Public hospitals in Ho Chi Minh City will have to implement financial and managerial autonomy from October 1, but are facing many challenges in order to ensure successful operations according to the new model.
Financial autonomy is designed to help reduce State expenditures so that funds can be diverted to preventive medicine and targeted to community-care programmes.
Reduced State spending will also allow the State to pay for more health insurance cards for the poor, including those near the poverty line and welfare recipients.
Although hospitals are expected to become a high-quality service industry and will no longer be overloaded if they have more funding, some hospitals worry about financial shortages if the model is widely applied.
The newly built Cu Chi Hospital in Cu Chi district on HCM City’s outskirts has a capacity of 300 beds but attracts far fewer patients due to a lack of high-skilled doctors that reduces confidence in the quality of care, according to hospital director Ho Hai Truong Giang.
The hospital chiefly provides healthcare services for social welfare beneficiaries and families rendering great services to the revolution.
Giang said due to the lack of patients, the hospital’s total revenues are low. If autonomy is applied, the hospital’s State budget will be cut, preventing it from training staff and developing services and specialties to attract more patients, Giang warned.
He also suggested that autonomy should be applied gradually to ensure a smooth transition from State funding to a market mechanism.
Other small district-level hospitals, such as hospitals in Can Gio and Nha Be districts, face the same problem.
Deputy Director of the HCM City Department of Health Tang Chi Thuong admitted that hospitals will initially face difficulties because they rely solely on the State budget.
Director of District 2 Hospital Tran Van Khanh said some hospitals of lower quality and prestige that do not attract enough patients will face many difficulties when they implement full financial autonomy, making it harder for them to improve.
He advised hospitals to balance their spending and collection and carefully calculate costs to ensure efficiency and avoid unnecessary spending.
The District 2 Hospital is among 10 public hospitals chosen to pilot the autonomy mechanism from 2016. The hospital invested in improving infrastructure and purchasing equipment as well as in developing more specialty departments and using complex techniques to attract patients, according to Khanh.
Additionally, to satisfy patients, the hospital has also focused on administrative reform and improving medical workers’ attitudes towards patients, he said.
Sharing the same view, deputy director of the municipal health department Thuong said medical staff need to consider patients as customers to provide the best service in order to bring in money. “If hospitals do not treat patients well, they will not come back,” he said.
The health department will strictly supervise public hospitals after implementing autonomy, he said.
Eighty two hospitals have been granted autonomy since the city began implementing this policy in 2006, he said. Ten managed to mobilise all the revenues they need to operate while the remaining are able to fund themselves in part.