Improving the quality of primary health care: Localities need to be more proactive

SGGP 10/28/2023 10:54

On October 19, 25, 26, and 27, the monitoring delegation of the Standing Committee of the Ho Chi Minh City People's Council, led by Vice Chairman of the Ho Chi Minh City People's Council Nguyen Van Dung, visited a number of districts to monitor the implementation of strengthening and improving the capacity of grassroots healthcare and taking care of people's health.

Retired doctor participates in medical examination and treatment for people at Tan Thoi Nhi Commune Health Station, Hoc Mon District, Ho Chi Minh City

Major shortage of staff

At the monitoring session of the delegation in Hoc Mon district, Dr. Ngo Cao Dung, Deputy Director of Hoc Mon District Medical Center, said that the total number of doctors working at the district medical center and health stations is 35 out of a total of 60 staffing targets. Of which, there are only 13 doctors in 12 health stations, in charge of over 420,000 people and 3 doctors do not have a practice certificate. There are 2 health stations lacking the position of station chief: Tan Thoi Nhi Commune Health Station and Xuan Thoi Thuong Commune Health Station. "For the past 3 years, we have not been able to recruit doctors to work at health stations, leading to people criticizing the stations, so the health stations only have an average of 150-200 visits/day. This is a very low rate if we consider the scale of people registering for medical examination and treatment at health stations with health insurance cards throughout the district," Dr. Dung admitted.

In Binh Chanh district, it is quite convenient when the Tan Kien Medical Cluster and a number of Central hospitals are located in the area, providing professional support and human resources for the grassroots health sector, so currently 16 health stations have 2-3 doctors/station. Thereby, in 9 months of 2023 alone, Binh Chanh district's grassroots health care has examined and treated nearly 20,000 patients. In the long term, according to Circular 03 of the Ministry of Health dated February 17, 2023 on guidelines for job positions, quotas for the number of employees, and the structure of civil servants according to professional titles in public health service units and considering the total population in the area, compared to the current 135 medical and medical staff, the district will lack 189 doctors. Binh Tan district currently lacks 34/233 staffing targets, and according to Circular 03, the district lacks 163 medical and medical staff.

In addition to the lack of medical staff, some medical centers, especially health stations, also face difficulties due to degraded facilities, outdated medical equipment, and lack of health insurance drugs, making it impossible to organize health insurance examination and treatment; and a serious shortage of doctors specializing in ear, nose, throat, and maxillofacial surgery. Localities are also slow in handing over public assets including facilities, finances, and personnel of medical centers previously managed by the Ho Chi Minh City Department of Health to districts, so renovation and repair cannot be carried out.

Still passive

Dr. Nguyen Huu Hung, Deputy Director of the Ho Chi Minh City Department of Health, said that the difficulty in allocating personnel has been a difficult point for the industry so far. However, most localities have not been really proactive in this work, because some districts are still lacking 25-40 staffing quotas. This is a problem in the recruitment stage. Regarding the shortage of drugs, especially drugs on the health insurance list, the city has sent a document requesting the Ministry of Health to allow the city to expand the list of local bidding at the earliest time.

Tan Thoi Nhi Commune Health Station (Hoc Mon District) has been used for over 20 years and is now degraded.

The delegates of the HCMC People's Council also requested that the locality should do a good job of on-site training and education; be bold in bidding for drugs; connect electronic medical records, and improve the information technology level of medical staff to better manage medical records. "The People's Committees of districts and towns need to advise the district and town Party Committees to have their own resolutions on improving the quality of primary health care; research and develop career guidance projects, recruit high school students with a passion for medicine in the area, and send them for training with funds from the budget. They will be an important local resource, making up for the shortage of local human resources," emphasized Mr. Cao Thanh Binh, Head of the Culture - Social Committee of the HCMC People's Council.

Vice Chairman of the Ho Chi Minh City People's Council Nguyen Van Dung said that Resolution 01/2022/NQ-HDND dated April 7, 2022 of the Ho Chi Minh City People's Council was issued not only to prevent the Covid-19 epidemic but also other epidemics. Resolution 01 also aims to improve the quality of grassroots health care, synchronous and modern investment in the end-line health system, to take better care of the health of people in Ho Chi Minh City and the Southern region. Therefore, the Ho Chi Minh City People's Council organized supervision sessions to re-evaluate the health sector and localities over 3 years of implementing Resolution 01 on specific policies to strengthen and improve the capacity of ward, commune and town health stations in the period of safe and flexible adaptation, effective control of the Covid-19 epidemic; What difficulties and obstacles are there in the Community Health Development Project to protect, care for and improve the health of people in the city in the period of 2021-2030 to supplement mechanisms and policies to successfully implement the resolution? "In the near future, the Department of Culture and Society, the People's Council of Ho Chi Minh City will work with the Management Board of Investment Projects for Construction of Civil and Industrial Works of Ho Chi Minh City - the unit assigned by the People's Council of Ho Chi Minh City to be the investor in building new, upgrading, renovating and purchasing equipment for 146 commune and ward health stations in the city so that the project can be implemented in the first quarter of 2024", Mr. Nguyen Van Dung emphasized.

Mr. Nguyen Thanh Sang, Permanent Vice Chairman of District 8 People's Committee, said: "Resolution 01 of the Ho Chi Minh City People's Council is a source of encouragement and motivation for grassroots health care to overcome difficulties, has supplemented a significant mechanism and funding source to support grassroots health care in the district to successfully complete the task of providing primary health care for the people. In particular, thanks to Resolution 01, the recruitment of doctors and physicians has achieved positive results. Out of 16 health stations in District 8, there are currently 8 health stations with 2 doctors, 3 health stations with 3 doctors, 1 health station with 4 doctors and 1 health station with 5 doctors. All doctors have practice certificates and 100% of health stations have security guards and cleaning staff. Facilities and medical equipment have been invested; ensuring adequate health insurance drugs to serve the people".

Source: https://www.sggp.org.vn/nang-chat-y-te-co-so-dia-phuong-can-vao-cuoc-chu-dong-hon-post711696.html