Vietnam seeking mechanism to maintain healthcare staff in public hospitals

Being the Head of the Neurosurgery Department in a public hospital in Ho Chi Minh City, C.T.S. has spent over 2 years fighting against Covid-19 with his colleagues in various locations. He then decided to move to a private hospital, saying that even though the salary of senior doctors in public hospitals has lately increased, he still had to shoulder much pressure and exhaustion both from work and from the community, especially after recent law-breaking cases in the medical field. He switched to a private hospital to enjoy more benefits and less pressure despite being harder to improve professionally.

Similar stories to C.T.S. are not difficult to meet all over Vietnam, particularly in major cities. Statistics from Hanoi Health Department reveal that only in the past 18 months, 860 healthcare employees in the city have quitted their job or moved to private hospitals. Many of these are experienced doctors. The same is happening in HCMC, where more than 1,100 healthcare employees stopped or changed their workplace last year, including 274 doctors and 610 nurses. This year, nearly 900 people continue to follow the trend.

The Health Ministry informed that the regions with the highest number of healthcare staff quitting their job are HCMC, Hanoi, the provinces of Dong Nai, Binh Duong, Long An.

Deputy Minister of Health Do Xuan Tuyen stated that the main reason of this tendency is low salary and disproportionate benefits in public hospitals to ensure the living standards, while those in private hospitals are much more attractive. High pressure and labor intensity in the former location since the beginning of the Covid-19 pandemic is also a prominent cause. They have affected the mental health of those laborers. Recent law-breaking cases detected in the medical field have also play a part to make the situation worse.

Explaining the above opinion in more details, Dr. Nguyen Huy Quang, former Head of the Legal Department under the Health Ministry, said that VND5-7 million a month (US$213-300) is the salary of a doctor in a public hospital with 10 years of experience to become reliable enough. This is ironically even lower than the salary of a housekeeper in major cities, at VND7-10 million per month ($300-427), not to mention much more pressure and demands from patients each day. It has left doctors with no time to relax properly to regenerate themselves.

Working in a private hospital, they feel more comfortable and ready to dedicate since they receive corresponding benefits and suitable salary for their devotion.

On seeking possible solutions to amend the situation, Deputy Minister Do Xuan Tuyen shared that the Health Ministry is proposing the Government to increase benefits from 40-70 percent to 100 percent for officials in the medical field as regulated at Article 3 of Decree No.56/2011/ND-CP, released on July 4, 2011.

Director of the HCMC Department of Health Tang Chi Thuong said that to maintain the healthcare staff in public hospitals around the city, his department has created a forum to collect opinions from these employees and give timely feedback to boost their working spirit. The department is developing policies to attract more laborers to public hospitals, especially those performing duty in grassroots clinics.

Stressing the importance of address the current job quitting trend in public hospitals, Assoc. Prof. Dr. Do Van Dung – Head of the Public Health Department in HCMC University of Medicine and Pharmacy – stated that the trend in a short term is affecting services to patients, but in a long term is creating a negative impression on the mind of the next doctor generations.

Public hospitals are the primary location for the training and practice of the healthcare staff and students. If most good doctors transfer to private ones because of better benefits and salaries, modern medical equipment and medicine, there will be a serious lack of senior teachers for next medical student generations, and thus unable to receive sufficient and proper training to improve their profession.

To tackle the issue, the Prime Minister has just asked that the Ministries of Health, Justice, Home Affairs to cooperate in reviewing regulations related to the structure and human resources of the medical field; boosting the mobilization of resources in the community to support medical human resources, especially those in grassroots clinics; creating a clear legal frame for public-private partnership in the medical field; encouraging financial autonomy in public medical organizations; preparing a method to precisely calculate medical service fees in public hospitals; and checking the unbalance status in each locality for corresponding adjustment to help one another.