More management needed in medical sector

The issue received a lot of attention from
National Assembly deputies during sessions held last month, especially
following a shocking incident where faults in maintaining and operating kidney
dialysis machines caused eight deaths in the northern province of Hoa Binh in
late May.

However, the discussion mostly revolved around
flawed policies and regulations that have caused significant losses for the
state budget.

Recent cases drawing public attention took place
at general hospitals in Hoai Duc and Thuong Tin rural districts of Hanoi.
According to documentation, the automated biochemical analysis equipment
purchased by the two hospitals was imported from Germany. In fact, the machines
turned out to be cheaper versions that were manufactured in China.

Recently released findings by the State Audit
showed that a lot of newly bought equipment has either fallen into a state of
disrepair or sustained damage, rendering them unusable even before being put
into operation.

One of the most scandalous revelations was the
fraudulent purchase of medical equipment in Gia Lai province in the Central
Highlands region: In the period between 2013-2015, the actual cost of medical
equipment, 5.6 billion VND (246,000 USD), was inflated to 16.7 billion VND (734,600
USD) in falsified documents.

Minister of Health Nguyen Thi Kim Tien, in her
answers to inquiries at the NA meeting, confirmed the veracity of reports on
broken equipment, especially at provincial level public hospitals, and
attributed this phenomenon to “being overused.”

However, many NA deputies were dissatisfied with
the Health Minister’s answers, which they deemed ‘ambiguous.’ NA deputies hoped
the government and the NA would soon arrive at appropriate measures to prevent
incidents relating to medical equipment and avoid mistakes that may come at the
cost of patients, as modern equipment is a necessity but decisions need to be
practical and mindful of the budget situation.

Associate Prof. Pham Khanh Phong Lan, head of the
HCM City Food Safety Management Board, also a member of HCM City NA delegation,
said that due to the fact that the cost of medical equipment is drawn from
state budgets, hospitals would try to get as much as possible. “Hospitals may
sometimes say in reports that they need state-of-the-art and expensive devices,
but the number of those capable of using such devices or the number of patients
actually in need of them are not enough, but if they don’t say they need it
this year then next year, the budget will be cut,” she said, adding that state
co-ordination must take into account these nuances to effectively manage state
resources and prevent waste.

Loose

According to the Ministry of Health (MoH), in
the last 5 years, the number of applications for medical equipment imports has
been on the rise.

In 2011, there were 3,846 applications, two
years later, the figure saw a slight increase to 4,025, but in 2015, the figure
jumped to 5,099 applications.

In 2015, for example, the four major groups of
the applications for medical equipment were intervention materials and implant
devices (26 percent), imaging medical equipment (20.7 percent), diagnostic
devices (16 percent), and resuscitation equipment (10 percent).

However, the Department of Medical Equipment
under the Ministry of Health said it was not able to get hold of the longevity
of the medical equipment imported into the country, since “the actual figure
also involves other sectors as well.”

The State Audit Office found that the Ministry
of Health had not properly categorised medical equipment or chemicals according
to types, technical standards appropriate to each medical service; and the
Ministry had not established a database on bidding prices for medical centres
in the country to be able to plan ahead.

Health Minister Tien said the MoH had submitted
Decree 36 on managing medical equipment and purchasing procedures to the NA
Standing Committee.

The regulations provided in this legislation
were claimed to be ‘relatively foolproof,’ with decentralised management taking
a focus as well as more assessment of the usage of medical equipment at local
levels.

In addition, MoH has developed schemes like the
establishment of a Patient Safety Council at the ministry’s Department of
Treatment Management as well as in hospitals.-VNA