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

JOINT CIRCULAR

Guidelines for conducting health examinations and certification for Vietnamese workers going to work abroad

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 regarding Vietnamese workers working abroad (hereinafter referred to as Decree No. 81/2003/NĐ-CP); the Ministry of Health, the Ministry of Labor, Invalids and Social Affairs, and the Ministry of Finance issue guidelines for conducting health examinations and certification for Vietnamese workers going to work abroad as follows:

I . APPLICABLE OBJECTS

These Circulars apply to Vietnamese workers, experts, and trainees going to work abroad (hereinafter collectively referred to as workers); hospitals permitted to conduct health examinations and certification for Vietnamese workers going to work abroad (hereinafter referred to as health examination hospitals) and labor export enterprises.

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

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

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

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

- Blood tests: 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 tests;

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

+ VDRL or RPR test

+ TPHA test

- HIV test (The hospital's HIV laboratory must meet the "Standard for Permitted Confirmation of HIV Positive Cases" 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 a permitted confirmation laboratory, the hospital may collaborate with this facility to jointly perform HIV testing for workers.

- Tuberculin skin test;

- Urine tests: urinary glucose, urinary protein;

- Pregnancy test;

- Drug test, morphine, amphetamine;

- Stool test for parasites;

- Electrocardiogram;

- Electroencephalogram;

- Ultrasound;

- Chest X-ray;

- Diagnosis of leprosy (if the hospital cannot perform leprosy diagnosis tests, it may collaborate with the Dermatology Center or the Provincial Center for Social Disease Control to jointly perform leprosy diagnosis tests for workers).

The specialist doctors directly conducting health examinations; doctors concluding test results must be physicians who have continuously practiced in that specialty for at least five years. Doctors reading and concluding X-ray film results must have a degree of at least a first-level specialist or master’s degree.

3. Clinical support tests and radiology must be performed using current common methods. If the foreign side requests additional types of tests and techniques, the health examination hospital must meet these requirements.

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

III. FILES, PROCEDURES, AND AUTHORITY TO RECOGNIZE HOSPITALS CONDUCTING HEALTH EXAMINATIONS AND CERTIFICATION FOR VIETNAMESE WORKERS GOING TO WORK ABROAD

The application file for recognition as a health examination hospital includes:

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

1. Documents:

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

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

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

2. Procedures:

c. Within thirty working days from the date of receipt of complete and valid files from hospitals applying for recognition as health examination hospitals, the Ministry of Health or the Department of Health must review and decide on the recognition of the health examination hospital. If the hospital does not meet the conditions for recognition, the Ministry of Health or the Department of Health must provide a written response stating the reasons.

3. Authority to recognize

a. The Ministry of Health reviews and recognizes hospitals under its jurisdiction, hospitals under other ministries and sectors, and non-public hospitals permitted to conduct health examinations and certification 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 assess 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 health examinations and certification for Vietnamese workers going to work abroad and reports to the Ministry of Health.

IV. ORGANIZATION OF HEALTH EXAMINATIONS AND CERTIFICATION

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

b. State management agencies for labor export shall notify and guide workers and labor export enterprises about health examinations and certification so that workers and enterprises can organize health examinations and certification at hospitals recognized by the Ministry of Health or the Department of Health.

1. General principles

a. Only hospitals that meet the standards and conditions recognized by the Ministry of Health and the Provincial Health Departments are permitted to organize health examinations and issue health certificates for Vietnamese workers going to work abroad.

b. The state management agency for labor export shall notify and guide workers and labor export enterprises on the process of health examination and issuance of health certificates so that workers and enterprises can organize for workers to undergo health examinations at hospitals recognized by the Ministry of Health and Provincial Health Departments for health check-ups.

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 state management agency for labor export, labor export enterprises, or foreign partners have 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 expenses equivalent to one round-trip economy class airfare from the country where the worker was returned to Vietnam. In cases where workers develop acute illnesses, illnesses with window periods, or female workers become pregnant after the hospital's health examination and certification, the workers themselves shall bear responsibility.

e. Health examinations and certifications are specialized activities of hospitals that 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:

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

- One or two Vice-Chairpersons 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 Chairperson of the Board or the person authorized by the Chairperson to sign the health certificate shall be responsible for the conclusion made. The health certificate (issued together with this Circular - Annex 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 the hospital conducting health examinations or by workers themselves.

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

- Workers conducting their own health examinations: Workers shall directly contact the hospital conducting health examinations 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 conducting health examinations shall organize health examinations, certifications, and collect fees in accordance 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 formula

- ABO blood group

- Blood urea

- Blood glucose

- Syphilis serology test

- HIV test

- Syphilis test: simultaneously perform two tests

+ VDRL (or RPR) test

- HIV test (The hospital's HIV laboratory must meet the "Standard for Permitted Confirmation of HIV Positive Cases" 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 a permitted confirmation laboratory, the hospital may collaborate with this facility to jointly perform HIV testing for workers.

- Malaria parasite detection in blood

- Stool test for parasites

- Urinalysis: urinary sugar, proteinuria

- Chest X-ray

b. Additional tests (if required):

- Electrocardiogram

- Electroencephalogram

- White blood cell formula

- Erythrocyte sedimentation rate

- Hematocrit ratio

- Rh blood group

- Hepatitis A, B, C tests

- Tuberculin skin test

- Ten-parameter urine analysis

- Pregnancy diagnosis

- Opiate or drug abuse test

- Amphetamine test

- Leprosy diagnosis test

- Tests for 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 Chairperson of the Board or the person authorized by the Chairperson to sign the Health Certificate;

4.7. Deliver the Health Certificate within five working days;

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

4.9. Store 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 hospital fee schedule according to the current regulations of the State, ensuring necessary costs for health examinations and certifications including clinical examination costs, near-clinical testing costs, diagnostic imaging costs, and other administrative costs.

- The fee for health examinations and certifications for workers is specified in Annex 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 hospital fee schedule.

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 conducting health examinations.

- 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 hospital fee collection.

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.

VI. IMPLEMENTATION

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 in accordance with 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.

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. Enterprises 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 conducted by health examination hospitals for workers and enterprises 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.