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

HCircular guiding the implementation of Government Decree No. 01/1998/NĐ-CP
dated January 3, 1998 on the local health care organization system

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 for Organization and Cadres issued the following guidance:

A. FUNCTIONS, TASKS, POWERS AND ORGANIZATION OF THE PROVINCE HEALTH DEPARTMENT

I. FUNCTION OF THE PROVINCE HEALTH DEPARTMENT

The Province 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 health funds and personnel within the provincial health system according to the authority delegated by competent authorities.

The Province 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 TASKS AND POWERS OF THE PROVINCE HEALTH DEPARTMENT

1. Developing planning and plans for the development of health services 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, technical, and operational matters in health 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 regulations of the state financial authorities;

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

5. Managing organizations, cadres, labor, salaries, and training and upgrading the health cadre team according to the delegation of the People's Committee of the province and state regulations;

6. Managing and using effectively the 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 medical supplies management;

8. Managing private medical practice in the province and implementing the issuance and revocation of licenses for private medical and pharmaceutical practice according to the law;

9. Leading and coordinating with relevant sectors, mass organizations, and social organizations in the province to conduct health education and communication activities and participate in health care and protection activities for the people;

10. Performing other tasks and powers assigned by the People's Committee of the province and the Ministry of Health;

III. THE PROVINCE HEALTH DEPARTMENT INCLUDES

1. Specialized and technical organizations under the Province Health Department:

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

Provinces in mountainous areas, Central Highlands, and those still having malaria and goiter patients accounting for more than 40% of the population shall continue to maintain the Malaria Control Center and Goiter Control Center for a certain period of time.

An International Health Quarantine Center shall only be established in provinces and cities with airports, seaports, and border gates that frequently interact internationally and have many people and transportation vehicles passing through.

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

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

1.3. Social Disease Prevention 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 Prevention 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: organized gradually 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 already established in provinces where bed utilization rates are low and conditions are insufficient for operation, should be dissolved and integrated into departments in provincial general hospitals.

1.10. Provincial Medical College: provinces that already have a Central Medical College or Technical College located in their territory shall not establish a provincial medical college.

The above units have legal personality, seals, and are authorized to open bank accounts; the establishment of other units different from the above provisions must be agreed upon in writing by the Ministry of Health and the Government’s Office for Organization and Cadres before the province issues a decision.

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

1.12. Production and Business Units for Pharmaceuticals and Medical Equipment: Established and operated according to the regulations of state-owned enterprise laws and industry guidelines.

1.13. Medical Appraisal Room: responsible for permanent technical and professional matters for the Medical Appraisal Council, this unit is located at the provincial general hospital, in provinces without a general hospital, it is located at the Province Health Department.

1.14. Provincial Medical Legal Appraisal Unit is organized according to state and Ministry of Health regulations.

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

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, such decisions must be approved by the Ministry of Health and the Civil Service Committee of the Government.

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 Civil Service Committee of the Government guiding the implementation of the aforementioned decree.

IV. FUNCTIONS, DUTIES, POWERS AND ORGANIZATIONAL STRUCTURE OF THE DISTRICT HEALTH CENTER, CITY DISTRICT HEALTH CENTER, TOWN HEALTH CENTER AND PROVINCE CITY HEALTH CENTER

1. The district health center, city district health center, town health center and province city health center (collectively referred to as the district health center) is an organization 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; it is also subject to management and direction by the People's Committee of the district, city district, town, and province city (collectively referred to as the People's Committee of the district) in the development of the annual health plan for the district, which must be submitted to the competent authority for approval and the center is responsible for implementing the plan after it has been approved.

The district health center is organized on the basis of the consolidation of existing health organizations in the district (health office, disease prevention and malaria control team, reproductive health and family planning team, social disease prevention team, district hospital, sub-institute in merged districts, regional maternity house, multi-purpose clinic area...).

The district health center is organized into two levels, having legal personality, with only one seal, and is provided with financial resources by the State and allowed to open an account at the Bank.

2. The district health center primarily has the following functions, duties, and powers:

2.1. Under the direction of the People's Committee of the district, develop the annual health development plan for the district, submit it to the competent authority for approval, and organize its implementation after the plan has been approved.

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... within the district to ensure good health care and protection of the people, particularly primary health care as stipulated by the Department of Health;

2.3. Manage the organization, staff, finances, pharmaceuticals, and medical equipment at the district level and at the 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 the commune, ward, township, village, hamlet, and village, and guide and inspect the professional activities of grassroots health stations;

2.6. Plan and implement training programs for health workers to ensure a reasonable structure; implement policies correctly for the health workforce in the district;

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

2.8. Lead and coordinate with relevant sectors, mass organizations, and the public in the district to carry out health education and participate in activities to care for and protect the health of 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 structure of the district health center includes:

3.1. Specialized technical units:

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

3.1.2. Maternal and Child Health Care - Family Planning Team;

3.1.3. Mobile Health Team: Applicable to highland, mountainous, island, remote, and far-flung districts, depending on the needs of each district, one to two teams can be established to support grassroots health when they are not yet capable of operating independently.

3.1.4. District Hospital - clinical and paraclinical departments; depending on the needs, actual situation, and number of beds allocated to each district, departments such as the central multi-purpose clinic, surgery-obstetrics, internal-traditional medicine, pediatrics-emergency resuscitation, infectious diseases, paraclinical (laboratory, ultrasound, radiology, pharmaceutical supplies...); the leadership of the district health center assigns one person from the leadership to be responsible for the treatment work of the center.

For districts, cities, towns, and provincial cities with central and provincial treatment facilities located on their territory and convenient transportation, only a central multi-purpose clinic (in cities, towns, and provincial cities, a regional maternity house can be established) is organized to perform preliminary patient care before transferring to higher levels, childbirth, and routine diagnosis and treatment.

3.1.5. Multi-purpose Clinic Area is organized in districts that were previously merged, highland, deep, and remote districts.

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

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

Planning and Operations Department;

Finance Department;

Organization and Administrative Management Department.

The district health center is led by the Director; the Director is assisted by 02 to 03 Deputy Directors.

The Director and Deputy Directors of the district health center are appointed, dismissed, or 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. COMMUNE HEALTH STATION, WARD HEALTH STATION, TOWN HEALTH STATION

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, 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 County 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 by the Director of the County Health Center regarding professional matters, operations, funding, and medical personnel; they are also subject to management and direction by the Chairman of the People's Committee of communes in developing health development plans to be submitted to competent authorities and are responsible for organizing the implementation of such plans after approval; they cooperate with various sectors and mass organizations in the commune in participating in activities aimed at caring for and protecting the health of the people.

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 functions, duties, and specific 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, of 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 carried out by the Director of the County 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 County 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 and County Health Centers.

C. IMPLEMENTATION

1. Regarding the specific functions, duties, and organizational structures for each specialized and technical unit under 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 local health organization system that conflict with this Circular are hereby abolished.

4. Any difficulties encountered during implementation should be reported to the relevant ministries for study and resolution./.