Need special, specific policies

The Ministry of Health has reported that after the Covid-19 outbreak, the health sector recorded nearly 10,000 health workers quitting or transferring jobs. One of the reasons for the large number of health workers quitting is that their income is too low compared to their standard of living.

15,000 VND for food is no longer appropriate.

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 and no longer suitable for the price situation. It 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, in which the main surgeon gets 280,000 VND/case. Such an allowance is really not commensurate with the doctor's labor.

If hospitals don't "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 the 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 regulating some specific allowances for civil servants, public employees, and workers in public health facilities and allowances for epidemic control. The amendments and supplements include: increasing allowances for surgery and procedures; increasing on-call and meal allowances for medical staff to reflect current inflation 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'm not sure how much it will increase, compared to the allowance that has been in place for a long time. But I think if someone is still wondering how much more money should be added for a doctor or health worker, they should think about when they or their relatives need to go to the hospital, get treatment and care. Therefore, they should decide, not think about it anymore," 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 of doctors' salaries and allowances, National Assembly representative Le Thi Ngoc Linh (Bac Lieu delegation) analyzed: Medical training typically takes a longer time, usually 6 years, sometimes up to 7 years, and the training costs are very high. However, upon graduation, doctors receive very low salaries, especially those working at the provincial and district levels, where salaries are even lower. Because of this, many doctors, after graduation, do not work at provincial hospitals but stay in cities for higher incomes. This leads to a shortage of personnel at the provincial and district levels, causing difficulties in providing medical care at these levels and affecting the public.

The healthcare sector is proposing an adjustment to allowances; I'm not sure by how much, compared to the allowances that have been in place for a long time. But I think that if anyone is still debating how much more money should be added for a doctor or healthcare worker, they should think about the time when they or their loved ones need medical treatment and care. Therefore, a decision should be made, instead of further debate.

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, stipulating that teachers' salaries are ranked at the highest level in the salary scale system for administrative and public service units. The medical field is also very important, because while teachers educate people, doctors and medical staff treat people. These are two very important fields that go hand in hand. Therefore, if possible, it is suggested that the National Assembly and the Government should consider the salary and allowance system for doctors and medical staff as well as teachers so that they can feel secure in their work of treating 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 for medical training is very high, especially at autonomous training schools, which are allowed to decide their tuition fees. Tuition for medical training is 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.

There is a need for incentives to retain skilled doctors in public hospitals to avoid disadvantaging poor patients who cannot afford the high costs of medical services.

"I believe that the medical profession, being considered a special profession, also needs special and specific policies, just like teachers. Currently, doctors and medical staff have the same basic salary as other civil servants. Some autonomous units may have additional income, but non-autonomous units or primary healthcare facilities without additional income face difficulties. This will make it hard to attract skilled doctors and medical staff to serve in remote areas and lower-level hospitals," Representative Nguyen Cong Hoang stated.

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 came into effect at the beginning of 2012, and has been in effect for over 12 years now. At the time the decision was issued, the basic salary was 830,000 VND/month. Since then, the basic salary has been adjusted 8 times and is currently at this level.

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.

This situation necessitates an adjustment to increase allowances, in order to match the efforts and living standards of healthcare workers, significantly improving their lives so they can focus on their work. I have repeatedly proposed adjusting the allowances for healthcare workers; this 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