Proposal to build "satellite hospitals" to reduce the load on upper-level hospitals

According to National Assembly delegate Tran Kim Yen (HCMC), the pilot opening of primary health care lines at the final level general hospitals in Hanoi, HCMC, Da Nang, and Can Tho will help solve the problem of overload at the upper level.

Continuing the program of the 10th session of the 15th National Assembly , National Assembly deputies contributed comments and recommendations to complete the draft Resolution of the National Assembly on a number of breakthrough mechanisms and policies for the work of protecting, caring for and improving people's health and investment policy for the National Target Program on health care, population and development for the period 2026 - 2035.

Maintain the professional quality of the lower level

Regarding the salary and allowance regime for medical staff, Deputy Nguyen Tam Hung (HCMC) welcomed the regulation to classify doctors' salaries from level 2 and 100% preferential allowance for special fields. However, he also suggested that the drafting committee consider adding professional responsibility allowances according to each job position, not just according to the specialty.

The reason is that at the grassroots level of health care and in resuscitation and anti-poison units, work pressure, on-duty intensity and occupational risks are very high, but if responsibility allowances are not regulated, it will be difficult to ensure retention and create sustainable career motivation. This is a decisive factor for the strategy of developing human resources for health care - the biggest challenge today.

Delegate Nguyen Tam Hung (HCMC). Photo: QUANG PHUC

Meanwhile, Deputy Pham Khanh Long Lan (HCMC) expressed his opinion that the regulations and policies on salaries for medical staff as in the draft Resolution of the National Assembly on a number of breakthrough mechanisms and policies for the work of protecting, caring for and improving people's health: "Doctors (including: traditional medicine doctors, dentists), preventive medicine doctors, pharmacists are ranked at level 2 of the recruited professional title", which is insignificant.

According to Deputy Pham Khanh Phong Lan, the "priority" of salary level 2, in reality, compared to level 1, is not significant, not much different. According to her, each salary level represents 3 years of work (if there are no mistakes), only about 0.3 to 0.4 times the basic salary coefficient.

Delegate Pham Khanh Phong Lan (HCMC). Photo: QUANG PHUC

"Why don't we also raise the level 3 and level 4? Applying policies only to doctors, pharmacists and preventive physicians is not comprehensive; because in reality there are many other medical staff. I think, if the Ministry of Health dares to propose, the National Assembly will also dare to decide," said Deputy Pham Khanh Phong Lan.

On the other hand, Deputy Tran Kim Yen (HCMC) said that for a long time, we have always pointed out the fact that lower-level hospitals are often empty of patients, while the specialized and general hospitals at the end of the line are always overloaded. To solve this problem, some general hospitals have organized "satellite hospitals". Preliminary assessment shows that this model has basically reduced the load for the upper line... but according to her, the legal corridor is lacking, so the Deputy proposed to build a model of satellite hospitals, general and specialized hospitals at the end of the line are allowed to open more facilities in areas far from the center in the draft Resolution to create a strong legal corridor, to allow the pilot to "go beyond" the current regulations.

Delegate Tran Kim Yen (HCMC). Photo: QUANG PHUC

“In the immediate future, Hanoi, Ho Chi Minh City, Da Nang, Can Tho… can be given priority to register for implementation first,” said Deputy Tran Kim Yen.

Expanding the beneficiaries

Delegate Nguyen Tam Hung (HCMC) agreed with the draft regulation on exempting hospital fees according to the roadmap until 2030 and increasing health insurance benefits for vulnerable groups. However, he suggested that the drafting committee consider adding criteria to determine the groups of subjects that will receive increased benefits based on the level of health risks and high risk of diseases instead of relying solely on social and administrative criteria.

According to the delegate, because in reality, people with high risks such as chronic diseases, genetic diseases, early metabolic disorders, etc. always need large and long-term treatment costs. Expanding the approach standard in the direction of "prioritizing according to health risks" will direct policies in the right direction, ensure health equity and contribute to reducing the disease burden of society in the long term.

Delegate Duong Khac Mai (Lam Dong). Photo: QUANG PHUC

Agreeing with Deputy Nguyen Tam Hung, Deputy Duong Khac Mai (Lam Dong) expressed the view that expanding health care benefits and reducing medical costs for people is a timely orientation, directly responding to the long-term aspirations of the people, especially the poor, the disadvantaged, the elderly, and people in difficult areas. However, according to him, this orientation must ensure feasibility and sustainability in implementation. Therefore, Deputy Duong Khac Mai suggested specifying more clearly the implementation roadmap in stages of 3 to 5 years, linked to the targets on balancing the Health Insurance Fund and the State Budget.

“Practice shows that the need for medical examination and treatment increases rapidly with the aging population and the increase in non-communicable diseases; if we do not design a tight enough roadmap, it may lead to the risk of imbalance in the medium and long term health insurance fund. Maximum health care for the people is only truly sustainable when the Health Insurance Fund is operated safely, stably and transparently,” said Deputy Duong Khac Mai.

According to Deputy Tran Thi Nhi Ha, the Ministry of Health needs to develop a basic annual screening package that is suitable for the budget and the Health Insurance Fund; at the same time, clearly stipulate the integration of examination and treatment results at medical examination and treatment facilities into electronic health records, avoiding duplication and overlap when performing screening. The ultimate goal is to create a continuous, complete and accurate flow of medical information for each person, helping to monitor, evaluate and detect diseases early in the most effective way.

Delegate Pham Khanh Phong Lan (HCMC) raised the issue that since the Covid-19 pandemic, there has been a situation where many patients have come to the hospital but run out of medicine, broken machines, and have had to perform outside procedures without being compensated or paid. Therefore, in order for the draft Resolution to "go further", she suggested adding a provision to make health insurance payments practical, because this is the right of the people. "Before talking about lofty things, let's do it, let's solve the problems that have existed for many years," Delegate Pham Khanh Phong Lan expressed her opinion.

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Source: https://www.sggp.org.vn/de-xuat-xay-dung-benh-vien-ve-tinh-de-giam-tai-tuyen-tren-post826500.html