* Hospital fees werealready increased in 2012. Why has the Ministry of Health (MOH) decidedto increase the hospital fees again in 2014?

A roadmap developed by the MoH on hospital fee increases was approved by thePrime Minister and is in line with Decree 85/2012/ND-CP.

Earlier in 2005, Party Politburo Resolution No. 46 also stated clearlythat hospital fees must be calculated on the basis of full recoverycosts for direct services received by patients.

The2012 fee adjustment only covered three out of the seven cost elementsincurred by patients. They include the cost of medicines, chemicals,consumable materials, electricity and water, equipment maintenance andothers.

Principally speaking, the other four costelements were not included in the 2012 fee adjustment. They are coveredby the Government.

However, in practice, the Statebudget allocated to hospitals is not sufficient. As a result, hospitalshave to look for different ways to cover various cost factors.

That's the reason why the MoH has drafted a road map to increase thehospital fee during 2014-18 in line with Government Decree No. 85.

Under the road map, in 2014 the hospital fee charged to patients willinclude the bed cost for in-patients and part of their surgery costs.

In 2015, the charge will further include the medicalequipment used for patient treatment; the hospital's management andoperation costs; and between 20-30 percent of the basic salary ofhospital staff at provincial hospitals in mountainous regions, in theCentral Highlands and district hospitals in Hanoi and Ho Chi Minh City.

From 2016-17, the basic salary cost for staff atprovincial and central hospitals, as well as district hospitals in thetwo major cities of Hanoi and Ho Chi Minh City, will be taken from thehospital fee.

Meanwhile the basic salary cost ofstaff at the remaining district hospitals nation-wide will be taken fromthe hospital fee.

After 2018, the full cost recovery policy in the medical service will be applied widely across the board.

* What benefits will the patients enjoy after the policy is introduced in 2018?

I believe when the policy is applied the service quality will beimproved considerably, as from then on the operation of the hospitalswill depend on the patients.

More patients meanmore money for hospitals and their staff. And of course, there must besome changes in the staff recruitment as by that time there will be nomore financial resources coming from the State budget.

By 2018, the recurrent State budget allocated to hospitals will beswitched to support people who have rendered services to the nation, thepoor, the ethnic minorities, children under 6 years old and others.

* Do you think by 2018 there will be no problem of overcrowded hospitals as at present?

There are various reasons leading to overcrowding. For example, thedemand for health care is increasing, transportation has improved, thelack of confidence in the health service at lower levels, and others.

I'm totally confident that after 2018, the situation will be much better.

* Do you mean the quality of the service will be on a par with the hospital fee increase?

Sure! If we just look back at one year after the hospital fee increase(2012-13), much improvement in the hospital service has been recorded.

A case in point is that all hospitals haveallocated 15 percent of the collected revenue to improve their services,particularly the out patient departments.

Inaddition, the MoH has issued several guiding documents and the standardsof operations (SOP) for the medical staff to apply.

In the meantime, the MoH will send frequent inspection missions to hospitals to ensure their high quality service.

In the long run, the MoH will switch to case management packag𝔉es for patients.-VNA