In the 2005-2007 period, the public health sector has achieved a lot of practical results in opening up services. However, there remain many challenges to overcome.

According to statistics from the Ministry of Health (MoH), the public health sector has spent more than VND2, 000 billion on extending medical facilities. Health centre have also diversified their services to provide specialized treatments. Many have become specialized and have also worked out better plans to make full use of the available human resources to meet the people’s demand for health-check ups.

One hundred percent of health centres under the Ministry of Health, hospitals and local medical departments have implemented Decree 43/2005/ND-CP on financial self-control. Medical units have now attracted capital sources from different sources such as cadres, investors and some credit institutions to install modern medical equipment and meet the demand for better healthcare services.

In addition, the private health sector has increasingly developed in recent times. Currently, the country has more than 30,000 private health units including 66 private hospitals with more than 300 clinics and 87 maternity hospitals. Moreover, around 22 private hospitals have been permitted to open. Although there is a shortage of beds and qualified staff, private health centres have provided medical check-ups to more than 3 million people, helping to reduce the number of inpatients in public hospitals. 

More options for people

Deputy general director of the Vietnam Social Insurance, Nguyen Dinh Khuong says the socialisation of health services has brought many practical benefits to people, especially medical insurance card holders. The number of medical insurance card holders now comes to around 36.7 million, accounting for roughly 42 percent of the country’s population. This has resulted in the expansion of social insurance agencies and the signing of insurance contracts with medical establishments as well as the better cooperation between public and private hospitals to meet the growing demand for health check-ups.

Mr Khuong says, each year, the state spends more than VND700 billion from its budget helping poor people access medical services. In 2006, an additional 20 million poor people enjoyed preferential policies on health-checkups. Especially in 2007, the government increased the face value of a insurance card from VND60,000 to VND80,000 per year, contributing to ensuring equal treatment and the practical interests for the poor and limiting the impact of market mechanisms on average earners.

The number of medical insurance cardholders has also increased rapidly, therefore many private clinics have signed contracts to provide healthcare services for these people. At present, about 1,800 hospital and clinics are registered to provide medical treatment for medical insurance cardholders, and about 60 percent of communal medical centres have contracts to care for medical insurance cardholders. In addition, the healthcare system in schools has been greatly improved, and now offers first-aid services to millions of students and pupils. The rights of medical-insurance cardholders have been increasingly expanded.

Removing obstacles for private healthcare sector
Many hospitals and clinics face financial difficulties while implementing the socialisation of health services and Decree 43. Although the Government has allocated stable State budget, it could only partially meet the high costs of hospitals and clinics. Furthermore, it will cost more for medial work as of January 1 according to the law on minimum salaries as revenues are still very limited.

Otherwise, private investors in this field claimed that it is very difficult to access preferential credit loans so they have to take out loans with high-interest rates. There are also some shortcomings in tax policies which have not encouraged the health care programme.

To resolve these issues, Deputy Prime Minister Nguyen Sinh Hung says that there is an urgent need to boost the socialisation of health services. A series of measures aimed at resolving issues related to land and investment capital will be added to the new Decree on the socialisation work. The Government will grant more financial assistance and provide more land for hospitals and clinics to expand their operations and upgrade facilities, he adds.

Regarding tax policies, Mr Hung says it is necessary to offer preferential treatment to both State-owned and private medical centres. The State will soon adjust its tax policies reasonably, so that businesses investing in upgrading the infrastructure of hospitals and schools will enjoy tax relief for the first four years of operation and a 50-percent tax reduction in their fifth to tenth year of operation.

Meanwhile, more and more medical workers have moved from State-owned hospitals to private ones. Health Minister Nguyen Quoc Trieu says that State-owned hospitals should improve management and raise the quality of medical workers in order to increase the quality of healthcare services, attracting more investment and encouraging further contributions from doctors and nurses.

He reveals that State-owned hospitals will not be equitised, and that those hospitals that are already established will be allowed to cooperate with investors to set up new joint stock hospitals.

According to Mr Trieu, to help hospitals effectively implement Decree 43, the Ministry of Health and the Ministry of Home Affairs will provide instructions on recruiting personnel. Accordingly, hospitals will be able to make their own decisions, purchasing equipment and upgrading technology. Health officials will also build an adequate and accurate roadmap for hospital services to strike a balance between hospitals revenue and expenditure in the near future.