On the morning of May 29, the National Assembly held a plenary session to discuss the mobilization, management and use of resources for Covid-19 prevention and control; and the implementation of policies and laws on grassroots healthcare and preventive medicine.
Delegate Nguyen Van Huy (Thai Binh) said that the report of the monitoring delegation showed that there are still many shortcomings, obstacles and difficulties in grassroots medical activities.
Due to the lack of specific guidance when changing, there is a lack of uniformity and differences in the organizational models of district health centers and commune health stations. Conditions for drugs and equipment at commune health stations are not guaranteed.
This has led to a decrease in the rate of health insurance examination and treatment at commune health stations out of the total number of health insurance examination and treatment at all levels of technical expertise nationwide (from 19.8% in 2017 to 14.6% in 2022). Mr. Huy said that this is something worth thinking about and must have a solution.
In addition, the human resources and capacity of grassroots health facilities have not met the requirements, and the treatment regime still has many shortcomings.
Mr. Huy noted that it is necessary to clearly institutionalize the scope of district-level health care, commune-level health care, and village-level health care associated with the specific functions and tasks of each level, especially clarifying the functions and tasks of the grassroots health care level with 3 levels of technical expertise: initial, basic, and specialized.
Organizing the activities of commune health stations in conjunction with promoting comprehensive management of personal health, management of chronic diseases, non-communicable diseases, and community nutrition; linking school health activities with commune health stations.
In addition, it is necessary to pay attention to innovating the financial mechanism and payment mechanism of the health insurance fund in the direction of increasing expenditure on primary health care. Innovating policies and methods of training and fostering; improving the capacity of primary health care workers, especially those working at commune health stations. Implementing reasonable mobilization and rotation of doctors and health workers to examine and treat health insurance patients at commune health stations.
To overcome the situation of medical staff quitting or changing jobs, Mr. Huy suggested that there should be solutions to increase income, ensure salaries, allowances, and satisfactory treatment for medical staff in general and grassroots medical staff in particular, commensurate with the specific nature of the work and task requirements.
Concerned that in 10-15 years, health stations will have no doctors
Also talking about grassroots healthcare, Delegate Nguyen Thi Yen Nhi (Ben Tre) worried: "It must be admitted that although the grassroots healthcare network is organized synchronously and covers all communes, even hamlets and neighborhoods, it has not really met the needs, especially during the recent Covid-19 pandemic."
The primary health care system is overloaded, mainly due to a lack of human resources, equipment, facilities and regular doctors.
Ms. Yen Nhi analyzed the reason as the shift of doctors to the private sector and big cities, due to the policy of streamlining the payroll, and reaching retirement age. Meanwhile, new graduates are very reluctant to work at the grassroots health sector; conditions for local forces to go to school to improve their qualifications are also very difficult.
With the above situation, the female delegate said that "if there is no suitable policy soon, in about 10-15 years, health stations will not have doctors to work". Currently, the salary policy, allowances, and benefits for health workers are not commensurate with the time, cost of studying, labor effort, and working environment conditions.
Ms. Yen Nhi cited: "A university student majoring in medicine spends up to 6 years with quite high expenses, maybe nearly 200 million VND/year, but when graduating and working, he receives a salary of about 5 million VND/month."
The female delegate also pointed out the reality that at the medical station, there is only one person on duty each night, but there are often complicated emergency cases of fighting and traffic accidents. Medical staff, especially women, do not dare to be on duty alone. Sometimes, they have to have a relative accompany them, or ask a colleague to be on duty and then divide the pre-duty allowance.
However, the nightly salary is only 25,000 VND, and the food is 15,000 VND, such an amount is "very modest" compared to the effort put in.
The National Assembly member said that this was the reflection of the medical stations when the Ben Tre province monitoring delegation came to survey. With the current regime and policies, it is very difficult to attract and retain people to work at the grassroots medical facilities.
Therefore, Ms. Yen Nhi recommends that the Government and the Ministry of Health study policies to attract and retain grassroots medical staff, train and improve their qualifications, and invest in facilities and equipment for grassroots health care.
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