Minister of Health Dao Hong Lam said this was being done in response to proposals from Thai Nguyen voters, raised before the 9th session of the 15th National Assembly, calling for continued salary reforms, livelihood improvement for healthcare workers, and policies to attract and retain doctors in grassroots healthcare.

The Minister noted that, in addition to the salary framework under Decree No204/2004 and related amendments, healthcare workers receive allowances such as professional preferential allowances, special allowances, hazardous work allowances, allowances for areas with extremely difficult socio-economic conditions, and specific allowances for certain hospitals or village health workers.

Some localities, including Nghe An, Phu Tho, Hue, Bac Ninh, Quang Ninh, and Ninh Binh, have issued regulations on specific expenses to attract healthcare workers to grassroots and preventive healthcare.

For example, in Quang Ninh, under Resolution 28/2023/NQ-HDND, until December 31, 2025, resident doctors, master’s degree holders in medicine, or level-I specialists working in Ba Che, Binh Lieu, Dam Ha, or Co To health centers receive a one-time support of VND700 million. Six-year-trained doctors receive VND450 million, with an additional VND50 million for those graduating with distinction. 

Doctors working at health stations receive support ranging from VND200–500 million, depending on training and location. Female doctors or ethnic minority doctors receive 1.2 times the standard support.

Proposals to increase income

Lan said the Ministry is proposing a starting salary at tier-2 for doctors, preventive medicine doctors, and pharmacists upon recruitment. 

Also, the Ministry is drafting a decree to replace Decree No56/2011 on professional preferential allowances, expected to be completed in December (previously planned for June). The proposed allowance ranges from 30–70 percent.

The current special allowance regime (covering on-call duties, surgeries, procedures, and epidemic prevention) is deemed “too low and outdated” by the Ministry. A new decree on special allowances, epidemic prevention allowances, and support for health workers in the villages under development, is expected to be finalized in September.

Under the proposal circulated in April, allowances for surgeries or on-call duties in public hospitals could increase nearly threefold. For example, MOH proposed a surgical allowance for the main surgeon, anesthetist or main sedative at VND790,000, an increase of VND510,000 (more than 2.8 times) compared to the current level.

For village and residential group health workers and village midwives, MOH has proposed increasing the monthly support level by 0.2 basic salary levels (currently 0.5 and 0.3 basic salary levels).

Proposals to increase salaries and allowances for medical staff have been consistently raised by the Ministry and voters. Lan has said that 24-hour on-call allowances were very low and inadequate, especially given the longer training periods compared to other professions. Under the latest regulations, doctors require six years of medical school and at least 12 months of practical training to obtain a practice license.

MOH reported that from early 2021 to mid-2022, nearly 10,000 healthcare workers nationwide resigned, with the highest numbers in HCM City, Hanoi, Dong Nai, An Giang, and Da Nang. Key reasons included economic pressures, low income, and the desire for better working environments.

Regarding healthcare policy, voters proposed requiring doctors to serve at least two years in grassroots disease prevention and treatment before working elsewhere. The Minister noted this suggestion and said the Ministry would coordinate to study appropriate policy proposals.

Service fees

Voters from many localities have called for adjusting healthcare service fees to fully cover costs, ensuring sufficient funding for healthcare facilities to operate.

Responding to these proposals, Minister of Health Dao Hong Lan noted that the 2023 Law on Medical Examination and Treatment stipulates that healthcare service fees are determined based on four factors: direct costs, labor (including salaries), management costs, and depreciation costs.

Currently, healthcare service fees only cover direct costs and salaries, while excluding management and depreciation costs. The inclusion of salaries in pricing was officially implemented on June 1, 2017.

However, the head of the health sector said that adjusting healthcare service prices “requires caution and a phased approach,” based on evaluations of CPI. 

This aims to ensure reasonable price adjustments while controlling inflation, stabilizing the macroeconomy, supporting universal health insurance coverage, and aligning with people’s ability to pay and the balance of the Health Insurance Fund.

Lan said her ministry is assessing the impact and proposing a timeline for incorporating management costs into healthcare service prices, with a report to be submitted to authorities for approval of the timeline.

Vo Thu