VietNamNet Bridge - More than half of the patients who should be treated at the district level hospitals and more than one third of those only needing treatment at the provincial level hospitals go to central level hospitals for treatment. Approximately 94 percent of patients at the Hanoi-based Central Pediatrics Hospital can be treated at the hospitals of lower levels.


Health sector faces a workforce crisis

Human resources training for healthcare in trouble


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In the medical field, the human factor plays a decisive role. The disease itself is different in each patient. Each patient is a problem. Doctors must have sufficient knowledge and ability to detect and resolve problems. Machinery and equipment are only the tools to help physicians to accomplish that.

From the story of the obstetric sector

Sharing the above point of view, Mr. Vu Xuan Phu, deputy director of the Central Lung Hospital, said the number of physicians is important but it does not guarantee for the treatment.

"The survival of patients can only be done if there are qualified and experienced doctors who can make accurate diagnosis and treatment methods. In the health care system, the quality of human resources occupies the top position," he stressed.

So, we can say that the human resources in the medical sector is the "knot of the knots." Health care is a particular market that is not like any other market because it relates directly to human life.

The year 2012 witnessed the high increase of obstetric accidents.

According to statistics of the Department of Maternal and Children Health, within six months of the year there are 88 fatal cases. Of these, there are only 28 deaths related to the available diseases of the mothers and the infants. Up to 60 cases of fatal accidents in which the mother or both the mother and her child died are due to events occurring during the labor.

In addition, of the 88 deaths, there are ten cases occurring at home, 14 on the road to the hospital and the remaining 64 deaths in hospitals.

Besides the objective factor that people preferred having babies in the year of the Dragon, which made the increase of the number of pregnant women, resulting in the rise of complications; the main reason is the poor expertise of obstetric doctors, especially those working at hospitals of the district or provincial levels.

Talking to the press, Mr. Nguyen Duy Khe, head of the Department of Maternal and Children Health, said the human resources at district and provincial hospitals are both insufficient and poor, particularly at the district-level hospitals. Khue cited an example that a doctor who is specialized in internal medicine was assigned as the head of the obstetric ward of a district-level hospital in HCM City because the hospital lacked obstetric doctors.

In Nghe An province, many district hospitals have only one obstetrician and some hospitals do not have a single pediatric pediatrician.

In that situation, whether the patient can entrust their health and their lives to such hospitals and such doctors?

Bone cancer diagnosed as arthritis

The story of Mrs. Luyen Thi Tan, 40, from Lang Giang district, Bac Giang province is typical for describing the way from district hospitals to central hospitals and it clearly explains why the people always prefer medical services at central hospitals.

Since early 2011, Tan’s daughter - Doan Phuong Thao, 9, began feeling arm fatigue when writing. Tan took her daughter to a private clinic, where she was diagnosed of arthritis. The girl was treated for a long time but she did not feel better. The child was taken to the district hospital and she received similar diagnosis.

Thao’s arthritis continued to be treated but the situation got worse when she could not raise her arms. In April 2012, more than one year from the day the signs of hand fatigue appeared, Tan brought her daughter to a big hospital in Hanoi.

Exams and scans showed that the child suffered from bone cancer. The cancer cells destroyed the bone tube in her right arm. At that time, she could not move her right arm.

Tan could only cry and wished to turn back the clock to not waste time treating the wrong disease at the hospitals of lower levels.

Mrs. Tan's story is perhaps the answer for why people prefer hospitals of the central level. This fact also coincides with the survey results of the Institute for Health Strategy and Policy Research in 2009.

Accordingly, at the Central Obstetrics Hospital in Hanoi, the rate of patients who came here to give birth is up to 56 percent. More than half of patients who only need treatment at hospitals of district level and more than one third of those who only need treatment at provincial level went to the Central Obstetrics Hospital. Especially, approximately 94 percent of patients at the Central Pediatrics Hospital in Hanoi could be treated at the hospitals of lower levels.

The study also revealed that patients tended to directly go to central hospitals for treatment, including rich and poor patients. Up to 73.7 percent of patients in the Hanoi-based Bach Mai Hospital came here as the first place. The rate is up to 89 percent and 97 percent at the Central Obstetrics Hospital and Tu Du Obstetric Hospital in HCM City.

Up to 80 percent of the patients said they choose the central-level hospitals because they believed in the expertise of doctors, modern equipment and facilities of these hospitals.

Quality of health workers: red alarm

Hanoi is a prime example for the problem of medical human resources.

As the political - economic - cultural – social center of the country, with 6.6 million people, the requirements for examination and treatment is heavy but the quality of human resources in the health sector of Hanoi is very alarming.

Of the 13,000 health workers in Hanoi, nearly 60 percent are at intermediate level. Only 10 percent of them (1,312 people) have postgraduate qualifications, 17.2 percent with university degree, 1.4 percent with college level, 2.3 percent of primary level and 10.5 percent of other levels of training.

In the national scope, according to Mr. Vu Xuan Phu, the latest statistics of the Ministry of Health show that the number of health workers at the college and intermediate degrees accounts for two thirds of total medical staff. The number of university-degree staff makes up one fourth. Only about 2 percent of staff have master's degrees and 0.5 percent with the Ph.D. level.

The late March 2013 mission of the Personnel and Organization Department of the Ministry of Health to the provinces of Gia Lai and Kon Tum in the Central Highlands obtained "gloomy" results.

The health care center in Gia Lai province had only five doctors. All of them are general doctors who are in-service trained.

In 2003, the Ministry of Health launched a study which showed that: The hospitals at grassroots levels had very high numbers of inaccurate diagnosis cases: 75% at district level and 59% at provincial level.

Yen Nhi