HCMC attracts doctors to grassroots healthcare centers

On February 13, the People's Council of Ho Chi Minh City and Ho Chi Minh City Television (HTV) organized a program called People Ask – Government Answers, the topic of grassroots health - public health.

Chairwoman of the municipal People’s Council Nguyen Thi Le, Vice Chairman of the People's Council of Ho Chi Minh City Nguyen Van Dung and Vice Chairman of Ho Chi Minh City People's Committee Duong Anh Duc were attending the meeting.

Responding to a question from voter Pham Quang Lam in District 1 about the current status of grassroots health care operations, Deputy Director of Ho Chi Minh City Department of Health Nguyen Anh Dung assessed that the fourth wave of coronavirus pandemic has shown the overload of the city health system, especially grassroots health care.

Currently, the epidemic is under control, and grassroots health care is gradually returning to its usual functions as before. However, all medical staff in centers in districts are overloaded with work as they must undertake 19 national target programs on reproductive health care, child health, elderly health, and specific programs on TB and HIV/AIDS prevention and control.

Overcrowding is also a weakness of the grassroots health system, so the government necessarily pours more money into the sector to strengthen grassroots medical stations’ capacity as well as have specific policies so that grassroots health care can take on primary health care tasks.

Regarding how to attract personnel to grassroots medical centers, Deputy Director Lam Hung Tan assessed that at present, each medical station has only 5-10 medical staff; thus, they are unable to meet the requirements of epidemic prevention and care for people's health.

Ho Chi Minh City has a very large population, most of the wards have over 50,000 people, even there are wards and communes with over 100,000 people, so it is difficult for the health station to take care of the tasks. Consequently, Ho Chi Minh City has proposed the Ministry of Health, the Ministry of Home Affairs, and related ministries and agencies to approve to recruit more staff for each healthcare station in districts.

As per the city’s proposal, each health station has at least 10 employees over 20,000 residents, and for every 2,000-3,000 people, an additional employee will be recruited to ensure that it is suitable to the size, density, and structure of the population in densely populated areas.

In respect of medical examination and treatment covered by health insurance at health stations, Deputy Director of Social Insurance in HCMC Nguyen Thi Thu Hang said that presently, 178 medical stations implementing medical examination and treatment are covered by health insurance.

The number of health insurance cards registered for initial medical examination and treatment at health stations is just over 9,000 cards out of a total of more than 8.2 million health insurance cards in Ho Chi Minh City. In 2021, only 114,000 patients covered by health insurance visited medical stations in districts.

Medical stations in districts are not patients’ opt for medical examination and treatment because Ho Chi Minh City has a network of quality and dense first-class and second-class general hospitals, so people go straight to the general and specialized hospitals.

Deputy Director of Ho Chi Minh City Department of Health Nguyen Anh Dung revealed the Department of Health has submitted to the municipal People’s Committee the pilot program to grant practice certificates to newly-graduated doctors to practice at a general hospital in combination with a medical station. This pilot program is the key to increasing human resources for the health station in the coming time.

In particular, the Department of Health has software to increase the connection of medical stations with big hospitals, staff of grassroots health stations can directly connect and discuss with experts at the last-line hospital for medical consultation and treatment.

Mentioning income, Deputy Director Nguyen Anh Dung said, the city health sector is sending a petition to the Ministry of Health asking to consider how regimes and policies at grassroots health care to shorten the gap of salary between staff in primary healthcare stations and their peers in big infirmaries.

One more issue the city is proposing is that doctors at grassroots medical centers can use their professional practice certificates to perform out-of-hours medical examination and treatment according to the specialty of their practice certificate. This helps to motivate and contribute to increasing income for grassroots medical staff.

Deputy Director of Ho Chi Minh City Department of Home Affairs Lam Hung Tan said that the city is currently providing additional support for medical staff working at the grassroots health level with VND300,000-VND900,000 per person monthly.

However, he admitted that additional bonus still does not meet the requirements of retaining good doctors and nurses. Currently, Ho Chi Minh City is proposing to the People's Council of Ho Chi Minh City to apply an additional income coefficient for medical staff working at the grassroots level with a maximum level of 1.8 times the current salary and allowances. Along with that, they will receive more training of professional skills for grassroots health workers.

Deputy Director of the Ho Chi Minh City Department of Planning and Investment Tran Anh Tuan affirmed that investment in facilities for the health sector is prioritized. The city needs VND 10,700 billion for construction, renovation and upgrading of infirmaries in the period 2021-2025. Currently, the city has 79 projects waiting for the approval of the municipal People's Council.

Particularly in 2022, the city has allocated VND5,042 billion for 60 projects. Along with that, Ho Chi Minh City proposed to the central government to spend more capital from the socio-economic recovery and development program in the health sector for 178 projects with a scale of over VND6,500 billion including renovation and upgrade of 16 new preventive medicine centers in districts, districts and Thu Duc city with a capital need of VND206 billion and 152 health stations in wards and communes costing VND569 billion.

Speaking at the program, Vice Chairman of the People's Committee of Ho Chi Minh City Duong Anh Duc said that the People's Committee of Ho Chi Minh City will soon complete the project to improve the health capacity of wards to submit to the People's Council of Ho Chi Minh City for consideration and approval.

The project focuses on factors such as organizational network, facilities, equipment, human resource development, mechanisms, and policies to attract doctors and medical staff to work at health stations, effectively promoting the family doctor model.

Ho Chi Minh City also proposed the social insurance agency and the Ministry of Health to allow the city to pilot the health insurance payment mechanism for family doctor's clinics and take care of patients at home as well as supplement more chronic disease drugs for medical stations in districts to reduce the pressure of health insurance examination at big hospitals.

Vice Chairman of Ho Chi Minh City People's Committee Duong Anh Duc emphasized that the People's Committee will also direct departments, agencies, and localities to strengthen information technology applications and exploit data management software in the health sector at health stations to gradually develop the family doctor model. In addition, the city focuses on the operating model of health stations in the form of public-private to ensure the best community health care.

Vice Chairman of the People's Council of Ho Chi Minh City Nguyen Van Dung suggested that the city administrations need to develop and implement synchronous solutions to improve the quality of operation of health care at the grassroots level to attract people.

He also emphasized that it is necessary to develop sustainable solutions to strengthen and arrange adequate human resources for the grassroots health care level, to meet the requirements of people's health care in the new normal. Along with that, it is necessary to develop appropriate remuneration policies to create new motivations for the grassroots medical staff and attract medical staff to work at the grassroots health care level.