It is not necessary for most patients to go to central hospitals when their illnesses can be treated at lower-level health facilities, she said at a meeting last weekend on improving ward-level clinics.
“Up to 35.4% of patients who go to central-level hospitals can be treated at provincial and district level hospitals. As many as 41.5% who go to provincial hospitals can be treated at district-level health facilities and 11% can be treated at ward clinics,” she said.
Grassroots-level healthcare facilities have not fulfilled their tasks of taking care of people’s health. Local health facilities are able to conduct an average of only 68.3% of medical techniques among 76 services. Facilities of the lowest quality can perform less than 20% of the services.
There are a limited number of medicines covered by health insurance at the grassroots level. Some types of medicines are not even available, she said.
Doctors at ward clinics are not allowed to prescribe medicine for high blood pressure and diabetes. Only district and provincial level hospitals can do so. A number of clinics do not have doctors. For these reasons, patients do not choose grassroots healthcare services, she said.
Twenty-six clinics in wards and towns of eight cities and provinces have been selected to implement a pilot programme by the health ministry on improving the quality of grassroots-level healthcare. However, most of the clinics need to upgrade their infrastructure and medical equipment to effectively implement the programme.
Tien said that among those selected clinics for the trial period, only healthcare facilities in Hanoi, Ho Chi Minh City and northern Yen Bai province have enough doctors. Other localities suffer a shortage of doctors and traditional physicians.
The health minister said that the key healthcare facilities in the programme will be equipped with beds, drug cabinets, X-ray machines, ultrasound and testing machines if necessary.
To address the shortage of doctors, staff will be rotated to work at each clinic for two to three days a week. Nurses and physicians will be moved to balance the numbers while administrators at the local clinics will be professionally trained, she said.
In the 2018-20 period, the health minister will send professional healthcare workers from central hospitals and grassroots-level healthcare facilities in Hanoi and HCM City to assist ward and town clinics in disadvantaged areas including Lao Cai province’s Bat Xat district, Yen Bai province’s Tran Yen district, Ha Tinh province’s Huong Son district and clinics in the capital city’s suburban areas like Ba Vi, Dan Phuong, Ha Dong, Nam Tu Liem districts.