Many doctors are concerned that even though the basic salary increases, their income may not increase - Illustration: NAM TRAN
But in revenue-generating public service units, including hospitals with autonomy in regular spending, the price of medical examination and treatment services has not increased, while revenue remains the same, making hospitals "half happy, half worried".
"Tug of war for a raise"
Especially for hospitals that rely mainly on health insurance for medical examination and treatment, salary increases are a challenge for balancing financial resources.
Speaking with Tuoi Tre, Mr. Nguyen Van Thuong, director of Duc Giang General Hospital (Hanoi), said that increasing wages will help improve workers' lives, especially when market prices and living costs are increasing.
However, for hospitals with autonomous regular expenditures, there will be certain difficulties.
Mr. Thuong is concerned that the current price of medical examination and treatment services is calculated based on the basic salary of 1.8 million VND, so when the basic salary increases to 2.34 million VND and the service price remains the same, it will make it difficult for the hospital to balance its revenue and expenditure.
"The hospital is reviewing positions and resources, we plan to use the salary stabilization fund to ensure salary increases for employees.
"When there is an official salary table, specific instructions will be given to increase salaries," said Mr. Thuong.
Director of Dong Da General Hospital (Hanoi) Nguyen Dinh Phuc also said that the hospital is currently waiting for specific instructions on salary tables to apply immediately, ensuring the rights of workers.
Mr. Phuc also said that the common difficulty of autonomous units in regular spending is balancing revenue and expenditure after the basic salary increase. Hospitals need to improve their revenue sources, but currently the price of medical services is not calculated correctly and fully.
In the immediate future, the hospital will have to balance its funds to pay salaries to employees, waiting for the adjustment of medical service prices. Only then can it ensure salary increases for employees.
Patients come to see a doctor about skin problems at the Dermatology Hospital in Ho Chi Minh City - Photo: X.MAI
Salary increase, but worry about not increasing income
Doctor Ha Ngoc Cuong, Phu Tho General Hospital, expressed his joy when the basic salary increased to 2.34 million VND.
Currently, with a salary coefficient of 2.67, Dr. Cuong's monthly income is nearly 6.6 million VND (including salary and allowances). This salary adjustment is suitable for the current increasing costs, helping doctors and nurses increase their income.
However, Dr. Cuong also expressed concern for hospitals: will increasing salaries increase income for medical staff?
"While medical service prices do not increase, it means that hospital revenue does not increase, so hospital leaders will have to balance revenue, and year-end bonuses and benefits will have to be reduced.
If the unit receives state budget and is not self-sufficient in spending, the salary will increase more clearly. Therefore, for hospitals, increasing salary does not necessarily increase income," Mr. Cuong commented.
Doctor Nguyen Dinh Lien, E Hospital (Hanoi), also said that increasing the basic salary for medical staff when service prices are not fully calculated will lead to "increasing salaries but not increasing income".
Mr. Lien said that the increase in the general base salary for civil servants approved by the National Assembly is a good sign when the consumer price index has increased in recent times.
"However, for a unit with autonomous regular spending like our hospital, there are not many changes.
Even after adjusting the price of medical examination and treatment services according to the basic salary, the income of medical staff will not change much because the increase in service prices is only enough to cover the basic salary and offset the increasing living expenses of staff.
But hospitals will still have difficulty balancing revenue and expenditure, and will not have the resources to invest in and improve facilities and equipment.
Besides, the current preferential policies to attract medical staff are still limited, many doctors cannot "stay" at public hospitals and move to private medical facilities.
In the long term, it is necessary to solve the requirement of calculating service prices correctly and sufficiently, so that public hospitals have more resources to invest, develop comprehensively, and ensure the lives of workers," he said.
Sharing the same opinion with Dr. Lien, a doctor working at a tertiary hospital in Ho Chi Minh City shared that if salaries increase but the hospital has to deduct salary funds to pay, "squeezing" other sources of expenditure, then the additional income for medical staff will also be "squeezed".
At the same time, when there is no source to compensate for year-end bonuses, Tet bonuses, rewards, and benefits, there will be even less, or even no, benefits.
In the long term, it is necessary to adjust the price list for medical examination and treatment appropriately so that the hospital can increase its revenue, the new income "pie" will expand, and by the end of the year, the total income of the hospital will increase and take care of the lives of workers.
Worried because revenue is still the same, where is the money to increase?
According to the leader of Bach Mai Hospital, currently a large proportion of hospitals nationwide implement a mechanism of autonomy in regular spending, which means using revenue to pay salaries, surgical and procedural allowances, professional activities (management, maintenance, etc.), and expenses for performing scientific and technological tasks.
The basic salary increases but the income remains the same, the "pie" remains the same so we have to stretch to divide it.
Therefore, according to this person, if salaries increase, allowances and bonuses may decrease, otherwise the fund will be in deficit. "Hospital fees are currently only calculated at 2/4 of the input factors, while management costs and equipment depreciation have not been calculated.
Costs for security, accounting, cashiers, information technology, and even management are not included in the hospital fee structure.
We hope to soon calculate hospital fees in the direction of calculating correctly and fully, with health insurance of many denominations and payment levels. With the current collection level, salaries will increase but in the medical sector, income will not increase at the corresponding salary increase level" - this person shared.
Need to calculate correctly and fully the price of medical examination and treatment services
In Ho Chi Minh City, hospitals that are self-sufficient in regular spending, especially those whose main source of income is from health insurance-covered medical examination and treatment, said they faced many difficulties when the basic salary increased but the price of medical examination and treatment services remained the same.
A leader of a district hospital in Ho Chi Minh City said that increasing the basic salary is a good thing for workers, in line with current market prices.
For district hospitals, the main source of revenue is health insurance. Currently, the price of medical examination and treatment services covered by health insurance has not increased, but the basic salary has increased, leading to the hospital not being able to find a source to compensate.
In the immediate future, the hospital will review all lists of cadres, civil servants, and public employees, and plan to use the salary reform fund to pay salaries in advance to medical staff in accordance with regulations.
Although the hospital is small, it has to pay its workers about 600 million VND each month.
"Hospitals are autonomous, basic salaries increase, but the "pie" remains the same.
When allocating funds for salary reform, other items will be reduced, so salary increases will not have significant improvements for autonomous units, except in cases where there is a large budget, which will improve.
In the long term, it is necessary to adjust the price of medical examination and treatment services under health insurance appropriately, accurately and sufficiently to create motivation for hospital development," he said.
Source: https://tuoitre.vn/tang-luong-co-so-tu-1-7-benh-vien-tu-chu-thap-thom-mung-lo-20240630225946811.htm
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