Ca Mau Health Sector after merger: Difficulties and solutions

After the merger of Ca Mau and Bac Lieu provinces into the new Ca Mau province, the health sector faced many difficulties and major challenges in the process of stabilizing its organization, personnel, facilities and finances. Although the sector has proactively implemented many measures to maintain medical examination and treatment activities and health care for the people, the existing problems require timely support from all levels and sectors to ensure the effective operation of the new provincial health system.

The entire sector currently has 8,960 people, including 101 civil servants, more than 6,600 public employees and more than 2,100 labor contracts. After the merger, the arrangement and reassignment of personnel encountered many difficulties, especially the problem of surplus positions of Health Station Heads. Previously, the two provinces had a total of 164 health stations in communes, wards, towns and regional polyclinics; now after the reorganization, there are only 64 stations, leaving 100 positions of station head unfilled. Meanwhile, many health stations are seriously lacking in human resources, not meeting the standards according to Circular 03/2023/TT-BYT of the Ministry of Health .

Recruitment and employment are also facing difficulties. Health care facilities must be financially autonomous according to Decree 60/2021/ND-CP, but many places "do not have enough revenue to cover expenses", owe salaries and suppliers, leading to a reluctance to recruit more staff, making the shortage of human resources even more serious.

A worrying fact is that most of the offices and medical facilities are seriously degraded. The Department of Health headquarters is often flooded in the rainy season, many hospitals and centers such as: Ca Mau General Hospital, Traditional Medicine - Rehabilitation Hospital, Bac Lieu Regional Medical Center, Ngoc Hien Medical Center... are operating in cramped conditions, are severely damaged or in unsuitable locations.

Medical equipment at many commune-level facilities was invested more than 10 years ago, but now no longer meets professional requirements. Some machines purchased from government bonds have been damaged but there is no funding to replace them, leading to disruption of professional activities.

Financial difficulties are the biggest bottleneck of the Ca Mau health sector after the merger. Up to now, health facilities still have a series of outstanding debts: salary debts, health insurance debts, debts to suppliers, budget debts, debts from Covid-19 epidemic prevention expenses... While many units have to make advances and borrow to maintain operations. This situation affects the supply of drugs and medical supplies, directly affecting patients.

After the merger, the management and operation between the two localities are not synchronized. In addition, there are differences between Decree 176/2025/ND-CP and the new Law on Health Insurance, causing problems in paying for medical examination and treatment costs for the elderly and social welfare beneficiaries.

Digital transformation of healthcare – a key task of the Government – ​​also faces major obstacles due to lack of investment resources for software, hardware, and human resource training, while most units have not been funded.

After the merger, the Health Department Inspectorate was transferred to the Provincial Inspectorate, forcing the handling of petitions, complaints and denunciations to be handed over to specialized departments. However, the staff was not trained and lacked experience, so this work was still confusing.

Particularly, the health care activities for provincial officials - transferred from the Provincial Health Care and Protection Board to the two general hospitals of Ca Mau and Bac Lieu - also have many problems. The drug purchase and settlement mechanism is not unified, some types of specialty drugs are not on the winning bid list, so hospitals find it difficult to buy. In addition, there is a difference in co-payment support policies between the two regions of Ca Mau and Bac Lieu.

Faced with the above situation, the Department of Health has proposed many key solutions. Regarding personnel, 100 redundant station heads will be arranged as deputy station heads, professional staff or transferred appropriately; in case of failure, staff reduction or early retirement will be considered. At the same time, the Department will urgently complete projects regulating functions, tasks, and new organizational structures to submit to competent authorities for approval, as a basis for recruitment and reasonable human resource arrangement.

Regarding facilities, the industry is developing a master plan for investment, repair, and upgrading the health system for the 2026-2030 period, encouraging socialization and public-private partnership in investing in equipment, paraclinical services, and testing.

In the financial field, the Department will review the autonomy level of each public service unit, develop an autonomy plan for the 2026-2030 period, and at the same time recommend the Provincial People's Committee to support regular budget expenditures for units facing difficulties, ensuring that medical examination and treatment activities are not interrupted.

Regarding digital transformation, the health sector will resolutely direct hospitals to deploy electronic medical records on schedule. At the same time, it will train and coach staff in inspection work, anti-corruption, and improve management and professional capacity.

Finally, to achieve the target of 95% of people participating in health insurance by 2025, the Department of Health will closely coordinate with the Provincial Social Insurance, departments, branches, sectors, organizations and local authorities to strengthen propaganda and mobilize people to participate, towards universal health coverage.

It can be seen that the merger of Ca Mau and Bac Lieu provinces has opened up new development opportunities, but at the same time, it has also posed unprecedented challenges for the health sector. To overcome this difficult period, it is necessary to have close attention and direction from the Provincial Party Committee and the Provincial People's Committee, synchronous coordination of the sectors, along with a sense of responsibility and efforts to overcome difficulties of the staff and civil servants of the health sector.

Only when synchronous solutions are implemented drastically and promptly, can the health system of Ca Mau province soon stabilize, improve the quality of medical examination and treatment, better serve people's health, and deserve to be a pillar in the work of protecting and caring for community health in the new development stage.

Source: https://soyte.camau.gov.vn/bai-khoa-hoc-chinh-tri-va-xa-hoi/nganh-y-te-ca-mau-sau-sap-nhap-kho-khan-va-nhung-giai-phap-thao-go-290766