VietNamNet Bridge - The structure of the health sector is disturbed and it no longer fits the current situation (the half-subsidized health sector operating in the market economy).
Human resource problem, according to the medical experts, is the macro problem facing the health sector. How to remove the "bottlenecks" of the health sector?
Tightly control the quality of human resource training
Deputy Minister of Health -- Nguyen Viet Tien, said at a recent conference that human resources is the most important resource determining the scope and quality of health services.
However, Tien had to admit that it is necessary to seriously consider the training quality of physicians, due to the fact that the new doctors cannot work independently after their graduation. In large hospitals, doctors who graduated for 5-6 years still need professional mentoring.
Mr. Vu Xuan Phu, Deputy Director of the Central Lung Hospital, described the fact of the health sector: While many officials and employees in state departments are overloaded with work, a large number of students of medical schools cannot find suitable jobs. That fact raises questions about the quality of education.
In other countries, in higher education, they control the output in the pyramidal form to screen a team of qualified health workers. In Vietnam, medical education training is defined as "special training" but it is very difficult to control the quality of graduates of medical schools.
In recent years, seeing the high demand for medical staff, many universities and colleges that are not specialized in medical training have offered medical training courses and their entrance exams are quite easy, raising concerns about the quality of the future doctors.
In an interview with VietNamNet about this phenomenon, Deputy Minister of Health Nguyen Viet Tien said that it is not because of lack of medical staff to suddenly increase the number of medical students because the medical sector is not allowed to “produce” products of poor quality.
Tien also said that medial training programs need to be reconsidered. These programs were appropriate in the past but they are no longer suitable to the current developments.
Mr. Vu Xuan Phu said Vietnam should clearly identify the grounds for training needs. The disease pattern in Vietnam is changing quickly, requiring urgent changes from medical schools to enhance the quality of human resources.
In addition to training programs, the recruitment of medical students for specific subjects is also a concern. In fact, many subjects such as tuberculosis, leprosy, mental illness, are at risk of "extinction” because they fail to recruit enough number of new students.
Reforming the health sector structure is a must
The "Human Resource Development Planning from 2011 - 2020" of the Ministry of Health aims to build a medical workforce that meets the healthcare quality, structure and reasonable distribution to contribute to improving the quality of healthcare services.
Accordingly, the health sector strives for reaching the goal of having 52 health workers (all subjects,) 10 doctors and 12 nurses for every 10,000 residents by 2020. The plan also proposes solutions for human resource development, including the grant of welfares and allowances for medical staff. At present, Vietnam has 40.5 medical workers for every 10,000 people, including nearly 7 doctors per 10,000 inhabitants.
If Vietnam has enough doctors, it is still a problem in the structure and distribution of doctors. It is an age-old story that doctors only want to work in big cities in search of better career. That is the legitimate needs of every human being. So what measures that the health sector has to use to solve this situation?
According to Mr. Tran Tuan, Director of Research Center for Training and Community Development, the structure of the health sector at present is disturbed and it no longer matches the new situation (the half-subsidized health sector operates in the market economy).
This has made a series of problems, including those of human shortcomings (as mentioned in the article), which is a "black spot" that makes the health care system less efficient.
Mr. Tran Tuan said that the first "no longer appropriate" thing is that the system of public health services is divided in levels and the investment is poured based on that division (commune, district, provincial and central levels).
That system leads to a consequence that hospitals at a specific level are limited to the certain medical services. As such, only hospitals of higher levels can develop while hospitals at the lower level are hindered from growth. It just makes sense to the people that only hospitals of the higher levels can perform high tech services. At the same time it explains the reason why doctors prefer to work at hospitals of higher levels.
"The hospitals of higher levels offer doctors with opportunities for skills development and high income earning. A doctor who works at a grassroots-level hospital for several years became a “village doctor” because he only has the opportunity to cure flu. His friends, who graduated at the same time with him, have become famous doctors after several working at big hospitals in big cities. What is your choice after graduation? These are legitimate needs of each physician," analyzed Tuan.
Tuan suggested changing the current structure of the health sector to deal with the above problems. He said that it is necessary to completely socialize health services, except for preventive medicine and grassroots health.
Besides the problems associated with the quality of medical human resources, there are many issues with the medical leaders, Tuan pointed out. He said that medical managers only operate within their available resources and their fields of operation. Therefore, they do not have an overview and lack cooperation with other sectors to address the problems to the root.
The temporary solutions
The Ministry of Health is carrying out a series of project to solve these shortcomings, including the projects to develop satellite hospitals, medical staff rotation, and bringing voluntary young doctors to work in mountainous and remote areas.
Mr. Nguyen Tuan Hung, deputy director of the Department of Organization and Personnel of the Ministry of Health, said under the latest project, excellent medical graduates who voluntarily work in poor districts will be trained for free for 20 months and is certified according to the training courses. In particular, before going to work in remote districts, they will be officially recruited by a big hospital. These doctors will also be provided with a lot of other incentives.
This project is assessed to be temporary but necessary in the current context of the health sector, the Ministry of Health said that in the long term, the country still has to train enough doctors and has policies to allocate medical resources reasonably.