According to the Ministry of Health, after the Covid-19 outbreak, the health sector recorded nearly 10,000 health workers quitting or transferring jobs. One of the reasons why a large number of health workers quit their jobs is that their income is too low compared to their standard of living.
15,000 VND FOR MEALS IS NO LONGER SUITABLE
According to Mr. Nguyen Tri Thuc, Deputy Minister of Health, Director of Cho Ray Hospital (HCMC), Decision No. 73/2011/QD-TTg dated December 28, 2011 of the Prime Minister stipulates allowance levels for civil servants, public employees, and workers in public health facilities and epidemic prevention regimes including: regular allowance, surgery and procedure allowance, epidemic prevention allowance and meal allowance. After many years of application, with the current socio-economic and living conditions, the applied allowance levels are no longer suitable and need to be adjusted to match the labor force.
Some opinions of National Assembly delegates said that salary and allowance policies for doctors need to be improved.
Typically, the 24/7 on-call allowance is 115,000 VND/person/shift, and the meal allowance is 15,000 VND/person/shift for grade 1 and special hospitals. This is too low, no longer suitable for the price situation, and needs to be changed in the direction of increasing so that workers can regenerate their labor force, especially those in the medical and health care sectors.
Similarly, the surgical allowance of the main surgeon for a special surgery is 280,000 VND/case, and for a type 1 surgery is 125,000 VND/case, which is no longer appropriate. A special surgery usually lasts 4-6 hours, even over 8 hours, but the total allowance is only 1.48 million VND for a surgical team of 7 people, of which the main surgeon receives 280,000 VND/case. Such an allowance is really not commensurate with the doctor's labor.
If we cannot "retain" good doctors in public hospitals , poor patients will suffer.
The Ministry of Health is developing a proposal to increase surgical and procedural allowances, increase on-call pay, and increase meal allowances for medical staff in line with the current inflation index and consumer prices. This proposal replaces allowance levels issued since 2011, and is expected to be issued in 2024.
In addition, the Ministry of Health is amending and supplementing Decision No. 73 on the regulation of a number of special allowances for civil servants, public employees, and workers in public health facilities and the anti-epidemic allowance regime. The amendments and supplements include: increasing surgery and procedure allowances; increasing the level of on-duty and meal allowances for medical staff in accordance with the current inflation index and consumer prices.
Sharing more about professional allowances, a director of a surgical hospital in Hanoi said that the current allowance for surgeons is 150,000 VND/case, regardless of whether it is a common surgery or a major surgery. "Saving a life is priceless, we should not discuss the "price" of life. However, we need to ensure that doctors at public hospitals have a suitable income to cover their living expenses, take care of their families, and pay for their children's education," he said.
"The health sector is proposing to adjust the allowance, I don't know how much it will increase, compared to the allowance that has been applied for a long time. But I think that if someone is still wondering how much more money should be added for a doctor or health worker, then think about when they or their relatives need to go to the hospital, get treatment and care. Therefore, a decision should be made, not wondered about any more," a doctor shared.
This doctor said: "It is true that many doctors from public hospitals have moved to private hospitals with much higher salaries. But do not discriminate against them, do not say that it is a brain drain, because they do their jobs well everywhere. Doctors everywhere work with their professional capacity. However, the issue that needs attention is that good doctors moving to private hospitals is only for the rich, while health insurance patients and poor patients have less opportunity to be examined and treated by good doctors. Therefore, if we do not "retain" good doctors in public hospitals, poor patients will be at a disadvantage."
C. SALARY AND ALLOWANCE POLICY NEEDS IMPROVEMENT
Sharing her perspective on the inadequacies in doctors' salaries and allowances, National Assembly delegate Le Thi Ngoc Linh (Bac Lieu delegation) analyzed: Training doctors usually takes a longer time, normally 6 years, it can be up to 7 years, and the cost of training is also very high. However, when doctors graduate, their salaries are very low, especially for doctors working at the provincial and district levels, whose salaries are even lower. Therefore, many doctors after graduation do not work at the provincial level but stay in the city to have a higher income. This leads to a shortage of human resources at the provincial and district levels, causing difficulties in medical examination and treatment at these levels, affecting the people.
A doctor in Hanoi
Therefore, the salary and allowance policies for doctors and nurses need to be improved. This will help attract young, talented doctors and nurses to work at the provincial and district levels. When the medical examination and treatment capacity of the provincial and district levels is improved with good human resources, it will limit the number of patients who have to go to higher levels for medical examination and treatment. This will ensure better health care for the people, support and promote people to participate in health insurance, and attract talented doctors and nurses to the provincial and district levels.
Currently, the National Assembly and the Government are very concerned about teachers' salaries, and have set teachers' salaries at the highest level in the salary scale and table of administrative and career units. The medical sector is also a very important sector, because if teachers train people, doctors and nurses do the work of saving people. These are two very important fields that go hand in hand. Therefore, if possible, it is recommended that the National Assembly and the Government consider the salary and allowance regime for doctors and nurses as well as teachers so that they can feel secure in their work of saving people and contributing to society.
Faced with the reality of "expensive" medical training costs, National Assembly delegate Nguyen Cong Hoang (Thai Nguyen delegation), Director of Thai Nguyen Central Hospital, said that the current tuition fees for medical training are very high, especially at autonomous training schools, which are allowed to decide their tuition fees. Tuition fees for medical training are very high compared to the average level of other vocational universities. In addition, medical training is also longer, and after graduating as a doctor, you still have to continue studying.
We need to provide incentives to "retain" good doctors in public hospitals to avoid disadvantages for poor patients who cannot afford high fees for medical services.
"I think that the medical profession is considered a special profession, so it also needs special policies, similar to teachers. Currently, doctors and nurses have the same basic salary as other civil servants. Some autonomous units may have some additional income, but non-autonomous units or grassroots health care units without additional income will also have some difficulties. And it will be difficult to attract good doctors and nurses to serve in remote areas and lower-level hospitals," said delegate Nguyen Cong Hoang.
Delegate Hoang also said that there should be a better salary and allowance policy for doctors and nurses, and that a law on doctors and nurses similar to the Law on Teachers currently being submitted to the National Assembly could be studied. Only then, according to Mr. Hoang, can there be a strategic solution to develop grassroots healthcare.
Adjusting allowances should have been done a long time ago
Decision No. 73/2011 took effect in early 2012, more than 12 years ago. At the time of the decision, the basic salary was 830,000 VND/month. Now, the basic salary has been adjusted 8 times, currently at
2.34 million VND/month, meaning an increase of 182%, but allowances related to surgery, procedures, on-call pay and meals have not been adjusted accordingly.
The above reality requires an increase in allowances to match the efforts and living standards of medical staff, helping to significantly improve the lives of medical staff so that they can work with peace of mind. I have repeatedly recommended adjusting allowances for medical staff, which should have been done a long time ago.
Deputy Minister of Health Nguyen Tri Thuc
Source: https://thanhnien.vn/dao-tao-bac-si-nghich-ly-hoc-phi-va-luong-can-chinh-sach-dac-biet-dac-thu-185241024220908563.htm
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