It gives the hospitals freedom to make decisions as it sees fit in various areas, from deciding on salaries for its employees or calling upon private funding to expand operations. Prime Minister Nguyen Xuan Phuc recently approved a decision to grant full autonomy for four hospitals for a trial period. It gives the hospitals freedom to make decisions as it sees fit in various areas, from deciding on salaries for its employees or calling upon private funding to expand operations.

Nguyen Ngo Quang, deputy head of the Department of Science, Technology and Training under the Ministry of Health, talked to Youth (Tuổi Trẻ) Newspaper’s weekend edition about the need for financial sources for health staff training.

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Nguyen Ngo Quang, deputy head of the Department of Science, Technology and Training under the Ministry of Health (centre).

It is required by law that doctors have to pursue 48 hours of extra training every two years. Who pays for such training?

Knowledge on medicines and medical techniques are changing rapidly. If doctors do not update themselves on such information, it would be very hard for them to meet the changing requirements of patient treatments. Currently there are two kinds of training for doctors. One is the compulsory 48 hours of extra learning, and the other one is based on each doctor’s choice. For instance, dentists can chose to have specific training on dental veneers. For the compulsory training, the hospitals have to pay and the funding will come from hospital fees. If doctors want to improve their professional skills to expand their scope as in the optional choice, they’ve got to pay for the training themselves.

But for hospitals that are switching to full autonomy, such training cost is not included in the hospital fees. In the long term, would there be a lack of funding for training?

I don’t think we have worry about that. The health ministry is well aware that training for doctors must be life-long and continuous. Hospitals that are switching to full autonomy can have the budget for doctors training from the hospitals’ investment and development fund.

In terms of training, we are also dividing the task of updating knowledge and skills for doctors into two groups. For the compulsory one, doctors can participate in conferences, seminars and specialised training courses. For the optional one, doctors can choose suitable courses to expand their professional scope. For these courses, the health ministry will have to evaluate the output quality.

How do you evaluate the quality of the extra training courses that have been delivered to doctors at local and grassroots hospitals in the past? Is it true that doctors at grassroots level have less opportunities to improve their skills compared to doctors at central levels or at major public hospitals?

I think the training courses provided to grassroots hospitals by the health ministry in the past are quite effective, but the health ministry can’t do everything itself. Local health departments and local hospital management authorities have to be responsible for providing training and knowledge to update their doctors.

We have the 1816 programme, which aims at improving the quality of primary health care at grassroots-level health facilities by sending doctors at central level to work at lower level hospitals.

But for this programme, the ministry could only supervise provincial level. Provincial hospitals need to provide support to hospitals at district or communal levels. And leaders of hospitals at these levels can even actively invite doctors from higher level hospitals to come and help training their doctors if they really want to improve and catch up.

Many say that doctors at central hospitals have more chance to go overseas for training courses, seminars while those at provincial or district levels find it hard to access to such opportunities. Is it possible that the health ministry could somehow monitor and allocate such opportunities?

I’m all in for doctors participating in training courses if they are capable of absorbing the knowledge and skills provided. I think if leaders of local hospitals truly care for improving their staff's skills and knowledge, they can find money for more training and co-operation.

For instance, leaders from Quang Ninh Province, Ninh Bình Province and Dong Nai Province have concerns about this. They have invited experts from China, from central hospitals like Bach Mai, Viet Duc, to help their doctors to acquire complicated medical techniques.

The health ministry can play its roles in creating the legal basis, but local authorities should have the responsibilities in making sure that their residents have better healthcare.

VNS