Thông tư 05/2021/TT-BYT

CIRCULAR

REGULATING IMPLEMENTATION OF PRACTICES OF DEMOCRACY IN ACTIVITIES OF PUBLIC MEDICAL ESTABLISHMENTS

Pursuant to the Government’s Decree No. 04/2015/ND-CP dated January 9, 2015, prescribing the application of practices of democracy to activities of state administrative authorities and public medical establishments;

Pursuant to the Government's Decree No. 75/2017/ND-CP dated June 20, 2017, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

Upon the request of the Organization and Staff Department of the Minister of Health,

The Minister of Health hereby issues the Circular, regulating implementation of practices of democracy in activities of public medical establishments.

Chapter I

GENERAL PROVISIONS

Article 1. Scope and subjects of application

1. Scope of application:

a) This Circular prescribes the implementation of practices of democracy in activities of public medical establishments, including: intramural democracy, democracy towards patients, legal representatives of patients and responsibilities for implementing democracy in operations of public medical establishments.

b) The practice of democracy in workplace relationships and working at healthcare establishments towards citizens (except for those specified in Clause 2 of this Article), related entities and agencies shall be subject to the provisions of Chapter III of the Government’s Decree No. 04/2015/ND-CP dated January 9, 2015 on the implementation of democracy in operations of state administrative agencies and public service units (hereinafter referred to as Decree No. 04/2015/ND-CP).

2. Subjects of application

a) This Circular applies to relevant civil servants, employees and other individuals (hereinafter collectively referred to as staff members) and patients, legal representatives of patients at public healthcare establishments (hereinafter referred to as medical establishments).

b) This Circular does not apply to healthcare establishments under the control of the Ministry of National Defense and the Ministry of Public Security.

Article 2. Purposes of implementation of intramural democracy

1. Promoting the ownership interest of staff members in their workplace and enhancing responsibilities of the head of each healthcare establishment for performance of medical services.

2. Building a contingent of qualified staff members, improving the quality and efficiency of provision of medical services to meet the health-sector development and innovation requirements.

3. Preventing and fighting corruption, wastefulness, bureaucracy, nuisance and harassment acts against patients and their legal representatives.

4. Raising the awareness of compliance with laws and rules and regulations of medical establishments amongst patients and their legal representatives during the period of their using medical services; preventing and deterring from violence against staff members of medical establishments on duty.

Article 3. Principles of implementation of democratic practices in operations of medical establishments

1. The implementation of democratic practices must comply with the provisions of the Constitution and laws; ensuring rights are accompanied by obligations and responsibilities; strictly sanctioning acts of misusing democracy, violating law, infringing upon the lawful and legitimate rights and interests of staff members and patients.

2. Ensuring the intramural Party committee’s leadership, leaders’ management of medical establishments, active participation of mass associations and members of medical establishments, the cooperation of patients and their legal representatives.

3. Ensuring the rights to exercise democracy of officials, employees, patients and legal representatives of patients; elevating roles and responsibilities of heads of medical establishments towards assurance of publicity and transparency for operations of medical establishments.

Chapter II

INTRAMURAL DEMOCRACY

Section 1. MATTERS THAT MUST BE PUBLISHED UNDER MEDICAL

Article 4. Must-be-published matters

1. The Party's guidelines, the State's policies and laws, especially in the health sector and matters related to the organization and operation of medical establishments, responsibilities and interests of staff members working at medical establishments.

2. Planning and strategy for development of medical establishments; guidelines, objectives, annual, quarterly and monthly work plans of medical establishments, wards, departments and affiliated units.

3. Working rules and regulations of medical establishments, wards, departments and affiliated units; duties and powers of leaders of medical establishments, wards, departments, affiliated units and staff members working for medical establishments.

4. Regulations on medical expertise, techniques, management and use of medical equipment in accordance with laws.

5. Matters related to financial activities in medical establishments: Estimation, settlement of annual operating costs and expenses of medical establishments according to current regulations of the State, including financial sources such as allocations from the state budget, health insurance contributions, revenues from public service activities, including prices of medical examination and treatment services; prices of other service activities; grants, aids, donations, funds obtained from joint ventures, affiliations, foreign loans and other revenues.

6. Implementation of internal spending regulations; limits on use of fuel, car, electricity, water and telephone; details of spending on savings of medical establishments; investment plans, details, progress, results, assets, public property, bidding for capital construction, procurement of drugs, chemicals, consumables and medical equipment in accordance with law; results of stocktaking and liquidation of assets in medical establishments; collection and spending of donations from charitable organizations and humanitarian activities.

7. Personnel matters: Placement scheme, number of employees, rules, regulations, processes, conditions and standards for recruitment, labor contracts; planning, appointment, dismissal, transfer, rotation; professional rank and title promotion, pay rate raise; training, education, permission for domestic or overseas educational programs; commendation, rewarding and disciplining of staff members in accordance with law.

8. Rules and regulations on research and application of science and technology; management and use of funds for scientific researches, findings and achievements of projects on research and application of advanced science and technology in accordance with law.

9. Competent state authority’s conclusions or decisions obtained from settlement of cases of petitions, feedbacks, complaints and denunciations related to medical services, misconduct, corruption, wastefulness and loss of funds and property; responses to petitions, feedbacks, complaints and accusations arising within a medical establishment.

10. Others that need to be published under the request of a medical establishment’s leader where necessary without any breach of laws.

Article 5. Publishing approaches and time

1. Publishing approach

Based on the characteristics and nature of operations and matters to be published, heads of medical establishments shall employ one of the following approaches:

a) Posting public notices at conspicuous and visible places within medical establishments;

b) Notices made in staff and process review meetings;

c) Written notices sent to all of staff members;

d) Written notices sent to leaders of wards, departments and directly affiliated units who are requested to notify each of their staff members;

dd) Written notices sent to directly supervisory Party committees, Executive boards of Trade Unions of medical establishments, each of staff members involved;

e) Information posted on authorized websites and information web pages of each medical establishment; 

g) Information exchanges made through direct conversations between leaders of medical establishments, heads of wards/departments and staff members of medical establishments.

2. Publishing duration shall be subject to regulations laid down in clause 2 of Article 8 in the Decree No. 04/2015/ND-CP and other regulations in force.

Section 2. MATTERS SUBJECT TO PUBLIC REVIEW OF STAFF MEMBERS AND DECISIONS OF LEADERS OF MEDICAL ESTABLISHMENTS

Article 6. Matters subject to public review of staff members

1. Action plans for implementation of the Party’s Resolutions, the State’s laws, health-sector policies related to the organization and operation of medical establishments.

2. Plans and strategies for development of medical establishments, development of high-tech specialized departments and divisions within each medical establishment.

3. Working plans, annual financial plans; plans for repair, upgradation and construction of new facilities; annual plan for supply of drugs, chemicals and consumable medical supplies; plans for purchase, use, and liquidation of assets of each medical establishment.

4. Internal rules and regulations of medical establishments, wards, departments and directly affiliated units; professional technical regulations of medical establishments, wards and directly affiliated units.

5. Plans and procedures for capital construction; procurement of drugs, chemicals and consumables; purchase and repair of medical equipment and supplies.

6. Plans, regulations and procedures for recruitment, labor contracts, selection of potential candidates holding offices as leaders of medical establishments, wards, departments and directly affiliated units; training, refresher's courses, appointment, dismissal, posting, secondment, rewarding and disciplining of staff members in accordance with law.

7. Measures for personal prevention, occupational safety and health, environmental sanitation, reform of working regimes, improvement of material and spiritual life for staff members; construction of cultural and civilized lifestyle within medical establishments.

8. Administrative procedures for receiving patients and handling medical examination and treatment for patients; measures to combat patient bureaucracy, nuisance and harassment and measures for practices of thrift, anti-extravagance and anti-corruption in medical examination and treatment activities.

9. Action plans to implement emulative movements of medical establishments; nomination for annual performance titles and awards; 6-month performance summary reports, year-end performance assessment reports of medical establishments.

10. Regulations on internal expenditures, regulations on institution and use of the welfare fund, reward fund or unemployment reserve fund.

11. Others to be publicly announced where necessary under decisions of medical establishments’ leaders.

Article 7. Forms of contribution of opinions

1. Sending opinions directly to leaders of medical establishments, wards, departments and other affiliated units.

2. Raising opinions at conferences or seminars held within medical establishments.

3. Raising opinions in the progress update meeting within departments or medical establishments.

4. Contributing opinions to functional departments or divisions of medical establishments. 

5. Sending opinions via electronic web pages, local networks, hotlines or mailboxes available at medical establishments.

6. Giving opinions at direct conversations or dialogues between leaders of medical establishments, wards/departments or affiliated units and staff members of medical establishments.

7. Requesting mass organizations to conduct surveys to collect opinions from staff members.

8. Handing out direct questionnaires; soliciting public feedbacks on draft documents from staff members.

Section 3. MATTERS UNDER PUBLIC SUPERVISION OF STAFF MEMBERS

Article 8. Matters within the supervision competence of staff members

1. Implementation of goals and objectives of working plans of medical establishments, wards, departments and affiliated units; implementation of resolutions passed in meetings of staff members.

2. Implementation of working rules and regulations of wards, departments and affiliated units and medical establishments.

3. Implementation of professional and technical engineering regulations.

4. Management and use of the state budget’s allocations, prices of medical services, health insurance collections, other lawful collections, and various funds of medical establishments.

5. Bidding and supply of drugs, chemicals, blood, fluids for transfusion and equipment; purchase, use and liquidation of assets.

6. Tendering process for capital construction, procurement and repair of equipment available at medical establishments.

7. Implementation of the State’s policies related to the lawful rights and interests of staff members of medical establishments.

8. Implementation of organization and personnel rules and regulations.

9. Implementation of publicly disclosed matters by leaders of medical establishments, wards and departments.

10. Results of responses to feedbacks, petitions, complaints or accusations of staff members, patients and legal representatives of patients under law.

Article 9. Supervisory forms

1. Supervision carried out through operations of the People’s Inspectorate, the Inspection Commissions under the control of the Party Committees of medical establishments. 

2. Supervision carried out at meetings of staff members.

3. Supervision carried out at regular meetings, work-in-progress review meetings or discussions of medical establishments, wards, departments and affiliated units.

4. Supervision carried out through operations of the Party organizations and mass organizations.

5. Supervision carried out through specialized councils and advisory boards within medical establishments.

Chapter III

DEMOCRATIC RELATIONSHIPS WITH PATIENTS, LEGAL REPRESENTATIVES OF PATIENTS

Section 1. MATTERS THAT MUST BE DISCLOSED TO PATIENTS, LEGAL REPRESENTATIVES OF PATIENTS

Article 10. Matters that need to be disclosed in a timely and open manner

1. Regulations on rights and obligations of patients to medical establishments.

2. Internal rules, regulations and maps of wards, departments and affiliated units of medical establishments.

3. Medical examination and treatment processes and procedures, and other related procedures.

4. Prices of medical examination and treatment services applied to patients with health insurance cards;  prices of unsolicited medical examination and treatment services applied to patients without health insurance cards; relief of prices of medical examination and treatment services; implementation of health insurance benefits; health insurance coverage of  medical examination and treatment costs according to the provisions of law.

5. Prices of on-demand medical examination and treatment services rendered to patients; prices of other services rendered by medical establishments.

6. Daily work schedules, on-call duty schedule of staff members; citizen reception schedules of heads of medical establishments.

7. Departments for reception of citizens, handling of feedbacks, petitions, complaints and denunciations of medical establishments.

8. Hotline number of the Ministry of Health.

9. Matters and acts that cause disorder, infringe on body, health, life or insult the honor and dignity of officers and employees of medical units.

10. Results and points indicating patient’s satisfaction.

Article 11. Public announcement approaches

1. Posting public notices and displaying information on electronic billboards

Publicly disclosing information prescribed in Article 10 herein by using: Written documents, drawings, diagrams and directional markings or signs showing way to zones, wards, departments or subordinate units; boards of internal rules, regulations or prices of medical examination and treatment services and prices of patient’s services at public places where a lot of patients walk. Posting notices at public places must be regular, continuous and timely.

2. Information, communication and counseling activities

Disseminating, communicating and counseling regulations, policies and issues related to medical examination and treatment activities when patients arrive at clinics, emergency rooms and wards.

3. Directly notifying patients, patient's legal representatives; organizing activities of patient councils of departments, wards and units.

Section 2. ISSUES UNDER OPINIONS OR SUPERVISION OF PATIENTS AND THEIR LEGAL REPRESENTATIVES

Article 12. Issues under contributed opinions or supervision

1. Implementation of the State’s health policies related to the lawful rights and interests of patients such as medical examination and treatment, health insurance; policies and prices of medical services prescribed in law.

2. Implementation of rules and regulations on medical examination and treatment services of medical establishments.

3. Morale and attitude of officials and employees toward rendering of medical services in medical establishments; detecting and reporting to heads or leaders of departments, wards and affiliated units on officials and employees who show signs of poor morale, attitude towards rendering of medical services, annoyance, harassment, dodging, discrimination and bribe solicitation towards patients or their legal representatives; proposing ideas, discussing and collaborating with medical staff in taking care of patients.

4. Environmental hygiene, maintenance of security and order at medical establishments.

5. Public relation, resolution of petitions, complaints and denunciations and results of settlement of petitions, complaints and denunciations filed by patients and their legal representatives against medical establishments.

Article 13. Forms of contribution of opinions and supervision

1. Raising opinions directly to medical staff at departments, wards or affiliated units.

2. Raising opinions to leadership at front departments of medical establishments.

3. Sending written opinions via mailboxes of medical establishments.

4. Raising voices by making calls to hotlines of medical establishments.

5. Raising opinions through direct conversation or meetings of patient councils of departments, wards and medical establishments.

Chapter IV

RESPONSIBILITIES FOR IMPLEMENTATION OF DEMOCRACTIC PRACTICES IN OPERATIONS OF MEDICAL ESTABLISHMENTS

Article 14. Responsibilities of heads of medical establishments

1. Heads of medical establishments shall be responsible for implementing democracy in the management and operation of medical establishments; strictly complying with the provisions of Article 4 of Decree No. 04/2015/ND-CP and the provisions of Articles 4, 6, 8 and 10 of this Circular; allocating annual funds for implementation.

2. On a monthly basis, holding direct dialogues to proactively capture thoughts and aspirations of staff members of medical establishments, patients, and their legal representatives; promptly responding to and resolving suggestions and questions (if any).

3. Holding periodic, monthly, quarterly and 06-monthly briefings to evaluate the performance of assigned tasks and set out key tasks and solutions to be carried out in the coming time at medical establishments. At the end of the year, heads of medical establishments must make a review of the medical establishment's activities at the conferences of staff members in accordance with the provisions of Circular No. 01/2016/TT-BNV dated January 13, 2016 of the Ministry of Home Affairs, providing guidance on implementation of a number of regulations of Decree No. 04/2015/ND-CP.

4. Evaluating and classifying the quality of staff members under their management according to the order and procedures prescribed by law.

5. Accepting feedback and criticism from staff members. When staff members register to meet and have specific purposes and reasons, scheduling meetings and discussions with them.

6. Publicly notifying staff members of the matters or issues specified in Articles 4, 6 and 8 of this Circular.

7. Promulgating regulations on management of equipment available at medical establishments to ensure practicality, efficiency and economy; economically using allocated funds; complying with financial disclosure regulations. The procurement of equipment, means and assets of a medical establishment must comply with the provisions of law.

8. Directing the adequate and timely provision of information, documents, methods of organization and implementation, responsibility for performance and accountability for the contents of work in medical establishments as prescribed, except for classified documents required by law.

9. Considering and promptly and legally settling petitions, complaints and denunciations of staff members, and recommendations of the People's Inspection Committee; promptly reporting to competent authorities of those issues not falling within its competence.

10. Promptly sanctioning people who have acts of obstructing the implementation of democracy in the operations of medical establishments and those who have acts of revenge or repression against staff members who file petitions, complaints or accusations or allegations according to regulations of law.

Article 15. Responsibilities of staff members

1. Responsibilities of heads of departments, wards and affiliated units

Raising awareness of, implementing and inspecting the implementation of this Circular according to the assigned functions, tasks and powers.

2. Responsibilities of staff members

Strictly abiding by the provisions of Article 6 of Decree No. 04/2015/ND-CP and this Circular.

Article 16. Responsibilities of patients, legal representatives of patients

1. Strictly complying with regulations related to the responsibilities of patients and the patient's legal representatives in accordance with laws and internal rules and regulations of medical establishments.

2. Implementing regulations on practices of democracy in activities of public medical establishments under the provisions of this Circular.

Article 17. Responsibilities of Party’s committees, mass organizations and the People’s Inspection Committee

1. Requesting Party’s committees at all levels to direct and instruct the implementation of democracy in activities of medical establishments.

2. Mass organizations shall be responsible for formulating and implementing regulations on democracy; communicating and disseminating publicly disclosed contents, and regularly supervising the implementation of democracy in activities of medical establishments.

3. The People’s Inspection Committee shall be responsible for inspecting the implementation of democracy in operations of medical establishments related to rights and interests of staff members.

Article 18. Responsibilities of directly supervisory authorities

Conducting the examination and inspection of the implementation of the provisions of this Circular; promptly imposing sanctions against violations when implementing democracy at medical establishments under their management.

Chapter V

IMPLEMENTATION PROVISIONS

Article 19. Entry into force

1. This Circular shall take effect as of July 1, 2021.

2. Decision No. 44/2007/QD-BYT dated December 12, 2007 of the Minister of Health, promulgating the Regulations on democracy at public hospitals shall expire as from the effective date of this Circular.

Article 20. Reference clause

In case where legislative documents and regulations used as references in this Circular are amended or supplemented or replaced, new versions thereof shall apply.

Article 21. Implementation

1. Organization and Staff Department – the Ministry of Health shall preside over and collaborate with concerned Departments or units in implementation and inspection of the implementation of this Circular.

2. Departments of Health in provinces and centrally-affiliated cities, medical authorities of ministries and sectoral administrations shall implement and inspect the implementation of this Circular within their remit; periodically and annually report on results of implementation of this Circular to the Ministry of Health in accordance with regulations./.

APPENDIX

LIST OF CONTENTS OF REPORT ON RESULTS OF IMPLEMENTATION OF PRACTICES OF DEMOCRACY IN ACTIVITIES OF PUBLIC MEDICAL ESTABLISHMENTS

Year:…………..

 (Annexed to the Circular No. 05/2021/TT-BYT dated May 5, 2021)

1. Incorporation and consolidation of the Steering Committee on democratic practices

2. Assignment of tasks of members of the Steering Committee, and formulation of the year-based plan

3. Communication and public disclosure activities (if any, specifying the specific form; if not, specifying the specific reasons)

4. Organization of training sessions and provision of instructions (number of participants, forms, eligible participants...)

5. Emulation campaign launching

6. Formulation of democracy regulations at medical establishments

7. Formulation of other regulations (e.g. Regulations on internal spending; emulation and commendation; salary increase ahead of time; training and retraining; delivery of speech and provision of information to the press....)

8. Citizen public relation, handling of petitions, complaints and denunciations (if any)

9. Operations of the People’s Inspection Committee 

10. Operation of public opinion mailboxes, hotlines...

11. Other measures to duly implement democracy at medical establishments.

12. Inspection and supervision of implementation of democracy at medical establishments

13. Preliminary, final review assessments, commendation, rewarding and disciplinary actions (quantity and form)

14. Difficulties and issues

15. Lesson and experience

16. Petitions and recommendations of medical establishments