To be able to discard the referral letter

During recent National Assembly sessions, health sector leaders expressed concerns that abolishing referral forms, as requested by voters, would overwhelm higher-level hospitals and cripple lower-level healthcare.

Để có thể bỏ giấy chuyển viện - Ảnh 1. — Patients receiving medical examinations covered by health insurance at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City - Photo: DUYEN PHAN

The ministry's concerns are valid, and this policy should not be implemented in the short term. However, in the long term, a roadmap is needed to move towards a healthcare system based on a network model (rather than an administrative hierarchy) where citizens – the customers – can choose the most suitable healthcare facilities for themselves.

Vietnam's current healthcare system still relies heavily on public hospitals, which are organized into a hierarchical structure of central and local levels, and upper and lower levels. Consequently, the professional skills and expertise of the staff, as well as the scale of budget investment, vary significantly between different levels.

Therefore, central hospitals and higher-level hospitals always have higher medical capacity than lower-level hospitals. If given the choice, who wouldn't choose the place with higher quality? It's inevitable that higher-level hospitals are overloaded, while lower-level hospitals are left idle when referrals are given.

However, in the long term, if the minister and the health sector have a strategy to reorganize the national healthcare system, then for each citizen, the "referral slip" to a higher-level hospital will no longer be necessary. That strategy should link two goals: strongly developing the private healthcare system and balancing the roles of public and private hospitals.

Instead of a hierarchical system, the Ministry of Health only manages a few key hospitals, focusing on high-tech medical research, linked to training and the transfer of medical technology. Hospitals purely for treatment purposes, such as Bach Mai, Viet Duc, and Cho Ray, must gradually reduce their investment budgets for medical examination and treatment.

All routine medical examinations and treatments should be handled by the general healthcare system, including both public and private sectors. This philosophy is what stimulates the development of the private healthcare system.

For example, if the current public-private ratio is 80-20, a step-by-step roadmap is needed to gradually ensure that private healthcare can achieve ratios of 70-30, 60-40, and 50-50.

And only when private healthcare develops and reaches even low-income areas will it be able to redistribute healthcare personnel to meet the healthcare needs more evenly across localities.

It should also be made clear that strengthening the grassroots healthcare system to serve the healthcare needs of the people is a noble goal.

However, it is important to recognize that the budget for primary healthcare investment must fulfill two crucial tasks: doing what the private sector cannot (disease prevention and control, epidemiological hygiene) and caring for people in disadvantaged, rural, and mountainous areas with geographical isolation.

In other words, primary healthcare should not be invested in a uniform manner, but should be concentrated only in rural, mountainous, and particularly disadvantaged areas where private hospitals are reluctant to expand, as well as for vulnerable groups of people who need support.

In large urban areas like Hanoi , Ho Chi Minh City, Da Nang, Hai Phong, etc., people rarely need to go to the ward for medical check-ups and treatment, so investing in basic healthcare facilities would be wasteful.

Vietnam's biggest challenge in the coming decades is an aging population, and consequently, the demand for healthcare will undoubtedly become an increasing pressure. A strong and sustainable healthcare system requires a balance between public and private sectors.

And the freedom to choose a suitable place for medical examination and treatment is a legitimate need of citizens of a developed country in 2045. The Minister of Health, therefore, should not only worry about the short-term "overwhelming" situation between upper and lower levels of healthcare but also needs a long-term vision and strategy for the future.

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Source: https://tuoitre.vn/de-co-the-bo-giay-chuyen-vien-20241028082708995.htm