Decentralization and delegation of authority in licensing and certification of practice in the field of medical examination and treatment
Báo Tin Tức•10/11/2024
According to the working program at the 8th Session of the 15th National Assembly, on the afternoon of November 11 and the morning of November 12, the National Assembly questioned Minister of Health Dao Hong Lan on a group of issues related to the health sector, including the issuance of licenses and practice certificates in the field of medical examination and treatment.
Scene of the National Assembly session on the morning of January 7. Illustration photo: Doan Tan/VNA
The Ministry of Health said that, to date, the Ministry and local Health Departments have issued 66,795 operating licenses and 637,519 practice licenses/practice certificates in the field of medical examination and treatment (excluding the Ministry of Public Security and the Ministry of National Defense). Of which, the number of applications for operating licenses at the Ministry of Health accounts for less than 1.5% of the total number of operating licenses nationwide (795 applications). Problems in licensing and practicing certificates Since the beginning of 2024, the Ministry of Health has issued 28 new operating licenses to private hospitals (16 operating licenses in the same period last year, an increase of 75%); issued 57 decisions to adjust operating licenses due to changes in the scope of professional activities and changes in the scale of activities (48 decisions in the same period last year, an increase of 18.75%). Basically, the Ministry of Health has promptly completed the remaining files. Currently, the number of newly submitted applications for operating licenses that have not been assessed at the Ministry of Health is 5 files. The Law on Medical Examination and Treatment adds new regulations to re-issue practice licenses after 5 years for practitioners as well as increase the number of training in medical specialties, subjects granted practice licenses and synchronous policies to facilitate the development of private medical examination and treatment facilities. This leads to an increase in the number of applications for practice licenses (with additional professional titles for medical examination and treatment that are granted practice licenses), operating licenses (the form of medical examination and treatment facilities is organized more flexibly). Preliminary estimates indicate an increase of about 20% in the number of applications for practice licenses. The shortcomings and limitations in licensing and practice certificates in the field of medical examination and treatment mentioned by the Ministry of Health are that inspection and examination work has not been regular and thorough, and that authorities at all levels, relevant agencies and local people have not been mobilized to participate in inspecting and supervising private medical examination and treatment activities. Slow digital transformation due to problems in price development and appraisal, difficulties in bidding, lack of resources to upgrade software, leading to the inability to meet the requirements for connection, synchronization and data communication to implement Project 06 of the Government on "Developing applications of population data, identification and electronic authentication to serve national digital transformation in the period 2022 - 2025, vision to 2030". Lack of projects and programs to improve the capacity and quality of medical examination and treatment practice management. According to the Ministry of Health, most Departments of Health reported a lack of human resources for practice management, performing administrative procedures for granting operating licenses and practice permits, while the number of practitioners and medical examination and treatment facilities requiring practice licenses and operating permits is very large. The majority of staff also perform many other tasks in addition to managing medical examination and treatment, prevention, and assessment. There is a shortage of human resources for practice management due to the need to streamline the payroll every year, having to work multiple tasks while the workload continues to increase. Promoting digital transformation, decentralization, and delegation of authority Promoting digital transformation, decentralization, and delegation of authority in performing administrative procedures are solutions proposed by the Ministry to overcome the above shortcomings and limitations. The Ministry of Health said it will focus on implementing three breakthrough solutions in licensing medical examination and treatment activities, including: building a new appraisal process in the direction of streamlining, transparency, streamlining and shortening appraisal time; increasing the number of appraisal teams by 4 times and doubling the personnel performing state management of granting practice licenses and operating licenses; enhancing coordination between licensing agencies and facilities in training on guidelines for building appraisal dossiers. To promote decentralization and delegation of authority in implementing administrative procedures, the Ministry of Health has completed drafting documents and has sought opinions from 63 provincial and municipal People's Committees on decentralizing licensing authority in the field of medical examination and treatment; accordingly, it is expected to be issued in December 2024.
In addition, the Ministry of Health has also completed the review and is carrying out procedures to submit to the Government for consideration to continue to promote decentralization of authority according to the provisions of Decree No. 96/2023/ND-CP detailing a number of articles of the Law on Medical Examination and Treatment. After decentralization, it is expected that the Ministry of Health will reduce the number of administrative procedure files on granting practice licenses and practice permits by about 70%. To promote digital transformation, the Ministry of Health is developing and submitting to the Government a Decree regulating the national database on health to enhance the application of information technology in health management activities in general and medical examination and treatment activities, granting operating licenses and practice licenses in particular. At the same time, the national system for managing medical examination and treatment practices will be upgraded to meet the requirements of public information disclosure of medical examination and treatment facilities and practitioners in order to save time and human resources in practice management. In the administrative procedure reform, the Ministry of Health has developed 7 internal procedures for the content of granting operating licenses and granting medical practice licenses to provide specific guidance on documents and records for implementation, in order to gradually specify detailed documents so that businesses know the content and requirements of the records that need to be prepared. The internal procedure has been simplified compared to the previous procedure from 2 to 5 steps (depending on each procedure). The average time for carrying out procedures for granting operating licenses and granting practice licenses has been shortened by an average of 10% to 20% depending on each record (depending on the scale, form of organization, form, and case of issuance). The internal procedure also includes checklist templates to help speed up the appraisal process, ensure consistency in the process of processing records, and publicly and transparently disclose the contents, requirements, conditions, and supporting documents. In addition, the Ministry will strengthen inspection, examination and supervision, organize interdisciplinary inspection teams to inspect the activities of private medical examination and treatment facilities, strictly handle individuals and organizations if there are violations; establish inspection teams to inspect the medical examination and treatment inspection activities of the Departments of Health of provinces and centrally-run cities.
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