Many illegal revenue and expenditure items discovered at the Ministry of Health

The State Audit Office assessed that in 2023, the management and use of public finance and public assets of the Ministry of Health and its affiliated units were basically implemented in accordance with State regulations, the State Budget Law, the Public Investment Law, the Construction Law and related guiding documents. However, the management and operation of budget revenue and expenditure still have many limitations and inadequacies.

Inadequacies in establishing, appraising and approving investment policies and investment projects

The report from the State Audit Office clearly stated that the Ministry of Health's work of registering demand and allocating capital for new projects starting in 2023 was not close to reality, leading to many projects registering capital but not being able to allocate it, having to adjust the capital plan twice during the year; capital allocation is still slow. The socio-economic recovery and development program according to Resolution No. 43/2022/QH15 by the end of the fiscal year 2023 only disbursed VND 23.14 billion/VND 1,465 billion, reaching 1.6% and by April 2024 only disbursed VND 34.186 billion/VND 1,465 billion, reaching 2.3%.

Some projects have approved scales that are not consistent with the appraisal results of the competent authorities on total floor area and construction area; organize selection and approve the results of selection of architectural design options before being granted planning licenses; prepare and submit for approval detailed project planning at a scale of 1/500 for 2 projects when the project is not subject to implementation. Determining the list of medical equipment to be invested in without explaining the necessity of investment, without analyzing investment needs based on layout diagrams, functional lines, equipment norms, and existing capacity, leading to many adjustments during the approval stage of the list of equipment; determining a number of medical equipment lists that are not suitable for project objectives; preparing, appraising, and approving total investment levels that are not suitable; determining the price of medical equipment without explaining the basis for price development...

Regarding progress management, the State Audit Office pointed out that in 2023, the Ministry of Health had 7 projects under the central budget that were behind schedule, including 3 group A projects with many problems leading to delays. At the time of the audit, the procedures were still being carried out according to the direction of competent authorities and had not been restarted; group B projects that were behind schedule had to be adjusted and extended. Although some projects had been extended, they were still behind schedule; some bid packages were behind schedule compared to the provisions of the original contract.

In particular, through checking the books, the State Audit Office also found many revenue and expenditure items that were not in accordance with regulations. Specifically, the Ministry of Health allocated the adjusted budget many times; allocated funds to implement the tuition exemption policy for students majoring in Tuberculosis, Leprosy, Psychiatry, and Forensic Medicine but had not been ordered by the State according to the provisions of Decree No. 81/2021/ND-CP dated August 27, 2021 of the Government; allocated funds for a number of tasks under the National Target Program on Sustainable Poverty Reduction that were not included in the expenditure content according to the provisions of Circular No. 46/2022/TT-BTC dated July 28, 2022 of the Ministry of Finance; approved a number of lists of tasks with unclear subjects to meet the objectives of the Program according to the provisions of Decision No. 90/QD-TTg dated January 18, 2022 of the Prime Minister; Assign aid estimates to affiliated units to own ODA projects without detailing each project according to the provisions of Circular No. 78/2022/TT-BTC dated December 26, 2022 of the Ministry of Finance.

Regarding revenue and expenditure of career and production and business activities, after inspection, some State Audit units have not recorded revenue from medical examination and treatment services for completed services; reflecting the nature of revenue sources incorrectly. Some medical services have a list of drugs and costs that have been included in the price structure of medical examination and treatment services paid by social insurance, but medical examination and treatment facilities still collect additional money from patients; applying incorrect prices for medical examination and treatment services. Implementing more pilot cases of new techniques and new methods than the number of pilot cases approved by the Ministry of Health. Some other service revenues but reflecting medical examination and treatment revenues; some hospitals generate revenue from performing technical services that are not specified in Circular No. 13/2023/TT-BYT dated June 29, 2023 such as surgical services on demand during or outside of working hours; liver transplant surgery; Patient collection of some technical services has been structured in the day price, bed in the surgical service price.

Ho Chi Minh City University of Medicine and Pharmacy Hospital has 3 medical examination and treatment facilities granted by the Ministry of Health in one medical examination and treatment license which is not in accordance with the provisions of Article 45 of Decree No. 109/2016/ND-CP dated July 1, 2016 of the Government regulating the issuance of practice certificates to practitioners and the issuance of operating licenses to medical examination and treatment facilities.

Regarding medical examination and treatment service expenses, the conclusion from the State Audit also clearly stated: The accounting of expenses in the year for some expenses is not in accordance with regulations. For example, medical examination and treatment expenses do not correspond to the revenue recorded in the year of 65.636 billion VND; allowances exceed or are not in accordance with regulations of 3.524 billion VND; expenses have not been deducted in the year for the value of drugs, bandages, chemicals, and consumables in inventory of 10.664 billion VND... In the bidding and procurement work, many units have not fully synthesized and reviewed the needs and quantity of inventory as a basis for developing a purchasing plan for the year; have not regularly reviewed and updated the bidding results and quotations of many other medical facilities within 12 months to develop a planned price; and have not implemented designated bidding for packages with a value of over 1 billion VND in accordance with regulations...

Regarding the management of drugs, chemicals, and supplies, there is still a situation of importing some winning bid drug lists with a shorter shelf life than that stated in the bidding documents and signed contracts; the drug import rate is low compared to the winning bid quantity, the import control components are not complete according to regulations; the number of exported drugs has not been compared with the actual number used in the treatment departments...

Through an audit at the Ministry of Health, the State Audit recommended handling the finances of VND 119,848 billion.

Proposal to handle financial 119,848 billion VND

Through the audit, the State Audit Office recommended handling the financial situation of 119,848 billion VND, including: Increasing state budget revenue by 62,194 billion VND; recovering and reducing budget expenditure by 57,654 billion VND... At the same time, the State Audit Office recommended the Ministry of Health and the audited units to rectify, learn from experience, and overcome shortcomings and limitations.

In addition, the State Audit Office recommends reviewing collective and individual responsibilities and considering handling according to regulations for existing errors: Establishing and approving projects that do not ensure capital sources, having to adjust the project according to the scale and total investment level, leading to the cost of establishing the Feasibility Study Report for the initial project not being used for the current project (National Institute of Forensic Medicine Project); establishing, approving cost estimates and implementing detailed construction planning at a scale of 1/500 for projects that are not subject to the provisions of Article 10 of Decree No. 44/2015/ND-CP dated May 6, 2015 of the Government (Project to build a 5-storey dormitory of Thai Binh University of Medicine and Pharmacy; Project to renovate and expand Hai Duong Central College of Pharmacy (phase 2), increasing project investment costs); Establish and assign budget estimates to implement the tuition exemption policy for students majoring in Tuberculosis, Leprosy, Psychiatry, and Forensic Medicine but have not been ordered by the State according to the provisions of Article 15 of Decree No. 81/2021/ND-CP dated August 27, 2021 of the Government; grant licenses, confirm the organizational structure and operating locations of Ho Chi Minh City University of Medicine and Pharmacy Hospital to conduct medical examination and treatment at 3 locations that do not comply with regulations; organize testing activities without a license to operate medical examination and treatment and a certificate to practice medical examination and treatment according to regulations at Ho Chi Minh City University of Medicine and Pharmacy.

Source: https://cand.com.vn/y-te/phat-hien-nhieu-khoan-thu-chi-sai-quy-dinh-tai-bo-y-te-i744463/