Hospital) and Ho Chi Minh City Orthopedic - Rehabilitation Hospital (merged into Thong Nhat Hospital).

Meanwhile, Hospital E is expected to become a part of Bach Mai Hospital, forming a hospital chain model. In addition, many specialized hospitals are proposed to be handed over to localities in their original state.

In addition, the Ministry of Health also proposed that some hospitals be transferred to become practice hospitals for medical schools. For example, the Danang Orthopedic and Rehabilitation Hospital was transferred to the Danang University of Medical Technology and Pharmacy, while the Central Hospital 71 and the Central Nursing and Rehabilitation Hospital were transferred to the Hanoi Medical University.

With the prevention and inspection system, the Ministry of Health proposed that the Central Institute of Hygiene and Epidemiology will continue to be under the Ministry, performing the functions of the central CDC. The Institute of Nutrition, the Institute of Occupational and Environmental Health and the Central Institute of Malaria - Parasitology - Entomology will merge into the Central Institute of Hygiene and Epidemiology.

In the South, the Ho Chi Minh City Institute of Malaria - Parasitology - Entomology and the Ho Chi Minh City Institute of Public Health are proposed to merge into the Ho Chi Minh City Pasteur Institute...

There has been much discussion about the proposal to merge or become part of larger hospitals with a long tradition of financial autonomy and industry leadership. How does the Associate Professor view this?

- Hospitals with high professional capacity, long tradition and effective financial autonomy usually have established a strong and sustainable organizational culture. Their staff usually comply with organizational regulations, have a respectful and friendly attitude towards customers, and always learn about new medical advances to apply to patient care.

These hospitals also often have modern management systems, so when merging with smaller hospitals, integrating organizational culture between the two old units is often not an obstacle.

The problem only occurs when a hospital with professional capacity has to merge with a larger hospital that is weak in management and expertise, and the personnel arrangement process is not fair.

Trends in modern healthcare

In the proposal to reorganize and arrange the hospitals under the Ministry of Health, it is easy to see that there are some main options. These are transferring the status quo to local management, converting into practice hospitals following the “hospital - school” model, or merging into central general hospitals or large-scale units.

In the opinion of the Associate Professor, which way is most suitable for the development of the medical industry in the new situation?

- According to the above analysis, the suitability of organizational culture is the decisive factor when choosing a merger method. Which method to choose can be reasonable in each specific situation.

If a specialized hospital has a tradition of cooperation with the school, appoints school lecturers in the hospital's leadership structure, and the medical staff has a culture of applying medical advances in patient care and is active in teaching practice to students, then converting it into a "hospital - school" practice hospital is completely reasonable.

This is also an option that fits the trend of the modern medical industry: specialization and integration of training/research.

Hospital 1A proposed to convert into a practice facility of Ho Chi Minh City University of Medicine and Pharmacy in the period 2028-2030 (Photo: Hoang Le).

If the hospital has never cooperated with a university but has a professional cooperative relationship with a general hospital in the same locality, has the same management culture and the general hospital does not have the specialty of the merged unit (or the department is still weak), then merging with the general hospital is reasonable, will optimize the care chain and improve operational efficiency.

If the current specialized hospital has certain strengths, but its working culture is not suitable with other local medical units, and the merger causes organizational overlap or overload, then temporarily handing it over to the provincial government for management without merging is also a suitable option.

Thank you for sharing, Associate Professor!

What did the former Director of the Ho Chi Minh City Department of Health say?

Talking to Dan Tri reporter, Dr. Nguyen The Dung, former Director of Ho Chi Minh City Department of Health, said that the arrangement and merger of the Ministry of Health when implemented must meet 3 criteria: "Quality - Efficiency - Performance".

He analyzed that depending on the management level of each locality, there would be plans to arrange and merge appropriate units. In particular, the Ministry of Health needs to ensure the concentration of state management functions, strategic and policy advice for the Central Government, so it is necessary to keep a number of large public service units to monitor and direct in terms of expertise, instead of directly controlling too many hospitals.

Dr. Dung cited that, when he was previously the head of the Ho Chi Minh City Department of Health, he proposed keeping Tu Du Hospital under the Department of Health instead of being managed by the Ministry of Health.

At the same time, he also presented a proposal to the city leaders to transfer all district-level hospitals (old) to the district-level hospitals for management, because the Department of Health at that time managed more than 30 city-level hospitals. This proposal was later approved.

The former Director of the Ho Chi Minh City Department of Health also stated that “hospital - school” is the basic model of the healthcare system (including hospitals affiliated with universities and “university hospitals”), so he strongly agrees with the direction of building this model.

Building a “university hospital” is a very persistent and gradual process, meeting many criteria. First, it must be a place for students to practice from the moment they first enter the school until they have mastered their skills. Second, it must be a place of the highest level of treatment (the last line of care for patients). And third, a “university hospital” must be a place where the pinnacle of scientific research converges (some of which have won Nobel Prizes).

“Vietnam does not have a family doctor network and does not have a university hospital of the right level. To solve the bottleneck for the development of the health sector, we must implement these two models,” said Dr. Nguyen The Dung.

Source: https://dantri.com.vn/suc-khoe/chuyen-gia-nganh-y-noi-ve-de-xuat-sap-xep-sap-nhap-benh-vien-cua-bo-y-te-20251022232025751.htm