According to deputy Hang, by 2018, all public hospitals nationwide became autonomous at different levels.

Among those, 14 per cent independently control their regular expenditures and investment; 27 per cent cover regular expenditures and 68 per cent manage part of regular expenditures.

Four health ministry’s hospitals this year have run full autonomy programmes.

The implementation of the autonomy mechanism for public hospitals has achieved numerous results. The number of autonomous hospitals has increased over the years. State budget spending on regular expenditures has fallen, helping increase the efficiency of State budget spending on healthcare. People have received support to buy health insurance cards and budget is spent on preventive medicine and grassroots healthcare.              

Autonomy helps hospitals proactively perform professional tasks, arrange their organisational structure, make use of human resources and finance effectively as well as mobilise financial resources to invest in healthcare equipment and ensure the quality of medical examination and treatment.

Autonomy also encourages hospitals to effectively use funding to increase staff incomes, set up funds and satisfy patients.

However, payroll management is implemented and regulated by the Law on Cadres and Civil Servants while the wage payment is implemented in accordance with the Government's Decree.

The implementation of autonomy at district-level hospitals, especially those in remote and mountainous areas, faces many difficulties because people live far away, limiting their access to healthcare services.

Many autonomous hospitals do not have enough revenue to pay medical staff. On the other hand, there has been no preferential mechanism to attract healthcare workers, especially skilled ones, to work in disadvantaged and mountainous areas. Healthcare workers are moving from public to private hospitals.

Deputy Hang said, in 2019, in response to the allocation of medical cost estimates under the health insurance programme, many hospitals treat simple cases while difficult ones are transferred to higher levels, causing overloading.

Hang proposed the Government improve the policy system, including policies on public hospital autonomy, speed up the roadmap in which budget allocation on hospital autonomy is switched to support people participating in health insurance, and prioritise budget for regular expenditures of hospitals at district level and in mountainous areas./.