JOINT CIRCULAR No. 10/2004/TTLT-BYT-BLDTBXH-BTC GUIDING THE IMPLEMENTATION OF HEALTH EXAMINATIONS AND CERTIFICATIONS FOR VIETNAMESE WORKERS GOING TO WORK ABROAD

JOINT CIRCULAR

JOINT CIRCULAR OF THE MINISTRY OF HEALTH - THE MINISTRY OF LABOR, WAR INVALIDS AND SOCIAL AFFAIRS - THE MINISTRY OF FINANCE NO. 10/2004/TTLT-BYT-BLDTBXH-BTC DATED DECEMBER 16, 2004 GUIDING THE IMPLEMENTATION OF MEDICAL EXAMINATIONS AND HEALTH CERTIFICATIONS FOR VIETNAMESE WORKERS GOING TO WORK ABROAD

Pursuant to Decree No. 81/2003/NĐ-CP dated July 17, 2003 of the Government detailing and guiding the implementation of the Labor Code on Vietnamese workers working abroad (hereinafter referred to as Decree No. 81/2003/NĐ-CP); the Joint Circular of the Ministry of Health, the Ministry of Labor, War Invalids and Social Affairs, and the Ministry of Finance guiding the implementation of medical examinations and health certifications for Vietnamese workers going to work abroad is hereby issued as follows:

I. APPLICABLE OBJECTS

This Circular applies to Vietnamese workers, experts, and trainees going to work abroad (hereinafter collectively referred to as workers); hospitals permitted to conduct medical examinations and health certifications for Vietnamese workers going to work abroad (hereinafter referred to as examination hospitals) and labor export enterprises.

II. STANDARDS AND REQUIREMENTS FOR HOSPITALS CONDUCTING MEDICAL EXAMINATIONS AND HEALTH CERTIFICATIONS FOR VIETNAMESE WORKERS GOING TO WORK ABROAD

Examination hospitals must meet the standards of general hospitals at level II or higher according to the classification of the Ministry of Health and must satisfy the following specific conditions:

1. The hospital must have all clinical specialties as stipulated in the Hospital Regulations (Annexed Decision No. 1895/1997/QĐ-BYT dated September 19, 1997 of the Minister of Health).

2. The hospital must have departments of clinical auxiliary services and radiology capable of performing basic tests:

- Blood test: blood formula, white blood cell formula, ABO blood group, Rh blood group, erythrocyte sedimentation rate, hemoglobin ratio, urea in blood, blood sugar;

- Detection of malaria parasites in blood;

- Hepatitis A, B, C, E testing;

- Syphilis testing, conducted simultaneously with two types of tests:

+ VDRL or RPR test

+ TPHA test

- HIV testing (The hospital's HIV laboratory must meet the "Standard for HIV Confirmation Testing Laboratories" issued together with Decision No. 3052/2000/QĐ-BYT dated August 29, 2000 of the Minister of Health). In cases where the hospital does not have an HIV laboratory but there is a local healthcare facility with an authorized HIV confirmation testing laboratory, the hospital may collaborate with this facility to jointly perform HIV testing for workers.

- Tuberculin skin test;

- Urine test: urinary glucose, urinary protein;

- Pregnancy test;

- Drug, morphine, amphetamine testing;

- Stool test for parasites;

- Electrocardiogram;

- Electroencephalogram;

- Ultrasound;

- Chest X-ray;

- Leprosy diagnosis test (In cases where the hospital lacks the capability to perform leprosy diagnosis tests, the hospital may collaborate with the Dermatology Center or the Provincial Center for Social Disease Control to jointly perform leprosy diagnosis tests for workers).

The specialist physician directly conducting the health examination must be a doctor who has continuously practiced in that specialty for at least five years. The doctor concluding the results of the X-ray films must have a qualification of at least a first-level specialist.

3. Clinical auxiliary tests and radiography must be performed using current common methods. If the foreign side requests additional types of tests and techniques, the examination hospital must meet those requirements.

4. The Chairman of the health examination board or the person authorized to sign the health certificate must hold a degree of at least a first-level specialist or master’s degree.

III. FILE, PROCEDURES, AND AUTHORITY FOR RECOGNITION OF HOSPITALS CONDUCTING MEDICAL EXAMINATIONS AND HEALTH CERTIFICATIONS FOR VIETNAMESE WORKERS GOING TO WORK ABROAD:

1. Documents:

The application file for recognition as an examination hospital includes:

- A letter from the hospital requesting permission to conduct medical examinations and health certifications for Vietnamese workers going to work abroad.

- A list of human resources, medical equipment, technical capabilities, and facilities of the hospital, meeting the conditions specified in Section II of this Circular.

2. Procedures:

a. Hospitals under the provincial Department of Health (hereinafter collectively referred to as the Department of Health): The application file for recognition as an examination hospital should be submitted to the Department of Health.

b. Hospitals under the Ministry of Health, other ministries, and non-public hospitals: The application file for recognition as an examination hospital should be submitted to the Ministry of Health.

Within thirty working days from the date of receipt of a complete and valid application file from the hospital requesting recognition as an examination hospital, the Ministry of Health or the Department of Health must review and decide on the recognition of the examination hospital. If the hospital does not meet the conditions for recognition, the Ministry of Health or the Department of Health must issue a written response stating the reasons.

3. Authority for Recognition

a. The Ministry of Health reviews and recognizes hospitals under its jurisdiction, hospitals under other ministries, and non-public hospitals permitted to conduct medical examinations and health certifications for Vietnamese workers going to work abroad. For non-public hospitals (which have not been classified), after receiving the application file, the Ministry of Health will conduct an assessment of the facility according to the standards set out in this Circular.

b. The Department of Health reviews and recognizes hospitals under the provinces and centrally-administered cities permitted to conduct medical examinations and health certifications for Vietnamese workers going to work abroad and reports to the Ministry of Health.

IV. ORGANIZATION OF MEDICAL EXAMINATIONS AND HEALTH CERTIFICATIONS

1. General principles

a. Only hospitals that meet the standards and conditions recognized by the Ministry of Health or the Department of Health are allowed to organize medical examinations and health certifications for Vietnamese workers going to work abroad.

b. The state management agency for labor export shall inform and guide workers and labor export enterprises about medical examinations and health certifications so that workers and enterprises can organize for workers to undergo medical examinations and health certifications at hospitals recognized by the Ministry of Health or the Department of Health.

c. Health standards: The hospital shall conduct health examinations based on the health standards issued together with this Circular (Annex 1) to examine and certify the health status of workers. In cases where the competent state management agency for labor export, the labor export enterprise, or the foreign partner has specific requirements, if such requirements comply with Vietnamese law, the hospital must also meet those requirements in organizing health examinations and certifications for workers.

d. The hospital conducting health examinations shall be responsible for the health conclusions of the workers. If a worker is returned to Vietnam due to incorrect examination and certification results from the hospital, that hospital must compensate the worker for all travel expenses equivalent to one round-trip economy class airfare from the country where the worker was returned to Vietnam. In cases where a worker contracts acute illnesses, illnesses with a window period, or becomes pregnant after the hospital's health examination and certification, the worker shall bear responsibility themselves.

e. Health examinations and certifications are specialized activities of the hospital and must be recorded and reported as part of the hospital’s overall operations.

2. Health Examination and Certification Board

a. The hospital conducting health examinations must establish a Health Examination Board, whose members include:

- Chairman of the Board: the Director or Deputy Director in charge of professional matters at the hospital;

- One or two Vice Chairmen of the Board;

- Several clinical doctors, laboratory technicians, and radiology specialists (as required under Section II of this Circular)

b. Functions and responsibilities of the Board:

- Organizing health examinations and certifications for workers;

- Resolving issues related to health examinations and certifications;

- The Chairman of the Board or the person authorized by the Chairman to sign the health certificate shall be responsible for the conclusion made. The health certificate (issued together with this Circular - Annex No. 2) is valid for three months from the date of issuance.

3. Organization of Health Examinations

Health examinations may be conducted centrally through labor export enterprises with hospitals or individually by workers.

- Centralized health examinations: Labor export enterprises shall contact and enter into contracts with hospitals to organize health examinations and certifications for workers in accordance with the provisions of this Circular.

- Individual health examinations: Workers shall directly contact the hospital to undergo health examinations and certifications in accordance with the provisions of this Circular.

Based on the health examination contract with the labor export enterprise or the request of the worker, the hospital shall organize health examinations, certifications, and collect fees in compliance with regulations without affecting other professional activities of the hospital.

4. Procedures for Organizing Health Examinations and Certifications

4.1. Receiving applications and completing administrative procedures;

4.2. Physical examination: pulse rate, respiration rate, body temperature, blood pressure, height, weight;

4.3. Comprehensive clinical examination across various specialties;

4.4. Performing mandatory tests and additional tests (if required);

a. Mandatory clinical tests and X-rays:

- Blood cell count

- ABO blood group

- Blood urea

- Blood glucose

- Syphilis serology test

- HIV test

- Syphilis test: simultaneously perform two tests

+ Venereal Disease Research Laboratory Test (VDRL) (or Rapid Plasma Reagin Test - RPR)

+ TPHA test

- Malaria parasite detection in blood

- Stool test for parasites

- Urinalysis: urine sugar, proteinuria

- Chest X-ray

b. Additional tests (if required):

- Electrocardiogram

- Electroencephalogram

- White blood cell count

- Erythrocyte sedimentation rate

- Hematocrit

- Rh blood group

- Hepatitis A, B, C serology

- Tuberculin skin test

- Ten-parameter urinalysis

- Pregnancy diagnosis

- Opiate or drug abuse test

- Amphetamine test

- Leprosy diagnosis test

- Tests for diagnosing other sexually transmitted diseases

- Ultrasound

- Other tests.

(Clinical doctors and those concluding near-clinical tests and X-rays must sign and clearly write their names on the health examination form).

4.5. Based on the results of the clinical examination and tests, the Board concludes on the health status of the worker;

4.6. Based on the Board's conclusion on the health status, the Chairman of the Board or the person authorized by the Chairman signs the Health Certificate;

4.7. Delivering the Health Certificate within five working days;

4.8. Settling the health examination contract with the labor export enterprise (if applicable);

4.9. Archiving the health examination records of workers in accordance with current regulations.

V. FEES FOR HEALTH EXAMINATIONS AND CERTIFICATIONS, MANAGEMENT AND USE OF REVENUE

1. Fee for health examinations and certifications

- The fee for health examinations and certifications is calculated based on the partial hospitalization fee schedule according to current state regulations, ensuring necessary costs for examinations and certifications including clinical examination, near-clinical tests, diagnostic imaging, and other administrative costs.

- The fee for health examinations and certifications for workers is specified in Annex No. 3 issued together with this Circular. The health examination fee schedule must be publicly displayed at the payment location.

The fee for health examinations and certifications will be adjusted when the state adjusts the hospitalization fee.

2. Management and use of health examination and certification fees:

- Workers or labor export enterprises must pay the health examination and certification fees according to the prescribed rates to the hospital.

- The health examination and certification fee is revenue for the hospital. The collection and expenditure of health examination fees must be accounted for in accordance with current regulations on hospitalization fees.

VI. IMPLEMENTATION

1. The Department of Health shall report to the Ministry of Health the list of provincial and municipal hospitals permitted to conduct health examinations and certifications for workers.

2. The Ministry of Health shall compile and notify the Ministry of Labor, Invalids and Social Affairs of the list of hospitals conducting health examinations for workers as stipulated in this Circular.

3. The Ministry of Labor, Invalids and Social Affairs shall notify labor export enterprises and workers about the list of hospitals conducting health examinations.

4. Businesses exporting labor shall closely cooperate with health examination hospitals to organize convenient and quality health examinations and certifications.

5. The Ministry of Health, the Ministry of Labor, Invalids and Social Affairs, and the Ministry of Finance shall be responsible for inspecting the implementation of health examinations and certifications by health examination hospitals for workers and businesses exporting labor.

VII. IMPLEMENTATION PROVISIONS

1. This Circular shall take effect fifteen days from the date of publication in the Official Gazette. Provisions in other documents that conflict with this Circular shall be abolished.

2. During the implementation process, if there are difficulties or obstacles, they should be reported to the joint ministries of Health, Labor, Invalids and Social Affairs, and Finance for study and resolution.