Thông tư 37/2016/TT-BYT

CIRCULAR

GUIDANCE ON FUNCTIONS, TASKS, POWERS AND ORGANIZATIONAL STRUCTURES OF MEDICAL CENTERS OF SUBURBAN, URBAN DISTRICTS, PROVINCIAL CITIES, AND MUNICIPALITY-CONTROLLED CITIES

Pursuant to the Government’s Decree No. 123/2016/ND-CP dated September 01, 2016 defining Functions, Tasks, Powers and Organizational Structures of Ministries and Ministerial-level Agencies;

Pursuant to the Government’s Decree No. 63/2012/ND-CP dated August 31, 2012 defining Functions, Tasks, Powers and Organizational Structure of Ministry of Health;

Pursuant to the Government’s Decree No. 24/2014/ND-CP dated April 06, 2014 stipulating organization structure of specialized agencies affiliated to People’s Committees of provinces or central-affiliated cities;

At the request of the Head of the Organization and Personnel Department affiliated to the Ministry of Health;

Minister of Health promulgates this Circular to provide guidance on the functions, tasks, powers and organizational structures of Medical Centers of suburban, urban districts, provincial cities, and municipality-controlled cities.

Chapter I

GENERAL PROVISIONS

Article 1. Scope

This Circular provides guidance on the functions, tasks, powers and organizational structures of Medical Centers of suburban, urban districts, provincial cities, and municipality-controlled cities (hereinafter referred to as District-level Medical Centers).

Article 2. Legal position

1. District-level Medical Centers are public medical service providers affiliated to Provincial Departments of Health, have legal status, separate head offices, seals and accounts opened at the State Treasuries and Banks as per the law.

2. District-level Medical Centers operate under the direct management of the Provincial Departments of Health in terms of organizational structure, personnel, operations, financial sources and material facilities; work according to professional instructions by provincial- or central-level medical agencies; and under the state management by District-level People's Committees in accordance with the law regulations.

Chapter II

FUNCTIONS, TASKS AND POWERS

Article 3. Functions

District-level Medical Centers are functioned to provide professional and technical preventive medicine services, medical examination and treatment, rehabilitation therapy and other medical services as regulated by law.

Article 4. Tasks and powers

1. Take actions to prevent and control infectious diseases, HIV/AIDS, non-communicable diseases and mystery diseases; organize vaccination and school medicine activities; prevent and control factors affecting the human health or generating and spreading epidemics; manage and improve human health.

2. Organize environment protection activities at healthcare facilities; manage occupational health and sanitation, and prevention of occupational diseases and accidents or injuries; manage sanitation in bury and cremation; monitor the quality of water used for drinking and daily activities, and community nutrition.

3. Take actions to prevent and control food poisoning in local areas; participate in the appraisal of the satisfaction of eligibility requirements by local food producers and traders as assigned; participate in inspections of the compliance with regulations on prevention and control of food poisoning and foodborne diseases; instruct and supervise foods producers and traders complying with regulations on foods safety, and discharge other duties relating to foods safety as prescribed by law and as assigned.

4. Give first aid, emergency aid, medical examination and treatment as well as rehabilitation therapies as regulated by competent authorities and defined in the License to provide medical examination and treatment services to patients who themselves seek medical services or are referred from other healthcare facilities or returned from healthcare facilities of higher level for further treatment or rehabilitation therapy; implement techniques, operations or referral procedures in accordance with the law regulations; provide medical examination services and grant health certificates; engage in medical assessment or forensic examination when so requested.

5. Provide reproductive health care services and take actions to improve nutritional status of mothers and babies; cooperate with relevant agencies in performing population and family planning affairs in accordance with the law regulations.

6. Do tests and medical imaging techniques so as to serve professional and technical activities within the ambit of functions and tasks of Medical Centers and as requested by patients; adopt measures to ensure biosafety at laboratories and radiation safety as regulated.

7. Disseminate and provide information about the Communist Party's and the Government's laws and policies on medicine; organize communications and health education activities in local areas.

8. Instruct and provide professional and technical guidance for regional general clinics, maternity wards, medical stations of communes, wards, commune-level towns, medical stations and midwifes of mountainous villages, and healthcare facilities in agencies, schools, farms, or factories in district regions.

9. Provide continuous training for officials within the scope of their management; organize training and drilling activities so as to improve professional and operational knowledge for healthcare staff of villages/ mountain villages and other entities as assigned by Provincial Departments of Health; play the role as practical establishments for medical students and provide them with guidance during their practical periods as regulated by law.

10. Supply, store, deliver, use and receive drugs, vaccines, medical biological products, chemicals and equipment serving professional activities as prescribed by Provincial Departments of Health and laws.

11. Implement local healthcare projects and programs as assigned and authorized by Provincial Departments of Health; provide detoxification by alternative medicines in accordance with the law; combine civil medical service and army medical service according to local actual situation.

12. Conclude contracts with social security offices so as to organize provision of medical examination and treatment services covered by health insurance at District-level Medical Centers and their affiliates in accordance with the law regulations.

13. Do research and participate in scientific research activities and apply advances in science and technology in relevant sectors.

14. Make statistics and reports in accordance with the law regulations.

15. Manage personnel, finance and assets within the scope of their competence and as prescribed by law.

16. Discharge other tasks and exercise other rights as assigned by Directors of Provincial Departments of Health and Chairpersons of District-level People's Committees.

Chapter III

ORGANIZATIONAL STRUCTURE, PAYROLL AND FINANCIAL SOURCES

Article 5. Leadership of District-level Medical Center

1. Each District-level Medical Center shall have a Director and Deputy Directors; the number of Deputy Directors shall be decided in conformity with the law regulations.

2. The appointment of Director and Deputy Directors of a District-level Medical Center shall be decided by the Director of the Provincial Department of Health as assigned or authorized by Chairperson of the Provincial-level People’s Committee and as prescribed by law. Dismissal, appointment, internal transfer, reward, commendation, discipline, approval for resignation or retirement and other benefits of Director and Deputy Directors of a District-level Medical Center shall be performed in accordance with the law regulations.

Article 6. Functional Departments of a District-level Medical Center

1. Each District-level Medical Center shall have the following Functional Departments:

a) Personnel & Administration Department;

b) Operational & Planning Department;

c) Department of Finance & Accounting;

d) Nursing Department.

2. Based on the nature and features of each district, Director of Provincial Department of Health shall, within its competence, make decisions on the establishment, division or combination of functional departments of Medical Center of that district; stipulate specific duties of such functional departments in accordance with regulations in this Article and other departments (if any) in the manner so as to effectively assist the Director of Medical Center of that district in managing its activities in conformity with actual needs and the law regulations.

Article 7. Specialized Departments of a District-level Medical Center

1. Each District-level Medical Center shall have the following Specialized Departments:

a) Disease and HIV/AIDS Control Department;

b) Public Health and Nutrition Department;

c) Food Safety Department;

d) Reproductive Healthcare Department;

dd) Outpatient Department/ General Clinic;

e) Intensive Care Department;

g) General Medicine Department;

h) General Surgery Department;

i) Pediatrics;

k) Traditional Medicine and Rehabilitation Department;

l) Inter-specialty Department (Odonto – Stomatology – Eye – Otorhinolaryngology);

m) Department of Pharmaceutical Products – Medical Equipment & Supplies;

n) Infectious Disease Department;

o) Bacterial Contamination Control Department;

p) Medical Imaging and Laboratory Department.

2. Based on the nature and features of each district, Director of Provincial Department of Health shall, within its competence, make decisions on the establishment, division or combination of specialized departments of Medical Center of that district; stipulate specific duties of such specialized departments in accordance with regulations in this Article and other departments (if any) in the manner so as to ensure the effective provision of technical and professional services in conformity with actual needs and the law regulations.

Article 8. Medical units affiliated to District-level Medical Center

1. Medical stations of communes, wards or commune-level towns: As regulated in the Circular No. 33/2015/TT-BYT dated October 27, 2015 by Ministry of Health providing for guidance on functions and tasks of medical stations of communes, wards and commune-level towns.

2. Regional General Clinics and Maternity Wards (if any): Discharge duties assigned by Director of Provincial Department of Health according to actual needs of local area.

Article 9. Payroll

1. Total persons working at a District-level Medical Center shall be determined on the basis of working positions according to functions, tasks and scope of activities of departments/units mentioned in Articles 5, 6, 7 and 8 herein and included in the payroll of public service providers of province or central-affiliated city assigned or approved by a competent authority.

2. Based on functions, tasks, organizational structure and list of job positions approved by a competent authority, the District-level Medical Center shall annually formulate a scheme on job positions, determine the number of its employees and submit report thereof to the Provincial Department of Health for applying for consideration and decision by a competent authority in accordance with the law regulations so as to ensure the fulfillment of all assigned tasks.

Article 10. Financial sources

1. Funding provided by state budget:

a) Funding for implementing policies on salary and allowances as prescribed by the Government;

b) Funding for covering recurrent expenditures of regional general clinics, maternity wards, medical stations of communes, wards, commune-level towns and mountain villages;

c) Regular operating funding for performing preventive medicine tasks of the Medical Center;

d) Funding provided by state budget for covering expenses which are not yet calculated in service prices;

dd) Funding for implementing programs and/or projects which are considered as current expenditures;

e) Funding for implementing projects on investment in infrastructure systems and equipment so as to ensure uninterrupted operation of Medical Center according to decision by a competent authority.

2. Revenues from provision of medical examination and treatment services and other medical & population services; revenues generated from other service fees and charges as regulated by law.

3. Financial sources and assets of target programs, national target program, projects with grant aid, ODA projects and other legal sources of funding as prescribed by the law.

Chapter IV

IMPLEMENTATION PROVISIONS

Article 11. Entry into force

1. This Circular takes effect as from December 10, 2016.

2. Decision No. 26/2005/QD-BYT dated September 09, 2005 by Minister of Health defining the functions, tasks, powers and organizational structures of preventive medicine centers of urban, suburban districts, district-level towns and provincial cities shall be abrogated as from the date of entry into force of this Circular.

Article 12. Transition provision

1. With regard to districts where district general hospitals or regional general hospitals have been established before the date of entry into force of this Circular, Provincial Departments of Health shall review and request People’s Committees of provinces or central-affiliated cities to make decisions on merger of district hospital and district-level medical center in conformity with actual conditions at each district by January 01, 2021.

2. With regard to a district where a district general hospital of rank II or higher has been established before the date of entry into force of this Circular, the operation of the district general hospital shall be maintained only if it is necessary according to the actual situation and characteristics of that district. The Provincial Department of Health shall review and submit report to the People’s Committee of that province or central-affiliated city on the plan for re-restructuring of District General Hospital and District-level Medical Center in the ways of avoiding the overlapping fulfillment of tasks, downsizing organizational structure, improving operational efficiency, ensuring financial balance and conforming to working requirements of hospital/medical center and local area.

Article 13. Responsibility and organization of implementation

1. People’s committees of provinces or central-affiliated cities shall:

a) Instruct Provincial Department of Health to organize the implementation of this Circular in the province or city;

b) Instruct District-level People’s Committee to make investment and development of medical career in district as assigned and cooperate with the Provincial Department of Health to strengthen healthcare affairs in district.

2. Departments of Health of provinces or central-affiliated cities shall:

a) Take charge of organizing the implementation of this Circular in province or city;

b) Take charge and cooperate with the Provincial Department of Home Affairs in submitting projects on strengthening District-level Medical Centers in the territory of province to the Provincial-level People’s Committee for approval in conformity with the provincial reality, the law regulations and this Circular provisions.

c) Promulgate within its competence or request the Provincial-level People’s Committee to promulgate Regulations on the functions, tasks, powers and organizational structures of District-level Medical Centers in province as regulated herein.

Difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health for consideration./.