Joint Circular No. 02/1998/TTLT-BYT-BTCCBCP guiding the implementation of Government Decree No. 01/1998/NĐ-CP dated January 3, 1998 on the system of local health organizations

JOINT CIRCULAR

Guidelines for implementing Decree No. 01/1998/NĐ-CP dated January 3, 1998

of the Government on the local health care organization system

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On January 3, 1998, the Government issued Decree No. 01/1998/NĐ-CP stipulating the local health care organization system. To implement this Decree, the Ministry of Health and the Government's Office of Organization and Cadres issued the following guidelines:

A. FUNCTIONS, DUTIES, LIMITATIONS AND ORGANIZATIONAL STRUCTURE OF THE PROVINCE HEALTH DEPARTMENT: FUNCTIONS OF THE PROVINCE HEALTH DEPARTMENT:

The provincial health department is a specialized agency under the People's Committee of the province (hereinafter referred to as the province), assisting the People's Committee in performing state management functions regarding health work within its jurisdiction; managing and directing in terms of professional and technical matters concerning health work; managing financial resources and human resources in the health system within the province according to the delegation of authority from competent agencies.

The provincial health department is subject to comprehensive management by the People's Committee of the province, while also being directed and guided in professional and technical matters by the Ministry of Health.

II. MAJOR DUTIES AND LIMITATIONS OF THE PROVINCE HEALTH DEPARTMENT:

1. Developing planning and plans for the development of the health sector in the province; organizing and supervising the implementation of such plans after they have been approved;

2. Submitting to the People's Committee of the province for issuance or issuing within its authority regulations on professional and technical matters in health care based on national and Ministry of Health regulations; guiding and supervising the implementation of these regulations throughout the province;

3. Managing and organizing the implementation of financial resources according to the provisions of the state financial authorities;

4. Organizing specialized inspections and supervision in health care related to hygiene, disease prevention, medical examination and rehabilitation, food hygiene, cosmetics, pharmaceuticals, medical equipment, and inspecting the implementation of policies and handling complaints and reports according to current regulations;

5. Managing organizations, staff, labor, salaries, and training and improving the cadre of health workers according to the delegation of the People's Committee of the province and national regulations;

6. Managing and using effectively facilities, materials, and assets assigned by the People's Committee of the province and the state according to current regulations;

7. Guiding and supervising the implementation of regulations, rules, standards, norms, economic and technical quotas established by the state, the Ministry of Health, and the People's Committee of the province regarding pharmaceuticals, equipment, and health supplies management;

8. Managing private practice in health and pharmaceuticals within the province and implementing the issuance and revocation of licenses for private practice according to the law;

9. Leading coordination with relevant sectors, mass organizations, and social organizations in the province to carry out health education and participate in activities to protect public health;

10. Performing other duties and powers delegated by the People's Committee of the province and the Ministry of Health.

III. THE ORGANIZATIONAL STRUCTURE OF THE PROVINCE HEALTH DEPARTMENT INCLUDES:

1. Specialized and technical organizations under the Department:

1.1. Preventive Health Center: Implementing tasks related to hygiene, disease prevention, occupational hygiene, malaria control, goiter prevention, international quarantine, food hygiene, school hygiene...

Provinces in mountainous areas, the Central Highlands, and those currently having a malaria or goiter rate exceeding 40% of the population shall continue to maintain the Malaria Control Center and Goiter Prevention Center for a certain period of time.

An International Health Quarantine Center shall only be established in provinces and cities with airports, seaports, major border gates, and frequent international exchanges, with many people and transportation vehicles passing through.

A Center for Occupational Health and Environmental Protection shall only be established in central cities and provinces with large industrial zones and a significant number of workers; the establishment of such centers in provinces must be agreed upon by the Ministry of Health and the Government's Office of Organization and Cadres.

1.2. Maternal and Child Health Care - Family Planning Center.

1.3. Social Disease Control Center: including diseases such as tuberculosis, leprosy, dermatology, mental health, trachoma.

Provinces that have integrated these specialties into departments in general hospitals or provincial specialized hospitals for operation shall not establish a Social Disease Control Center.

1.4. Health Education and Communication Center.

1.5. Pharmaceutical and Cosmetic Testing Center: Including quality testing of pharmaceuticals and cosmetics.

1.6. Provincial General Hospital: the highest level hospital for diagnosis and treatment in the province.

1.7. Regional General Hospital: gradually establishing regional general hospitals according to the needs and structure of each community cluster to bring diagnostic and treatment services closer to the people, ensuring everyone can be cared for at the nearest hospital.

1.8. Provincial Traditional Medicine Hospital.

1.9. Specialized Hospitals such as Tuberculosis, Mental Health, Pediatrics, Obstetrics and Gynecology, Cadres, Nursing, and Rehabilitation; if the utilization rate of beds in these hospitals is low and they lack the conditions to operate, they should be dissolved and their operations integrated into departments in the provincial general hospital.

1.10. Provincial Health Vocational School: Provinces that already have a Central Health Vocational School or College located in the province shall not establish a provincial health vocational school.

The above units have legal personality, seals, and are authorized to open bank accounts; organizing units different from the above provisions must obtain written approval from the Ministry of Health and the Government's Office of Organization and Cadres before the province issues a decision.

1.11. District Health Centers (as detailed in Part IV of this Circular).

1.12. Organizations for the production and trade of pharmaceuticals and medical equipment: organized and operated according to the regulations of the State Enterprise Law and the guidance of the health sector.

1.13. Medical Appraisal Room: responsible for the permanent professional and technical work of the Medical Appraisal Council, this unit is located at the provincial general hospital, in provinces without a general hospital, it is located at the provincial health department.

1.14. Provincial Medical Legal Appraisal Organization is established according to the regulations of the state and the Ministry of Health.

1.15. Cadre Health Protection: Established according to current regulations, the health sector is responsible for professional and technical work.

1.16. Medical insurance is organized in accordance with the regulations of the State and the Ministry of Health.

2. Functional departments assisting the Director of the Department of Health

- Planning and Integration Department;

- Medical Practice Department;

- Pharmaceutical Management Department;

- Financial Accounting Department;

- Organization and Cadre Department;

- Health Inspectorate;

- Administrative Management Department.

The above departments constitute a general organizational model; localities may decide to establish fewer departments based on specific characteristics and circumstances. In special cases where additional departments need to be established, approval from the Ministry of Health and the Government's Organizational and Cadre Board is required.

The Department of Health is led by the Director; the Director is assisted by 02 to 03 Deputy Directors. The appointment, dismissal, and removal of the Director of the Department of Health shall be carried out in accordance with the provisions set forth in Chapter 2, Article 8, Points 5 and 6 of Decree No. 15/CP dated March 2, 1993 of the Government and Circular No. 233/TCCP-TC dated April 15, 1993 of the Government's Organizational and Cadre Board guiding the implementation of the aforementioned decree.

IV. FUNCTIONS, DUTIES, POWERS AND ORGANIZATIONAL STRUCTURE OF HEALTH CENTERS IN DISTRICTS, COUNTIES, MUNICIPALITIES AND PROVINCE-CITY

1. Health centers in districts, counties, municipalities, and province-cities (collectively referred to as district health centers) are organizations under the Department of Health, subject to management, direction, guidance, inspection, and supervision by the Director of the Department of Health regarding professional matters, operations, financial resources, and medical personnel; they are also subject to management and direction by the People's Committee of the district, county, municipality, or province-city (hereinafter collectively referred to as the People's Committee of the district) in the development of annual health plans for the district, which must be submitted to the competent authority for approval, and they are responsible for implementing these plans after approval.

District health centers are organized on the basis of the merger of existing health organizations in the district (health offices, disease prevention and control teams - malaria, family planning and reproductive health teams, sexually transmitted disease prevention teams, district hospitals, merged sub-institutes, area midwifery houses, multi-disciplinary clinics...).

District health centers are organized into two levels, have legal personality, possess only one seal, receive state funding, and are allowed to open bank accounts.

2. District health centers have the following main functions, duties, and powers:

2.1. Under the direction of the People's Committee of the district, develop annual health development plans for the district, submit them to the competent authority for approval, and organize their implementation after approval.

2.2. Carry out tasks related to diagnosis and treatment, rehabilitation, prevention, integration of modern medicine with traditional medicine, vaccination, epidemic prevention, malaria prevention, goiter prevention, pregnancy management, maternal and child health care, and technical duties related to family planning; supply medicines, especially essential medicines, to the community; direct, inspect, and guide the professional activities of public health units, agricultural, forestry, and industrial enterprises, agencies, schools, etc., within the district to ensure good health care and protection for the people, particularly primary health care as stipulated by the Department of Health;

2.3. Manage organization, staff, finances, pharmaceuticals, and medical equipment at the district level and grassroots health level;

2.4. Assist the People's Committee of the district in inspecting compliance with laws in state health activities and private medical and pharmaceutical practices within the district according to national regulations and provincial delegation;

2.5. Develop and consolidate the health network from the district to communes, wards, towns, villages, hamlets, and ethnic groups, and guide and inspect the professional activities of grassroots health stations;

2.6. Plan and implement training programs for health staff to ensure a reasonable structure; implement policies and benefits for health staff in the district;

2.7. Summarize and disseminate the application of scientific and technological advancements in diagnosis, treatment, prevention, and grassroots health movements;

2.8. Lead coordination with relevant sectors, mass organizations, and the public in the district to conduct health education and participate in health care and protection activities for the people;

2.9. Perform other duties and powers assigned by the People's Committee of the district and the Department of Health.

3. The organizational components of district health centers include:

3.1. Specialized technical units:

3.1.1. Disease Prevention Team: Implement hygiene, epidemic prevention, malaria prevention, goiter prevention, and social disease prevention...

3.1.2. Maternal and Child Health - Family Planning Team;

3.1.3. Mobile Health Team: Established in highland, mountainous, island, remote, and far-flung areas based on each district's needs, from 01 to 02 teams to support grassroots health when insufficient capacity exists;

3.1.4. District Hospital - clinical and paraclinical departments; based on needs, actual conditions, and bed allocation, organize departments such as central multi-disciplinary clinics, surgery-obstetrics, internal-traditional medicine, pediatrics-emergency care, infectious diseases, paraclinical (laboratory, ultrasound, radiology, pharmaceutical supplies...); the Center's leadership assigns a member to oversee treatment activities.

Districts, counties, municipalities, and province-cities with central and provincial treatment facilities and convenient transportation may only organize central multi-disciplinary clinics (in municipalities, midwifery houses can be established) to provide initial patient care before transferring to higher levels, childbirth assistance, and routine diagnosis and treatment.

3.1.5. Multi-Disciplinary Clinics in Merged Districts, Highland, Remote, and Far-Flung Areas.

3.1.6. Grassroots Health Station Organization (as detailed in Part V of this Circular).

3.2. Functional Departments Assisting the Director of the District Health Center Include:

- Planning and Professional Affairs Department;

The Representative Office operates under a system combining sections and some online specialists.

- Organization and Administrative Management Department.

District health centers are led by the Director; the Director is assisted by 02 to 03 Deputy Directors.

The Director and Deputy Directors of district health centers are appointed, dismissed, and removed by the Director of the Department of Health after obtaining written agreement from the Chairman of the People's Committee of the district.

V. HEALTH STATIONS IN COMMUNES, WARD, AND TOWNSHIP.

1. Primary health care facilities on the territory of communes, wards, towns (referred to collectively as primary health care stations) are the first technical medical units that come into contact with the people, within the national health system, tasked with providing initial technical health care services, early detection and prevention of epidemics, initial health care and normal childbirth assistance, supplying essential medicines, promoting the population to implement family planning measures, and enhancing health.

Primary health care stations are responsible for assisting the Director of the District Health Center and the Chairman of the People's Committee of communes, wards, towns (hereinafter referred to collectively as the People's Committee of communes) in carrying out assigned tasks related to health work in their respective areas.

2. Primary health care stations are subject to management, direction, and guidance from the Director of the District Health Center regarding professional matters, operations, funding, and medical personnel; they are also subject to management and direction from the Chairman of the People's Committee of communes in developing health development plans to be submitted to competent authorities and are responsible for implementing these plans after approval; they cooperate with various sectors and mass organizations in the commune in participating in activities aimed at caring for and protecting public health.

3. Operating funds and infrastructure construction costs for primary health care stations are mobilized from central, local government budgets, aid, charity, community contributions, etc.; these revenues and expenditures are managed in accordance with current regulations set by the State.

4. The specific functions, responsibilities, and policies of primary health care stations continue to be implemented according to Decision No. 58/TTg dated February 3, 1994, and Decision No. 131/TTg dated March 4, 1995, issued by the Prime Minister, and Circular No. 08/TT-LB.

5. The appointment, dismissal, and removal of the head and deputy head of primary health care stations are made by the Director of the District Health Center after obtaining written agreement from the Chairman of the People's Committee of communes.

B. STAFFING MANAGEMENT:

The staffing of the Department of Health and District Health Centers is determined by the Chairman of the Provincial People's Committee based on the tasks of the sector, national standards, and actual conditions in the province within the total administrative and public service staffing allocated to the province. On this basis, the Director of the Department of Health balances and allocates to subordinate organizations under the Department and District Health Centers.

C. IMPLEMENTATION ORGANIZATION:

1. Regarding the specific functions, responsibilities, and organizational structures for each specialized and technical unit within the preventive system, outpatient and inpatient treatment system... shall be guided by the Ministry of Health.

2. The Director of the Department of Health and the Head of the Provincial Civil Service and Administration Board assist the Provincial People's Committee in implementing this Circular.

3. This Circular takes effect fifteen days from the date of signature; all previous documents concerning the organizational structure of local health systems that conflict with this Circular are hereby abolished.

4. In the course of implementation, if there are difficulties or obstacles, they should be reported to the relevant ministries for study and resolution.